A RANDOMIZED ACTIVE CONTROLLED CLINICAL STUDY TO EVALUATE EFFICACY AND SAFETY OF RESVERATROL AS AN ADJUVANT THERAPY IN PATIENTS WITH HYPERTENSION

Objectives: No long-term clinical efficacy and safety study of resveratrol as adjuvant therapy along with gold standard therapy has been conducted in patients with essential hypertension. The aim of this study was to investigate the efficacy and safety of resveratrol as an adjuvant therapy in newly diagnosed hypertensive patients.Methods: In this randomized active-controlled study, hypertensive patients (male/female) of 20-65 years aged were randomized (1:1) to receive telmisartan 20 mg or telmisartan 20 mg plus resveratrol 1 g daily for 12 months. Efficacy variables included a change in systolic and diastolic blood pressure (DBP) from baseline and were followed up for every 3 months. Treatment-emergent adverse events were assessed.Results: A total of 60 hypertensive patients were analyzed (telmisartan [n=30] and telmisartan plus resveratrol [n=30]). Resveratrol as an adjuvant with telmisartan significantly reduced in systolic (p<0.001) and DBP (p<0.001) as compared to telmisartan monotherapy. Change in systolic and DBP from baseline was significantly higher in telmisartan plus resveratrol group than telmisartan (p<0.001) at all followed visits. Both the study drugs have similar safety profile and found well tolerable.Conclusions: Resveratrol plus Telmisartan was found to be superior over telmisartan monotherapy in reducing systolic and DBP in newly diagnosed hypertensive patients. Both the study drugs were effective with comparable safety profile. Our study supports the long-term clinical efficacy and safety study of resveratrol along with gold standard therapy in essential hypertension.Keywords: Essential hypertension, Resveratrol, Systolic and diastolic blood pressure, Telmisarta

Global Warming And Environmental Imbalance

The natural resources like earth, wind, water, trees are the basis of human-life. For the bright future of human beings, it is essential to use these resources with a great care. ‘Environment’ means the physical, chemical and biological surroundings in which an organism exists. Thus, environment is the gift of nature. Prior to 20th century, there was no major evidence of human influence on environment. Environmental degradation up to this period was mainly due to natural disasters, like cyclone, earthquake etc. Up to that period; natural resources were not used beyond their regenerative capacities. So, what was used, was regenerated. But, after the population explosion in the world, the situation started changing. Gradually, this led to serious environmental degradation behind which, the need and greed of human kind is responsible. Ever increasing pollution, demolition of forests and bio-diversity, increase in global warming, etc. have alarmed us for awareness of environmental protection. Worldwide environmental awareness was started during the 1960s. The main impetus came from the publication of a book ‘Silent Spring’ by Rachel Carson in 1962. This book revealed the risk of using some pesticides and their bad effects on human life and thereby showed the necessity for the protection of earth. The world summit held at Rio-de-Janero in 1992, had focused the attention towards environmental problems. The economists also started looking afresh tothecentraleconomicproblemofresource scarcity in relation to their possible uses. After 1970, many economists started arguing that development can be made sustainable only with efficient and judicious use of natural resources. In this paper, we have described various factors responsible for environmental hazards and we have also suggested our duties regarding the protection of the earth

Rare case of Hirayama’s disease

Hirayama’s disease is a rare benign neurological disorder also known as monomelic amyotrophy, Sobue disease,Juvenile Muscular Atrophy of Distal Upper Extremity (JMADUE). It mainly affects young males in their second or third decades and is most commonly seen in Asian countries like Japan, Malaysia and India. In majority of the cases the cause of the disease is unknown. An 18 year male came with weakness in his right hand and forearm since 1 year. Examination revealed weakness and wasting of muscles of forearm and hand without lower limb involvement and normal deep tendon reflexes. MRI showed focal short segment hyperintense signal in the ventral and right lateral aspect of the cervical cord at C5-C6 level with the involved segment measuring 4x3mm in size. Based on clinical and radiological features a diagnosis of focal amyotrophy was made. Patient is given a cervical collar to prevent flexion at the neck and physiotherapy in the form of hand and forearm exercises were started. Regular follow up of the patient once every 2 months is being done. Hirayama’s disease is a rare, benign, self-limiting neurological disorder. Early diagnosis and management by preventing cervical flexion with the help of a cervical collar has shown to halt the progression of the disease

Synthesis, Biological Evaluation and Molecular Modeling Studies of Novel Chromone/Aza-Chromone Fused α-Aminophosphonates as Src Kinase Inhibitors

A series of novel chromone/aza-chromone fused α-aminophosphonate derivatives were synthesized in good yields using silica chloride as the catalyst. All the synthesized compounds were tested for their c-Src kinase inhibitory activity. Aza-chromone compound showed Src kinase inhibition with an IC50 value of 15.8 µM. The compounds were subjected to molecular docking and dynamics simulations to study the atomic level interactions with an unphosphorylated proto-oncogenic tyrosine protein kinase Src (PDB code 1Y57) as well as phosphorylated tyrosine protein kinase Src (PDB code 2H8H). Docking and molecular dynamic results revealed phosphorylated Src tyrosine kinase protein better results than unphosphorylated tyrosine Src kinase protein. Chemoinformatics study revealed the compounds had lead like properties. Machine learning (SVR) models were built to study the structure activity correlations. A CC of 0.835 was obtained when the SVR model was applied to the 17 synthesized compounds. It is envisaged that the work will provide guidelines for future drug design efforts for Src kinase inhibitors

A dosemetric and radiobiological impact of VMAT and 3DCRT on lumbosacral plexuses, an underestimated organ at risk in cervical cancer patients

Background: The purpose of this study was to evaluate dosimetric and radiobiological difference between volumetric modulated arc therapy (VMAT) and 3-dimensional conformal radiotherapy (3DCRT) in organ at risk (OAR) lumbosacral plexus (LSP) in cervical cancer patients. Materials and methods: 30 patients of cervical cancer who were treated using 3DCRT or VMAT along with chemotherapy followed by brachytherapy were enrolled. LSP was delineated retrospectively. Dosimetric and radiobiological difference was evaluated. Patients were followed for radiation induced lumbosacral plexopathy (RILSP). Results: Median follow-up was 12 months (3–16 months). 53.3% of patients were treated by 3DCRT and 46.7% by VMAT. The mean (±SD) LSP volume: 119.03 ± 15 cm3. The mean volume percentages (%) of the LSP: V5, V10, V20, V30, V40, V50, V55, and V60 were 100%, 99.8%, 99.2%, 94.3%, 84.03%, 59.7%, 0%, 0%, respectively. All patients received doses to the LSP in excess of 50 Gy, one patient received 55 Gy. A statistically significant difference was observed in the median value of V20, V30, V40, V50, D50, P2, P4, P7, P8, P9, and P10 across two different techniques of radiotherapy — VMAT and 3DCRT. None of the patients presented with RILSP. NTCP value was less in VMAT plans compared to 3DCRT, which is also statistically significant. Conclusion: RILSP is a rare and often refractory complication of pelvic radiotherapy. Advance radiotherapy technique with proper OAR delineation and constraint can prevent the occurrence of RILSP. VMAT has potential benefits for the probability of dose reduction in LSP. Further studies are required focusing on dose distribution in LSP–OAR and radiotherapy modality

Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain

Background: The goal of treatment in arteriovenous malformation (AVM) is total obliteration of the AVM, restoration of normal cerebral function, and preservation of life and neurological function. Aim: To analyze the results of X-knife and surgery for AVM of the brain. The endpoints for success or failure were as follows: success was defined as angiographic obliteration and failure as residual lesion, requiring retreatment, or death due to hemorrhage from the AVM. Materials and Methods: From May 2002 to May 2007, 54 patients were enrolled for this study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%, grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated by microsurgical resection out of which Grade I was seen in 5 patients, Grade II was seen in 17 patients, Grade III was seen in 9 patients and Grade V was seen in 7 patients. Rest of the sixteen patients were treated by linear accelerator radiosurgery out of which Grade II was seen in 6 patients, Grade III was seen in 5 patients and Grade IV was seen in 5 patients. The follow up was in range of 3-63 months. In follow up, digital subtraction angiography/ magnetic resonance angiography (DSA/MRA) was performed 3 months after surgery and 1 year and 2 years after stereotactic radiosurgery (SRS). Results: Among the patients treated with X-knife, 12/16 (75%) had proven angiographic obliteration. Complications were seen in 4/16 (25%) patients. Among the patients treated with microsurgical resection, 23/38 (61%) had proven angiographic obliteration. Complications (both intraoperative and postoperative) were seen in 19/38 (50%) patients. Conclusions: Sixty-one percent of patients were candidates for surgical resection. X-knife is a good modality of treatment for a low-grade AVM situated in eloquent areas of the brain and also for high-grade AVMs, when the surgical risk and morbidity is high

Obesity and diabetes are major risk factors for epicardial adipose tissue inflammation

BACKGROUND. Epicardial adipose tissue (EAT) directly overlies the myocardium, with changes in its morphology and volume associated with myriad cardiovascular and metabolic diseases. However, EAT's immune structure and cellular characterization remain incompletely described. We aimed to define the immune phenotype of EAT in humans and compare such profiles across lean, obese, and diabetic patients. METHODS. We recruited 152 patients undergoing open-chest coronary artery bypass grafting (CABG), valve repair/replacement (VR) surgery, or combined CABG/VR. Patients' clinical and biochemical data and EAT, subcutaneous adipose tissue (SAT), and preoperative blood samples were collected. Immune cell profiling was evaluated by flow cytometry and complemented by gene expression studies of immune mediators. Bulk RNA-Seq was performed in EAT across metabolic profiles to assess whole-transcriptome changes observed in lean, obese, and diabetic groups. RESULTS. Flow cytometry analysis demonstrated EAT was highly enriched in adaptive immune (T and B) cells. Although overweight/obese and diabetic patients had similar EAT cellular profiles to lean control patients, the EAT exhibited significantly (P ≤ 0.01) raised expression of immune mediators, including IL-1, IL-6, TNF-α, and IFN-γ. These changes were not observed in SAT or blood. Neither underlying coronary artery disease nor the presence of hypertension significantly altered the immune profiles observed. Bulk RNA-Seq demonstrated significant alterations in metabolic and inflammatory pathways in the EAT of overweight/obese patients compared with lean controls. CONCLUSION. Adaptive immune cells are the predominant immune cell constituent in human EAT and SAT. The presence of underlying cardiometabolic conditions, specifically obesity and diabetes, rather than cardiac disease phenotype appears to alter the inflammatory profile of EAT. Obese states markedly alter EAT metabolic and inflammatory signaling genes, underlining the impact of obesity on the EAT transcriptome profile

Simulation of typical civil aircraft fuel transfer process

While aircraft fuel systems are not regarded as one of the complex features of an aircraft, they are essential systems of all aircraft. Their role and functional characteristics play a critical aspect in the design, certification, operation of both military and commercial planes. Engine fuel consumption varies according to the aircraft mission. In this paper, a typical aircraft fuel system configuration is discussed and fuel transfer analysis i.e. simulation of aircraft fuel system performed on MSC EASY5 platform is presented. The results are verified by comparing with the engine requirements