EVALUATING RISK FACTORS, CLINICAL AND THERAPEUTIC PROFILE OF STROKE PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL

Objective: According to the World Health Organization, stroke is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged 15–59 years old. This study mainly aims to evaluate the prevalence of risk factors, clinical features, pattern of drugs prescribed, and severity of stroke among patients. Methods: A cross-sectional study was carried out in a tertiary care teaching hospital on 210 patients for a period of 6 months. Patients aged 18 years and above were included in the study. The severity of stroke was assessed using National Institute of Health Stroke Scale (NIHSS). Results: The majority of the patients were under the age group of 61–70 years (31%). The incidence of ischemic stroke (81%) was more common compared to hemorrhagic stroke (19%). Males (66%) are prone to stroke compared to females (34%). The most common risk factor was hyperlipidemia (29%) followed by hypertension (17%). Antihypertensives (28%) were most commonly used drugs followed by antihyperlipidemics (23%). Most of the prescriptions were prescribed with 4–6 drugs per prescription (62%). Moderate stroke (69%) was most commonly observed in patients. A total of 147 drug-drug interactions were observed. Among 147 drug-drug interaction, the most commonly observed drug-drug interaction was aspirin with metformin (15%). Conclusion: The present study emphasizes on the need to identify risk factors and providing awareness among the patients by a pharmacist in minimizing the disease burden. Early identification of risk factors and pattern of therapy based on therapeutic guidelines plays a crucial role in qualitative patient care

T2D-Db: An integrated platform to study the molecular basis of Type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>Type 2 Diabetes Mellitus (T2DM) is a non insulin dependent, complex trait disease that develops due to genetic predisposition and environmental factors. The advanced stage in type 2 diabetes mellitus leads to several micro and macro vascular complications like nephropathy, neuropathy, retinopathy, heart related problems etc. Studies performed on the genetics, biochemistry and molecular biology of this disease to understand the pathophysiology of type 2 diabetes mellitus has led to the generation of a surfeit of data on candidate genes and related aspects. The research is highly progressive towards defining the exact etiology of this disease.</p> <p>Results</p> <p>T2D-Db (Type 2 diabetes Database) is a comprehensive web resource, which provides integrated and curated information on almost all known molecular components involved in the pathogenesis of type 2 diabetes mellitus in the three widely studied mammals namely human, mouse and rat. Information on candidate genes, SNPs (Single Nucleotide Polymorphism) in candidate genes or candidate regions, genome wide association studies (GWA), tissue specific gene expression patterns, EST (Expressed Sequence Tag) data, expression information from microarray data, pathways, protein-protein interactions and disease associated risk factors or complications have been structured in this on line resource.</p> <p>Conclusion</p> <p>Information available in T2D-Db provides an integrated platform for the better molecular level understanding of type 2 diabetes mellitus and its pathogenesis. Importantly, the resource facilitates graphical presentation of the gene/genome wide map of SNP markers and protein-protein interaction networks, besides providing the heat map diagram of the selected gene(s) in an organism across microarray expression experiments from either single or multiple studies. These features aid to the data interpretation in an integrative way. T2D-Db is to our knowledge the first publicly available resource that can cater to the needs of researchers working on different aspects of type 2 diabetes mellitus.</p

piRNABank: a web resource on classified and clustered Piwi-interacting RNAs

Piwi-interacting RNAs (piRNAs) are expressed in mammalian germline cells and have been identified as key players in germline development. These molecules, typically of length 25–33 nt, associate with Piwi proteins of the Argonaute family to form the Piwi-interacting RNA complex. These small regulatory RNAs have been implicated in spermatogenesis, repression of retrotransposon transposition in germline cells, epigenetic regulation and positive regulation of translation and mRNA stability. piRNABank is a highly user-friendly resource which stores empirically known sequences and other related information on piRNAs reported in human, mouse and rat. The database supports organism and chromosome-wise comprehensive search features including accession numbers, localization on chromosomes, gene name or symbol, sequence homology-based search, clusters and corresponding genes and repeat elements. It also displays each piRNA or piRNA cluster on a graphical genome-wide map (http://pirnabank.ibab.ac.in/)

Anti diabetic effect of ethanolic extract of leaves of Ocimum sanctum in alloxan induced diabetes in rats

Background: Diabetes mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycemia resulting from defects of reduced insulin secretion, decreased glucose utilization and increase in glucose production. It is estimated that there are currently 285 million people worldwide and this number is set to increase to 438 million by the year 2030. India has the highest number of patients with known diabetes worldwide, with a prevalence of 11.6%. The aim of the study was to evaluate the anti diabetic activity of ethanolic extract of leaves of plant Ocimum sanctum in alloxan induced diabetes in rats.Methods: The study was conducted on 4 groups of 6 rats each to evaluate the hypoglycaemic effect of ethanolic extract of Ocimum sanctum. Glibenclamide was used as a standard drug and the results were compared in reference to it. Tween 80 was given for both normal and diabetic control groups. The fasting blood sugar levels were recorded on 1st, 3rd, 5th, 7th, 10th days by glucometer.Results: The results indicate that the test compound ethanolic extract of Ocimum sanctum has significant and sustained oral hypoglycaemic activity, comparable with the hypoglycaemic effect of glibenclamide, a sulfonylurea.Conclusion: The hypoglycaemic potential of the test compound is found to be comparable with that of the standard drug glibenclamide

Expression and role of PAICS, a de novo purine biosynthetic gene in prostate cancer

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143605/1/pros23533_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143605/2/pros23533.pd

Multiple Genome Wide Association Mapping Models Identify Quantitative Trait Nucleotides for Brown Planthopper (Nilaparvata lugens) Resistance in MAGIC Indica Population of Rice

Brown planthopper (BPH), one of the most important pests of the rice (Oryza sativa) crop, becomes catastrophic under severe infestations and causes up to 60% yield loss. The highly disastrous BPH biotype in the Indian sub-continent is Biotype 4, which also known as the South Asian Biotype. Though many resistance genes were mapped until now, the utility of the resistance genes in the breeding programs is limited due to the breakdown of resistance and emergence of new biotypes. Hence, to identify the resistance genes for this economically important pest, we have used a multi-parent advanced generation intercross (MAGIC) panel consisting of 391 lines developed from eight indica founder parents. The panel was phenotyped at the controlled conditions for two consecutive years. A set of 27,041 cured polymorphic single nucleotide polymorphism (SNPs) and across-year phenotypic data were used for the identification of marker–trait associations. Genome-wide association analysis was performed to find out consistent associations by employing four single and two multi-locus models. Sixty-one SNPs were consistently detected by all six models. A set of 190 significant marker-associations identified by fixed and random model circulating probability unification (FarmCPU) were considered for searching resistance candidate genes. The highest number of annotated genes were found in chromosome 6 followed by 5 and 1. Ninety-two annotated genes identified across chromosomes of which 13 genes are associated BPH resistance including NB-ARC (nucleotide binding in APAF-1, R gene products, and CED-4) domain-containing protein, NHL repeat-containing protein, LRR containing protein, and WRKY70. The significant SNPs and resistant lines identified from our study could be used for an accelerated breeding program to develop new BPH resistant cultivars

Implication of sperm RNAs in transgenerational inheritance of the effects of early trauma in mice.

Small non-coding RNAs (sncRNAs) are potential vectors at the interface between genes and environment. We found that traumatic stress in early life altered mouse microRNA (miRNA) expression, and behavioral and metabolic responses in the progeny. Injection of sperm RNAs from traumatized males into fertilized wild-type oocytes reproduced the behavioral and metabolic alterations in the resulting offspring.We thank M. Rassoulzadegan and V. Grandjean for help with the sperm purification, F. Manuella and H. Hörster for assistance with the MSUS paradigm, H. Welzl for help with behavior, G. Vernaz for help with western blotting, R. Tweedie-Cullen and P. Nanni for help with mass spectrometry, A. Patrignani for advice on DNA and RNA quality assessment, and A. Chen and A. Brunner for constructive discussions. This work was supported by the Austrian Academy of Sciences, the University of Zürich, the Swiss Federal Institute of Technology, Roche, the Swiss National Science Foundation, and The National Center of Competence in Research “Neural Plasticity and Repair”. P.S. was supported by a Gonville and Caius College fellowship.This is the accepted manuscript. The final version is available in Nature Neuroscience 17, 667–669 (2014), doi:10.1038/nn.369

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe