Management of dyslipidemia in children

Dyslipidemia is an important etiologic factor in the development of cardiovascular disease (CVD), which is a leading cause of death worldwide As CVD begins in childhood, and as dyslipidemia is an important risk factor for CVD, screening and treatment of dyslipidemia in adolescents and children becomes an important health matter. This review deals with issues related to screening, diagnosis and treatment of dyslipidemia in children and adolescents

Meaningful Clinical Conversation: Guidance from the Gita

Chronic disease care is a challenging vocation. One of the reasons for this is the need to inform and share decision making with patients. Communication and conversational skills are the pillars of chronic care delivery. In this editorial, we take guidance from the Srimad Bhagavad Gita in order to improve the quality of clinical conversations, and make them meaningful. The Gita encourages us to be ‘saatvik’ or balanced in thought, words and deeds, to perform ‘penance’ of mind, speech and body, and to accept equanimity. This introspective opinion piece should help us polish our communication skills, and improve interaction with our patients

The Spirit and Science: Is the Endocrine System the Essence of Existence?

In this reflective opinion piece, the authors offer a unique insight into the connection between spirituality and science. A reading of the Shrimad Bhagvad Gita, through the eyes of an endocrinologist, uncovers unexpected corollaries and correlations between spirituality or religion on one hand, and science or rationale, on the other

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Long PFN in unstable subtrochantric fracture with absent lateral wall support in proximal fragment with delayed augmentation with encircalage wire and bone grafting

In 1949 Boyd and Griffin Subtrochanteric fracture femur as a variant of peritrochanteric fracture with higher incidence of unsatisfactory result both in the elderly and young. Most of this fracture is with higher incidence of unsatisfactory result after operative treatment This single case study shows one of the unpredicted iotrogenic complications. Material and method: Patient is 78yr female patient with multiple co-morbid conditions with subtrochanetric fracture. Surgery was done with long PFN nail  inserted with good purchase in head, reduction check under C-arm with  in antero-posterior & lateral  view shows little malreduction and nail  is out of medulary cavity in proximal fragment. Revision in same sitting not possible due to some medical reasons. Revision surgery done after fitness and reduction held with encieclage wire and bone grafting done. Conclusion: Even without lateral wall support if there is good purchase of screws in head and shaft, there will be good union and good functional outcome

A PROSPECTIVE STUDY ON ANAEMIA AS A MORTALITY RISK FACTOR IN DIABETIC AND NON-DIABETIC PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION.

Introduction: Short-term mortality is related to hyperglycemia, acute myocardial infarction (AMI), and anemia. Diabetes patients are more likely to suffer from anemia. To investigate the impact of diabetes patients also having anemia on myocardial infarction outcomes, we conducted a retrospective study. Methodology: From a registry that is disease-specific and population-based, information about every patient consecutively hospitalized with AMI was gathered. Diabetes and anemia were present in four groups of patients. Results: 32.2% of Group A, 16% of Group B, 21.45% of Group C, and 6.6% of Group D experienced 30-day mortality (all p < 0.001). Groups A, B, C, and D had, in that order, 31 days to 36 months mortality rates of 47.6%, 20.8%, 34.3%, and 10.4% (all p < 0.001). At 36 months, the odds ratios for diabetes and anemia were 1.61 (1.40–1.84, p < 0.001) and 1.58 (1.37–1.86, p < 0.001), respectively, suggesting that both illnesses remained independent risk factors for death. Of the deaths that occurred between 31 days and 36 months, 43.7% in Group A were due to cardiovascular causes, 54.0% in Group B, 47.1% in Group C, and 50.9% in Group D (p < 0.05, A vs. B). Conclusion: When compared to either diabetes or anemia patients alone, patients who have diabetes and anemia both have a greater death rate. In all groups, cardiovascular death continued to be the most common death cause. Recommendation: According to our findings, individuals with anemia who have experienced a myocardial infarction with or without diabetes may safely have prompt primary percutaneous coronary intervention; nevertheless, they should take extra care to maintain hemoglobin levels

A PROSPECTIVE COHORT STUDY OF PROTEINURIA CHANGES AND MYOCARDIAL INFARCTION RISKS IN DIABETIC OR PRE-DIABETIC PATIENTS.

Objective:  This prospective cohort study aimed to investigate the relationship between changes in proteinuria and the risk of myocardial infarction (MI) in individuals with diabetes or pre-diabetes. Methodology: The prospective study was conducted involving 200 participants in India, with data collection occurring during routine medical examinations from 2020 to 2022. The participants were followed up, and data collection concluded in 2023. Results: Among the participants, those with persistent proteinuria exhibited a significantly higher risk of MI, with a 2.5-fold increased hazard compared to those without proteinuria. Furthermore, a reduction in proteinuria over time was associated with a 21% decrease in MI incidence. This relationship was not observed in individuals without proteinuria, highlighting the importance of persistent proteinuria in influencing MI risk.  Conclusion: The findings emphasize the critical role of persistent proteinuria as a predictor of elevated MI risk in individuals with diabetes and pre-diabetes. Monitoring and managing proteinuria could potentially mitigate the risk of future heart attacks in this population. Recommendations: Healthcare professionals should consider routine monitoring of proteinuria levels in outpatient settings for individuals with diabetes and pre-diabetes. Exploring interventions to lower proteinuria levels for heart attack prevention is recommended, including lifestyle modifications, medications, or targeted therapies. Improved comprehension of the mechanisms connecting proteinuria to the risk of MI is essential for the formulation of efficient preventive approaches. This study underscores the significance of early detection and management of proteinuria in diabetic patients and pre-diabetics to reduce the risk of myocardial infarction

Chimeras of Escherichia coli and Mycobacterium tuberculosis Single-Stranded DNA Binding Proteins: Characterization and Function in Escherichia coli

Single stranded DNA binding proteins (SSBs) are vital for the survival of organisms. Studies on SSBs from the prototype, Escherichia coli (EcoSSB) and, an important human pathogen, Mycobacterium tuberculosis (MtuSSB) had shown that despite significant variations in their quaternary structures, the DNA binding and oligomerization properties of the two are similar. Here, we used the X-ray crystal structure data of the two SSBs to design a series of chimeric proteins (mβ1, mβ1′β2, mβ1–β5, mβ1–β6 and mβ4–β5) by transplanting β1, β1′β2, β1–β5, β1–β6 and β4–β5 regions, respectively of the N-terminal (DNA binding) domain of MtuSSB for the corresponding sequences in EcoSSB. In addition, mβ1′β2ESWR SSB was generated by mutating the MtuSSB specific ‘PRIY’ sequence in the β2 strand of mβ1′β2 SSB to EcoSSB specific ‘ESWR’ sequence. Biochemical characterization revealed that except for mβ1 SSB, all chimeras and a control construct lacking the C-terminal domain (ΔC SSB) bound DNA in modes corresponding to limited and unlimited modes of binding. However, the DNA on MtuSSB may follow a different path than the EcoSSB. Structural probing by protease digestion revealed that unlike other SSBs used, mβ1 SSB was also hypersensitive to chymotrypsin treatment. Further, to check for their biological activities, we developed a sensitive assay, and observed that mβ1–β6, MtuSSB, mβ1′β2 and mβ1–β5 SSBs complemented E. coli Δssb in a dose dependent manner. Complementation by the mβ1–β5 SSB was poor. In contrast, mβ1′β2ESWR SSB complemented E. coli as well as EcoSSB. The inefficiently functioning SSBs resulted in an elongated cell/filamentation phenotype of E. coli. Taken together, our observations suggest that specific interactions within the DNA binding domain of the homotetrameric SSBs are crucial for their biological function

Setting the stage for cohesion establishment by the replication fork

Comment on: Rudra S, et al. Cell Cycle 2012; 2114-2

Formulation and evaluation of new polyherbal germicidal toothpaste containing ajwain oil

The main object of the present research is to provide a formulation useful as natural herbal tooth paste which obviates the drawbacks of the earlier tooth pastes.And its to provide a good tooth paste which can give effective protection to teeth and free them from any toxicity or toxic residue and irritation when regularly used. It should be cosmetically acceptable having pleasant odour and should not leave stain on teeth or fingers after use. Brightening the teeth by removing stains would be a prerequisite of the formulation.Still another object of the present invention is highlight the potential of extract of ajwain seed in inhibiting  the activity of Streptococcus mutans bacteria which are major cause of dental caries. The study attributed presence of naphthalene derivative responsible for such protective antibiofilm activity. Ajwain oil is proven to cure tooth pain. Along with equal parts of clove oil and water, it is used as home remedy to floss mouth and treat tooth ache, bad breath and tooth decay. Keywords: Halitosis, Gingivitis and Periodontiti