Correlation of CD4 count with Carotid Intima Media Thickness in HIV patients

BACKGROUND: HIV patients have increased risk of cardiovascular disease events. HIV infected individuals may exhibit more rapid IMT(intima media thickness) progression in the carotid artery compared with uninfected individuals due to inflammatory state present in HIV infected. Low CD4 count has been identified as a risk factor but data has not been consistent as studies have not confirmed the reported associations of low CD4+ T-cell count with clinical or subclinical CVD. AIM OF THE STUDY: To investigate the correlation between CD4 count and CAROTID INTIMA MEDIA THICKNESS as a marker of atherosclerosis in HIV patients. METHODS: This was an observational study that included 100 HIV patients from medical wards and those attending OPD at ART center at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. Patients selected for clinical study as per inclusion/exclusion criteria- demographic data, past medical history, ART drug history, duration of illness is collected from patients.CD4 T cell count is measured. Carotid artery intima media thickness is measured using B-mode ultrasound. RESULTS: At p75 values of CIMT adjusted for age, significant values, p=0.015, are noted in age groups below 30 years and above 50 years. 54 % were males and 46 % were females and CIMT values at p75 distributed for the sexes was significant p=0.007, indicating that females had more significant increase in CIMT than males. Comparing age groups, significant at p75, p =0.004, patients on ART for 6-10 years had more CIMT values compared to other age groups. The mean CD4 counts was found to be in decreasing trend with increasing percentile of CIMT. The count was 344, 323, 306 for p25, p50, p75 respectively and was significant with p value < 0.001 indicating a correlation between CD4 count and CIMT and it was found to have a negative correlation (the Correlation is significant at the 0.01 level (2-tailed) meaning that the CIMT values were increasing in trend when there was a fall in mean CD4 count. There was also a negative correlation between CIMT values and ART duration indicating that CIMT was more for patients who are on prolonged ART. CONCLUSION: It was found that HIV-infected patients with a low CD4+ T-cell count had a significantly increased carotid intima media thickness (CIMT) indicating that there is increased atherosclerosis in these immunocompromised group of patients. CIMT was increased in older age group, females than males and patients on prolonged ART. Further studies to reduce chronic inflammation beyond ART are required to investigate whether or not this improves vascular inflammation and ultimately reduces atherosclerotic risk in HIV patients

Formulation and Evaluation of Matrix tablets of Ambroxol hydrochloride using Natural hydrophilic polymer

Se prepararon comprimidos matriciales de liberación prolongada de clorhidrato de ambroxol con diversas proporciones de fármaco: polímero tales como F-1(1:1), F-2(1:1,5) y F-3 (1:2). Se utilizó goma xántica para la formación de la matriz y celulosa microcristalina como diluyente. Se prepararon y evaluaron gránulos para determinar la densidad aparente sin compactar, la densidad compactada, el índice de compresibilidad, el índice de Hausner y el ángulo de reposo. Todos los gránulos se lubricaron y comprimieron con punzones planos de 9 mm. Los comprimidos se evaluaron para determinar la uniformidad de peso, el contenido de principios activos, la friabilidad, la dureza y la disolución in vitro. Todas las formulaciones se ajustaron a los estándares farmacopeicos. F-3 mostró una liberación prolongada de fármaco durante 12 horas con una liberación del 97,3% y el perfi l de liberación fue similar al de la muestra de clorhidrato de ambroxol comercial (A-MS). Además, se realizaron estudios de estabilidad según la guía ICH. La liberación de fármaco sigue cinéticas de orden cero (0,9661) y se determinó que el mecanismo era difusión combinada con erosión.Sustained release matrix tablets of ambroxol hydrochloride of different drug: polymer ratios, such as F-1(1:1), F- 2(1:1.5) and F-3 (1:2). Xanthan gum was used as matrix former and microcrystalline cellulose was used as diluent. Granules were prepared and evaluated for loose bulk density, tapped density, compressibility index, hausners ratio and angle of repose. All the granules were lubricated and compressed using 9mm fl at-faced punches. Compressed tablets were evaluated for uniformity of weight, content of active ingredient, friability, hardness and In-vitro dissolution. All the formulations showed compliance with Pharmacopoeial standards. F-3 showed the sustained release of drug for 12 hours with 97.3% release and the release profi le was close to the marketed sample of ambroxol hydrochloride (A-MS) and Stability studies were performed as per ICH guide. The drug release follows zero order kinetics (0.9661) and the mechanism was found to be diffusion coupled with erosion

A Qualitative Exploration of Sport and Social Pressures on Elite Athletes in Relation to Disordered Eating

Introduction: Athletes are at increased risk of disordered eating compared to non-athletes. Inspired by previous investigation into quantitative work on an etiological model of disordered eating in athletes, the current study aimed to explore a problematic aspect of the model: athletes' lived experiences of social and sport pressures in relation to the onset of disordered eating and differing eating behaviors. / Methods: Nine (N = 9) male and female athletes representing a range of endurance sports took part in semi-structured interviews. Thematic analysis was utilized. / Analysis: Analysis revealed two main themes each with two corresponding subthemes (1) Conflating physical appearance and sporting ability with the subthemes of (1a) social comparison in a sporting world and (1b) societal notions of “the athlete body” and (2) Living as an athlete with the corresponding subthemes of (2a) discipline and sacrifice and (2b) the balancing act. / Discussion: It is the complex interaction between societal expectations as lived out in social messages and comparisons, and sport pressures that contributes to the development of disordered eating behaviors. These findings suggest that prevention and treatment of disordered eating in athletes can be applied from those already established in non-sporting realm

Antidiabetic activity of Manomani chooranam aqueous extract on female wistar albino rats

Background: The aim of the present study was to evaluate the antidiabetic potential of Manomani chooranam (MMC), an indigenous polyherbal siddha formulation in Streptozotocin (STZ) induced diabetic female Wistar albino rats.Methods: Aqueous extract of MMC was prepared. Wistar albino rats were divided into six groups (n=6). Group 1 was kept as normal control, Group 2, 3, 4, 5 and 6 were induced diabetes. After induction, the group 2 was kept as diabetes control; Group 3 received the standard drug metformin (100 mg/kg), whereas Groups 4, 5 and 6 were treated with the aqueous extract of MMC at 500 mg/kg, 1000 mg/kg and 1250 mg/kg doses, respectively for the 21 days. Blood sugar was estimated at the end of each week. At the end of the study, rats were sacrificed and the pancreas was analyzed for histopathological changes. Data expressed as mean±standard error of the mean. Statistical analysis was done using one-way ANOVA followed by post hoc Tukey's test. p<0.05 considered statistically significant.Results: The groups which received aqueous extract of MMC at 500 mg/kg, 1000 mg/kg and 1250 mg/kg showed a significant decrease in the mean blood sugar level when compared to normal level. The groups which received MMC shows significant reduction in blood sugar level in comparison with standard drug metformin 100 mg/kg.Conclusions: The aqueous extract of MMC was able to decrease the elevated blood sugar levels in dose dependent manner

Vibrational and stochastic resonances in driven nonlinear systems:part two

Nonlinearity is ubiquitous in both natural and engineering systems. The resultant dynamics has emerged as a multidisciplinary field that has been very extensively investigated, due partly to the potential occurrence of nonlinear phenomena in all branches of sciences, engineering and medicine. Driving nonlinear systems with external excitations can yield a plethora of intriguing and important phenomena – one of the most prominent being that of resonance. In the presence of additional harmonic or stochastic excitation, two exotic forms of resonance can arise: vibrational resonance or stochastic resonance, respectively. Several promising state-of-the-art technologies that were not covered in Part One of this Theme Issue are discussed here. They include inter alia the improvement of image quality, the design of machines and devices that exert vibrations on materials, the harvesting of energy from various forms of ambient vibration, and control of aerodynamic instabilities. They form an important part of the Theme Issue as a whole, which is dedicated to an overview of vibrational and stochastic resonances in driven nonlinear systems. resonances in driven nonlinear systems

Impact of Splenic Artery Embolization on the Success Rate of Nonoperative Management for Blunt Splenic Injury

Introduction Nonoperative management (NOM) has become the treatment of choice for hemodynamically stable patients with blunt splenic injury. Results of outcome after NOM are predominantly based on large-volume studies from level 1 trauma centers in the United States. This study was designed to assess the results of NOM in a relatively low-volume Dutch level 1 trauma center. Methods An analysis of a prospective trauma registry was performed for a 6-year period before (period 1) and after the introduction and implementation of splenic artery embolization (SAE) (period 2). Primary outcome was the failure rate of initial treatment. Results A total of 151 patients were reviewed. An increased use of SAE and a reduction of splenic operations during the second period was observed. Compared with period 1, the failure rate after observation in period 2 decreased from 25% to 10%. The failure rate after SAE in period 2 was 18%. The splenic salvage rate (SSR) after observation increased from 79% in the first period to 100% in the second period. During the second period, all patients with failure after observation were successfully treated with SAE. The SSR after SAE in periods 1 and 2 was respectively 100% and 86%. Conclusions SAE of patients with blunt splenic injuries is associated with a reduction in splenic operations. The failure and splenic salvage rates in this current study were comparable with the results from large-volume studies of level 1 trauma centers. Nonoperative management also is feasible in a relatively low-volume level 1 trauma center outside the United State

Understanding Inequality: The Experiences and Perceptions of Equality, Diversity, and Inclusion of those Working or Studying within Sport and Exercise Psychology

Discrimination and inequality are ever present in today's society, with athletes facing racial abuse and LGBTQ+ individuals fearing for their safety at international events. Due to these additional stressors, the role of sport psychologists becomes increasingly important when supporting athletes from minority groups. An online questionnaire was developed to gain greater understanding of the equality, diversity, and inclusion (ED&I) knowledge, perceptions, and experiences of those working, studying or researching in the field of sport and exercise psychology. The findings of the current study highlight the ongoing experiences of sexism, racism, homo/transphobia, and ableism experienced by participants, as well as the need for more suitable, in-depth training around ED&I subjects and guidance on meaningful action to combat inequality and discrimination in the field. The involvement of individuals from minority groups in the development, delivery and evaluation of training and research is necessary to move towards true inclusion

Understanding Inequality: The Experiences and Perceptions of Equality, Diversity, and Inclusion of those Working or Studying within Sport and Exercise Psychology

Discrimination and inequality are ever present in today's society, with athletes facing racial abuse and LGBTQ+ individuals fearing for their safety at international events. Due to these additional stressors, the role of sport psychologists becomes increasingly important when supporting athletes from minority groups. An online questionnaire was developed to gain greater understanding of the equality, diversity, and inclusion (ED&I) knowledge, perceptions, and experiences of those working, studying or researching in the field of sport and exercise psychology. The findings of the current study highlight the ongoing experiences of sexism, racism, homo/transphobia, and ableism experienced by participants, as well as the need for more suitable, in-depth training around ED&I subjects and guidance on meaningful action to combat inequality and discrimination in the field. The involvement of individuals from minority groups in the development, delivery and evaluation of training and research is necessary to move towards true inclusion