Occurrence and risk factors of Vitamin D deficiency in Indian children living with HIV – A case–control study

Background: Vitamin D deficiency (VDD) is highly prevalent in healthy individuals. Studies suggest that Vitamin D plays an important role in immune system. Objective: The objective of this study was to assess the frequency of VDD in Indian children living with HIV (CLHIV) and to find out the risk factors associated with it. Materials and Methods: It was a cross-sectional comparative study conducted in a tertiary care teaching hospital of North India. A total of 52 CLHIV were enrolled consecutively from the pediatric HIV center and an equal number of age- and sex-matched controls were enrolled from the pediatric outpatient department. Serum Vitamin D levels of cases and controls were assessed and compared. Various risk factors, both classical (age, sex, sunlight exposure, average dietary intake of calcium, and Vitamin D) and disease related (WHO and immunological stage, duration, and regimen of treatment), were evaluated for VDD in CLHIV. Results: The prevalence of VDD in cases and controls was 69.23% and 19.23%, respectively (p<0.001). The mean serum Vitamin D level of the cases (18.24±11.2 ng/dL) was significantly lower than that of controls (31.58±17.31 ng/dL) (p<0.001). The risk factor that predicted the occurrence VDD in CLHIV was a poor intake of Vitamin D. Conclusion: CLHIV are more prone to VDD; hence, there is a need to regularly evaluate, supplement, and monitor for Vitamin D status in these children

Site-Specific Effects of PECAM-1 on Atherosclerosis in LDL Receptor-Deficient Mice

Objective—Atherosclerosis is a vascular disease that involves lesion formation at sites of disturbed flow under the influence of genetic and environmental factors. Endothelial expression of adhesion molecules that enable infiltration of immune cells is important for lesion development. Platelet/endothelial cell adhesion molecule-1 (PECAM-1; CD31) is an adhesion and signaling receptor expressed by many cells involved in atherosclerotic lesion development. PECAM-1 transduces signals required for proinflammatory adhesion molecule expression at atherosusceptible sites; thus, it is predicted to be proatherosclerotic. PECAM-1 also inhibits inflammatory responses, on which basis it is predicted to be atheroprotective. Methods and Results—We evaluated herein the effect of PECAM-1 deficiency on development of atherosclerosis in LDL receptor– deficient mice. We found that PECAM-1 has both proatherosclerotic and atheroprotective effects, but that the former dominate in the inner curvature of the aortic arch whereas the latter dominate in the aortic sinus, branching arteries, and descending aorta. Endothelial cell expression of PECAM-1 was sufficient for its atheroprotective effects in the aortic sinus but not in the descending aorta, where the atheroprotective effects of PECAM-1 also required its expression on bone marrow–derived cells. Conclusion—We conclude that PECAM-1 influences initiation and progression of atherosclerosis both positively and negatively, and that it does so in a site-specific manner. (Arterioscler Thromb Vasc Biol. 2008;28:1996-2002

Impact of increase of caesarean section on postpartum hemorrhage in a tertiary care center of India over 6 years

Background: PPH (postpartum hemorrhage) is the leading cause of maternal mortality. Despite of all the medical advancement, maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Caesarean section is an obstetric intervention where, normal delivery can pose a risk for mother or foetus. The rate of caesarean section has increased worldwide. A survey conducted by WHO found that the worldwide rate of caesarean section increased from 26.4% between 2004 to 2008, to 31.2% between 2010 to 2011.Methods: We collected data of the caesarean sections and patients who developed PPH over 6 years. We studied the association of temporal increase of caesarean section with PPH.Results: Uterine atonicity continues to be the most common etiology of PPH each year, however, there is an increase in tissue abnormality (retained placenta, placenta praevia, accreta, increta, percreta) over years as there is a significant increase in the incidence of caesarean section. Atonic uterus was the most common cause for obstetric hysterectomies and mortality due to PPH every year.Conclusions: Family planning advise is essential in developing country like ours to counsel patients to prevent multiparity, thus reducing PPH. It is also important to train all the health workers in periphery and referral centers to manage the third stage of labor and atonic uterus to save the mothers. Sagacious attitude towards the decision of caesarean section is needed to prevent maternal morbidity and mortality

Caries Pattern In Primary Molars With Early Pulpal Involvement In Mixed Dentition

INTRODUCTION: Caries in primary dentition may lead to high risk in permanent dentition; it is therefore important to identify those children who are caries affected. Specific and distinct patterns of caries attack might indicate a distinct etiology or are most likely associated with the subsequent development of carious lesions on other surfaces of teeth.AIM: To assess caries susceptibility and prevalence in primary teeth and evaluate the prevalence of caries according to individual molar surfaces in 4-8 year old children.MATERIAL AND METHODS: A cross sectional retrospective study was conducted in the pediatric department of SGT Dental College using convenient sampling with caries in teeth as chief complaint. 70 radiographs were examined in the age group of 4-8 years. Lesions present on mesial, distal and occlusal surfaces were recorded on the chart after radiographic examination.RESULTS: As per results, distal surface of D(45.40%) and mesial surface of E (37.80%) showed maximum caries on adjacent proximal surfaces and significant dependence (p value<0.05) was found between the presence of lesions on adjacent proximal surfaces. The D(76.1% )and E(79.1% )showed significantly higher caries experience on the proximal surfaces in conjunction with occlusal caries but were statistically not significant.CONCLUSION: In the presence of non-proximal caries (occlusal caries), the chances of proximal caries are increased as seen radiographically. Thus need for treatment, are likely being underestimated during visual examinations alone

An assessment of demographic variables affecting employees’ organizational commitment in India’s thermal power sector

This study aims to analyze the impact of three demographic variables (gender, age, and work experience) on the commitment levels of employees in the Indian thermal power sector. 379 responses were collected through convenience sampling from the executives of NTPC Ltd, a major power utility in India. The facets of organizational commitment (affective commitment, normative commitment, and continuance commitment) were assessed using a standard scale. The quantitative research was done using statistical instruments of one-way ANOVA and independent sample t-test. The findings revealed a positive correlation between the three components of organizational commitment: affective, continuance, and normative. Further, the results highlighted that age plays an essential role in organizational commitment levels; it is found that commitment increases with the age of employees (F = 5.781, p < 0.01). However, gender is not making any variation in organizational commitment (F = –0.502, p < 0.01). Therefore, male and female employees enjoy equal commitment levels toward their work. The study further indicated that work experience significantly influences organizational commitment (F = 4.800, p < 0.01), and it is found to be greater for more experienced employees

Plasma peptidome profiling of acute hepatitis E patients by MALDI-TOF/TOF

Background Hepatitis E is endemic to resource-poor regions, where it manifests as sporadic cases and large waterborne outbreaks. The disease severity ranges from acute self-limited hepatitis with low mortality to fulminant hepatic failure with high mortality. It is believed that the host response plays an important role in determining the progression and outcome of this disease. We profiled the plasma peptidome from hepatitis E patients to discover suitable biomarkers and understand disease pathogenesis. Results The peptidome (< 10 kDa) fraction of plasma was enriched and analyzed by mass spectrometry. A comparative analysis of the peptide pattern of hepatitis E patients versus healthy controls was performed using ClinPro Tools. We generated a peptide profile that could be used for selective identification of hepatitis E cases. We have identified five potential biomarker peaks with m/z values of 9288.6, 7763.6, 4961.5, 1060.572 and 2365.139 that can be used to reliably differentiate between hepatitis E patients and controls with areas under the receiver operating characteristic curve (AUROC) values of 1.00, 0.954, 0.989, 0.960 and 0.829 respectively. A number of proteins involved in innate immunity were identified to be differentially present in the plasma of patients compared to healthy controls. Conclusions Besides the utility of this approach for biomarker discovery, identification of changes in endogenous peptides in hepatitis E patient plasma has increased our understanding of disease pathogenesis. We have identified peptides in plasma that can reliably distinguish hepatitis E patients from healthy controls. Results from this and an earlier proteomics study are discussed

Podophyllum hexandrum Offers Radioprotection by Modulating Free Radical Flux: Role of Aryl-Tetralin Lignans

We have evaluated the effect of variation in aryl-tetralin lignans on the radioprotective properties of Podophyllum hexandrum. Two fractionated fractions of P. hexandrum [methanolic (S1) and chloroform fractions (S2)], with varying aryl-tetralin lignan content were utilized for the present study. The peroxyl ion scavenging potentials of S1 and S2 were found to be comparable [i.e. 45.88% (S1) and 41% (S2)] after a 48 h interval in a time-dependent study, whereas in a 2 h study, S2 exhibited significant (P < 0.05) antioxidant activity in different metal ion + flux states. In the aqueous phase, S2 exhibited non-site-specific reactive oxygen species scavenging activity, i.e. 73.12% inhibition at 500 μg ml(−1). S1 exhibited 58.40 ± 0.8% inhibition (at 0.025 μg ml(−1)) of the formation of reactive nitrite radicals, comparable to S2 (52.45 ± 0.825%), and also showed 45.01% site-specific activity (1000 μg ml(−1)), along with significant (P < 0.05) electron donation potential (50–2000 μg ml(−1)) compared to S2. Such activities of S1 could be attributed to the significantly (P < 0.05) higher levels of podophyllotoxin β-d-glucopyranoside (16.5 times) and demethyl podophyllotoxin glucoside (2.9 times) compared with S2. Together, these findings clearly prove that aryl-tetralin lignan content influences the radiation protective potential of the Podophyllum fractions to a great extent

Rapid Host Defense against Aspergillus fumigatus Involves Alveolar Macrophages with a Predominance of Alternatively Activated Phenotype

The ubiquitous fungus Aspergillus fumigatus is associated with chronic diseases such as invasive pulmonary aspergillosis in immunosuppressed patients and allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis or severe asthma. Because of constant exposure to this fungus, it is critical for the host to exercise an immediate and decisive immune response to clear fungal spores to ward off disease. In this study, we observed that rapidly after infection by A. fumigatus, alveolar macrophages predominantly express Arginase 1 (Arg1), a key marker of alternatively activated macrophages (AAMs). The macrophages were also found to express Ym1 and CD206 that are also expressed by AAMs but not NOS2, which is expressed by classically activated macrophages. The expression of Arg1 was reduced in the absence of the known signaling axis, IL-4Rα/STAT6, for AAM development. While both Dectin-1 and TLR expressed on the cell surface have been shown to sense A. fumigatus, fungus-induced Arg1 expression in CD11c+ alveolar macrophages was not dependent on either Dectin-1 or the adaptor MyD88 that mediates intracellular signaling by most TLRs. Alveolar macrophages from WT mice efficiently phagocytosed fungal conidia, but those from mice deficient in Dectin-1 showed impaired fungal uptake. Depletion of macrophages with clodronate-filled liposomes increased fungal burden in infected mice. Collectively, our studies suggest that alveolar macrophages, which predominantly acquire an AAM phenotype following A. fumigatus infection, have a protective role in defense against this fungus

Role of IL-4 and IFN-gamma in regulating macrophage differentiation during murine allergic bronchopulmonary mycosis.

Allergic bronchopulmonary mycosis (ABPM) is a hypersensitivity lung disease in humans that results from persistent exposure to fungal allergens due to active fungal colonization in the lungs. This disease is often a complication in asthma and cystic fibrosis. The objective of this study was to investigate the role of cytokines IL-4 and IFN-gamma in the polarization of lung macrophages during this disease. In a murine model of ABPM developed using C. neoformans, an opportunistic fungus, we here show that a dynamic balance exists between these cytokines. IL-4 is required for the development of ABPM, whereas IFN-gamma counteracts its effects. Therefore, mice that lack IFN-gamma develop severe progressive infection and allergic pathology, including crystal formation in their lungs and hyalinosis. We also show that these crystals are made of YM1, a chitinase-like protein of unknown function. Macrophages play a central role in host defense against C. neoformans. Polarization of macrophages to either a classically activated macrophage (caMac) or an alternatively activated macrophage (aaMac) affects their immune function. To elucidate the role of IL-4 and IFN-gamma in altering the polarization state of these cells, macrophages were isolated from C. neoformans -infected IL-4 KO and IFN-gamma KO mice and their polarization state was determined using a set of previously defined markers. Mice that lacked IL-4 developed caMacs, whereas mice that lacked IFN-gamma developed aaMacs. In WT mice, where both IL-4 and IFN-gamma were present, caMac as well as aaMac were generated. Generation of differentially polarized macrophages signifies the underlying mechanism for the development of this disease. CD4+ T cells are major producers of cytokines. Removal of CD4+ T cells in this murine model abrogated allergic pathology; however it did not affect fungal clearance from the lungs, and these cells were not required for the generation of aaMacs. Together, these results illustrate an important role for the IL-4/IFN-gamma balance in influencing macrophage functions during an ongoing fungal infection. Identification of fungal and host factors that are involved in macrophage polarization and altering their immune functions is critical in understanding pathogenesis.Ph.D.Health and Environmental SciencesImmunologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/125952/2/3224811.pd