The Economics of Weight Loss

Obesity is now being considered one of the biggest health concerns globally. Ironically, while India records the largest no. of underweight population in the world along with China, it has also been placed in the top five countries in terms of obesity as per a new study by the Lancet Journal. Obesity entails various direct and indirect costs in terms of lower productivity and higher medical expenditure and has the potential to lower economic growth. This paper analyses the need for strengthening government regulations in the weight loss industry. After analyzing the causes of obesity and its negative effects on both health and the economy at large and reviewing the loopholes of the existing regulations in India, certain policy recommendations have been provided

High rate of caesarean section in cases of intrauterine fetal demise in a low resource setting: Why?

Background: Stillbirth as an obstetric complication is emotionally devastating for the women as well as the clinician and having a caesarean section for stillbirth is even more catastrophic. The aim of the present research was to study the indications of caesarean section in women with intrauterine fetal demise in a low resource setting.Methods: This was an observational study for assessing the indication of caesarean section among 222/ 550 stillbirths from June 2013 to May 2014 in a tertiary care teaching hospital of North India. 7024 births occurred in the institution over a period of 1 year out of which 550 were stillbirths. Stillbirths which weighed over 500 grams were included in the study. Details of women with intrauterine fetal demise in which caesarian section was done were noted and analyzed.Results: Out of 550 stillbirths, 222 women underwent caesarean section. Rate of caesarean section among women with stillbirth was 40.36%.  Placenta previa (23.87%), Rupture uterus (22.1%), obstructed labour (10.8%), transverse lie (9.45%), failed induction (7.20%), massive abruption (5.86%), non-progress of labour (5.40%), eclampsia/pre-eclampsia related causes (4.95%), acute fetal distress (4.95%), were leading indications of caesarean sections. Out of 222 women, 162 (73%) women had anaemia (Hb <11g%). Severe anaemia (haemoglobin less then 7gm/dl) was present in 51 cases (23%).Conclusions: Caesarean section done for intrauterine death in present study were mostly inevitable. Reducing intrapartum stillbirths by improving essential obstetric services will ultimately result in reducing caesarean section rates in stillbirths in developing countries. Further studies are needed both in developing and developed countries to strategize the management of intrauterine dead fetus to prevent such high rate of caesarean section

Evaluation of causes of still birth in a tertiary care teaching hospital

Background: Whenever pregnancy occurs there is an expectation that every pregnancy will end with the birth of a healthy baby, yet in a developing country like India 22 in every 1000 births are stillborn. The objective of this study was to evaluate the rate and causes of still birth in a tertiary care teaching hospital, Queen Mary, King George Medical college and university, Lucknow, Uttar Pradesh, India.Methods: Present study was an observational study in a tertiary care hospital. 7024 births occurred in the institution over a period of 1 year out of which 550 were stillbirths. Stillbirths which weighed over 500 grams were included in the study. After informed consent, details of history about epidemiological factors, obstetric history and medical history were obtained. Antenatal investigations including imaging, delivery details and stillborn morphological characteristics were analyzed to identify the cause of stillbirthResults: Out of 7024 deliveries, stillbirth rate was 78.30/1000 total births. Cause of intrapartum stillbirth showed statistically significant correlation with patient’s place of residence (rural>urban), distance of health centre from her house, time taken to reach first point of contact and her parity. The major obstetrical causes of stillbirth identified were APH 22.36%, hypertensive disorders of pregnancy 19.27%, IUGR 15.27%, unexplained causes 11.09%, mal-presentations 9.64%, rupture uterus 9.09% and obstructed labour 6.36%. Severe anemia was found in 24.91% as an associated obstetrical cause of stillbirth.Conclusions: The rate of stillbirth is higher as compared to the Indian data (22/1000 total births). Antepartum obstetric complications (APH, hypertensive disorder of pregnancy, IUGR) were the most common. 15.45% cases showed intrapartum causes of stillbirth (obstructed labour and rupture uterus) which was significantly higher than developed countries where such cases are negligible. The higher number of intrapartum deaths indicate that better healthcare services can drastically reduce stillbirth rates in developing countries

Pueraria tuberosa as Dipeptidyl-Peptidase-IV Inhibitor Prevents Streptozotocin-Induced Intestinal Stress

BACKGROUND: Enhanced expression of PTY-2 dipeptidyl-peptidase-IV (DPP-IV) has been found to improve has been found in various intestinal diseases. Pueraria tuberosa tuber water extract-2 (PTY-2) is already known to have DPP-IV inhibitory potential. At the mRNA level, this inhibition has not yet been investigated. Increased incretin secretion due to inhibition of DPP-IV could lead to the suppression of stress and apoptosis of intestinal cells. AIM: In this research, we tried to study the antioxidant, anti-apoptotic, and DPP-IV inhibitory effect of PTY 2 against intestinal damage induced by STZ. METHODS: We found morphological damage to the intestine following streptozotocin (STZ) injection (65 mg/kg bw) in male Charles foster rats through histological examination. Superoxide dismutase (SOD) and DPP-IV mRNA expressions were analyzed by polymerase chain reaction and cell apoptosis was examined by tunnel assay and Bcl 2 immunoexpression. RESULTS: In STZ-induced diabetic control, the number and length of villi were decreased, but these damages were reversed by 10 days of PTY-2 treatment. SOD expression was found to be decreased whereas DPP-IV expression was enhanced with significant intestinal cell apoptosis in the diabetic control group. Treatment with PTY-2 decreases stress by upregulating SOD expression and by downregulating the expression of DPP-IV. These PTY-2 recoveries contribute to the suppression of apoptosis in the intestinal cells. CONCLUSION: The protective action of PTY-2 against STZ mediated intestinal damage is demonstrated by these short studies. Therefore, PTY-2 may be taken as a herbal remedy for diabetes-induced intestinal damages

Estimation and comparison of thrombocyte count by peripheral blood smear method and automated method in women with pregnancy

Background: Thrombocyte is important and very essential component of blood and have significant role in maintenance of hemostasis. Thrombocyte count is an important investigation done in various acquired and congenital coagulable states which include conditions like pregnancy. Thrombocyte count is routinely done by automated hematology analyzer method. The automated hematology analyzer counters are not usually available at all centres especially in peripheral and rural side though thrombocytes can also be assessed from the peripheral blood smears, which can be easily and precisely done at any set up. Aim and objective of this study was to compare the thrombocyte estimation by peripheral blood smear method and automated hematology analyzer in pregnant women.Methods: Thrombocyte estimation was done from samples taken from 120 normal pregnant women between December 2018 to March 2019, where samples were Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated. Thrombocyte was counted manually using PBS (Leishman stain) and hematology analyzer (Sysmex XN1000 series). Thrombocyte counts were expressed in Mean and standard Deviation. Statistical analysis was done by student’s t test using MS excel and SPSS version 17.Results: Thrombocyte count by PBS have mean value of 2.04 lacs/mm3 with standard deviation of 0.56 lacs/mm3 and by automated method have mean value of 1.89 lacs/mm3 and standard deviation of 0.71 lacs/mm3 with p value 0.010. Thus, there was no statistically significant difference found between two methods.Conclusions: Estimation of thrombocyte count on the basis of manual thrombocyte count is a reliable technique and can be used to validate automated thrombocyte counts. It can also be used in under resourced laboratories, where there are no automated counters of good precision available. In fact, all the tests showing abnormal thrombocyte counts must be reported only after cross examining on PBS

The Center for Innovations in Business and Management Practice CO-RELATIONAL REVIEW INTERFACE BETWEEN ACADEMIC ACHIEVEMENT AND PROFESSIONAL SUCCESS

Abstract The performance of real life achievers vis-à-vis academic achievers has long been a subject of debate and discussion. It has often been witnessed that real life achievers often do no

Central Composite Designed Formulation, Characterization and In-Vitro Cytotoxic effect of Erlotinib Loaded Chitosan Nanoparticulate System

© 2019 Elsevier B.V. The most common cause of deaths due to cancers nowadays is lung cancer. The objective of this study was to prepare erlotinib loaded chitosan nanoparticles for their anticancer potential. To study the effect of formulation variables on prepared nanoparticles using central composite design. Erlotinib loaded chitosan nanoparticles were prepared by ionic gelation method using probe sonication technique. It was found that batch NP-7 has a maximum loading capacity and entrapment efficiency with a particle size (138.5 nm) which is ideal for targeting solid tumors. Analysis of variance was applied to the particle size, entrapment efficiency and percent cumulative drug release to study the fitting and the significance of the model. The batch NP-7 showed 91.57% and 39.78% drug release after 24 h in 0.1 N hydrochloric acid and Phosphate Buffer (PB) pH 6.8, respectively. The IC50 value of NP-7 evaluated on A549 Lung cancer cells was found to be 6.36 μM. The XRD of NP-7 displayed the existence of erlotinib in the amorphous pattern. The optimized batch released erlotinib slowly in comparison to the marketed tablet formulation. Erlotinib loaded chitosan nanoparticles were prepared successfully using sonication technique with suitable particle size, entrapment efficiency and drug release. The formulated nanoparticles can be utilized for the treatment of lung cancer

A novel Plasmodium falciparum rhoptry associated adhesin mediates erythrocyte invasion through the sialic-acid dependent pathway

Erythrocyte invasion by Plasmodium falciparum merozoites is central to blood-stage infection and malaria pathogenesis. This intricate process is coordinated by multiple parasite adhesins that bind erythrocyte receptors and mediate invasion through several alternate pathways. P. falciparum expresses 2700 genes during the blood-stages, of which the identity and function of many remains unknown. Here, we have identified and characterized a novel P. falciparum rhoptry associated adhesin (PfRA) that mediates erythrocyte invasion through the sialic-acid dependent pathway. PfRA appears to play a significant functional role as it is conserved across different Plasmodium species. It is localized in the rhoptries and further translocated to the merozoite surface. Both native and recombinant PfRA specifically bound erythrocytes in a sialic-acid dependent, chymotrypsin and trypsin resistant manner, which was abrogated by PfRA antibodies confirming a role in erythrocyte invasion. PfRA antibodies inhibited erythrocyte invasion and in combination with antibodies against other parasite ligands produced an additive inhibitory effect, thus validating its important role in erythrocyte invasion. We have thus identified a novel P. falciparum adhesin that binds with a sialic acid containing erythrocyte receptor. Our observations substantiate the strategy to block P. falciparum erythrocyte invasion by simultaneously targeting multiple conserved merozoite antigens involved in alternate invasion pathways

L-Arginine attenuates oxidative stress condition during cardiomyopathy

99-104Increased production of oxygen free radicals and decreased oxidant capacity occur in coronary artery diseases (CAD). This pro-oxidant shift in intracellular redox state may induce cell death by either direct cell membrane damage by lipid peroxidation or apoptosis through activation of transcription factors. These changes occur not only in cardiomyocytes, but also in cardiac sympathetic nerves, which are very sensitive to oxidative damage. Patients with heart failure encounter reduced peripheral blood flow at rest, during exercise and in response to endothelium-dependent vasodilators. Current treatments of cardiomyopathy, a degenerative condition of the myocardium frequently associated with heart failure have done little to enhance patient survival. Decreased myocardial contractility and altered regulation of peripheral circulation along with oxidative conditions are important contributors to the symptoms and prognosis of the disease process. Nitric oxide formed from L-arginine (2-amino-5 guanidinovaleric acid) metabolism in endothelial cells contributes to regulation of blood flow under these conditions. L-Arginine is the precursor of nitric oxide, an endogenous messenger molecule involved in a variety of endothelium-mediated physiological effects in the vascular system. In the present study, we investigated the effect of oral administration of L-arginine (3 g/day) on the intracellular redox status of the patients of ischemic cardiomyopathy aged 45-60 yrs. The enzymatic and non-enzymatic antioxidant parameters like superoxide dismutase, catalase, total thiols (TSH) and ascorbic acid along with pro-oxidant parameters, such as xanthine oxidase, as well as index of oxidative stress as protein carbonyl content and malondialdehyde (a marker of lipid peroxidation) were investigated in the plasma and RBC lysate. L-Arginine (3 g/day) administration was found to improve the levels of these parameters in the patients and regulate the blood flow, as evident by the improved blood pressure of the patients. Thus, it is inferred that L-arginine attenuates the oxidative stress conditions along with maintaining the blood pressure rate of patients suffering from cardiomyopathy. </span