Role of vitamin D supplementation as adjunctive therapy to escitalopram in patients of major depressive disorder: a 8 week prospective, randomized, interventional, clinical study

Background: Depression is a major public health problem and occurs in persons of all ages, and is associated with increased morbidity, soaring costs for treatment and reduced productivity and quality of life. Vitamin D is involved in numerous brain processes including neuroimmunomodulation, neuroprotection, neuroplasticity, regulation of neurotrophic factors, and making it biologically plausible to be associated with depression. Aim of the present study is to compare the therapeutic effects of vitamin D given along with escitalopram versus escitalopram given alone in patients with major depressive disorder.  Methods: In this prospective, randomized, interventional clinical study, 60 patients with a diagnosis of major depressive disorder based on ICD-10 criteria were randomly assigned into two groups, one group received 60000IU vitamin D3 weekly plus 10 mg escitalopram OD daily while the other group received escitalopram10 mg OD daily alone for 8 weeks. Depression severity was assessed at 2-week intervals using the 24-item Hamilton Depression Rating Scale (HDRS). Serum 25(OH) vitamin D levels were measured in all the patients at baseline and after intervention.Result: Fifty nine patients completed the trial. Depression severity based on HDRS decreased significantly after intervention, with a significant difference between the two groups. The vitamin D3+escitalopram combination was significantly better than escitalopram alone from the fourth week of treatment. Conclusion: Role of vitamin D in mood disorder and its dietary supplementation is effective as an adjuvant treatment along with SSRIs in depressive disorders, especially in vitamin D deficient patients

Comparative evaluation of itopride and domperidone in gastroesophageal reflux disease

Background: Gastroesophageal reflux disease (GERD) presents in various ways in terms of symptoms and severity. This study was conducted to assess the severity of GERD patients and to evaluate the effect of itopride and domperidone on symptoms and severity of GERD.Methods: A single-blind study was carried out in 70 patients. Group A (n=35) patients were kept on itopride therapy, 50 mg thrice a day before meal. Group B (n=35) patients were kept on domperidone therapy, 10 mg thrice a day before meal. Patients of both groups were given rabeprazole, 20 mg once a day for hyperacidity. Patients served their own control. Each patient was followed-up at 2 weeks interval up to 8 weeks.Results: The most common symptom was heartburn, present in 95.71% patients. Regurgitation was the next most common symptom (65.71%). The most common lesion seen endoscopically (according to Savary Miller classification) was grade I (38.57%). In 24.29% patient, only symptoms of GERD were present without any endoscopically visible mucosal injury. At the end of 2, 4, 6, and 8 weeks, relief of symptoms was more with a combination of itopride and rabeprazole in comparison to the combination of domperidane and rabeprazole, but the difference was statistically insignificant. Healing rate at the end of 4th and 8th week was slight better with a combination of itopride and rabeprazole, but the difference again was statistically insignificant.Conclusion: Combination of itopride and rabeprazole showed insignificantly better results, both symptomatically and endoscopically in comparison to the combination of domperidone and rabeprazole

Trends in the Epidemiology of Hepatitis B Virus and Hepatitis C Virus Infections at a Tertiary Care Hospital in East Delhi: A 7-Year Retrospective Analysis

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are major global health problems. In 2009, the national Integrated Disease Surveillance Programme (IDSP) began conducting surveillance across all Indian states for epidemic-prone diseases including viral hepatitis. Hence this retrospective study was conducted to identify trend changes in HBV and HCV epidemiology over a period of 7 years at a tertiary care hospital in Delhi. Enzyme-linked immunoassay result entries for Hepatitis B surface antigen (HBsAg) and Hepatitis C antigen and/or anti-HCV antibody were analyzed. The 7-year seroprevalence of HBV and HCV was found to be 3.084% and 5.381% respectively. The seroprevalence of HBsAg was maximum in 2010. Since then the seroprevalence has shown a small decrease. Government of India has included HBV vaccine in the National Universal Immunization Program in the entire country in 2011-12. We consider the reduction in HBsAg seroprevalence to represent a true fall in HBV transmission due to vaccination and/or public consciousness. In the present study, HCV infection appeared to be more common than HBV infection. During last few years, seroprevalence of HCV also increased, which is possibly attributable to an increase in the population of Delhi and a heavy load of the migrant population. These figures may be important for estimation of the disease burden in this region. The study provides a fine reference for future studies, because of the large number of cases investigated over a long period of 7 years and draws attention to the lacunae in ongoing immunization programs

Platelets and Inflammation: Relations between Platelet Counts and Markers of Inflammation

Platelets, or thrombocytes are small non-nucleated cells that are primarily responsible for the formation of the platelet plug, and consequently in primary hemostasis. However, their role is not limited only to a response to cell injury, but they also respond to systemic inflammation. Due to factors such as a shared lineage with other cells of the blood, recent studies showing the molecular expression of immune modulators on platelets, and the release of inflammatory molecules leading to chemoattraction by responder molecules. These implications may also go deeper into the pathogenesis of cancers in the human body, and quantification of that relation, platelets with inflammation, is the aim of the stud

Problem-based learning versus lecture-based learning in pharmacology in a junior doctor teaching program: a crossover study from northern India

Background: The undergraduate MBBS training in our country is still in the traditional mode. The main part of the curriculum consists of lecture, tutorial, practical and ward teaching classes with a limited number of problem based session. The objective of the study was undertaken to compare PBL with LBL in terms of students’ knowledge retention in the subject of Pharmacology in undergraduate medical training.Methods: The current survey was planned and executed by the Department of Pharmacology in collaboration with Medical Education Unit, MSDS Medical College, Fatehgarh in the batch currently posted in the Department of Pharmacology for practical classes. Fifty MBBS students posted were enrolled for the study and were divided in 2 groups. One of the topics was presented as LBL for the first group and as PBL for the second group. The other topic was presented as PBL for the first group and as LBL for the second group. Intervention and control groups were taken as those used PBL and LBL respectively. T test was used to compare mean scores obtained by students in the intervention and control groups.Results: Mean scores obtained by students in the intervention group (topics learnt with PBL) were higher (3.80 Vs 2.84) than mean scores obtained by students in the control group (topics learnt with LBL). Mean scores obtained by students in the intervention group were higher (3.72 Vs 2.96) than mean scores obtained by students in the control group.Conclusions: The current study indicates usefulness of Problem-based learning (PBL) over Lecture-based Learning (LBL) in terms of retention of knowledge. However further studies involving more number of students are warranted in order to generate stronger evidence on this tool for improving medical education in our setup.

QUALITY FACTOR OF SEISMIC CODA WAVES IN GARHWAL HIMALAYAS

ABSTRACT Seismic wave propagating through the earth experiences some reduction in the energy content. This decay in the wave energy is known as the seismic wave attenuation. The study of attenuation characteristics of these waves shed light on the heterogeneous nature of the Earth. Usually, seismic wave attenuation for local earthquakes is determined from the analysis of coda waves. Digital seismogram data of 75 earthquakes that occurred in Garhwal Himalaya region during 2004 to 2006 and recorded at different stations have been analyzed to study the seismic coda wave attenuation characteristic in this region. In the present study, 90 seismic observations from local earthquake events with hypocentral distance less than 250 km and magnitude range between 1.0 and 5.0 is used to study coda Q , i.e. c Q , using the single isotropic scattering model. C Q Values are estimated at 10 central frequencies 1.5, 3, 5, 7, 9, 12, 16, 20, 24 and 28 Hz using a starting lapse-time LT=50 s and four coda window-lengths , WL= 10, 20, 30, 40 s . In the considered frequency range, C Q fit the frequency dependent power-law or low attenuation at higher frequency may indicate that the heterogeneity decreases with increasing depth, in the study region

Metabolic effects of oral vitamin D supplementation as an adjuvant therapy on subjects with type 2 diabetes

Background: It is common for patients with type 2 diabetes mellitus (T2DM) to have vitamin D deficiency. Aim of the study is to determine the metabolic effects of oral vitamin D supplementation in a cohort of T2DM subjects.Methods: Subjects with T2DM were divided into two groups. Group A (Control) included subjects who received the standard treatment (conventional antidiabetic drugs). Group B (Intervention), apart from the standard treatment (conventional antidiabetic drugs), was also supplemented with Vitamin D3. All the patients were followed up at baseline, 6 months, 12 months and 18 months.Results: Vitamin D deficiency was noted down in all the study subjects. Even after 18 months of supplementation, all subjects remained vitamin D deficient. There was a significant improvement in the circulating levels of 25-hydroxyvitamin D. Improvement in the lipid profile of subjects was observed as evidenced by a decrease in total cholesterol (5.0±0.92 mmol/l) as compared to baseline (5.5±1.6 mmol/l). HOMA-IR changed significantly after 18 months of supplementation from baseline (7.0±1.06 vs 10.8±1.96 nmol/l).Conclusions: Supplementation to achieve higher levels of vitamin D remains a promising adjuvant therapy for T2DM patients. Additionally, the intervention brought out a favourable change in HDL/LDL ratio among study subjects

A Comparative Study of Endoscopic Biopsy and Endoscopic FNAC in Gastrointestinal Malignancies

Objectives: Gross description of gastro-intestinal malignancy is facilitated by endoscopy of the upper and lower gastro-intestinal tract and also provides tissue for definitive diagnosis. Currently, direct vision endoscopic forceps biopsy & FNAC are two standard techniques used to establish a preoperative diagnosis in gastro-intestinal malignancies. The objective of our study is to evaluate the diagnostic accuracy of endoscopic findings when combined with fine needle aspiration and endoscopic biopsy in the diagnosis of gastrointestinal malignancies. So, we compare both techniques (endoscopic forceps biopsy & endoscopic FNAC) to each other and how accurately both techniques are diagnosing the lesion in combination with each other. Material and Method: In our study, 40 cases of suspected gastro-intestinal malignancies underwent endoscopic biopsy & FNAC in a period of one and half years. Result: Out of 40 cases, total malignant lesions were accounting for 32 cases. 27 cases were diagnosed as malignant by biopsy. FNAC showed positive results in 28 cases. The FNAC was found to be 81.82% Sensitive and 85.71% Specific & an accuracy of 82.5%. Biopsy had Sensitivity 81.82% Specificity 100% & Accuracy 85%. The Combined accuracy of both endoscopic FNAC and biopsy was 93.93%. Conclusion: The advent of endoscopic biopsy & FNAC have facilitated the detection & diagnosis of gastrointestinal malignancies. Biopsy though is considered to be diagnostic, Fine Needle Aspiration along with Biopsy can help in the detection of additional cases of malignancy. Thus, both procedures applied together can detect more malignant cases & can establish a more definitive diagnosis. Keywords: Endoscopy, FNAC, Biopsy, Gastrointestinal Malignancie

Needle Stick Injury among Health Care Workers and Its Aftermath in a Tertiary Care Hospital in East Delhi, India

Needle stick injuries (NSI) present serious occupational threat to healthcare workers (HCW).Due to lack of epidemiological data on NSI in this geographical region, the present study was conducted to estimate incidence rate of NSI, identify factors associated, assess awareness of HCWs and evaluate post-injury sero-reactivity rates. This cross-sectional observational study involved 524 HCWs (151 medical and 373 paramedical staff). A validated questionnaire was filled by investigator using interviewing technique. Blood sample was collected from study subjects who reported NSI within last 28 days, at the time of NSI and subsequently after 1, 3 and 6 months. Screening for HBsAg, anti-HCV and anti-HIV 1/2 antibodies was done using commercially available Enzyme-Linked Immunosorbent Assay Kit. Sixty-three HCWs, comprising mainly of medical staff, gave history of NSI in preceding 28 days. The most frequent procedure leading to NSI included recapping needles and suturing in 28.57%, while commonest root cause was haste in 61.91%. Majority (61.91%, 39/63) suffered from NSI during latter part of their duty hours. None became HBsAg, anti-HCV or HIV seropositive. The proportion of NSI among HCWs who had received training on prevention and management of NSI was significantly lower than those who were untrained. Hence training programs emphasizing on safe techniques must be conducted regularly and HCWs putting in long working hours must be allowed to take breaks. Needle stick injury among health care workers and its aftermath in a tertiary care hospital in East Delhi, India

Watch the Moon, Learn the Moon: Lunar Geology Research at School Level with Telescope and Open Source Data

Science-AI Symbiotic Group at Seven Square Academy, Naigaon was formed in 2023 with the purpose of bringing school students to the forefronts of science research by involving them in hands on research. In October 2023 a new project was started with the goal of studying the lunar surface by real-time observations and open source data. Twelve students/members from grades 8, 9, 10 participated in this research attempt wherein each student filled an observation metric by observing the Moon on various days with a Bresser Messier 150mm/1200mm reflector Newtonian telescope. After the observations were done, the members were assigned various zones on the lunar near side for analysis of geological features. Then a data analysis metric was filled by each of students with the help of Lunar Reconnaissance Orbiter Camera's/ LROC's quickmap open access data hosted by Arizona State University. In this short paper a brief overview of this project is given. One example each of observation metric and data analysis metric is presented. This kind of project has high impact for school science education with minimal costs. This project can also serve as an interesting science outreach program for organisations looking forward to popularise planetary sciences research at school level.Comment: 14 pages, 7 figure