Urinary tract infections at first antenatal check-up: a single centre prospective study

Background: Pregnant women with asymptomatic bacteriuria (ASB) are more likely to develop acute pyelonephritis, postpartum UTI, hypertensive disease, anemia, prematurity, low birth weight babies and prenatal death if untreated.Methods: Total 780 pregnant women attending for first antenatal check-up in a medical college were enrolled for the study. Those with any symptoms of UTI, like burning micturition, frequency, urgency, dysuria or fever were excluded from the study. All were subjected to undergo urine culture and sensitivity to the commonly used antibiotics in that area, irrespective of period of gestation, age and parity. Prevalence of ASB, most common infecting organism and antibiotic sensitivity pattern were analyzed.Results: The prevalence of ASB in 25 years age group (26.06% versus 18.80%; p = 0.020). Out of the 780 culture samples, 52 had more than 3 type colonies indicating contamination and 22 had budding yeast colonies, thus excluded from the study. No growth was found in 551 samples (78.05%). The prevalence of ASB was 21.95%. The most common organism isolated was ESBL-ve E coli (32.25%), followed by ESBL +ve E coli (21.29%) and Enterococcus (15.48%) respectively. E coli were mostly sensitive to nitrofurantoin, amikacin and cotrimoxazole whereas enteroccocus was sensitive to vancomycin.Conclusions: ASB is more common during pregnancy even in first antenatal check-up. We suggest routine urine culture and sensitivity during first antenatal check-up to detect ASB and treat with proper antibiotic to prevent the complications and development of resistance

Vitamin D receptor gene polymorphisms and prognosis of breast cancer among African-American and Hispanic women.

BackgroundVitamin D plays a role in cancer development and acts through the vitamin D receptor (VDR). Although African-Americans have the lowest levels of serum vitamin D, there is a dearth of information on VDR gene polymorphisms and breast cancer among African-Americans and Hispanics. This study examines whether VDR gene polymorphisms are associated with breast cancer in these cohorts.MethodsBlood was collected from 232 breast cancer patients (Cases) and 349 non-cancer subjects (Controls). Genotyping for four polymorphic variants of VDR (FokI, BsmI, TaqI and ApaI) was performed using the PCR-RFLP method.ResultsAn increased association of the VDR-Fok1 f allele with breast cancer was observed in African-Americans (OR = 1.9, p = 0.07). Furthermore, the FbTA, FbtA and fbtA haplotypes were associated with breast cancer among African-Americans (p<0.05). Latinas were more likely to have the VDR-ApaI alleles (Aa or aa) (p = 0.008). The VDR-ApaI aa genotype was significantly associated with poorly-differentiated breast tumors (p = 0.04) in combined Cases. Kaplan-Meier survival analysis showed decreased 5-year disease-free-survival (DFS) in breast cancer patients who had the VDR-Fok1 FF genotype (p<0.05). The Cox regression with multivariate analysis revealed the independent predictor value of the VDR-FokI polymorphism for DFS. The other three variants of VDR (BsmI, TaqI and ApaI) were not associated with disease outcome.ConclusionsVDR haplotypes are associated with breast cancer in African-Americans, but not in Hispanic/Latinas. The VDR-FokI FF genotype is linked with poor prognosis in African-American women with breast cancer

Rise in Mid-Tropospheric Temperature Trend (MSU/AMSU 1978–2022) over the Tibet and Eastern Himalayas

The high-altitude Hindu Kush-Himalayan region (HKH, average ~5 km from msl) and the adjacent Indo-Gangetic plains (IG plains, ~0–250 m msl), due to their geographical location and complex topography, are reported to be highly sensitive to climatic changes. Recent studies show that the impacts of climate change and associated changes in water resources (glacial/snow melt water and rainfall) in this region are multifaceted, thereby affecting ecosystems, agriculture, industries, and inhabitants. In this study, 45 years of Microwave Sounding Unit/Advanced Microwave Sounding Unit (MSU/AMSU)-derived mid-tropospheric temperature (TMT, 3–7 km altitude) and lower tropospheric temperature (TLT, 0–3 km altitude) data from the Remote Sensing Systems (RSS Version 4.0) were utilized to analyze the overall changes in tropospheric temperature in terms of annual/monthly trends and anomalies. The current study shows that the mid-tropospheric temperature (0–3 km altitude over the HKH region) has already alarmingly increased (statistically significant) in Tibet, the western Himalayas, and the eastern Himalayas by 1.49 °K, 1.30 °K, and 1.35 °K, respectively, over the last 45 years (1978–2022). As compared to a previous report (TMT trend for 30 years, 1979–2008), the present study of TMT trends for 45 years (1978–2022) exhibits a rise in percent change in the trend component in the high-altitude regions of Tibet, the western Himalayas, and the eastern Himalayas by approximately 310%, 80%, and 170%, respectively. In contrast, the same for adjacent plains (the western and eastern IG plains) shows a negligible or much lower percent change (0% and 40%, respectively) over the last 14 years. Similarly, dust source regions in Africa, Arabia, the Middle East, Iran, and Pakistan show only a 130% change in warming trends over the past 14 years. In the monthly breakup, the ‘November to March’ period usually shows a higher TMT trend (with peaks in December, February, and March) compared to the rest of the months, except in the western Himalayas, where the peak is observed in May, which can be attributed to the peak dust storm activity (March to May). Snow cover over the HKH region, where the growing season is known to be from September to February, is also reported to show the highest snow cover in February (with the peak in January, February, or March), which coincides with the warmest period in terms of anomaly and trend observed in the long-term mid-tropospheric temperature data (1978–2022). Thus, the current study highlights that the statistically significant and positive TMT warming trend (95% CI) and its observed acceleration over the high-altitude region (since 2008) can be attributed to being one of the major factors causing an acceleration in the rate of melting of snow cover and glaciers, particularly in Tibet and the Eastern Himalayas

Vitamin D receptor gene polymorphisms and prognosis of breast cancer among African-American and Hispanic women.

Vitamin D plays a role in cancer development and acts through the vitamin D receptor (VDR). Although African-Americans have the lowest levels of serum vitamin D, there is a dearth of information on VDR gene polymorphisms and breast cancer among African-Americans and Hispanics. This study examines whether VDR gene polymorphisms are associated with breast cancer in these cohorts.Blood was collected from 232 breast cancer patients (Cases) and 349 non-cancer subjects (Controls). Genotyping for four polymorphic variants of VDR (FokI, BsmI, TaqI and ApaI) was performed using the PCR-RFLP method.An increased association of the VDR-Fok1 f allele with breast cancer was observed in African-Americans (OR = 1.9, p = 0.07). Furthermore, the FbTA, FbtA and fbtA haplotypes were associated with breast cancer among African-Americans (p<0.05). Latinas were more likely to have the VDR-ApaI alleles (Aa or aa) (p = 0.008). The VDR-ApaI aa genotype was significantly associated with poorly-differentiated breast tumors (p = 0.04) in combined Cases. Kaplan-Meier survival analysis showed decreased 5-year disease-free-survival (DFS) in breast cancer patients who had the VDR-Fok1 FF genotype (p<0.05). The Cox regression with multivariate analysis revealed the independent predictor value of the VDR-FokI polymorphism for DFS. The other three variants of VDR (BsmI, TaqI and ApaI) were not associated with disease outcome.VDR haplotypes are associated with breast cancer in African-Americans, but not in Hispanic/Latinas. The VDR-FokI FF genotype is linked with poor prognosis in African-American women with breast cancer

Linkage disequilibrium (LD) between VDR polymorphisms in African-American and Hispanic/Latina women.

<p>Note: All samples were in Hardy-Weinberg Equilibrium (HWE) among the groups. LD was calculated between markers among African-Americans or Hispanics/Latinas. D′ is the prime between the loci; LOD is the log of likelihood odds ratio, a measure of confidence in the D'value; r² is the correlation coefficient between the two loci.</p

VDR haplotypes, Breast Cancer, and Ethnicity.

∧<p>Cases vs. Controls, Significance is P<0.05;</p>*<p>African-American vs. Hispanic/Latina ethnicity, Significance is P<0.05.</p

Five-year disease free survival (DFS) of breast cancer patients in relation to VDR gene polymorphisms.

<p>Kaplan-Meier survival curves were used to compare the 5-year DFS between the VDR gene polymorphisms in (a) VDR-FokI, (b) VDR-BsmI, (c) VDR-ApaI, and (d) VDR-TaqI. The differences between the curves were estimated by log-rank test, where P<0.05 was considered statistically significant.</p

Distribution of VDR-FokI, VDR-BsmI, VDR-TaqI and VDR-ApaI genotypes in African-American and Hispanic/Latina Cases and Controls.

<p>Note: For analysis of alleles F and f, B and b, T and t, A and a, each subject was used twice. <b>F</b>- wild type FokI, <b>f</b>- polymorphic FokI; <b>B</b>- wild type BsmI, <b>b</b>-polymorphic BsmI; <b>T</b>- wild type TaqI, <b>t</b>- polymorphic TaqI; <b>A</b>- wild type ApaI, <b>a</b>- polymorphic ApaI.</p>*<p>P-value is significant if P<0.05;</p>†<p>Analysis adjusted for age, BMI and ethnicity;</p>††<p>Analysis adjusted for age and BMI.</p

Summary of Studies on Breast Cancer and VDR polymorphisms.

<p>AA: African-American.</p>*<p>for postmenopausal women.</p>∧<p>for early-onset breast cancer (age<50).</p>#<p>OR adjusted for age at diagnosis, number of live births, age at menarche and menopause.</p>a<p>associated with low risk of breast cancer.</p