Vascular action of glycine in hypertensive rat models

Glycine, a lipophilic non-essential amino acid biosynthesized from L-serine, L-alanine and L-threonine, plays a role in the biosynthesis of proteins, nucleotides, and glutathione. It is a neurotransmitter in the central nervous system and acts as a co-agonist at the N-methyl-D aspartate (NMDA) receptor. Oral administration of glycine is helpful in the management of schizophrenia. While long-term oral treatment with glycine is considered to exert a cardio-vascular protective role by overcoming endothelial dysfunction and oxidative stress, there are no systematic studies examining the cardiovascular effects of glycine. Recently, we showed that the precursor/metabolite of glycine, L-serine, evoked endothelium-dependent vasodilatation in rat mesenteric arterioles. Acute intravenous administration of L-serine produced a rapid, dose-dependent fall in blood pressure (BP) in both normotensive and hypertensive rats. These responses were abolished in the combined presence of the Ca2+ activated small and intermediate conductance K+ channel inhibitors, apamin and Tram-34/charybdotoxin. In contrast, intravenous administration of glycine evoked a fall in BP in normotensive Wistar-Kyoto (WKY) rats and an elevation of BP in spontaneously hypertensive rats (SHR), and in WKY rats subjected to chronic nitric oxide (NO) synthase (NOS) inhibition by oral treatment with NOS inhibitor, L-NAME (NG-nitro-L-arginine-methylester). Therefore, in vivo and in vitro studies were designed to address the mechanisms that contribute to the opposite effects of glycine in normotensive vs. hypertensive rats. Experiments were performed using 14 weeks old male WKY, chronic L-NAME treated WKY and SHR strains. In vivo studies involved examination of changes in systemic hemodynamic parameters such as mean arterial pressure (MAP), heart rate (HR), total peripheral resistance (TPR) and cardiac output (CO) as well as regional hemodynamic parameters of changes in blood flow and vascular resistance in major organs/tissues following acute intravenous administration of glycine using fluorescent microsphere distribution technique. Parallel complementary in vitro studies were conducted to examine the effects of glycine on changes in basal tone and phenylephrine (PE) constricted tone in aortic rings with endothelium-intact and endothelium-denuded states after isolation from WKY and SHR strains. All these studies were conducted in the presence and absence of two NMDA antagonists, MK-801 and memantine. In normotensive WKY rats, glycine (1 mmol/L) administration decreased MAP (

A rare case of Mullerian agenesis with descent of gonads

Presence of ovary in inguinal hernia is a rare condition. The diagnosis is made either radiologically or laparoscopically. We report a case of primary amenorrhoea with ovarian inguinal hernia. Psychological support should be provided as a part of management.

Xanthogranulomatous oophoritis: a rare chronic inflammatory non-neoplastic ovarian pseudotumor

Xanthogranulomatous inflammation is a form of chronic inflammation which is destructive to the affected organ and is characterized by clustering of foamy macrophages among other inflammatory cells. It is mostly localized to the kidney, renal pelvis and uncommonly found in organs like ovary and fallopian tube. Very few cases of xanthogranulomatous oophoritis have been reported till date. Along with its rarity, this pseudotumor may be confused with ovarian neoplasm and tuberculosis. Here we report a 45 year old female who presented clinically and radiologically with suspicion of malignancy. The histopathological analysis revealed it as xanthogranulomaotus oophoritis

A comparative study of ovulation induction with clomiphene versus clomiphene and bromocriptine in follicular phase of normoprolactinemic PCOS women

Background: Hypothalamic pituitary axis dysfunction accounts for majority of ovulatory disorders and a predominant cause of women with PCOS. There is a dopaminergic control on gonadotropin secretion. In normoprolactinemic PCOS patients transient rise in serum prolactin can be observed during the late follicular phase and luteal phase. So, the aim of the study is to know the effect of bromocriptine and clomiphene in ovulation induction as compared to clomiphene alone.Methods: Based on the various inclusion and exclusion criteria, seventy patients were randomly assigned into two groups. The patients in the first group were treated with tablet of clomiphene citrate (100 mg) from day 3 to day 7 of each cycle. The patients in the other group received 100mg of clomiphene citrate from day 3 to day 7 of each cycle and tablet bromocriptine (2.5 mg) from day5 to day14. Both groups were followed up with follicular study for three months. At the end of the three cycles the hormonal statuses of the patients were determined.Results: There was no significant difference found in other hormones like serum FSH, LH and estradiol in both groups. The follicular diameter and the average endometrial thickness was increased to a significant level in the CC+Bcrt group as compared to the CC group. The rate of ovulation and pregnancy rate was higher in combination group.Conclusions: Bromocriptine with clomiphene in follicular phase has an advantage of improving follicular diameter, endometrial thickness and hence ovulation and pregnancy rates.

Knowledge, attitude towards human papillomavirus and HPV vaccine among medical students of a tertiary care teaching hospital in India

Background: The objective of the study was to assess the awareness of the human papillomavirus (HPV) infections and vaccination among the young students of a tertiary care teaching hospital.Methods: A cross sectional study was done among the students of a tertiary care teaching hospital. The students were assured of the confidentiality and were provided a questionnaire about HPV infection and HPV vaccine.Results: About 94.3% of students implicated that HPV is a causative agent of cervical cancer and 5.7% students didn’t know about the association. About 72.1% were aware of the availability of the vaccine to be immunized against HPV infection but 3.3% answered wrongly and 24.6% didn’t know about it. Thirty one percent students knew the correct age of initiation of the vaccination, 23% answered wrongly and about 45.9% of the students didn’t know the answer. Only 4.1 % of the students have been vaccinated with HPV vaccine. About 63.9% students didn’t agree to vaccinate themselves against HPV as they felt it would give a false sense of security and 68.8% of the students were against the routine vaccination of the young Indian population against HPV as the sexual exposure occurs at late age. 73% students referred the age of vaccination to be >25 years.Conclusions: Lack of knowledge among medical students can be detrimental to the health of the society. So there is a need to create awareness among the future health educators against various aspects of HPV, cervical cancers and its prevention

Prescribing pattern of antimicrobial agents in pediatrics department of a teaching hospital

Background: Antibiotics are commonly used in pediatric illness and irrational use of antibiotics can lead to bacterial resistance. Appropriate studies should be done to frame proper guidelines for the use of antibiotics in pediatric population. The objective of the study was to determine the prescribing pattern of antibiotics and to analyze the rational use of antibiotics in pediatric department.Methods: An observational prospective study was carried out for a period of 3 months in the Department of Pediatrics. The data were recorded in the specific format, and the result was analyzed by descriptive statistics.Results: In this study, 347 prescriptions containing antibiotics were analyzed, out of which 54.6% were of male child and 45.4% were of female child. About 40.6% of the patients were in the age group of 1-5 years. A single antibiotic was prescribed in 78% of patients. Respiratory tract infections were the most common disease (68.2%), followed by skin infections (12.3%), gastrointestinal diseases (9.5%), and fever without focus (6.5%). Cephalosporins were the most commonly prescribed antibiotic group (35%).Conclusion: Irrational use of antibiotics can lead to bacterial resistance and can worsen the existing disease conditions. So, antibiotics should be prescribed according to the WHO guidelines or other rational strategy, especially in the pediatric age group

Screening of Group B Streptococcal and Candida Infections in Antenatal Women Visiting a Tertiary Care Hospital and the Neonatal Outcome

Reproductive tract infections in antenatal women are frequently occurring public health concern affecting the quality of life in the infected women and further affects the neonatal outcome negatively. Vaginal infections are predominantly caused due to the disturbance in the normal vaginal microflora. Group B Streptococcus (GBS) is a major peritoneal pathogen leading to morbidity and mortality in both mother and neonates leading to complications like preterm labour, chorioamnionitis and Preterm rupture of membrane (PROM). Further, Vulvovaginal candidiasis (VVC) is a frequently encountered gynaecological disease causing morbidity in 3/4th of women at least once in their life span. It leads to infertility in non-pregnant women. It results in adverse pregnancy outcomes such as chorioamnionitis and congenital abnormalities in the neonates. The aim of this study is to screen for potential bacterial and yeast infections with focus on GBS and Candida infections and its neonatal outcome. Candida species and GBS were identified by routine culture-based tests. HiChrome agar was used for speciation of Candida species. CAMP test was performed for GBS; further identification was done using Streptococcal grouping kit. GBS was found in 15% of the antenatal women and Candida Species was found to be most common with an infection rate of 50%. Lower segment Cesarean section (LSCS) rate in GBS positive women was 60% and in Candida Non albicans positive women was found to be 65.38%. 33% of the neonates born to GBS positive mothers had respiratory distress. Infection in antenatal women negatively influenced the mode of delivery and the mean body weight of the neonates born to infected mothers were comparatively less

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe