Time to think beyond sickle cell screening and haemoglobin electrophoresis: a case report and review of literature of sickle cell D-Punjab falsely labelled as sickle cell SS from central India

Sickle cell haemoglobin D disease (D-Punjab) is a rare variant of sickle cell disease (SCD) reported from central India. Exact incidence of pulmonary thrombosis in patients with HbSD is unknown. Pulmonary thrombosis is known complication of SCD but rare in case of HbSD pattern. We reported a case of 34-year-old male patient with HbSD (D-Punjab) with acute chest syndrome (ACS). CT pulmonary angiogram revealed near complete thrombosis of right middle lobe segmental and subsegmental branches with pulmonary infarct. Our patient responded to anticoagulant therapy. This case report is a reminder that HPLC should be done in all patients with sickle cell disease along with solubility test and hemoglobin electrophoresis to detect exact incidence of hemoglobin D disease in central India

Ultra Flexible Nanocarrier for Enhanced the Ocular Delivery of Quercetin in Management of Macular Edema

Quercetin (Que) and its derivatives are naturally taking place phytochemicals with promising bioactive belongings. The antidiabetic, anti-inflammatory, antioxidant, antimicrobial, anti-Alzheimer’s, antiarthritic, cardiovascular, and wound-healing possessions of Que have been extensively investigated, as well as its anticancer commotion against different cancer cell lines has been newly reported. Que and its derivatives are found predominantly in the Western starve yourself, and people might benefit from their defensive effect just by taking them via diets or as a food enhancement. Bioavailability-related drug-delivery systems of Que have also been markedly exploited, and Que nanoparticles become visible as a promising proposal to enhance their bioavailability. The present review aims to make available a brief overview of the therapeutic things, new insights, and forthcoming perspectives of Que. Plants and plant parts are used for its aroma, flavor, or therapeutic properties. There are a number of recompense associated with using plants and plant phytoconstituents as contrasting to pharmaceutical merchandise

Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence

Type 1 diabetes mellitus (T1DM) is an autoimmune ?-cell destruction, usually leading to absolute insulin deficiency, insulin resistance, or by a combination of both. Both the incidence and prevalence of diabetes T1DM is suspected to be high in India, but in the absence of nation-wide registry, the possibility of exact numbers is unsure. Till date, studies done among the population have seen prevalence more than the incidence of the disease, which has led to late screening and diagnosis of the disease within the community settings. India is already suffering from the burden of type 2 DM, in the process of screening those, patients with T1DM are somewhat getting ignored. Furthermore, cost associated with the treatment expenditure and social status of the people suffering from the disease too have a role to consider which has been totally side-lined in national programmes like National Program for Control of Diabetes, Cardiovascular disease, and Stroke (NPCDCS). There is also scarcity of data on the incidence of T1DM which could aid in formulating better policy avenues for the patients suffering from the disease.  Reports on trends in T1DM are more commonly available from countries with better established public health surveillance systems and diabetes research infrastructure. From India, due to scarcity of data on T1DM, we had to rely on published literature of some major centers across the country. Results from the Indian Council of Medical Research (ICMR) first phase, till July 2011 which included 5546 patients found T1DM among 63.9% cases and predominately among children; at registration 11.1% had already developed chronic complication of T1DM. As India is already suffering from the burden of type 2 DM, during current management and treatment, the problem lies at various levels which needs to be addressed. We propose a setting based, life course approach for T1DM where every age group will have access to the health care system either directly or indirectly from intra-natal life till elderly age group through health approach based on scientific methods delivered through health system. In this regard a central registry having enumeration and provisioning of mandatory Insulin to all through a national policy being implemented by NPCDCS is what policy makers must take up at urgent bases if we want to bend the curve of rising T1DM and prevalence of overall diabetes in India

Legal Framework for Implementation of Trans-fat Regulations in India

Background: The widespread consumption of trans-fats across the world represents a worrying scenario, as it is directly responsible for coronary heart disease and related mortality. Recognizing its dangers, the WHO has set an agenda to eliminate trans-fats by 2023. In India, the Food Safety And Standards Authority ensures safe and wholesome food consumption. In light of the WHO’s standards for the elimination of trans-fats, the FSSAI recently notified limits of trans-fatty acids to not more than 3% in all fats and oils by January 2021 and 2% by January 2022, as well as a limitation on all food products in which edible oils and fats are ingredients to not contain trans-fatty acids of more than 2% mass of total oils/fats in the product by January 2022. Objective: Given the need to eliminate the consumption of trans-fats, it is necessary to assess the implementation of trans-fat regulations in India in order to determine the current status of enforcement and suggest measures for improvement. Methods: Empirical research was conducted through a questionnaire to analyze India’s current status and difficulties in enforcing trans-fat regulations. Results: Although all states have included compliance of trans-fat regulation in the agenda of the State Surveillance Plan but are facing some implementation challenges such as lack of lab infrastructure, lack of trained manpower, unsupportive FBOs, insufficient budget, lack of testing kits, and excluding proprietary food from compliance with trans-fat regulations. Further, all states have felt the need to develop a guideline/manual to facilitate enforcement of the trans-fat regulations. In light of this, the article has critically analyzed the Legal framework for implementing Trans-fat Regulations in India to identify specific implementation challenges due to scattered regulations and recommend suggestive measures for developing the guidelines/manual to facilitate effective implementation of the said regulation

Breast tumor representation & noise removal using Fuzzy c-mean algorithm and DWT

ABSTRACT -Breast cancer is one of the major causes of death among women. Small clusters of micro calcifications appearing as collection of white spots on mammograms show an early warning of breast cancer. Primary prevention seems impossible since the causes of this disease is still remain unknown. An improvement of early diagnostic techniques is critical for women's quality of life. Mammography is the main test used for screening and early diagnosis. Contrast-enhanced magnetic resonance of the breast is the most attractive alternative to standard mammography. This paper is presents a breast tumor representation and noise removal using fuzzy c mean algorithm and dwt. Discrete wavelet transform (DWT) is used to extract high level details from MRI images. The processed image is added to the original image to get the sharpened image. Then Cmeans algorithm is applied to the sharpened image in which the tumor region can be located using the thresholding method

Correlations of adherence to iron supplements and prevalence of anemia in antenatal women

Background: The prevalence of anemia in pregnant women has remained unacceptably high worldwide despite the fact that routine iron supplementation during pregnancy has been almost universally recommended to prevent maternal anemia. The major problem with iron supplementation during pregnancy is compliance. The objective of this study was to correlate iron supplements compliance among pregnant women and incidence of anemia during pregnancy.Methods: A Prospective observational study was conducted over a period of nine months from August 2015 to April 2016 in the department of obstetrics and gynecology, Bharati Hospital and Research Center, Pune. Pregnant women more than 14 weeks who attended antenatal care unit were enrolled in this study. Data for compliance was collected by two methods - first by personal interview as well as looking for the empty iron tablet strips. Pregnant women were followed till the date of delivery and maternal outcome were noted.Results: Our results show that 64% were strictly compliant, 33% with partially complaint and 3% with non-complaint with iron supplements. The mean Hemoglobin concentration of pregnant women who strictly complies with iron supplements were 11.6 g/dl where the non-compliant and partially complaint to iron supplements were 9.7 g/dl. The prevalence of anemia was found to be more in partial and non-compliant to iron supplements (13% p value <0.001).Conclusions: Anaemia, low haemoglobin levels were found more in non-complaint and partially complaint pregnant women. The findings from our study highlighted that antenatal health and a nutritional intervention program for pregnant women is needful

Antenatal Screening for Hemoglobinopathies with HPLC

Introduction: Hemoglobinopathies are the most commonly encountered monogenic disorders of blood in Southeast Asia and Indian subcontinent. Screening of individuals at increased risk of being carriers for thalassemia and hemoglobinopathies, can identify couples with a 25% risk of having a pregnancy with a significant genetic disorder, for which prenatal diagnosis is possible. This study is done to know the prevalence of hemoglobinopathies and variant of haemoglobin using cation exchange high performance liquid chromatography (CEHPLC).Materials and Methods: 2 ml of venous blood was collected in EDTA vials from the pregnant mothers after informed consent. The blood was subjected to complete hemogram, peripheral blood smear and HPLC using Variant Hemoglobin Testing System (BioRad Laboratories). Beta Thalassemia short programme was used. Descriptive analysis was done and data is presented in numbers and percentages.Results: 467 blood samples from various ethnic groups were evaluated. 70 (14.99%) samples showed features of hemoglobinopathies by HPLC. There were 46 (9.85%) cases of HbE heterozygous,12 (2.57%) cases of HbE homozygous, 9(1.93%) cases of Beta Thalassemia Trait, 2 (0.43%) cases of double heterozygous and 1 (0.21%) case of Hb-D Iran.Conclusion: This study showed a high prevalence of hemoglobinopathies in antenatal mothers necessitating an appropriate screening strategy for antenatal mothers. We also concluded that HPLC is a sensitive technique for studying hemoglobinopathies during pregnancy and may be utilized for screening