Correlation between vitamin D and lipid profile in patients with ischemic stroke

Background: This study aimed to investigate the relationship between serum vitamin D level and lipid profile in ischemic stroke patients.Methods: 217 patients with ischemic stroke were selected for analysis between ages 45 and 80 years admitted at our hospital from January 2014 to December 2015. Measurement of serum vitamin-D concentration was made by electrochemiluminescence immunoassay. Confounding variables like diabetes, hypertension, smoking, alcohol, tobacco, BMI, CRP, S. uric acid, duration of sunlight exposure, prior history of drug intake or fracture and S. calcium were considered. 200 age and sex matched controls were taken. The source of data was questionnaires and multiple linear regression analysis and correlation analysis were used.Results: A positive correlation was seen between vitamin D and serum cholesterol, VLDL, LDL, triglycerides, cholesterol/HDL ratio and LDL/HDL ratio but inverse correlation between vitamin D and HDL.Conclusions: In ischemic stroke patients increase in vitamin D is associated with increase in atherogenic lipids

Isolation, characterization and comparative genomics of bacteriophage SfIV: a novel serotype converting phage from Shigella flexneri

BACKGROUND Shigella flexneri is the major cause of shigellosis in the developing countries. The O-antigen component of the lipopolysaccharide is one of the key virulence determinants required for the pathogenesis of S. flexneri. The glucosyltransferase and/or acetyltransferase genes responsible for the modification of the O-antigen are encoded by temperate serotype converting bacteriophage present in the S. flexneri genome. Several serotype converting phages have previously been isolated and characterized, however, attempts to isolate a serotype converting phage which encodes the modification genes of serotypes 4a strain have not been successful. RESULTS In this study, a novel temperate serotype converting bacteriophage SfIV was isolated. Lysogenisation of phage SfIV converted serotype Y strain to serotype 4a. Electron microscopy indicated that SfIV belongs to Myoviridae family. The 39,758 bp genome of phage SfIV encompasses 54 open reading frames (orfs). Protein level comparison of SfIV with other serotype converting phages of S. flexneri revealed that SfIV is similar to phage SfII and SfV. The comparative analysis also revealed that SfIV phage contained five proteins which were not found in any other phages of S. flexneri. These proteins were: a tail fiber assembly protein, two hypothetical proteins with no clear function, and two other unknown proteins which were encoded by orfs present on a moron, that presumably got introduced in SfIV genome from another species via a transposon. These unique proteins of SfIV may play a role in the pathogenesis of the host. CONCLUSIONS This study reports the isolation and complete genome sequence analysis of bacteriophage SfIV. The SfIV phage has a host range significantly different from the other phages of Shigella. Comparative genome analysis identified several proteins unique to SfIV, which may potentially be involved in the survival and pathogenesis of its host. These findings will further our understanding on the evolution of these phages, and will also facilitate studies on development of new phage vectors and therapeutic agents to control infections caused by S. flexneri

Tibialis anterior muscle hernia : a case of chronic, dull pain and swelling in leg diagnosed by dynamic ultrasonography

BACKGROUND: Symptomatic muscle hernias are not uncommon in the lower extremities and are a rare cause of chronic leg pain. They are most commonly seen in the tibialis anterior muscle, occurring through fascial defects, usually after trauma. There are about 200 cases of muscle hernias described in the literature. The diagnosis is challenging as most of the patients present with non-specific chronic leg pain. Dynamic muscle ultrasonography at rest and at stress is often used for the diagnosis. CASE REPORT: We describe a case of tibialis anterior muscle hernia presenting with persistent dull pain and swelling along the anterior aspect of the leg on straining the leg muscles. Dynamic ultrasonography was performed, which showed a defect in the fascial sheath of the muscle through which the tibialis anterior muscle herniated and produced a focal bulge along the anterior aspect of the leg. Based upon physical examination and dynamic ultrasonographic findings, a diagnosis of tibialis anterior muscle hernia was made. CONCLUSIONS: Tibialis anterior muscle hernia is a rare diagnosis and should be included in the differential diagnosis in a patient with chronic leg pain and swelling. Dynamic ultrasound is crucial in confirming the diagnosis and should be done on straining the muscles of the affected limb

Effect of anti-epileptic drugs on cognitive functions: a prospective study in individuals with newly diagnosed complex partial seizure and generalized tonic clonic seizure

Background: Epilepsy, the third most common neurologic disorder, deteriorates cognitive functions of the patients. Approximately 1% of the world’s population is suffering from epilepsy. Opinions regarding impact of anti-epileptic drugs on cognition are divided. So, this study was designed to assess the impact of anti-epileptic drugs on cognitive performance of patients with complex partial seizure and generalized tonic clonic seizure in Department of Medicine, at Government Medical College, Surat, Gujarat, India.Methods: In present study, cognitive functions were assessed in 50 patients of newly diagnosed complex partial seizure and generalized tonic clonic seizure coming to the Department of Medicine, Surat. The cognitive functions were evaluated by Addenbrooke’s Cognitive Examination (ACE)-III, which assessed memory, attention, fluency, language and visuo-spatial abilities. Follow-up was done after six months of baseline.Results: Baseline and Follow-up data from 50 patients were analysed. Patient treated with anti-epileptic drugs showed significant improvement in memory, attention, language and visuo-spatial abilities whereas improvement in fluency was not significant. Paired t-test and Wilcoxon Signed Ranks Test were used to analyse the data. For statistical analysis of data SPSS 19.0 software was used.Conclusions: The available data indicate that the anti-epileptic drugs on short-term administration do not adversely affect cognitive function in patients with newly diagnosed CPS and GTCS. Importantly, the data suggest that the effects exerted by AEDs could depend on factors linked to patient characteristics and individual susceptibility and to comment on those factors further studies are needed

To study the relation between spontaneous bacterial peritonitis and serum ascitis albumin gradient in chronic liver disease patients

Background: About half the patients with cirrhosis develop ascites during 10 years of observation. The present study was designed to study the relation between spontaneous bacterial peritonitis and serum ascites albumin gradient in chronic liver disease patients.Methods: This prospective observational study was done in 55 patients with chronic liver disease attending IPD of tertiary hospital. Based on investigation findings, patients were divided into two groups: Group A-Patients with sterile cirrhotic ascites, Group B- Patients with spontaneous bacterial peritonitis. Detailed history, examination and relevant investigation were done. Data was collected, recorded and statistical calculation was done using in Microsoft excel 2007.Results: Most common presenting symptoms of SBP patients were increasing ascites refractory to treatment (90%), followed by peripheral edema (80%). Jaundice and hepatic encephalopathy was found in 75% and 65% respectively. Serum and ascites albumin levels were lower in Group B (2.54±0.33 and 0.43±0.23 g/dl respectively) as compared to Group A (2.85±0.36 and 0.91±0.31 g/dl respectively) and it was statistically significant. The Mean±SD of SAAG for group A and group B was (1.94±0.36) and (2.09±0.47 g/dl) respectively. This difference was statistically not significant.Conclusions:Study conclude that the development of spontaneous bacterial peritonitis in chronic liver disease patients with sterile ascites is directly proportional to ascitic fluid albumin and serum albumin concentration whereas occurrence of SBP is not affected by variation in SAAG ratio if it is already higher than 1.1 g/dl.

A study to know the serum total testosterone levels in type II diabetes mellitus male patients from North India

Background: Diabetes mellitus is major public health issue facing the world in present century and the prevalence of type 2 diabetes is increasing explosively.  There are various diabetes related complications, one of which is low testosterone levels in men. This study was designed to estimate the serum testosterone level in male patients of type 2 diabetes mellitus.Methods: The patients of type -2 diabetes mellitus were picked up from out-patient and in-patients section of the hospital at random.Results: Seventy male  patients with type 2 diabetes mellitus were enrolled during the study period. The mean age of study population was 56.36±10.26 years (range 36-70), while that of control group patients was found to be 39.80±7.92years. Family history of diabetes was present in 14 (22.2%) patients. The mean HbA1c in study group was 8.83±1.95 %, which was significantly higher as compared to control group with HbA1c 4.82±0.40 %. Among study group, lower serum total testosterone level was observed in 85.7 % cases and normal level in 14.3 % cases. Among control group, lower serum total testosterone level was observed in 6.7 % cases and normal level in 93.3 % cases.Conclusions: The present study highlighted that significant difference in serum total testosterone level has been observed between cases and control groups (X2 =55.7, P=0.0001)

Role of low dose danazol therapy for endometriosis related infertility and its comparison with laparoscopic fulguration in low resources

Background: The objective was to study the role of laparoscopic fulguration and danazol therapy for endometriosis in case of infertility followed by comparison of both therapies.Methods: The present cross–sectional study was conducted in the department of obstetrics and gynecology SN Medical College Agra. Over the period from December 2010 to November 2013. Symptomatic women (n=50) of age group 20-39 yrs coming to gynecology OPD were selected for study group. The study group was subjected to detailed history, physical examination laboratory test, ultrasound examination, and laparoscopy. Then 50 patients were allotted for laparoscopic fulguration and 50 for danazol treatment.Results: Out of 100 on transvaginal sonography, 10%of patient have cyst 2cm size, rest 70% have normal scan. On laparoscopy 52% of patient have red lesion, 16% have bluish black lesion, 20% have yellow brown lesion rest 22% have normal findings. On danazol therapy pelvic pain and dysmenorrhoea was relieved in 64% and 52% conceived .on laparoscopic fulguration symptom were relieved in 69% and 60% conceived.Conclusions: Based on this study it can be concluded that choice of therapy depend on age of patient,  duration of infertility, physical findings, goal of surgery, experience of surgeon and most important the  availability of resources. In this study result was comparable