Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy

Background: Diabetes Mellitus in pregnancy has long been recognized as a serious problem for both mother and fetus. Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Even though there are many diagnostic criteria and guidelines for management of GDM, there still exists lack of consensus regarding diagnosis and management of patients with GDM. After Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, International Association of Diabetes in Pregnancy Study Group (IADPSG) has formulated a new consensus guideline for diagnosing hyperglycaemia in pregnancy which has formed the back bone for this particular study. The aim of this study was to assess the incidence of GDM using current international consensus guidelines with 75g Oral Glucose Tolerance Test (OGTT) and evaluation of maternal and fetal outcome.Methods: All antenatal patients were screened for GDM with 75g OGTT and their glycaemic control was evaluated throughout pregnancy. Either Medical Nutritional Therapy or Oral Hypoglycaemic Agents or Insulin Therapy was advised for glycaemic control. Maternal and neonatal outcomes were evaluated.Results: A total of 856 Antenatal patients were screened and 111 were diagnosed as GDM, showing an incidence of 13%. Medical Nutritional Therapy was found to be an effective method for glycaemic control in GDM.Conclusions: The incidence of GDM in the studied population was found to be 13%. Previous history of GDM was found to be the most significant high risk factor associated with GDM followed by family history of Diabetes. Medical Nutritional Therapy was found to be highly effective in the management of GDM. Only 9% of GDM patients required insulin therapy. With adequate glycaemic control, all late pregnancy complications and neonatal complications can be alleviated

Knowledge, attitudes and practices (KAP) regarding menstruation among girls in Aurangabad, India and their correlation with sociodemographic factors

Background: Menstruation has always been surrounded by different perceptions throughout the world. Nowadays, there is some openness toward menstruation, but differences in attitude still persist between different populations depending upon the education, socioeconomic status and the surroundings. We conducted this study to assess the knowledge regarding menstruation, their attitudes and the practises undertaken by the young girls of India .A prewritten questionnaire was distributed to these girls and the answers were analysed.Methods: A school based cross-sectional study design was employed in Aurangabad, Maharashtra. A multi stage sampling technique was used to select 1000 female high school and junior college and pharmacy college students. Data collection was carried out from May 2018 to August 2018 using a pre- tested structured questionnaire. The data were entered into a computer using Epi-info version 3.5.1 and then exported to SPSS for Windows version 20.0 for analysis. Bivariate and multivariate logistic regression analysis was done at 95 % confidence interval.Results: In this study 682and 552 respondents had good knowledge and practice of menstruation respectively. The findings of the study showed a significant positive association between good knowledge of menstruation and educational status of mothers (AOR = 1.51, 95% CI = 1.02-2.22), (AOR = 2.42, 95% CI:1.64-3.56). Educational status of the mother (AOR = 2.03, 95 % CI =1.38-2.97), revealed significant positive association with good practice and attitude of menstrual process.Conclusions: The findings showed that the knowledge and practice of menstruation is low. Hence awareness programmed should be conducted in schools regularly. Participation of mothers can also add to the knowledge and good practice scores of the young girls

Magnetically Targeted Endothelial Cell Localization in Stented Vessels

ObjectivesA novel method to magnetically localize endothelial cells at the site of a stented vessel wall was developed. The application of this strategy in a large animal model is described.BackgroundLocal delivery of blood-derived endothelial cells has been shown to facilitate vascular healing in animal models. Therapeutic utilization has been limited by an inability to retain cells in the presence of blood flow. We hypothesized that a magnetized stent would facilitate local retention of superparamagnetically labeled cells.MethodsCultured porcine endothelial cells were labeled with endocytosed superparamagnetic iron oxide microspheres. A 500:1 microsphere-to-cell ratio was selected for in vivo experiments based on bromo-deoxyuridine incorporation and terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assays. Stents were magnetized and implanted in porcine coronary and femoral arteries using standard interventional equipment. Labeled endothelial cells were delivered locally during transient occlusion of blood flow.ResultsThe delivered cells were found attached to the stent struts and were also distributed within the adjacent denuded vessel wall at 24 h.ConclusionsMagnetic forces can be used to rapidly place endothelial cells at the site of a magnetized intravascular stent. The delivered cells are retained in the presence of blood flow and also spread to the adjacent injured vessel wall. Potential applications include delivering a cell-based therapeutic effect to the local vessel wall as well as downstream tissue

Importance of Propionibacterium acnes hemolytic activity in human intervertebral discs:A microbiological study

Most patients with chronic lower back pain (CLBP) exhibit degenerative disc disease. Disc specimens obtained during initial therapeutic discectomies are often infected/colonized with Propionibacterium acnes, a Gram-positive commensal of the human skin. Although pain associated with infection is typically ascribed to the body's inflammatory response, the Gram-positive bacterium Staphylococcus aureus was recently observed to directly activate nociceptors by secreting pore-forming α-hemolysins that disrupt neuronal cell membranes. The hemolytic activity of P. acnes in cultured disc specimens obtained during routine therapeutic discectomies was assessed through incubation on sheep-blood agar. The β-hemolysis pattern displayed by P. acnes on sheep-blood agar was variable and phylogroup-dependent. Their molecular phylogroups were correlated with their hemolytic patterns. Our findings raise the possibility that pore-forming proteins contribute to the pathogenesis and/or symptomology of chronic P. acnes disc infections and CLBP, at least in a subset of cases

Coronary artery endothelial dysfunction is positively correlated with low density lipoprotein and inversely correlated with high density lipoprotein subclass particles measured by nuclear magnetic resonance spectroscopy.

OBJECTIVE: The association between cholesterol and endothelial dysfunction remains controversial. We tested the hypothesis that lipoprotein subclasses are associated with coronary endothelial dysfunction. METHODS AND RESULTS: Coronary endothelial function was assessed in 490 patients between November 1993 and February 2007. Fasting lipids and nuclear magnetic resonance (NMR) lipoprotein particle subclasses were measured. There were 325 females and 165 males with a mean age of 49.8+/-11.6 years. Coronary endothelial dysfunction (epicardial constriction>20% or increase in coronary blood flow<50% in response to intracoronary acetylcholine) was diagnosed in 273 patients, the majority of whom (64.5%) had microvascular dysfunction. Total cholesterol and LDL-C (low density lipoprotein cholesterol) were not associated with endothelial dysfunction. One-way analysis and multivariate methods adjusting for age, gender, diabetes, hypertension and lipid-lowering agent use were used to determine the correlation between lipoprotein subclasses and coronary endothelial dysfunction. Epicardial endothelial dysfunction was significantly correlated with total (p=0.03) and small LDLp (LDL particles) (p<0.01) and inversely correlated with total and large HDLp (high density lipoprotein particles) (p<0.01). CONCLUSIONS: Epicardial, but not microvascular, coronary endothelial dysfunction was associated directly with LDL particles and inversely with HDL particles, suggesting location-dependent impact of lipoprotein particles on the coronary circulation

Cell-intrinsic differences between human airway epithelial cells from children and adults

Summary The airway epithelium is a protective barrier that is maintained by the self-renewal and differentiation of basal stem cells. Increasing age is a principle risk factor for chronic lung diseases, but few studies have explored age-related molecular or functional changes in the airway epithelium. We retrieved epithelial biopsies from histologically normal tracheobronchial sites from pediatric and adult donors and compared their cellular composition and gene expression profile (in laser capture-microdissected whole epithelium, fluorescence-activated cell-sorted basal cells and basal cells in cell culture). Histologically, pediatric and adult tracheobronchial epithelium were similar in composition. We observed age-associated changes in RNA sequencing studies, including higher interferon-associated gene expression in pediatric epithelium. In cell culture, pediatric cells had higher colony-formation ability, sustained in vitro growth and out-competed adult cells in a direct competitive proliferation assay. Our results demonstrate cell-intrinsic differences between airway epithelial cells from children and adults in both homeostatic and proliferative states

A Replication Study of GWAS-Derived Lipid Genes in Asian Indians: The Chromosomal Region 11q23.3 Harbors Loci Contributing to Triglycerides

Recent genome-wide association scans (GWAS) and meta-analysis studies on European populations have identified many genes previously implicated in lipid regulation. Validation of these loci on different global populations is important in determining their clinical relevance, particularly for development of novel drug targets for treating and preventing diabetic dyslipidemia and coronary artery disease (CAD). In an attempt to replicate GWAS findings on a non-European sample, we examined the role of six of these loci (CELSR2-PSRC1-SORT1 rs599839; CDKN2A-2B rs1333049; BUD13-ZNF259 rs964184; ZNF259 rs12286037; CETP rs3764261; APOE-C1-C4-C2 rs4420638) in our Asian Indian cohort from the Sikh Diabetes Study (SDS) comprising 3,781 individuals (2,902 from Punjab and 879 from the US). Two of the six SNPs examined showed convincing replication in these populations of Asian Indian origin. Our study confirmed a strong association of CETP rs3764261 with high-density lipoprotein cholesterol (HDL-C) (p = 2.03×10−26). Our results also showed significant associations of two GWAS SNPs (rs964184 and rs12286037) from BUD13-ZNF259 near the APOA5-A4-C3-A1 genes with triglyceride (TG) levels in this Asian Indian cohort (rs964184: p = 1.74×10−17; rs12286037: p = 1.58×10−2). We further explored 45 SNPs in a ∼195 kb region within the chromosomal region 11q23.3 (encompassing the BUD13-ZNF259, APOA5-A4-C3-A1, and SIK3 genes) in 8,530 Asian Indians from the London Life Sciences Population (LOLIPOP) (UK) and SDS cohorts. Five more SNPs revealed significant associations with TG in both cohorts individually as well as in a joint meta-analysis. However, the strongest signal for TG remained with BUD13-ZNF259 (rs964184: p = 1.06×10−39). Future targeted deep sequencing and functional studies should enhance our understanding of the clinical relevance of these genes in dyslipidemia and hypertriglyceridemia (HTG) and, consequently, diabetes and CAD

A Distributed Implementation Of The Transform Model

The Transform access-control model is based on the concept of transformation of access rights. It has previously been shown that Transform unifies a number of diverse access control mechanisms such as amplification, copy flags, separation of duties and synergistic authorization. It has also been shown that Transform has an efficient algorithm for safety analysis of the propagation of access rights (i.e., the determination of whether or not a given subject can ever acquire access to a given object). In this paper we propose a distributed implementation of Transform. Our design is based on capabilities with identities of subjects buried in them. This ensures unforgeability of capabilities as well as enables enforcement of &quot;mandatory&quot; controls on propagation of capabilities from one subject to another. The design provides for immediate, selective, partial and complete revocation on a temporary as well as permanent basis