Leptin and obesity.

An imbalance between calorie intake and energy expenditure produces obesity. It has been a major problem in societies of the developing and developed world. In obesity an excessive amount of fat accumulates in adipose tissue cells as well as in other vital organs like liver, muscles, and pancreas. The adipocytes contain ob genes and express leptin, a 16 kDa protein. In the present communication, we reviewed the molecular basis of the etiopathophysiology of leptin in obesity. Special emphasis has been given to the use of leptin as a drug target for obesity treatment, the role of diet in the modulation of leptin secretion, and reduction of obesity at diminished level of blood leptin induced by physical exercise.

Gender-specific brain regional variation of neurons, endogenous estrogen, neuroinflammation and glial cells during rotenone-induced mouse model of Parkinson's disease.

Rotenone (RT) produces reactive oxygen species (ROS) by inhibiting the mitochondrial electron transport chain; causing dopaminergic (DA) cell death in the substantia nigra (SN) and simulates other models of induced Parkinson's disease (PD). There is a sincere dearth of knowledge regarding the status of glial cells, neuroprotective estrogen and the status of neuroinflammatory TNF-α in the different brain regions in either sex during healthy, as well as during PD conditions. In the present study of RT-induced mouse model of PD, we have selected the frontal cortex (FC), hippocampus (HC) and SN from either sex of Swiss albino mice as these are the major regions involved during PD pathogenesis. During non pathogenic conditions, the ROS-scavenging enzyme activity varied among the brain regions and also in between genders. The number of DOPA decarboxylase-positive cells, astrocytes and microglia was similar in the respective regions of the brain in both the sexes. The level of proinflammatory cytokine TNF-α was same in the respective FC and HC in either sex except that of SN. The expression level of estrogen and its receptors varied among the three brain regions. During RT treatment, ROS-scavenging enzyme activities increased, DOPA decarboxylase-positive neurons and fibers in DA as well as in norepinephrinergic (NE) systems become degenerated, number of astrocytes decreased and microglial cells increased in those specific brain regions in either of the sexes except in the SN region of males where astrocyte number remained unaltered and microglial cell percentage decreased. TNF-α increased in the FC and SN but remained unaltered in the HC of both sexes. Estradiol level decreased in the HC and SN but the level unevenly varied in the FC. Similarly, the estrogen bound and nuclear-cytosolic receptor α and ß also varied differentially among the brain regions of the two sexes. Therefore our present study depicts that there exists a clear variation of neuronal and astroglial cell population, estrogen and its receptor levels in different brain regions of both the sexes during control and RT-treated pathogenic condition and these variations have major implication in PD pathogenesis and progression.

Shear flow instability in a strongly coupled dusty plasma.

Linear stability analysis of strongly coupled incompressible dusty plasma in presence of shear flow has been carried out using the generalized hydrodynamical (GH) model. With the proper Galilean invariant GH model, a nonlocal eigenvalue analysis has been done using different velocity profiles. It is shown that the effect of elasticity enhances the growth rate of shear flow driven Kelvin- Helmholtz (KH) instability. The interplay between viscosity and elasticity not only enhances the growth rate but the spatial domain of the instability is also widened. The growth rate in various parameter space and the corresponding eigenfunctions are presented.

An assessment of psychiatric disturbances in Graves disease in a medical college in eastern India.

BACKGROUND: Graves' disease is a unique conglomeration of cardiovascular, neurological, ophthalmological, and other systemic manifestations. In this study we have tried to explore the psychiatric dimensions of this disease. AIMS: This study attempted to explore clinical features, types, and treatment outcome of psychiatric disturbances in Graves disease. STUDY DESIGN: This is a purposive study following the criteria of DSM IV. MATERIALS AND METHODS: A total of 36 adult patients of newly diagnosed Graves disease and 30 age- and sex-matched controls were included. Data enumerated were age, sex, date of admission, analysis of psychiatric signs, and symptoms by one independent observer, diagnostic categorization, effect of treatment, and outcome. Follow-up evaluation was done after 1 year. Statistical Analysis : Statistical analysis was done by the standard error of difference, the chi-square test, and paired Student's T-test. RESULTS: Among 36 patients 32 were female and 4 were male. Fifteen patients (41.67%) were diagnosed with generalized anxiety disorders (GAD), 6 (16.67%) with mood disorder, 6 (16.67%) with obsessive compulsive disorder (OCD), and 2 each with personality disorder and schizophreniform disorder. The common symptoms were insomnia, irritability, and anxiety. The frequency of GAD was statistically more significant in the Graves disease group in comparison to control. Fourteen patients agreed to take both antithyroid and antipsychotropic medications (group 1). The rest were treated with only antithyroid drug (group 2). There was significant improvement in both groups and no difference between the groups. CONCLUSION: The prevalence of certain psychiatric manifestations in Graves' disease was significantly higher than in the control group. There was no significant difference between therapy with antithyroid drugs and combination of antithyroid with psychotropic medications.

A cross-sectional study of cutaneous drug reactions in a private dental college and government medical college in eastern India.

BACKGROUND: Cutaneous drug reactions are a common impediment in therapy, the incidence ranging from 2% to 8%. This cross-sectional study was designed to compare different trends of cutaneous drug reaction in two different socio-economic groups of patients in the same region. AIMS: The aim was to evaluate common drugs implicated in causing reactions, describe the adverse cutaneous drug reactions, study the characteristics of patients presenting with the reactions. STUDY DESIGN: This is an observational study of cross-sectional type. MATERIALS AND METHODS: The study was carried out in the department of Oral and Maxillofacial surgery in a Private dental College and department of General Medicine in a Medical College only on outdoor basis for 3 years. Out of 2000 patients observed in each college for their necessary treatment 75 patients in the dental College and 200 patients in the Medical College were reported to have various types of cutaneous drug reactions. Diagnosis was based on detailed history including temporal correlation between drug intake and onset of rash and thorough clinical examination Apart from history of drug intake, information regarding associated other allergy, comorbidity and severity (whether hospitalization was required or not) was recorded. Rechallenge with the drug was not possible due to ethical problem. RESULTS: Out of 2000 patients observed in each college 75 patients in dental College and 200 patients in Medical College were documented to have different kinds of cutaneous drug reactions. A total of 30 were male and 45 female in dental college whereas 90 male and 110 female patients were enrolled in Medical College. The age group of the patients in both the colleges ranged from 18 to 75 years. Common culprits observed in this study were antibiotics and NSAIDs. They had contributed 53% and 40% of the total skin reactions respectively in dental college and 47.5% and 45% in Medical College. We encountered 6 patients of systemic lupus erythematosus (SLE), 20 patients with allergic rhinitis and 12 patients with bronchial asthma in the whole proceedings. The duration of drug intake varied from 15 minutes to 2 weeks. The most common reaction noted was maculopapular rash 37 (50.5%), urticaria 15 (20%), fixed drug eruption (FDR) 15 (20%), angioedema 6 (8%) in dental College whereas a little different trend was observed in the medical college. Hospitalization was required in two cases of Steven--Johnson syndrome caused by NSAIDS in the dental College whereas 11 patients were hospitalized for the same indication in the medical College. Except for maculopapular rash, all other skin reactions were observed more frequently with NSAIDS in dental College whereas Steven--Johnson syndrome is predominantly observed in Medical College with anticonvulsants. In all the cases causative drugs were withdrawn. A total 40% of the patients required only antihistaminic, 35% required antihistaminic and topical corticosteroid and rest required a combination of antihistaminic, oral and topical corticosteroids. CONCLUSION: Commonest drugs causing drug reactions are antibiotics mainly beta lactams and quinolones. Severe reactions were seen in our series with anticonvulsants and NSAIDS. Association with other diseases could not be inferred due to this modest patient pool.

Familial hypoparathyroidism.

A family with hereditary (familial) hypoparathyroidism is reported where three of the total four siblings were affected and each presented with different manifestation-one brother with refractory epilepsy since early childhood, another brother with unilateral extrapyramidal features in adult life, and their only sister having recurrent attacks of tingling and numbness due to hypocalcemia since 12 years of age.

An unusual case of obstructive jaundice.

Tuberculosis of the pancreas is a rarity, reported in a handful of literature. We enumerate the case of a young girl with high fever, jaundice, and right hypochondrial pain, whose investigations revealed a mass at the head of the pancreas. FNAC from the mass astoundingly proclaimed tuberculosis.

Splenic metastasis and bleeding manifestations--an unusual association with gastric malignancy.

Splenic metastasis is a rare clinical entity--incidence being 0.6% at autopsy and 1.1% at splenectomy. We report the case of a 30 year old female who presented with purpura and melena and who was later diagnosed to have a mucinous adenocarcinoma of stomach with disseminated intravascular coagulation and splenic metastasis.

Phenomenology of mania - a factor analysis approach.

The phenomenology of mania has not been empirically studied adequately. Various studies have revealed 2. 4 & 5 factors as the core features defining the manic state. Differences in the Bipolar disorders have been reported across culture in the past further complicating the issue.This study was carried out to study the core features of the manic state and compare it with similar studies across culture.Hundred consecutive patients attending the Central Institute of Psychiatry's Out Patient Services for the first time with a diagnosis of manic episode or bipolar disorder, current episode mania as per Diagnostic Criteria for Research were taken up for the study.Factor analysis using Principal Components with Varimax rotation was carried out. Factor score were tested for normal distribution using Kolmogorov Smirnov statistic.The findings revealed three factors representing psychomotor acceleration, thought disorder and mood All distributions were normal. Mood was found to be on a continuum with euphoria and irutability on the opposite poles.

Rise of intrasynaptosomal Ca2+ level and activation of nitric oxide synthase in adult rat cerebral cortex pretreated with 3-5-3'-L-triiodothyronine.

Accumulation of free, ionized calcium (Ca2+) and stimulation of nitric oxide synthase (NOS) activity in depolarization-induced synaptosomes prepared from adult rat cerebral cortex have been demonstrated after addition of various doses (0.1-1,000 nM) of 3,5,3'-L-triiodothyronine (T3). The effects of T3 doses on those parameters are found to occur in a dose-dependent manner. The T3 (100 nM)-induced optimum rise in intrasynaptosomal Ca2+ level [Ca2+]i seems to be an early event occurring within 5 s; whereas, the maximum stimulation of NOS activity is observed during 10 to 30 s of T3 (100 nM) administration, indicating a delayed effect. T3 has no such effects on those parameters in synaptosomes at nondepolarized condition. Although the rise in [Ca2+]i and stimulation of NOS activity after application of T3 seem to be sequential events, the present data indicate a definite role of T3 in nongenomic signal generation and transfer in mature rat cerebral cortex.

Gender difference in resolution of mania.

Gender differences are being increasingly reported across psychiatric disorders. Females are known to be more at risk for developing unipolar depressive disorders. In bipolar disorder there is more dysphoria, rapid cycling and more number of depressive episodes in females. However studies on gender difference in resolution are scarce. This study was conducted in Central Institute of Psychiatry to assess the gender difference in resolution of mania. 24 males and 16 females were rated at day 0, 3, 7, 14, 21 & 28 on scale for Manic States, ft was found that males settled faster than females, which was evident at day 14. The rate of resolution was more in males in the first week. Remission was also reached earlier by males.

Secondary gender identity disorder - a case report.

An eighteen year old Christian male, diagnosed as Bipolar Affective Disorder, 2nd manic episode with mood congruent psychotic features presented during the episode with the explicit wish for sex reassignment surgery. He even claimed to be married to a local man. With effective management of the manic episode, his wish for sex reassignment surgery has completely subsided. This report discusses the literature regarding secondary gender identity disorder occurring in psychotic conditions and further implications of the same.

An in vivo chloroquine sensitivity study in relation to low transmission potential and imported malaria in Kerala.

The study highlights the presence of chloroquine resistant Plasmodium falciparum strains in Kerala state, India for the first time. The emergence of chloroquine resistant P. falciparum in a low transmission area is dependent on the imported cases while build up of resistance is mainly due to persistence of resistant parasites which have more opportunities for transmission.

An in-vitro profile of the action of four antimalarials on indigenous cases of Plasmodium falciparum malaria in Karnataka.

In view of the emergence of chloroquine resistant Plasmodium falciparum from more and more geographical areas profiling of the responses to other available antimalarials by in vitro methods have become essential. A preliminary study undertaken in two Primary Health Centres of Karnataka State, India show the presence of strains of P. falciparum resistant to chloroquine and amodiaquine. The response for amodiaquine was poor as compared to chloroquine. The isolates were, however, sensitive to mefloquine and quinine.

Localization of the focus of origin of resistance in Plasmodium falciparum.

An attempt has been made to identify the focus of origin of Plasmodium falciparum resistance. Several factors have been analysed and the importance of mean parasite recrudescence time (M.P.R.T.) in the identification of focus of origin of resistance is highlighted.