Observational assessment and correlates to blood pressure of future physicians of Bengal.

INTRODUCTION: Hypertension is a modern day epidemic and growing public health problem. A sizable proportion of world populations suffer from prehypertension or hypertension. OBJECTIVES: The present study was carried out to detect the prevalence of undiagnosed hypertension among undergraduate medical students and to identify the associated risk factors. MATERIALS AND METHODS: The study was observational in nature and was done in medical colleges of Bengal. Study tool was a predesigned, pretested, validated, and semi-structured questionnaire containing both open-ended and close-ended questions. Data were collected through self-administration, clinical, and anthropometric examination. The data were then tabulated, analyzed and interpretation was done by using percentage and Chi-square test. RESULTS: Most of the students (63%) were young adults, predominantly males (67%) and day scholars (71%). Almost one-third of them either suffered from hypertension or at risk of hypertension. Hypertension was found higher among male students. Family history of hypertension or diabetes mellitus was not associated with hypertension. Vegetarian or nonvegetarian diet or extra-salt consumption was also not associated with hypertension. Smoking was shown positively associated with hypertension but alcohol consumption was not. Higher per capita monthly income and overweight or obesity were shown positively associated with hypertension. CONCLUSION: The overall prevalence of hypertension in this study was 13% and there were positive association of hypertension with multiple socio-demographic factors like age, sex, type of family, per capita monthly income, residence, BMI, smoking, etc.

Multi-Institutional Clinical Outcomes of Biopsy Gleason Grade Group 5 Prostate Cancers Treated With Contemporary High-Dose Radiation and Long-Term Androgen Deprivation Therapy.

AIMS: This multicentric retrospective study reports long-term clinical outcomes of non-metastatic grade group 5 prostate cancers treated with external beam radiotherapy (EBRT) alone with long-term androgen deprivation therapy (ADT). MATERIALS AND METHODS: Patients treated across 19 institutions were studied. The key endpoints that were evaluated were 5-year biochemical recurrence-free survival (bRFS), metastases-free survival (MFS), overall survival, together with EBRT-related acute and late toxicities. The impact of various prognostic factors on the studied endpoints was analysed using univariate and multivariate analyses. RESULTS: Among the 462 patients, 88% (405) had Gleason 9 disease and 31% (142) had primary Gleason pattern 5. A prostate-specific membrane antigen positron emission tomography-computed tomography scan was used for staging in 33% (153), 80% (371) were staged as T3/T4 and 30% (142) with pelvic nodal disease. The median ADT duration was 24 months; 66% received hypofractionated EBRT and 71.4% (330) received pelvic nodal irradiation. With a median follow-up of 56 months, the 5-year bRFS, MFS and overall survival were 73.1%, 77.4% and 90.5%, respectively. Primary Gleason pattern 5 was associated with worse bRFS, MFS and overall survival with hazard ratios of 0.51 (95% confidence interval 0.35 to 0.73, P < 0.001), 0.64 (95% confidence interval 0.43 to 0.96, P = 0.031) and 0.52 (95% confidence interval 0.28 to 0.97, P = 0.040), respectively, whereas pelvic nodal disease was associated with worse bRFS (hazard ratio 0.67, 95% confidence interval 0.46 to 0.98, P = 0.039) and MFS (hazard ratio 0.56, 95% confidence interval 0.37 to 0.85, P = 0.006). The acute and late radiation-related toxicities were low overall and pelvic nodal irradiation was associated with higher toxicities. CONCLUSION: Contemporary EBRT and long-term ADT led to excellent 5-year clinical outcomes and low rates of toxicity in this cohort of non-metastatic grade group 5 prostate cancers. Primary Gleason pattern 5 and pelvic node disease portends inferior clinical outcomes.

Chest wall radiotherapy with volumetric modulated arcs and the potential role of flattening filter free photon beams.

PURPOSE: The goal of the work was to assess the role of RapidArc treatments in chest wall irradiation after mastectomy and determine the potential benefit of flattening filter free beams. METHODS AND MATERIAL: Planning CT scans of 10 women requiring post-mastectomy chest wall radiotherapy were included in the study. A dose of 50 Gy in 2 Gy fractions was prescribed. Organs at risk (OARs) delineated were heart, lungs, contralateral breast, and spinal cord. Dose-volume metrics were defined to quantify the quality of concurrent treatment plans assessing target coverage and sparing of OARs. Plans were designed for conformal 3D therapy (3DCRT) or for RapidArc with double partial arcs (RA). RapidArc plans were optimized for both conventional beams as well as for unflattened beams (RAF). The goal for this planning effort was to cover 100% of the planning target volume (PTV) with ≥ 90% of the prescribed dose and to minimize the volume inside the PTV receiving > 105% of the dose. The mean ipsilateral lung dose was required to be lower than 15 Gy and V(20 Gy) < 22%. Contralateral organ irradiation was required to be kept as low as possible. RESULTS: All techniques met planning objectives for PTV and for lung (3DCRT marginally failed for V(20 Gy)). RA plans showed superiority compared to 3DCRT in the medium to high dose region for the ipsilateral lung. Heart irradiation was minimized by RAF plans with ~4.5 Gy and ~15 Gy reduction in maximum dose compared to RA and 3DCRT, respectively. RAF resulted in superior plans compared to RA with respect to contralateral breast and lung with a reduction of ~1.7 Gy and 1.0 Gy in the respective mean doses. CONCLUSION: RapidArc treatment resulted in acceptable plan quality with superior ipsilateral tissue sparing compared to traditional techniques. Flattening filter free beams, recently made available for clinical use, might provide further healthy tissue sparing, particularly in contralateral organs, suggesting their applicability for large and complex targets.

Post Kala azar dermal leishmaniasis (PKDL) presenting with ulcerated chronic paronychia like lesion.

A 50-year-old lady, resident of urban Bihar, presented with inflamed proximal nail fold of a single digit for one and half months. The lesion on distal finger was remarkable for ulceration. Mucocutaneous examination revealed multiple hypopigmented macules and patches, notable for absence of scaling. The presence of ulceration was not consistent with chronic paronychia, hence, she was asked for biopsy. She declined and opted for trial of antibiotic and anti-fungal treatment. At two weeks of follow up, no improvement was noted at all. At the same time, she developed multiple juicy papules in perioral area and on neck. She tested positive by rK 39 tests. Histopathology from periungual area showed LD body. She was diagnosed as Post Kala-azar dermal leishmaniasis and was treated with miltefosine 50 mg twice daily for three months, resulting in complete resolution of all lesions.

Relationship between arterial oxygen saturation and hematocrit, and effect of slow deep breathing on oxygen saturation in Himalayan high altitude populations.

BACKGROUND: The oxygen saturation of haemoglobin is reduced in high altitude-living organisms. Increase in the hematocrit is responsible for rise in the hemoglobin concentration so that the oxygen carrying capacity in the hypobaric hypoxic subject is elevated. OBJECTIVES: To compare two different high altitude populations, in order to study the relationship between arterial oxygen saturation and hematocrit. METHODS: In the cross-sectional study of two populations residing at altitude of 2800 m and 3760 m are compared for the difference in hematocrit. The oxygen carrying capacity of arterial haemoglobin (SaO2) is determined by pulse oximetry. The sample is drawn from the natives of two small villages, Thini at Jomsom (2800 m) and Jharkot (3760 m) in Mustang district of Nepal. The natives at 2800 m are termed as lower high altitude population and local residents at 3760 m are said to be higher altitude population in this study. The sample blood was drawn by venipuncture and packed cell volume was determined by Wintrobe's method. RESULTS: The hematocrit obtained from 3760 m altitude population and the lower high altitude population at altitude of 2800 m differ significantly with the p value < 0.0001and the SaO2 in both the population fails to show any difference with p value > 0.05. Deep breathing exercise in these populations however increased SaO2 significantly. CONCLUSION: The higher altitude natives have greater arterial oxygen saturation than lower altitude population which is due to rise in red cell concentration. The slow deep breathing raises oxygen saturation irrespective of altitude.

Superfluid stiffness of a KTaO3-based two-dimensional electron gas.

After almost twenty years of intense work on the celebrated LaAlO3/SrTiO3system, the recent discovery of a superconducting two-dimensional electron gas (2-DEG) in (111)-oriented KTaO3-based heterostructures injects new momentum to the field of oxides interface. However, while both interfaces share common properties, experiments also suggest important differences between the two systems. Here, we report gate tunable superconductivity in 2-DEGs generated at the surface of a (111)-oriented KTaO3 crystal by the simple sputtering of a thin Al layer. We extract the superfluid stiffness of the 2-DEGs and show that its temperature dependence is consistent with a node-less superconducting order parameter having a gap value larger than expected within a simple BCS weak-coupling limit model. The superconducting transition follows the Berezinskii-Kosterlitz-Thouless scenario, which was not reported on SrTiO3-based interfaces. Our finding offers innovative perspectives for fundamental science but also for device applications in a variety of fields such as spin-orbitronics and topological electronics.

Alcohol functionality in the fatty acid backbone of sphingomyelin guides the inhibition of blood coagulation.

Cell-surface sphingomyelin (SM) inhibits binary and ternary complex activity of blood coagulation by an unknown mechanism. Here we show the OH functionality of SM contributes in forming the close assembly through intermolecular H-bond and through Ca2+ chelation, which restricts the protein-lipid/protein-protein interactions and thus inhibits the coagulation procedure.

Whole cell protein profiling reiterate phylogenetic relationships among strains of Yersinia enterocolitica biovar 1A as discerned earlier by different genotyping methods.

AIM: To evaluate whole cell protein profiling vis-à-vis genotyping to discern phylogenetic relationships among strains of Y. enterocolitica biovar 1A. METHODS AND RESULTS: Whole cell protein profiling of Y. enterocolitica biovar 1A strains was performed using SDS-PAGE. Twenty-one distinct protein profile types were obtained among a collection of 81 strains isolated from clinical and nonclinical sources. Whole cell protein profiling exhibited discriminatory index (DI) of 0·80 and clustered the strains into two distinct clonal groups. The clinical and the aquatic serotype O:6,30-6,31 strains were clustered into two discrete subgroups. CONCLUSIONS: Whole cell protein profiling displayed sufficient diversity among strains of Y. enterocolitica biovar 1A, and the phylogenetic relationships obtained were in good agreement with those established earlier by genotyping techniques. SIGNIFICANCE AND IMPACT OF THE STUDY: Whole cell protein profiling was as discriminatory as some of the genotyping methods and has the potentiality to be used as an adjunct tool to study epidemiology of Y. enterocolitica.

Psychometric properties of the WHOQOL-BREF in an Iranian adult sample.

To evaluate discriminant validity, reliability, internal consistency, and dimensional structure of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in a heterogeneous Iranian population. A clustered randomized sample of 2,956 healthy with 2,936 unhealthy rural and urban inhabitants aged 30 and above from two dissimilar Iranian provinces during 2006 completed the Persian version of the WHOQOL-BREF. We performed descriptive and analytical analysis including t-student, correlation matrix, Cronbach's Alpha, and factor analysis with principal components method and Varimax rotation with SPSS.15. The mean age of the participants was 42.2 +/- 12.1 years and the mean years of education was 9.3 +/- 3.8. The Iranian version of the WHOQOL-BREF domain scores demonstrated good internal consistency, criterion validity, and discriminant validity. The physical health domain contributed most in overall quality of life, while the environment domain made the least contribution. Factor analysis provided evidence for construct validity for four-factor model of the instrument. The scores of all domains discriminated between healthy persons and the patients. The WHOQOL-BREF has adequate psychometric properties and is, therefore, an adequate measure for assessing quality of life at the domain level in an adult Iranian population.

Early experiences of abuse and current depressive disorders in Iranian women.

Early experience of abuse may be viewed as a risk factor for mental disorders in women later in life. This case-control study in Isfahan screened 709 women aged 20-45 years using the Beck Depression Inventory and structured clinical interviews for Diagnostic Statistical Manual-IV criteria. Lifetime history of abuse was determined using a standard questionnaire. Among the women 35.1% had experienced fear of or actual abuse (physical, sexual or both) in childhood or adolescence. The risk of having major depression in adult life was significantly higher in women who experienced abuse in childhood and adolescence (OR 4.3), severe degrees of abuse (OR 3.9) or multiple forms of abuse (OR 3.8).

What are the predictors of work impairment in Iranian patients with depressive disorders?

The purpose of this study is to estimate the predictors of working ability in depressed patients. Two hundred and twenty-six patients with depression consecutively admitted on outpatient basis from March 2003 to May 2006 were classified into working and non working groups. Severity of depression was measured by the Beck Depression Inventory and their occupational adjustment 2 months prior to the last episode was determined by Occupational Adjustment Scale, a subscale of Social Adjustment Scale. The groups were almost similar in terms of age, sex, education, and marital status. There were significant differences between them in terms of family history of depression, episodes of depression, history of suicide attempts, duration of illness and severity of depression (P < 0.01). The working depressed group differed significantly from the impaired depressed group in terms of work experience, job turnover, and overall occupational adjustment (P < 0.01). History of suicide attempt, family history of depression, time lost, severity of depression, pre-morbid occupational adjustment, age, and illness duration emerged as the most important predictors, explaining 64% of the patients' working ability. Our observations are on line with robust literature across the globe. Nature of illness condition as well as societal attitude can explain the impairment condition in depressed patients. Presence of a comprehensive integrated approach to their treatment and rehabilitation is imperative.

First report on characterization and pathogenicity study of emerging Lactococcus garvieae infection in farmed rainbow trout, Oncorhynchus mykiss (Walbaum), from India.

"Warm water lactococcosis" in farm-reared rainbow trout, Oncorhynchus mykiss (Walbaum) in the northern Himalayan region of India, caused by bacterium Lactococcus garvieae is described in this study. Nine bacterial isolates were recovered from the organs of haemorrhagic septicaemia rainbow trout and were subjected to biochemical and molecular identification. Cell surface characteristics and virulence of the bacterial isolates are also described. All the nine bacterial isolates had homogenous biochemical characteristics and were Gram-positive, short chains forming (two to eight cells long), α-haemolytic, non-motile ovoid cocci. Partial 16S rDNA nucleotide sequence (~1,400 bp) of current isolates shared 99% identities with the 16S rDNA nucleotide sequence of L. garvieae R421, L. garvieae FMA395 and L. garvieae CAU:1730. The identity of the bacterial isolates was further confirmed by PCR amplification of L. garvieae-specific ~1,100 bp fragment. Transmission electron microscopy (TEM) of one representative isolate, L. garvieae RTCLI04, indicates that the isolated strain lacks thick outer capsule and is of KG+ (non-capsulates) phenotype. An intraperitoneal and intramuscular injection (2.6 × 105 CFU ml-1 ) and also immersion in bacterial suspension @ of 2.6 × 105 CFU ml-1 to healthy rainbow trout juveniles (body weight: 27.5 ± 3.7 g) with L. garvieae RTCLI04 caused 80%, 60% and 10% cumulative mortality in challenged fish, respectively, within 15 days post-infection. The haemorrhagic septicaemic disease was reproduced experimentally. Histopathological examination of organs of experimentally infected fish revealed extensive degenerative and inflammatory changes in eye, kidney, gill and liver. PCR amplification of several putative virulence genes such as haemolysins, adhesins, LPxTG-containing surface proteins and adhesins cluster confirms the virulence of our Indian L. garvieae isolates. To the best of our knowledge, we are reporting for the first time that L. garvieae is associated with fatal haemorrhagic septicaemia in farmed rainbow trout in India.

Psychological profile of Iranian patients with low-back pain.

A hospital case-control study in Isfahan, Islamic Republic of Iran, compared the psychological features of 200 patients with low-back pain with 350 matched controls. The control group scored lower than patients in all dimensions of the Symptom Checklist-90 checklist. Female patients were more psychologically affected by low-back pain than males. In both groups, grudge, general complaints, anxiety, depression, obsessive-compulsive behaviours, somatization and phobia varied with level of education. Patients' levels of depression and anxiety were related to occupational background. Longer duration of illness was accompanied by higher levels of anxiety, depression, obsessive-compulsive behaviours and somatization.

Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital in Nepal.

Use of cancer chemotherapeutic drugs is associated with several adverse drug reactions (ADRs) ranging from mild nausea to fatal myelosuppression. Data regarding safety profile of cancer chemotherapy is lacking in Nepal. To study the pattern of ADRs caused by cancer chemotherapeutic drugs in Manipal Teaching Hospital (MTH), Pokhara, Nepal. Hospitalized patients treated with cancer chemotherapy drugs from 1st January to 30th June 2006, was studied retrospectively. Necessary information was collected from the patients' hospital records. Total 60 patients underwent chemotherapy among which 25 (41.67%) developed ADRs. More than half (60 %) were male and 40 % were of age group 61-70 years. The mean SD age was 57.8 +/- 11.54 years. More than half of the patients (56%) who developed ADRs were on adjuvant chemotherapy. Alkylating agents were responsible for the ADRs in nearly half of the patients (52%) followed by antimetabolites (20%). Cisplatin was the individual drug responsible for 44% of the ADRs. The onset of the ADR was within a day in 44% of the patients. Thirty six percent of patients developing ADRs stayed in the hospital for 1-4 days. Hematological system was affected primarily (40.47% of the patients), followed by the gastrointestinal tract (33.33%). Grade I neutropenia was the most common ADR affecting 28.6% of the patients, followed by emesis (21.4%). Increased dose of antiemetics was needed in 38.5% of the patients to manage the ADRs. Levamisole was the drug used primarily (30.43%) for managing ADRs. Male patients and age group 61-70 years were highly predisposed to ADRs. Cisplatin was the common drug responsible for ADRs. Levamisole was commonly used in managing the ADRs. Similar studies covering more patients form different regions are needed to validate our findings.

Studies on manganese nodule leached residue 4. Physicochemical characterization and catalytic activity of acetic acid treated manganese nodule leached residue.

The catalytic activity of water-washed manganese nodule leached residue (WMNLR) samples improved by treating with acetic acid. The effects of acetic acid treatment on the physicochemical properties and catalytic activity of manganese nodule leached residue have been studied. The surface area, surface oxygen, surface hydroxyl groups, surface acidity, electron donating properties, etc., increase gradually with acid treatment up to 0.5 M and thereafter show a decreasing trend. The rate constant of H2O2 decomposition, catalytic activity of CO oxidation, and esterification of acetic acid also show a similar trend to that of surface properties.

Mitochondria-targeted fluorescent polymersomes for drug delivery to cancer cells.

Mitochondria is an attractive target to deliver anticancer drugs. We have synthesized a cationic triphenylphosphonium ion conjugated fluorescent polymer which self-assembles into nanosized polymersomes and targets the encapsulated anticancer drug doxorubicin to cancer cell mitochondria.

Effect of heat treatment on the physico-chemical properties and catalytic activity of manganese nodules leached residue towards decomposition of hydrogen peroxide.

The effect of calcination temperature on the physico-chemical characterization of manganese nodule leached residue (MNLR) and water-washed manganese nodule leached residue (WMNLR) has been investigated on the basis of chemical analysis, XRD, TG-DTA, FTIR, surface hydroxyl groups, surface oxygen, reducing and oxidizing sites, surface area. XRD and IR confirm the presence of amorphous iron oxyhydroxides, delta-MnO2, which are converted to alpha-Fe2O3 and gamma-Mn2O3 phases above 400 degrees C of calcination, respectively. A solid solution of Fe2O3 and Mn2O3 is formed above 700 degrees C. The surface area, surface hydroxyl group, surface oxygen, reducing and oxidizing sites increase with the increase in calcination temperature up to 400 degrees C and then decrease with further rise in calcination temperature up to 700 degrees C. The catalytic activity of the sample towards H2O2 decomposition shows the similar trend as surface properties. A suitable Mn(3+)Mn4+ couple favours H2O2 decomposition reaction. The activity has been correlated with various physico-chemical properties.