GPIIb/IIIa Receptor Targeted Rutin Loaded Liposomes for Site-Specific Antithrombotic Effect.

Rutin (RUT) is a flavonoid obtained from a natural source and is reported for antithrombotic potential, but its delivery remains challenging because of its poor solubility and bioavailability. In this research, we have fabricated novel rutin loaded liposomes (RUT-LIPO, nontargeted), liposomes conjugated with RGD peptide (RGD-RUT-LIPO, targeted), and abciximab (ABX-RUT-LIPO, targeted) by ethanol injection method. The particle size, ζ potential, and morphology of prepared liposomes were analyzed by using DLS, SEM, and TEM techniques. The conjugation of targeting moiety on the surface of targeted liposomes was confirmed by XPS analysis and Bradford assay. In vitro assessment such as blood clot assay, aPTT assay, PT assay, and platelet aggregation analysis was performed using human blood which showed the superior antithrombotic potential of ABX-RUT-LIPO and RGD-RUT-LIPO liposomes. The clot targeting efficiency was evaluated by in vitro imaging and confocal laser scanning microscopy. A significant (P < 0.05) rise in the affinity of targeted liposomes toward activated platelets was demonstrated that revealed their remarkable potential in inhibiting thrombus formation. Furthermore, an in vivo study executed on Sprague Dawley rats (FeCl3 model) demonstrated improved antithrombotic activity of RGD-RUT-LIPO and ABX-RUT-LIPO compared with pure drug. The pharmacokinetic study performed on rats demonstrates the increase in bioavailability when administered as liposomal formulation as compared to RUT. Moreover, the tail bleeding assay and clotting time study (Swiss Albino mice) indicated a better antithrombotic efficacy of targeted liposomes than control preparations. Additionally, biocompatibility of liposomal formulations was determined by an in vitro hemolysis study and cytotoxicity assay, which showed that they were hemocompatible and safe for human use. A histopathology study on rats suggested no severe toxicity of prepared liposomal formulations. Thus, RUT encapsulated nontargeted and targeted liposomes exhibited superior antithrombotic potential over RUT and could be used as a promising carrier for future use.

Negative DNA supercoiling makes protein-mediated looping deterministic and ergodic within the bacterial doubling time.

Protein-mediated DNA looping is fundamental to gene regulation and such loops occur stochastically in purified systems. Additional proteins increase the probability of looping, but these probabilities maintain a broad distribution. For example, the probability of lac repressor-mediated looping in individual molecules ranged 0-100%, and individual molecules exhibited representative behavior only in observations lasting an hour or more. Titrating with HU protein progressively compacted the DNA without narrowing the 0-100% distribution. Increased negative supercoiling produced an ensemble of molecules in which all individual molecules more closely resembled the average. Furthermore, in only 12 min of observation, well within the doubling time of the bacterium, most molecules exhibited the looping probability of the ensemble. DNA supercoiling, an inherent feature of all genomes, appears to impose time-constrained, emergent behavior on otherwise random molecular activity.

Analysis of risk factors contributing to road traffic accidents in a tertiary care hospital. A hospital based cross-sectional study.

PURPOSE: Road traffic accidents (RTAs) are a public health issue and cost a lot to individuals, families, communities and nations. Trauma care systems in India are at a nascent stage of development. There is gross disparity between trauma services available in various parts of the country. Rural area in India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. The present study is to study the trends of occurrence of RTA cases by month, week and time of accident occurrence as well as to research the types of vehicle involved in accidents and other various risk factors related to them. METHODS: During 1st January 2017 to 31st December 2017, a hospital-based and cross-sectional study of RTA victims was conducted. The patients were admitted in emergency department of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, when stabilized, they were shifted to the orthopaedics and surgery ward. RESULTS: In the study, 654 road accident victims were included, of which the majority were males (77.5%) and the most of them belonged to rural (67%). RTA victims according to the month of occurrence majority were found in January (12.5%) and evening was time of a day with maximum accidents (32.1%). Mortality cases of RTA victims based on type of road user and it shows decreasing trend of mortality of motorcyclists (54.2%) followed by pedestrian (25.1%). CONCLUSION: There should be control over people driving vehicles under the influence of alcohol and drivers over-speeding and rash driving on urban roads as well as rural village roads.

O-Antigen-Dependent Colicin Insensitivity of Uropathogenic Escherichia coli.

The outer membrane of Gram-negative bacteria presents a significant barrier for molecules entering the cell. Nevertheless, colicins, which are antimicrobial proteins secreted by Escherichia coli, can target other E. coli cells by binding to cell surface receptor proteins and activating their import, resulting in cell death. Previous studies have documented high rates of nonspecific resistance (insensitivity) of various E. coli strains toward colicins that is independent of colicin-specific immunity and is instead associated with lipopolysaccharide (LPS) in the outer membrane. This observation poses a contradiction: why do E. coli strains have colicin-expressing plasmids, which are energetically costly to retain, if cells around them are likely to be naturally insensitive to the colicin they produce? Here, using a combination of transposon sequencing and phenotypic microarrays, we show that colicin insensitivity of uropathogenic E. coli sequence type 131 (ST131) is dependent on the production of its O-antigen but that minor changes in growth conditions render the organism sensitive toward colicins. The reintroduction of O-antigen into E. coli K-12 demonstrated that it is the density of O-antigen that is the dominant factor governing colicin insensitivity. We also show, by microscopy of fluorescently labelled colicins, that growth conditions affect the degree of occlusion by O-antigen of outer membrane receptors but not the clustered organization of receptors. The result of our study demonstrate that environmental conditions play a critical role in sensitizing E. coli toward colicins and that O-antigen in LPS is central to this role.IMPORTANCEEscherichia coli infections can be a major health burden, especially with the organism becoming increasingly resistant to "last-resort" antibiotics such as carbapenems. Although colicins are potent narrow-spectrum antimicrobials with potential as future antibiotics, high levels of naturally occurring colicin insensitivity have been documented which could limit their efficacy. We identify O-antigen-dependent colicin insensitivity in a clinically relevant uropathogenic E. coli strain and show that this insensitivity can be circumvented by minor changes to growth conditions. The results of our study suggest that colicin insensitivity among E. coli organisms has been greatly overestimated, and as a consequence, colicins could in fact be effective species-specific antimicrobials targeting pathogenic E. coli such as uropathogenic E. coli (UPEC).

Correction: Analysis of long dsRNA produced in vitro and in vivo using atomic force microscopy in conjunction with ion-pair reverse-phase HPLC.

Correction for 'Analysis of long dsRNA produced in vitro and in vivo using atomic force microscopy in conjunction with ion-pair reverse-phase HPLC' by Alison O. Nwokeoji, et al., Analyst, 2019, 144, 4985-4994.

Analysis of long dsRNA produced in vitro and in vivo using atomic force microscopy in conjunction with ion-pair reverse-phase HPLC.

Long double-stranded (ds) RNA is emerging as a novel alternative to chemical and genetically-modified insect and fungal management strategies. The ability to produce large quantities of dsRNA in either bacterial systems, by in vitro transcription, in cell-free systems or in planta for RNA interference applications has generated significant demand for the development and application of analytical tools for analysis of dsRNA. We have utilised atomic force microscopy (AFM) in conjunction with ion-pair reverse-phase high performance liquid chromatography (IP-RP-HPLC) to provide novel insight into dsRNA for RNAi applications. The AFM analysis enabled direct structural characterisation of the A-form duplex dsRNA and accurate determination of the dsRNA duplex length. Moreover, further analysis under non-denaturing conditions revealed the presence of heterogeneous dsRNA species. IP-RP-HPLC fractionation and AFM analysis revealed that these alternative RNA species do not arise from different lengths of individual dsRNA molecules in the product, but represent misannealed RNA species that present as larger assemblies or multimeric forms of the RNA. These results for the first time provide direct structural insight into dsRNA produced both in vivo in bacterial systems and in vitro, highlighting the structural heterogeneity of RNA produced. These results are the first example of detailed characterisation of the different forms of dsRNA from two production systems and establish atomic force microscopy as an important tool for the characterisation of long dsRNA.

Quantitation of interactions between two DNA loops demonstrates loop domain insulation in E. coli cells.

Eukaryotic gene regulation involves complex patterns of long-range DNA-looping interactions between enhancers and promoters, but how these specific interactions are achieved is poorly understood. Models that posit other DNA loops--that aid or inhibit enhancer-promoter contact--are difficult to test or quantitate rigorously in eukaryotic cells. Here, we use the well-characterized DNA-looping proteins Lac repressor and phage λ CI to measure interactions between pairs of long DNA loops in E. coli cells in the three possible topological arrangements. We find that side-by-side loops do not affect each other. Nested loops assist each other's formation consistent with their distance-shortening effect. In contrast, alternating loops, where one looping element is placed within the other DNA loop, inhibit each other's formation, thus providing clear support for the loop domain model for insulation. Modeling shows that combining loop assistance and loop interference can provide strong specificity in long-range interactions.

Quantitation of the DNA tethering effect in long-range DNA looping in vivo and in vitro using the Lac and λ repressors.

Efficient and specific interactions between proteins bound to the same DNA molecule can be dependent on the length of the DNA tether that connects them. Measurement of the strength of this DNA tethering effect has been largely confined to short separations between sites, and it is not clear how it contributes to long-range DNA looping interactions, such as occur over separations of tens to hundreds of kilobase pairs in vivo. Here, gene regulation experiments using the LacI and λ CI repressors, combined with mathematical modeling, were used to quantitate DNA tethering inside Escherichia coli cells over the 250- to 10,000-bp range. Although LacI and CI loop DNA in distinct ways, measurements of the tethering effect were very similar for both proteins. Tethering strength decreased with increasing separation, but even at 5- to 10-kb distances, was able to increase contact probability 10- to 20-fold and drive efficient looping. Tethering in vitro with the Lac repressor was measured for the same 600-to 3,200-bp DNAs using tethered particle motion, a single molecule technique, and was 5- to 45-fold weaker than in vivo over this range. Thus, the enhancement of looping seen previously in vivo at separations below 500 bp extends to large separations, underlining the need to understand how in vivo factors aid DNA looping. Our analysis also suggests how efficient and specific looping could be achieved over very long DNA separations, such as what occurs between enhancers and promoters in eukaryotic cells.

Risk of perimetric blindness among juvenile glaucoma patients.

AIM: To estimate rates of progression and to asssess the projected lifetime risk of blindness among treated eyes of juvenile-onset primary open glaucoma (JOAG) patients. METHODS: Rates of change of the visual field index of JOAG patients (diagnosed between the age of 10-40 years), with at least 5 year follow up, were used to estimate the lifetime risk of perimetric blindness. Both the eyes of patients were included in the analysis wherever possible. Average life expectancy of the population was used to calculate the lifetime risk of perimetric blindness. A regression analysis of factors contributing to faster rates of progression was performed. RESULTS: One hundred and two eyes of 54 patients were included in the study. Mean age at the time of baseline visual field was 26.6 ± 9.8 years (15-40 years). The average visual field index change per year was -0.9% (range -6.4 to +2.0% per year) and 18 eyes (17%) showed a progression greater than -2% per year. The cumulative risk of an eye losing 50% and 100% of its visual field index was 30% and 22% respectively over the patients' lifetime. The projected risk of bilateral blindness among JOAG patients over their lifetime was 10%. Long term IOP fluctuation was significantly associated with faster rates of progression (Odds ratio = 2.74; p = 0.012). CONCLUSIONS: Though the rate of visual field deterioration with treatment, among juvenile glaucoma patients is lower compared to that among other types of primary glaucoma, the projected lifetime risk of perimetric blindness in these eyes is similar, despite the longer duration of disease in this age group.

Enhanced tethered-particle motion analysis reveals viscous effects.

Tethered-particle motion experiments do not require expensive or technically complex hardware, and increasing numbers of researchers are adopting this methodology to investigate the topological effects of agents that act on the tethering polymer or the characteristics of the polymer itself. These investigations depend on accurate measurement and interpretation of changes in the effective length of the tethering polymer (often DNA). However, the bead size, tether length, and buffer affect the confined diffusion of the bead in this experimental system. To evaluate the effects of these factors, improved measurements to calibrate the two-dimensional range of motion (excursion) versus DNA length were carried out. Microspheres of 160 or 240 nm in radius were tethered by DNA molecules ranging from 225 to 3477 basepairs in length in aqueous buffers containing 100 mM potassium glutamate and 8 mM MgCl2 or 10 mM Tris-HCl and 200 mM KCl, with or without 0.5% Tween added to the buffer, and the motion was recorded. Different buffers altered the excursion of beads on identical DNA tethers. Buffer with only 10 mM NaCl and >5 mM magnesium greatly reduced excursion. Glycerol added to increase viscosity slowed confined diffusion of the tethered beads but did not change excursion. The confined-diffusion coefficients for all tethered beads were smaller than those expected for freely diffusing beads and decreased for shorter tethers. Tethered-particle motion is a sensitive framework for diffusion experiments in which small beads on long leashes most closely resemble freely diffusing, untethered beads.

Long-term success of mitomycin-augmented trabeculectomy for glaucoma after vitreoretinal surgery with silicone oil insertion: a prospective case series.

PURPOSE: To evaluate the long-term success of trabeculectomy with mitomycin C for glaucoma after vitreoretinal surgery with silicone oil insertion. METHODS: Prospective evaluation of patients who underwent trabeculectomy with mitomycin C (superior or inferior site) for glaucoma after vitreoretinal surgery. Parameters examined included intraocular pressure (IOP), visual acuity, and glaucomatous neuropathy status, preoperatively and at multiple follow-up visits postoperatively till 12 months. Success, both absolute (IOP <21 mmHg) and qualified (IOP <21 mmHg with the use of medications and/or needling), was determined at each follow-up visit. RESULTS: Nineteen patients with mean age of 29 ± 16 years had a mean untreated baseline IOP of 42.5 ± 10.66 mmHg, which reduced to 23.82 ± 7.58 at 1 year (P = 0.008). Preoperative decimal visual acuity was 0.12 ± 0.21, which worsened to 0.07 ± 0.08 at the final follow-up (P = 0.81). Total success rate was 36.9% at the end of 1 year, whereas absolute success rate was only 15.8%. Duration between vitreoretinal surgery and silicone oil removal, preoperative IOP, or site of surgery did not determine success rate. CONCLUSION: Twelve-month success rate for trabeculectomy with mitomycin C in glaucoma after vitreoretinal surgery with silicone oil insertion is lower than reported for most refractory glaucomas.

Drug resistance patterns in Mycobacterium leprae isolates from relapsed leprosy patients attending The Leprosy Mission (TLM) Hospitals in India.

Implementation of multidrug therapy (MDT) in leprosy control programmes has significantly reduced the global prevalence of the disease in the last two decades. After many years of use of MDT, it is expected that drug resistance in Mycobacterium leprae may emerge. This is a major concern, especially during the stage of elimination. In the present study, slit-skin smears were collected from 140 leprosy relapse cases from different Leprosy Mission hospitals across India. DNA extracted from 111 (79%) of these samples was analysed for the genes associated with drug resistance in M. leprae. More than 90% of the patients relapsed as multibacillary (MB) cases. In our study, four (3.6%) of the DNA samples analysed showed mutations associated with rifampicin resistance. We also observed that mutations associated with resistance to dapsone and ofloxacin were observed in 9 (8.1%) of the DNA samples each; two samples had both dapsone and ofloxacin resistance. Further surveillance and appropriate interventions are needed to ensure the continued success of chemotherapy for leprosy.

Efficacy of platelet-rich plasma in alleviating split skin graft morbidities.

Introduction: Skin grafting is a routinely employed technique to cover the skin defect. Though the skin grafts are technically effortless, they are tiresome because of the prolonged duration of hospital stay, labor-intensive, demanding repeated dressings, and also create a second wound. Platelet-rich plasma (PRP) is one that has a higher concentration of platelets than the blood. Alpha granules of the platelets are rich in growth factors. Aims and Objectives: To assess the effect of PRP on split-thickness skin graft uptake and donor site healing. Materials and Methods: In a single-center-based prospective study done from August 2018 to June 2020, 60 patients with acute and chronic wounds were divided into two equal groups. Autologous PRP was applied on the recipient wound bed and donor site in PRP group, and conventional methods like staples/sutures were used to anchor the skin grafts and standard of care of the donor site in a control group. Results: Instantaneous graft adhesion was observed in all patients of PRP group. The first graft inspection was delayed. Seroma, hematoma, total number of dressings, and duration of stay in hospital were significantly reduced in the PRP group. Donor site pain in the postoperative period was notably reduced in PRP group. PRP also remarkably hastened the donor site healing. Conclusion: The application of PRP promotes graft take, minimizes complications, enhances donor site wound healing, mitigates donor site pain, and has immense economic benefits due to the reduced number of dressing changes and shorter hospital stay.

A Comparative Evaluation of Topical Application Versus Perilesional Injection of Platelet-Rich Plasma in Diabetic Foot Ulcer.

Diabetic foot ulcer (DFU) is globally a major health burden predisposing to limb amputation. Among the various treatment modalities, platelet-rich plasma (PRP) is emerging as a promising agent. It stimulates wound healing by providing a higher concentration of essential growth factors locally. Though the role of PRP in DFU healing is established, still the route of administration with maximal efficacy is yet to be defined. Our study aims to evaluate the efficacy of autologous PRP in the treatment of diabetic ulcers and compare the effect of topical and perilesional injections of PRP in DFU healing. We conducted a single-centre, prospective, interventional study on 60 patients with DFU, in 2 groups of 30 patients each. They were treated with freshly prepared autologous PRP injection perilesionally and topically respectively, once a week for 4 weeks. Ulcer size was assessed, using "imito-measure" software at presentation and 2, 4, 8, and 12 weeks post-therapy. Serum MMP-9 levels were assessed in both groups, pretreatment and post-treatment. For statistical analysis, SPSS software V-23 was used. On assessment, both groups had comparable baseline characteristics, Wagner's grading, and glycemic indices. The percentage reduction in the size of the wound at 2 weeks, 1 month, 2 months, and 3 months was greater in the perilesional group as compared to the topical PRP group.

Growth Assessment of Under-Five Children of Employed and Unemployed Mothers of Etawah District, Uttar Pradesh: A Cross-Sectional Study.

Introduction The under-five age group is crucial because the health profile of this age group will have a huge effect on the future development of the nation. Early infancy is marked by several distinct developmental characteristics. Progress in each domain of childhood development is used to track a child's development. Objectives The objectives of the present study were to assess and compare the growth of under-five children of employed and unemployed mothers in the Etawah District of Uttar Pradesh, India. Material and methods A community-based cross-sectional survey was carried out in Etawah district's urban and rural areas between January 2021 and June 2022. A total of 200 mothers with children under the age of five were recruited using the purposive sampling method. To gather pertinent information, a semi-structured, pre-tested, interviewer-administered questionnaire was used. Results In the present study on the comparison of the growth of children among employed and unemployed mothers, it shows that 48 children (50.5%) with a weight between 10.5 and 15 kg were of employed mothers, while 52 children weighing less than 10.5kg were of unemployed mothers (p<0.001). Forty-four children (57.1%) with a chest circumference of more than 48 cm were of employed mothers, while 26 children (78.8%) with a chest circumference of less than 45 cm were of unemployed mothers (p = 0.001). Conclusion The present study indicates that statistically significant differences were found in age-appropriate gain in weight and chest circumference, which was higher among the children of employed mothers in comparison to children of unemployed mothers. There was no statistically significant difference in age-appropriate gain in height, head circumference, or mid-upper arm circumference among the children of employed mothers and unemployed mothers.

Immune Profiles in Multisystem Inflammatory Syndrome in Children with Cardiovascular Abnormalities.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), a sequela of severe acute respiratory syndrome coronavirus-2 infection (SARS-CoV2), has been progressively reported worldwide, with cardiac involvement being a frequent presentation. Although the clinical and immunological characteristics of MIS-C with and without cardiac involvement have been described, the immunological differences between cardiac and non-cardiac MIS-C are not well understood. METHODS: The levels of type 1, type 2, type 17, other proinflammatory cytokines and CC chemokines and CXC chemokines were measured using the Magpix multiplex cytokine assay system in MIS-C children with MIS-C cardiac (MIS-C (C) (n = 88)) and MIS-C non-cardiac (MIS-C (NC) (n = 64)) abnormalities. RESULTS: MIS-C children with cardiac manifestations presented with significantly increased levels of cytokines such as IFN-γ, IL-2, TNFα, IL-5, IL-1α, IL-1ß, IL-6, IL-10 and IL-12p70 and chemokines such as CCL2, CCL3, CCL11 and CXCL10 in comparison to MIS-C children without cardiac manifestations. Clustering analysis revealed that cytokines and chemokines could clearly distinguish MIS-C children with and without cardiac manifestations. In addition, these responses significantly diminished and normalized 9 months after treatment. CONCLUSIONS: This is one of the first studies characterizing and differentiating systemic inflammation in MIS-C with and without cardiac involvement from a low- and middle-income country (LMIC). Our study contributes to the existing body of evidence and advances our knowledge of the immunopathogenesis of MIS-C in children.

Assessment of knowledge and their practices regarding malaria among members of Village Health Sanitation Committee in rural Uttar Pradesh: A cross-sectional study.

Background: In 2019, the global number of malaria cases was estimated at 229 million. An estimated 409,000 deaths were attributed to malaria in 2019. Under-five children are the most susceptible to malaria, accounting for 67% (274,000) of all malaria deaths worldwide in 2019. This study aimed to assess knowledge and practices regarding malaria among Village Health Sanitation Committee (VHSC) members in rural Uttar Pradesh. Methodology: This cross-sectional study was conducted in the villages of four districts of Uttar Pradesh with high malaria burden. In the present study, 484 participants were interviewed from four districts of Uttar Pradesh. Results: Nearly all the participants (97.1%) have heard about malaria. Majority of the participants (97.1) were aware that mosquito bites spread malaria. However, many participants were also having a false awareness that malaria is spread by other modes like drinking contaminated water, touching each other, eating contaminated food, and so on. More than half of the participants told that mosquitoes are responsible for malaria breeds in stagnant clean water (25.6%) and stagnant dirty water (28.5%). Nearly half of them were aware that mosquitoes' biting time was sunset (42.1%) and sunrise (7.8%). Conclusion: In the present study, many participants were having a false awareness that malaria is spread by other modes like drinking contaminated water, touching each other, eating contaminated food, and so on. Even the knowledge regarding any government program for the prevention and control of malaria of the mosquitoes was very weak. There is an urgent requirement of increasing knowledge among the VHSC members to reduce the malaria burden in the country.

FRET measurement of cytochrome bc1 and reaction centre complex proximity in live Rhodobacter sphaeroides cells.

In the model purple phototrophic bacterium Rhodobacter (Rba.) sphaeroides, solar energy is converted via coupled electron and proton transfer reactions within the intracytoplasmic membranes (ICMs), infoldings of the cytoplasmic membrane that form spherical 'chromatophore' vesicles. These bacterial 'organelles' are ideal model systems for studying how the organisation of the photosynthetic complexes therein shape membrane architecture. In Rba. sphaeroides, light-harvesting 2 (LH2) complexes transfer absorbed excitation energy to dimeric reaction centre (RC)-LH1-PufX complexes. The PufX polypeptide creates a channel that allows the lipid soluble electron carrier quinol, produced by RC photochemistry, to diffuse to the cytochrome bc1 complex, where quinols are oxidised to quinones, with the liberated protons used to generate a transmembrane proton gradient and the electrons returned to the RC via cytochrome c2. Proximity between cytochrome bc1 and RC-LH1-PufX minimises quinone/quinol/cytochrome c2 diffusion distances within this protein-crowded membrane, however this distance has not yet been measured. Here, we tag the RC and cytochrome bc1 with yellow or cyan fluorescent proteins (YFP/CFP) and record the lifetimes of YFP/CFP Förster resonance energy transfer (FRET) pairs in whole cells. FRET analysis shows that that these complexes lie on average within 6 nm of each other. Complementary high-resolution atomic force microscopy (AFM) of intact, purified chromatophores verifies the close association of cytochrome bc1 complexes with RC-LH1-PufX dimers. Our results provide a structural basis for the close kinetic coupling between RC-LH1-PufX and cytochrome bc1 observed by spectroscopy, and explain how quinols/quinones and cytochrome c2 shuttle on a millisecond timescale between these complexes, sustaining efficient photosynthetic electron flow.

Clinical spectrum and treatment response in patient of chronic myeloid leukemia in correlation with ABO blood group.

Background: Several studies have been conducted to evaluate and investigate the molecular mechanisms underlying alterations in ABO blood group antigens in oncogenesis. We observed that no study has been reported yet that correlate cytological, molecular and haematological responses of Imatinib therapy in chronic myeloid leukemia (CML) patients with different types of blood groups. Objective: To determine the distribution of CML in the ABO blood group, clinical spectrum of CML in different blood groups, and treatment response of CML patients in correlation with ABO and Rh blood groups. Material and Methods: All the patients included in the study were diagnosed on the basis of clinical features, peripheral smears and bone marrow aspiration findings. Real-time reverse transcriptase polymerase chain reaction (PCR) and cytogenetic analysis were done in all patients at the time of initiation of therapy. Blood grouping and Rh typing of each patient were done at the initiation of therapy. Results: Out of 100 included patients, 58 were male and 42 were female patients. It was observed that 45 (45%) patients were having a B+ blood group; 33% patients were having O+ blood group, followed by A+ (10%), AB+ (8%), A- (2%), B- (1%) and AB- (1%). Around 43.64% study subjects with O + blood groups showed complete cytogenetic response, followed by B+ (41.82%), A+ (10.91), A- (1.82) and AB+ (1.82). An equal number of patients (40% each) with O+ and B+ blood groups, followed by A+ (20%) showed undetectable Abelson-breakpoint cluster region (BCR-ABL)/ratio (%). About 75% of patients showed complete haematological response (CHR) and 25% showed PHR. Patients with B+ and O+ blood groups (41.33%) showed a CHR. It was observed that a maximum number of patients were suffering from symptoms of an abdominal mass (37%), 43.24% of patients with B+ blood group showed an abdominal mass, followed by O+ (35.13%), A+ and AB+ (8.11% each), B - and AB- (2.70% each). Conclusion: This study revealed that study subjects with B+ and O+ blood groups showed better cytogenetic, molecular and haematological responses as compared with patients with other blood groups at 6 and 12 months of treatment with Imatinib.

Morbidity Patterns among Menopausal Women in Rural Uttar Pradesh, India: A Cross-Sectional Study.

OBJECTIVES: The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. METHODS: This community-based cross-sectional study included menopausal women aged 45-55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. RESULTS: A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. CONCLUSIONS: This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage. Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.