Role of Demographic Factors on Seroprevalence of Transfusion Transmitted Infections among Blood Donors in Delhi, India - A Four Years Retrospective Study

Background: Blood donors belong to a heterogeneous group of people in society, differing in their demographic characteristics and the psychological factors that motivate their behavior. It is important to analyze the various blood donor characteristics in order to manage blood donor programmes. Blood safety and blood supply are profoundly impacted by method of recruitment, specific health history taking and blood screening.Objective: The present study was conducted to determine the role of various demographic factors lie age, sex and occupation on the seroprevalence of transfusion transmitted infections (TTIs) among the blood donors at a tertiary care hospital in Delhi over a period of 4 years. Methods: A 4 year retrospective study was conducted at the blood bank of a tertiary care hospital. All data were collected from blood bank records and included records of 1347 voluntary and 7451 replacement donors from January 2014 to December 2017. Screening of blood units was done by enzyme-linked immune sorbent assay (ELISA) method for Human Immune Deficiency Virus (HIV), and hepatitis B virus (HBV) and hepatitis C virus (HCV). Syphilis was tested by rapid plasma resin (RPR) card test. Malaria was tested by antigen rapid diagnostic test. Any sample found reactive was retested for confirmation. Results: Total 8798 blood donor’s samples were analyzed. 4.27% were female and 95.73% were male. Among the 8798 blood donors, 128 blood donors were positive, prevalence of TTIs was at 1.45 %. The overall positivity rates of anti-HIV, HBsAg, anti-HCV, anti-TP and MP were 0.19%, 0.80%, 0.40%, 0.06 % and 0.01% respectively. The prevalence of TTIs was 1.47% for male and 1.06 % for female in the donation population, the prevalence of TTI positive donations was highest in age group of 51-60 years. Regarding occupation, farmers showed the highest incidence (3.36%) of TTIs while businessmen (1.16%) ranked as the bottom. Conclusion: Overall prevalence of TTI is more in voluntary blood donors as compared to replacement donors. Women are safer donors as compared to males. The prevalence of TTI positive donations was highest in age group of 51-60 years. Farmers showed the highest incidence (3.36%) of TTIs while businessmen (1.16%) ranked as the bottom

Optimizing treatment and analysis of prognostic factors for locally advanced nonsmall cell lung cancer in resource‑limited population.

BACKGROUND: Lung cancer most commonly presents in advanced stages in developing countries, where combined modality treatment using chemo‑radiotherapy (CTRT) is the standard of care. MATERIALS AND METHODS: A retrospective audit of patients of nonsmall cell lung cancer (NSCLC) treated at a single Institute from January 2008 to December 2012 was conducted. Various prognostic factors affecting disease‑free survival (DFS) and overall survival (OS) were studied by univariate and multivariate analysis. All patients were meticulously followed‑up clinically and telephonic contacts. RESULTS: Overall 171 patients of NSCLC were treated with definitive CTRT using concurrent chemotherapy in 66% patients and sequential therapy in 28% patients. The actuarial 2 years DFS was 17.5% and 2 years OS was 61.5%. Complete response to treatment resulted in significantly better DFS and OS. Definitive CTRT was very well‑tolerated in these patients with good compliance. CONCLUSION: Definitive CTRT, sequence being individualized depending on performance status and disease stage at presentation, is a feasible and effective treatment modality for locally advanced NSCLC patients in the developing world. Response to treatment is an important prognostic factor for treatment outcomes.

In vitro studies reveal antiurolithic effect of Terminalia arjuna using quantitative morphological information from computerized microscopy

ABSTRACT Purpose: For most cases, urolithiasis is a condition where excessive oxalate is present in the urine. Many reports have documented free radical generation followed by hyperoxaluria as a consequence of which calcium oxalate (CaOx) deposition occurs in the kidney tissue. The present study is aimed to exam the antilithiatic potency of the aqueous extract (AE) of Terminalia arjuna (T. arjuna). Materials and Methods: The antilithiatic activity of Terminalia arjuna was investigated in vitro nucleation, aggregation and growth of the CaOx crystals as well as the morphology of CaOx crystals using the inbuilt software ‘Image-Pro Plus 7.0’ of Olympus upright microscope (BX53). Antioxidant activity of AE of Terminalia arjuna bark was also determined in vitro. Results: Terminalia arjuna extract exhibited a concentration dependent inhibition of nucleation and aggregation of CaOx crystals. The AE of Terminalia arjuna bark also inhibited the growth of CaOx crystals. At the same time, the AE also modified the morphology of CaOx crystals from hexagonal to spherical shape with increasing concentrations of AE and reduced the dimensions such as area, perimeter, length and width of CaOx crystals in a dose dependent manner. Also, the Terminalia arjuna AE scavenged the DPPH (2, 2-diphenyl-1-picrylhydrazyl) radicals with an IC50 at 13.1µg/mL. Conclusions: The study suggests that Terminalia arjuna bark has the potential to scavenge DPPH radicals and inhibit CaOx crystallization in vitro. In the light of these studies, Terminalia arjuna can be regarded as a promising candidate from natural plant sources of antilithiatic and antioxidant activity with high value.

2D map of proteins from human renal stone matrix and evaluation of their effect on oxalate induced renal tubular epithelial cell injury

Purpose Proteins constitute a major portion of the organic matrix of human calcium oxalate (CaOx) renal stones and the matrix is considered to be important in stone formation and growth. The present study evaluates the effect of these proteins on oxalate injured renal epithelial cells accompanied by a 2D map of these proteins. Materials and Methods Proteins were isolated from the matrix of kidney stones containing CaOx as the major constituent using EGTA as a demineralizing agent. The effect of more than 3kDa proteins from matrix of human renal (calcium oxalate) CaOx stones was investigated on oxalate induced cell injury of MDCK renal tubular epithelial cells. A 2D map of >3kDa proteins was also generated followed by protein identification using MALDI-TOF MS. Results The >3kDa proteins enhanced the injury caused by oxalate on MDCK cells. Also, the 2D map of proteins having MW more than 3kDa suggested the abundance of proteins in the matrix of renal stone. Conclusion Studies indicate that the mixture of >3kDa proteins in the matrix of human renal stones acts as promoter of calcium oxalate crystal nucleation and growth as it augments the renal epithelial cell injury induced by oxalate. The effect of promoters masks the inhibitors in the protein mixture thereby leading to enhanced renal cell injury. 2D map throws light on the nature of proteins present in the kidney stones. .

Cytoprotective role of the aqueous extract of Terminalia chebula on renal epithelial cells

PURPOSE: Kidney stone is one of the most prevalent diseases worldwide. Calcium oxalate (CaOx) has been shown to be the main component of the majority of stones formed in the urinary system of the patients with urolithiasis. The present study evaluates the antilithiatic properties of Terminalia chebula commonly called as "harad" which is often used in ayurveda to treat various urinary diseases including kidney stones. MATERIALS AND METHODS: The antilithiatic activity of Terminalia chebula was investigated on nucleation and growth of the calcium oxalate crystals. The protective potency of the plant extract was also tested on oxalate induced cell injury of both NRK-52E and MDCK renal epithelial cells. RESULTS: The percentage inhibition of CaOx nucleation was found 95.84% at 25µg/mL of Terminalia chebula aqueous extract which remained almost constant with the increasing concentration of the plant extract; however, plant extract inhibited CaOx crystal growth in a dose dependent pattern. When MDCK and NRK-52E cells were injured by exposure to oxalate for 48 hours, the aqueous extract prevented the injury in a dose-dependent manner. On treatment with the different concentrations of the plant extract, the cell viability increased and lactate dehydrogenase release decreased in a concentration dependent manner. CONCLUSION: Our study indicates that Terminalia chebula is a potential candidate for phytotherapy against urolithiasis as it not only has a potential to inhibit nucleation and the growth of the CaOx crystals but also has a cytoprotective role.

Diminution of oxalate induced renal tubular epithelial cell injury and inhibition of calcium oxalate crystallization in vitro by aqueous extract of Tribulus terrestris

PURPOSE: Recurrence and persistent side effects of present day treatment for urolithiasis restrict their use, so an alternate solution, using phytotherapy is being sought. The present study attempted to evaluate the antilithiatic properties of Tribulus terrestris commonly called as “gokhru” which is often used in ayurveda to treat various urinary diseases including urolithiasis. MATERIALS AND METHODS: The activity of Tribulus terrestris was investigated on nucleation and the growth of the calcium oxalate (CaOx) crystals as well as on oxalate induced cell injury of NRK 52E renal epithelial cells. RESULTS: Tribulus terrestris extract exhibited a concentration dependent inhibition of nucleation and the growth of CaOx crystals. When NRK-52E cells were injured by exposure to oxalate for 72 h, Tribulus terrestris extract prevented the injury in a dose-dependent manner. On treatment with the different concentrations of the plant, the cell viability increased and lactate dehydrogenase release decreased in a concentration dependent manner. CONCLUSION: The current data suggests that Tribulus terrestris extract not only has a potential to inhibit nucleation and the growth of the CaOx crystals but also has a cytoprotective role. Our results indicate that it could be a potential candidate for phytotherapy against urolithiasis.

A comparative evaluation of DIAGNOdent with visual and radiography for detection of occlusal caries: An in vitro study.

Background: The diagnosis of dental caries is fundamental to the practice of dentistry. Despite the fact that dental caries has declined considerably, it is still a problem of great importance. The reduction in caries prevalence has not occurred uniformly for all the surfaces. The greatest reduction was observed at lesions located on smooth surfaces, so that occlusal caries are most common in children. Aim: The purpose of this study is to determine the clinical efficacy of DIAGNOdent in detecting occlusal caries. Materials and Methods: A total number of 50 teeth were subjected for visual, radiographic, and DIAGNOdent examinations. All the three methods were compared to histology which is a gold standard. Results: The result obtained showed that DIAGNOdent is superior to visual and radiographic methods in diagnosing occlusal caries.

Brain areas activated after ejaculation in healthy young human subjects.

Brain mechanisms for the refractory period that characteristically follows ejaculation in animals and human are poorly understood. The possibility of active inhibition of brain areas being responsible for the post-ejaculatory inhibitory state has not been ruled out. Using Blood Oxygen Level Dependent (BOLD) functional magnetic resonance imaging (fMRI) we have mapped brain areas in healthy young volunteers immediately after ejaculation. Functional imaging of the brain for 30 minutes beginning after three minutes of ejaculation induced by masturbation showed spatio-temporal activation in amygdala, temporal lobes and septal areas. The septal areas were observed to be active for a shorter duration than the amygdala and the temporal lobe. Thus the temporal sequence of involvement of the above neural structures may contribute to temporary inhibition of sexual arousal/penile erection during the post-ejaculatory refractory period in humans.

Interleukin-1 receptor antagonist gene polymorphism in patients with rheumatoid arthritis in India.

BACKGROUND & OBJECTIVES: Interleukin-1 receptor antagonist (IL-1Ra) is a naturally occurring anti-inflammatory molecule that blocks action of IL-1. Polymorphism in IL-1Ra gene intron 2 results in differences in production of IL-1Ra. These polymorphisms are reportedly associated with autoimmune disease susceptibility in different studies. However, such data are lacking from India. We undertook this study to examine the IL-1Ra polymorphism as a susceptibility marker in patients with rheumatoid arthritis (RA). METHODS: DNA samples from 107 patients with RA and 111 healthy controls were used to study genotypes of the IL-1RA gene by PCR. Allelic frequencies and carriage rates were calculated and compared in both the groups. RESULTS: Among the 107 patients with RA, 93 were females and 75 per cent were seropositive for rheumatoid factor. The frequencies of IL-1RA alleles in controls were as follows: Allele 1 (IL- 1RN*1) was 83.33 per cent, IL-1RA allele 2 (IL-1RN*2) was 16.21 per cent and allele 3 (0.46%). In RA patients the allele frequencies were 84.11 per cent for IL-1RN*1, 14.95 per cent for IL- 1RN*2, 0.47 per cent each for IL-1RN*3 and IL-1RN*4. There was no difference in frequency of different alleles between the two groups. However, homozygosity for allele 2 was more frequent in controls (9.91%) as compared to patients (4.67%). INTERPRETATION & CONCLUSION: Our findings indicated that IL-1RA polymorphism was not a susceptibility marker in RA nor did it show any association with seropositivity, Sjögren's syndrome or subcutaneous nodules. Further studies with large sample need to be done to confirm these findings.

Genetic diversity and bottleneck studies in the Marwari horse breed.

Genetic diversity within the Marwari breed of horses was evaluated using 26 different microsatellite pairs with 48 DNA samples from unrelated horses. This molecular characterisation was undertaken to evaluate the problem of genetic bottlenecks also, if any, in this breed. The estimated mean (-/+ s.e.) allelic diversity was 5.9 (-/+ 2.24), with a total of 133 alleles. A high level of genetic variability within this breed was observed in terms of high values of mean (-/+ s.e.) effective number of alleles (3.3 -/+ 1.27), observed heterozygosity (0.5306 -/+ 0.22), expected Levene's heterozygosity (0.6612 -/+ 0.15), expected Nei's heterozygosity (0.6535 -/+ 0.14), and polymorphism information content (0.6120 -/+ 0.03). Low values of Wright's fixation index, F(IS) (0.2433 -/+ 0.05) indicated low levels of inbreeding. This basic study indicated the existence of substantial genetic diversity in the Marwari horse population. No significant genotypic linkage disequilibrium was detected across the population, suggesting no evidence of linkage between loci. A normal 'L' shaped distribution of mode-shift test, non-significant heterozygote excess on the basis of different models, as revealed from Sign, Standardized differences and Wilcoxon sign rank tests as well as non-significant M ratio value suggested that there was no recent bottleneck in the existing Marwari breed population, which is important information for equine breeders. This study also revealed that the Marwari breed can be differentiated from some other exotic breeds of horses on the basis of three microsatellite primers.

Prolonged feeding practice and its effects on developing dentition.

Muscular activity of the lips, cheeks, and the tongue are important factors, which not only guide the occlusal development but also affect the growth of the jaws. Bottle feeding has been known to cause a myriad of changes in the oro-facial development. But the adverse effects of feeding practices with respect to developing dentition has been a subject of controversy. Hence a study was designed with the aim and objectives to check the commonly adopted feeding practices in South Kanara, to compare the occlusion of 3-to 5-year-old children with breast feeding, bottle feeding or combination, and to check whether prolonged feeding has any adverse influence on developing dentition. A total of 250 questionnaires were distributed to parents of 3- to 5-year-old children of which 153 were chosen for recording the impression and for studying the occlusion under various parameters. The results of the study indicated definite potential hazards of prolonged breast and bottle feeding especially with a tendency to develop openbite and posterior crossbite. It also suggested that an early preventive and interceptive approach.

Maxillo- mandibular relationship--a cephalometric study.

An accurate assessment of apical base relationships using cephalometrics has been a perennial problem in orthodontics. The currently available literature suggests that reference points and planes are subject to change with treatment. Hence, an assessment of sagittal jaw relationship was done using five angular measurements and an attempt was made to determine the one which is statistically more accurate.

Comparative evaluation of clinical efficacy of gallium and amalgam alloys in primary molars.

The present study was conducted to compare the clinical efficacy (marginal integrity and bulk fracture) of two alloys--Galloy (gallium based) and Aristaloy (amalgam based) in primary molars. 90 primary molars with initial caries formation were selected. 45 were restored with Galloy and 45 with Aristaloy in Class I and II preparations. They were evaluated at two-month intervals for 6 months. The results showed that Galloy performed at par with Aristaloy with regards to marginal integrity and bulk fracture. Hence Galloy can be considered as an interesting substitute in Pedodontic practice.

Neurophysiology of pain: insight to orofacial pain.

This is a very exciting time in the field of pain research. Major advances are made at every level of analysis from development to neural plasticity in the adult and from the transduction of a noxious stimulus in a primary afferent neuron to the impact of this stimulus on cortical circuitry. The molecular identity of nociceptors, their stimulus transduction processes and the ion channels involved in the generation, modulation and propagation of action potentials along the axons in which these nociceptors are present are being vigorously perused. Similarly tremendous progress has occurred in the identification of the receptors, transmitters, second messenger systems, transcription factors, and signaling molecules underlying the neural plasticity observed in the spinal cord and brainstem after tissue or nerve injury. With recent insight into the pharmacology of different neural circuits, the importance of descending modulatory systems in the response of the nervous system to persistent pain after injury is being reevaluated. Finally, imaging studies revealed that information about tissue damage is distributed at multiple forebrain sites involved in attentional, motivational, and cognitive aspects of the pain experience.

Role of chest CT scan in determining etiology of primary spontaneous pneumothorax.

BACKGROUND: Spontaneous pneumothorax occurs subsequent to a disruption in the continuity of visceral pleura and escape of air into pleural space. It is usually difficult, sometimes impossible to detect evidence of pulmonary pathology by clinical or conventional radiographic methods. Computed tomography provides additional informations not obtainable with conventional diagnostic modalities. METHODS: To determine the role of CT scan in the aetiological diagnosis and subsequent management of patients with primary spontaneous pneumothorax, a perspective study was undertaken. RESULTS: A total of 40 patients with spontaneous pneumothorax with normal skiagram chest after management of pneumothorax, were included in the study. In 75% of these cases, CT revealed underlying lung pathology as a cause for primary spontaneous pneumothorax. CONCLUSION: Our study shows that CT scan is a useful imaging modality in determining the aetiology of primary spontaneous pneumothorax.

Endothelium-dependent brachial artery flow mediated vasodilatation in patients with diabetes mellitus with and without coronary artery disease.

AIM OF THE STUDY: Endothelial function as assessed by brachial artery flow mediated vasodilatation (FMD) has been shown to be impaired in patients with coronary artery disease (CAD). Since diabetes mellitus (DM) has been considered to be CAD risk-equivalent, we sought to determine whether endothelial dysfunction is present in patients with DM independent of presence of CAD. METHODOLOGY: One hundred and ninety eight individuals were included in the study and divided into four groups: Group 1--patients with risk factors for CAD, but no DM or CAD; Group 2--patients with DM but no CAD; Group 3--patients with CAD but no DM and Group 4--patients with both DM and CAD. Brachial artery FMD assessment was performed once in all subjects and FMD was calculated as percentage increase in brachial artery diameter in response to increase in brachial artery flow. RESULTS : Mean FMD was significantly higher in Group 1 (7.03 +/- 2.87%) compared to the other three groups. Mean FMD in Group 2 (5.51 +/- 2.12%) was similar to that in Group 3 (4.56 +/- 2.70%; p value 0.195) but significantly higher than that in Group 4 (4.26 +/- 1.93%; p value 0.038). There was no statistically significant difference in mean FMD in Group 3 and Group 4 (p value 0.65). CONCLUSION : Endothelial function as assessed by FMD is significantly impaired in diabetics compared to non-diabetics in absence of CAD. In addition, similar degree of impairment in endothelial function is seen in diabetics without CAD and non-diabetic patients having CAD, implying CAD risk-equivalence of diabetes.

Traumatic injuries to the incisors in children of South Kanara District. A prevalence study.

Trauma to the teeth is a commonly encountered problem. Many studies have stated the prevalence of traumatic injuries, range from 4% to 19.5%. In the present study, the prevalence of traumatic injuries to incisors teeth was studied. The unique feature of this study was that it related the associated causes with the severity of fractures (fracture types). In the present study prevalence was found to be 13.8% and this was associated with various factors such as age group involved, sex, place of injury and the overjet of the dentition.

A comparative study of effects of cigarette and bidi smoking on respiratory function tests.

The effects of cigarette and bidi smoking on pulmonary function tests have been studied in 90 healthy males from North India Forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expiratory volume in 1 sec (FEV) were determined in 30 nonsmokers (as control group), 30 cigarette smokers and 30 bidi smokers. All the above pulmonary function parameters were found to be lower among smokers as compared to nonsmokers. Moreover, the decrease in the pulmonary function tests was greater in cigarette smokers as compared to bidi smokers.

DOTS versus self administered therapy (SAT) for patients of pulmonary tuberculosis: a randomised trial at a tertiary care hospital.

Tuberculosis is a major public health problem in a developing country like India, it is made worse by poor adherence to and frequent interruption of treatment. Treatment of tuberculosis requires strict discipline in order to eradicate mycobacteria and to cure the disease. In the present study we have conducted a randomized control trial, to compare the effectiveness of Directly Observed Therapy Short Course (DOTS) versus Self Administered Therapy (SAT) in a tertiary care hospital.

The effect of indigenous Neem Azadirachta indica [correction of (Adirachta indica)] mouth wash on Streptococcus mutans and lactobacilli growth.

Neem is one of the most widely researched tropical tree, with almost all it's parts being put for a variety of uses. In the present study, the antibacterial effect of Neem mouthwash against salivary levels of streptococcus mutans and lactobacillus has been tested over a period of 2 months. Also it's effect in reversing incipient carious lesions was assessed. While streptococcus mutans was inhibited by Neem mouthwashes, with or without alcohol as well as chlorhexidine, lactobacillus growth was inhibited by chlorhexidine alone. The initial data appears to prove it's effect in inhibiting S. mutans and reversing incipient carious lesions, longer term clinical trials are essential.