Future perspectives in addressing the global issue of vitamin D deficiency.

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 µg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 µg for those aged 1-70 years and 20 µg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

Isolation of Brucella melitensis from a human case of chronic additive polyarthritis.

Brucellar arthritis remains under diagnosed owing to non-specific clinical manifestations. Here, we report isolation of Brucella melitensis from synovial fluid of 5th metatarsophalangeal joint of a 39-year-old lady having unusually chronic asymmetric, additive, peripheral polyarthritis. This isolation was confirmed by Bruce-Ladder polymerase chain reaction (PCR). The patient had a history of contact with an aborted goat. Rose Bengal Plate Agglutination Test (RBPT) and Standard Tube Agglutination Test (SAT) were positive for Brucella-specific antibodies both for patient and in contact with sheep and goats. The patient was treated with doxycycline and rifampicin for 16 weeks and was recovered fully.

Depth matters: cells grown on nano-porous anodic alumina respond to pore depth.

Recent experiments have shown unambiguously that living cells respond to the nano-topography of surfaces they grow on-specifically, the fate of stem cells grown on nano-porous titania or alumina have been shown to be decided by the pore size. However, most experiments have focused on pore size or pitch. Here we show that in addition to pore size and pitch, the depth of the pores has a profound effect on cell morphology and the arrangement of the actin cytoskeleton.

Profile of patients of leptospirosis in sub-Himalayan region of North India.

CONTEXT: Leptospirosis is an emerging zoonosis world wide; it is being reported in many areas of south-east Asia now. A recent surge in the number of patients with leptospirosis has been noted in the Sub-Himalayan region of North India which was uncommon. We present here a case series of 13 patients who were positive for leptospirosis either by IgM Elisa or PCR method. AIMS: To study the profile of leptospirosis in a sub-Himalayan state of North India i.e. Himachal Pradesh. SETTINGS AND DESIGN: This was a retrospective study of leptospira positive patients who were admitted in IGMC, Shimla. The study was conducted in Indira Gandhi Medical College, Shimla situated at a moderate altitude in North India. METHODS AND MATERIAL: All patients presenting in Medical College Hospital during three months from 1st August to 31st October who tested IgM positive or borderline or PCR positive for leptospirosis were taken into the study. Their presenting complaints, examination findings and lab findings were recorded and analyzed based on the Faine's criteria and modified Faine's criteria. Patients with clinical features of Leptospirosis and who tested positive for IgM Leptospirosis were taken as IgM lepto can be falsely positive. RESULTS: Out of total 13 patients there were 3 males and 10 females, age range was from 24 to 78 yrs and mean was 44 yrs. Predominant complaints were fever, jaundice, myalgia, and headache. All had contact with animals or contaminated environment. LFT's were deranged in 12 and renal functions were deranged in all. Ten had positive results for IgM against leptospira while 2 had borderline positive result. One patient was positive by PCR method using G1, G2 primers. Ten patients had Weil's syndrome and this was the main presentation of leptospirosis in our group, one had acute respiratory distress syndrome (ARDS) and needed ventilator. There were no deaths. All responded to injectable ceftriaxone and oral doxycycline. Applying Faine's criteria only 7 were positive, but using modified Faine's criteria all 13 were positive for leptospirosis. CONCLUSIONS: Leptospirosis was unexpectedly found to be positive in many of our patients who were having pyrexia during the monsoons. A recent surge has been noted in the number of cases with leptospirosis in this state. The possibility of co-infection especially with scrub typhus must be considered in cases with atypical presentation and severe illness. Most of the patients were from rural background with poor hygienic conditions. There was no mortality and main complication was Weil's syndrome in 77 percent.

The genus Gelsemium: An update.

The review includes 103 references on the genus Gelsemium, and comprises ethnopharmacology, morphology, phytoconstituents, pharmacological reports, clinical studies and toxicology of the prominent species of Gelsemium. Alkaloids and iridoids constitute major classes of phytoconstituents of the genus. Most popular species of the genus are the Asian G. elegans and the two North American related species, G. sempervirens and G. rankinii. Gelsemium species are categorized under medicinal as well as poisonous plants. Amongst various species, G. elegans and G. sempervirens possess medicinal value, and have been traditionally used as nervous system relaxant. These plants have been explored exhaustively for their anticancer activity. In the concluding part, the future scope of Gelsemium species has been emphasized with a view to establish their multifarious biological activities and mode of actions.

Unilateral blepharospasm and blepharoptosis with bilateral vertical gaze palsy in thalamic hemorrhage.

We present here case of a 49-year-old female with unilateral left sided blepharospasm and blepharoptosis, bilateral vertical gaze palsy, right hemiparesis and right seventh nerve supranuclear palsy as a manifestation of left thalamic hemorrhage. To our knowledge this is the first reported case of a combination of unilateral blepharospasm and blepharoptosis with bilateral vertical gaze palsy.

Cutaneous sporotrichosis: an unusual clinico-pathologic and therapeutic presentation.

This report presents a number of unusual clinico-histopathologic and therapeutic features in a culture proven case of cutaneous sporotrichosis. These include lymphocutaneous sporotrichosis involving face; its dissemination in an otherwise healthy patient; its histology mimicking cutaneous cryptococcosis; two episodes of severe purulent inflammatory reaction bordering the lesion during therapy with saturated solution of potassium iodide; no therapeutic response to potassium iodide therapy and rapid healing of lesion with high-dose of fluconazole.

Isolation, purification and some structural features of the mucilaginous exudate from Musa paradisiaca.

The water-soluble polysaccharides isolated from the vascular gel of Musa paradisiaca, were fractionated via anion exchange chromatography into four fractions. Fractionated polymers contained arabinose, xylose and galacturonic acid as major sugars, together with traces of galactose, rhamnose, mannose and glucose residues. Methylation analysis revealed the presence of a highly branched arabinoxylan with a significant amount of terminal arabinopyranosyl units and an arabinogalactan type I pectin. Periodate oxidation studies supported the results of methylation analysis.

Effect of yoga training on reaction time, respiratory endurance and muscle strength.

There is evidence that the practice of yoga improves physical and mental performance. The present investigation was undertaken to study the effect of yoga training on visual and auditory reaction times (RTs), maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), 40 mmHg test, breath holding time after expiration (BHTexp), breath holding time after inspiration (BHTinsp), and hand grip strength (HGS). Twenty seven student volunteers were given yoga training for 12 weeks. There was a significant (P < 0.001) decrease in visual RT (from 270.0 +/- 6.20 (SE) to 224.81 +/- 5.76 ms) as well as auditory RT (from 194.18 +/- 6.00 to 157.33 +/- 4.85 ms). MEP increased from 92.61 +/- 9.04 to 126.46 +/- 10.75 mmHg, while MIP increased from 72.23 +/- 6.45 to 90.92 +/- 6.03 mmHg, both these changes being statistically significant (P < 0.05). 40 mmHg test and HGS increased significantly (P < 0.001) from 36.57 +/- 2.04 to 53.36 +/- 3.95 s and 13.78 +/- 0.58 to 16.67 +/- 0.49 kg respectively. BHTexp increased from 32.15 +/- 1.41 to 44.53 +/- 3.78s (P < 0.01) and BHTinsp increased from 63.69 +/- 5.38 to 89.07 +/- 9.61 s (P < 0.05). Our results show that yoga practice for 12 weeks results in significant reduction in visual and auditory RTs and significant increase in respiratory pressures, breath holding times and HGS.

Comparative neurotoxicity of cadmium in growing and adult rats after repeated administration.

The effect of cadmium administration (Cd 0.4 mg/kg, ip, intraperitoneally, daily for 30 days) on its accumulation, contents of 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HIAA) in different brain regions in growing and adult rats was investigated. Cadmium was found to significantly increase the levels of 5-HT and 5-HIAA in all the brain regions of adult rats while the levels of 5-HT and 5-HIAA were significantly decreased in most of the brain regions of growing rats. The accumulation of cadmium in all the brain regions was significantly more marked in growing rats compared to adults after identical exposure. In conclusion, there was an age difference in both the accumulation of cadmium and 5-HT turnover in the brain regions. However, the regional neurochemical changes were not correlated with the magnitude of cadmium accumulation in both the groups.