The effect of vitamin D supplementation on cardiorespiratory fitness and muscle strength in male adults undergoing basic military training.

BACKGROUND: Vitamin D deficiency (VDD) is ubiquitous in the Indian subcontinent. VDD has been shown to impair muscle functions. However, the association of VDD with cardiorespiratory endurance is uncertain. Hence, we enrolled and supplemented vitamin D in military recruits with VDD with an aim to evaluate effect of supplementation on cardiorespiratory endurance and muscle strength. METHOD: We enrolled 90 military recruits with VDD and randomly allotted them to two groups equally. The group I received cholecalciferol granules 60,000 IU every fortnight for twelve weeks (cases), and the group II was observed as control. Muscle strength and cardiorespiratory endurance was assessed with a battery of tests (standing broad jump, bent arm hang test, 20 m shuttle run) at baseline and repeated at the end of training (nineteen weeks). Blood samples were collected for measurement of serum 25(OH)D and parathyroid hormone. RESULTS: In Group I and Group II, there was significant increase in 25(OH) D levels (25.8 ± 7.1 and 17.3 ± 3.5 ng/ml, respectively), and in VO2 max (9.8 ± 8.8 and 12.7 ± 8.6 ml/kg/min, respectively) compared with the baseline values. However, no significant change was observed in muscle strength after supplementation. There was no difference between the groups in VO2 max and muscle strength at baseline and at the end of training. CONCLUSION: Vitamin D supplementation did not improve muscle strength and cardiorespiratory endurance in military recruits with VDD. A significant rise in 25(OH) D was observed even in those not supplemented with vitamin D.

Faecal occult blood testing screening for colorectal cancer and 'missed' interval cancers: are we ignoring the elephant in the room? Results of a multicentre study.

AIM: Biennial faecal occult blood testing (FOBT) is used to screen for colorectal cancer throughout the UK. Interval cancers are tumours that develop in patients between screening rounds who have had a negative FOBT. Through a multicentre study, we compared the demographics of patients with interval cancers, FOBT screen detected cancers and cancers that developed in patients who chose not to participate in the screening programme. METHOD: Five hundred and sixteen colorectal cancers were detected in the screening age group (60-74 years) population in three UK National Health Service hospitals over 2 years. One hundred and twenty seven (25%) were interval cancers, 161 (31%) were screen detected and 228 (44%) were cancers that developed in patients who had declined FOBT. The interval cancer group had a higher incidence of right-sided cancers (38% vs 29% and 24%), a higher proportion of high tumour stages (Dukes C and D) (70% vs 53% and 33%) and a shorter time from diagnosis to death (10 months vs 13 months and 24 months) compared to patients who had declined the FOBT and the FOBT screen detected cancers. Of all the patients studied, those with right-sided interval cancers had the worst outcome. CONCLUSION: A quarter of the colorectal cancers diagnosed in our study were interval cancers. Patients with right-sided interval cancers had the highest proportion of Dukes C and D tumours coupled with the shortest survival time after diagnosis compared with the other groups.

The relationship between serum 25-hydroxy vitamin D, parathormone and bone mineral density in Indian population.

OBJECTIVES: Vitamin D deficiency (VDD) is a global problem. Not all patients with VDD have clinical manifestations or secondary hyperparathyroidism. We studied the interaction between serum 25-hydroxy vitamin D (25OHD), parathormone (PTH) and bone mineral density (BMD) in Indian adolescents and adults. DESIGN: Population survey. PATIENTS: A total of 1829 adolescents and 1346 adults aged 50 years and above were analysed in this study. MEASUREMENTS: Serum biochemistry, 25OHD, PTH and BMD were estimated. Subjects were grouped according to quartiles of serum PTH. VDD was defined as severe (25OHD ≤ 5 ng/ml), moderate (25OHD ≤ 10 ng/ml) and mild (25OHD ≤ 20 ng/ml) and secondary hyperparathyroidism (SHPT) when serum PTH levels >65 pg/ml. RESULTS: Only 30-40% of subjects with moderate and severe VDD, respectively, had SHPT. BMD decreased from Quartile 1 to Quartile 4 of PTH at all sites among adolescents and adults, with only a marginal decline in serum 25OHD levels between these quartiles. Further, within each PTH quartile, there was no difference in BMD according to categories of VDD. Analysing BMD in the different PTH quartiles, the PTH cut-offs beyond which BMD showed a significant decline, was 35 pg/ml in adolescents and 53 pg/ml in adults. CONCLUSIONS: Less than half of the subjects with VDD have SHPT. BMD levels start to decline at PTH values currently considered to be normal. These data suggest the need to redefine SHPT in different age groups keeping in mind the relationship between PTH and BMD. This may also influence the decision to supplement subjects with VDD.

Influence of cultivar and maturity at harvest on the essential oil composition, oleoresin and [6]-gingerol contents in fresh ginger from northeast India.

Severe flooding of the Brahmaputra River during the monsoon season and continuous rainfall in the northeast region (NER) of India cause an enormous loss of ginger crop every year. In this context, the present study investigates the variation in the essential oil composition and oleoresin and [6]-gingerol contents in 10 different fresh ginger cultivars harvested at 6- and 9-month maturity from five different states of NER. Monoterpenes, sesquiterpenes, and citral composition in the essential oil were evaluated to ascertain their dependence upon the maturity of ginger. Except Mizoram Thinglaidum, Mizoram Thingria, Nagaland Nadia, and Tripura I ginger cultivars, all other cultivars showed an increase in the citral content during the maturity that was observed for the first time. At 6-month maturity, a higher undecanone level was found in Nagaland Nadia (7.36 ± 0.61%), Tripura I (6.23 ± 0.61%), and Tripura III (9.17 ± 0.76%) cultivars, and these data can be used as a benchmark to identify those immature varieties. Interestingly, the Nagaland Nadia cultivar showed higher ar-curcumene (9.57 ± 0.58%) content than zingiberene (5.84 ± 0.24%), which was unique among all cultivars. Ginger harvested at 9-month maturity from the Tripura II cultivar had the highest citral content (22.03 ± 0.49%), and the Meghalaya Mahima cultivar had the highest zingiberene content (29.89 ± 2.92%). The oleoresin content was found to decrease with maturity in all cultivars, except Assam Fibreless and Manipur I. Moreover, the highest oleoresin (11.43 ± 0.58 and 9.42 ± 0.63%) and [6]-gingerol (1.67 ± 0.03 and 1.67 ± 0.05 g) contents were observed for Tripura II and Nagaland Nadia, respectively. This study suggests that Tripura and Nagaland are the most ideal locations in NER for ginger cultivation to obtain high yields of oleoresin and [6]-gingerol contents and harvesting at the 6-month maturation will compensate for the loss of ginger crop caused by the Brahmaputra River flooding in NER every year.

Turmeric (Curcuma longa L.) volatile oil inhibits key enzymes linked to type 2 diabetes.

Anti-diabetic capacity of Curcuma longa volatile oil in terms of its ability to inhibit glucosidase activities was evaluated. Turmeric volatile oils inhibited glucosidase enzymes more effectively than the reference standard drug acarbose. Drying of rhizomes was found to enhance α-glucosidase (IC50 = 1.32-0.38 µg/ml) and α-amylase (IC50 = 64.7-34.3 µg/ml) inhibitory capacities of volatile oils. Ar-Turmerone, the major volatile component in the rhizome also showed potent α-glucosidase (IC50 = 0.28 µg) and α-amylase (IC50 = 24.5 µg) inhibition.

Process development for the enrichment of curcuminoids in turmeric spent oleoresin and its inhibitory potential against LDL oxidation and angiotensin-converting enzyme.

Turmeric (Curcuma longa) contains biologically active colouring constituents, curcuminoids, which are isolated from the turmeric rhizome by solvent extraction. The mother liquor left after the separation of curcuminoids is known as turmeric spent oleoresin (SOT). The present study developed a method for the enrichment of curcuminoids in SOT. By using this method, curcuminoids in the SOT (8.4%) were doubled (17.5%). Presence of curcuminoids in enriched fraction was confirmed by high performance liquid chromatography (HPLC) and liquid chromatography coupled with mass spectroscopy analysis. Further studies on this fraction showed that it can effectively inhibit angiotensin-converting enzyme and low-density lipoprotein oxidation with IC(50) values of 19.45 µg/ml and 30.52 µg/ml, respectively. The results showed that curcuminoids enriched fraction (CEF) can reduce the risk of hypertension and cardiovascular diseases. In addition to this fraction, a turmerone-rich hexane fraction was also separated from the spent oleoresin.

Non- epidermidis coagulase-negative staphylococcal bacteremia: clinical predictors of true bacteremia.

In order to explore the clinical significance and risk factors for true bacteremia caused by coagulase-negative staphylococci (CNS) other than Staphylococcus epidermidis, a retrospective cohort study of 160 patients with at least one blood culture positive for non- epidermidis CNS was performed. True bacteremia was diagnosed in 32 (20%) of the patients. On multivariate analysis the following factors were associated with true bacteremia: (i) more than one positive blood culture, (ii) presence of a central venous catheter, and (iii) methicillin resistance. The results of this study indicate that non- epidermidis CNS can cause significant bloodstream infections.

Analysis of the 5' end of the rat plasma membrane Ca(2+)-ATPase isoform 3 gene and identification of extensive trinucleotide repeat sequences in the 5' untranslated region.

We have characterized the 5' end of the rat gene encoding isoform 3 of the plasma membrane Ca(2+)-ATPase using S1 nuclease protection and DNA sequence analysis. The 5'-untranslated region consists of over 900 nucleotides and includes a 217-nucleotide sequence composed of alternating tracts of TCC and ACC trinucleotides. Analysis of genomic sequences 5' to the transcription initiation site revealed potential binding sites for transcription factors that are active in muscle and brain.

Production of a nested set of glycosylphosphatidylinositol structures from a glycosylphosphatidylinositol-anchored protein.

Glycosylphosphatidylinositol (GPI) membrane anchors are synthesized in the endoplasmic reticulum of eukaryotic cells. Synthesis of the core GPI structure is achieved by the sequential transfer of monosaccharides and phosphoethanolamine to phosphatidylinositol. The assembly process can be reproduced in vitro using membrane preparations supplemented with sugar nucleotides. With one exception, however, none of the biosynthetic enzymes involved have been isolated. One impediment to progress in the isolation of these enzymes is the nonavailability of adequate amounts of partially assembled GPI structures for use as assay substrates. In this paper we present procedures to prepare these structures from a GPI-anchored protein. The methods described include selective dephosphorylation of the GPI-anchored variant surface glycoprotein from Trypanosoma brucei variant 118 to generate Man alpha 1-2Man alpha 1-6Man alpha 1-4GlcN alpha 1-6-myo-inositol-P-dimyristoylglycerol (Man3GlcN-PI), followed by exoglycosidase treatments and N-acetylation to produce Man2GlcN-PI, Man1GlcN-PI, GlcN-PI, and GlcNAc-PI. Procedures are also described for the stabilization and purification of these structures. It is anticipated that the convenient preparation of this range of partially assembled GPIs will be useful not only in developing assays for the eventual purification of the GPI biosynthetic enzymes but will also contribute to evaluating the specificity of the phospholipases that hydrolyze GPI anchors.

Inhibition of angiogenesis and growth of human non-malignant and malignant meningiomas by TNP-470.

Meningiomas are relatively common (22%) vascular brain tumors. 3-11% of meningiomas are malignant, and defy currently available therapy. Inhibition of neovascularization is one potential strategy for treating these hypervascular tumors. Inhibition of tumor-induced angiogenesis by TNP-470 (previously termed AGM-1470), a synthetic analogue of fumagillin, was tested on the growth of human non-malignant and malignant meningiomas in nude mice. TNP-470 significantly inhibited tumor neovascularization and tumor growth of both non-malignant and malignant meningiomas. TNP-470 is now in human trial and should be tested for efficacy in treating malignant or recurrent aggressive meningiomas.

Utilization of village health workers within a primary health care programme in The Gambia.

The utilization of Village Health Workers (VHWs) was studied in a rural area of The Gambia 3 years after the introduction of a village-based Primary Health Care (PHC) programme. Of 23 children who died from conditions treatable at village level, only five were first seen by the VHW. Fourteen were seen elsewhere in the region by staff more qualified than the first tier workers. The implications of this pattern of utilization on the lack of impact of VHWs on mortality are discussed. Only half of the non-fatal illnesses were attended to by VHWs. Reasons for this included such factors as lack of knowledge of services available, shortages of money, absence of the VHW at critical periods and social or political disputes with VHWs. Attempts must be made to tackle these fundamental problems if VHWs are to be successfully incorporated into the health services.

PIP: A researcher reviewed village health worker (VHW) utilization in a primary health care (PHC) program in villages around Farafenni in North Bank division of The Gambia. 47 children 7 years old died between April 1986-March 1987. WHWs could have treated the illnesses (malaria, diarrhea, and acute respiratory infection) that killed 23 (49%) of these children. Yet they treated only 6 of the 23 while other health workers in the region treated 14 children. 3 children received no treatment. Further a traditional healer later treated 3 of those seen by a VHW before death. Parents of a fatally ill child with diarrhea were a bit more likely to take the child to a traditionally healer than a VHW. None of the VHWs referred any of the fatally ill children to the next PHC level. Chronic diarrhea/malnutrition, chronic cough, meningitis, measles, and septicemia caused the death of 20 of the 24 remaining children. A VHW treated only 1 of the 24 remaining children before death. Moreover a VHW saw only 48% of the living children who had experienced illness during the study period. The remaining children went to other health providers. 26% of mothers claimed they had forgotten that VHWs could treat illnesses. In fact, 75% of those who had forgotten did not clearly understand the role of the VHW. They tended to think that the VHW provided only prevention information. 20% could not afford a VHW, yet they paid much more for other health workers. Another 26% said that the VHW was not available at the time. 5% reported the VHW to be unsupportive. The remaining 21% did not know why they did not take their child to a VHW. When the researcher pushed these mothers, 61% gave personal animosity as a reason and 39% did not want to talk about it. In conclusion, the VHWs did not receive adequate training, had limited range of drugs, were poorly supervised, and often not available.