Non-invasive predictors to grade esophageal varices in liver cirrhosis patients.

Background: Portal hypertension commonly occurs due to liver cirrhosis, and esophageal varices (EV) is one of the major complications associated with it. The most common cause of death in liver cirrhosis is EV bleeding. Hence, GE screening for EV is required, which is an invasive procedure. Regular use of endoscopy results in low compliance due to cost and discomfort for patients. Hence, identifying non-invasive markers that could grade EV provides a useful screening tool for family physicians and primary health centers (PHCs) by referring the patient to higher centers for definitive treatment, which could reduce mortality due to variceal bleeding in cirrhotic patients. Aims: To assess non-invasive predictors of grade EV in patients diagnosed with liver cirrhosis. Settings and Design: Cross-sectional study. Methods and Material: A total of 109 patients with liver cirrhosis underwent clinical and biochemical evaluation, USG abdomen with spleen bipolar diameter, ascitic fluid analysis, and upper GE with a grade of EV are recorded. Statistical Analysis Used: SPSS software with Student t-test, Chi-square t-test, analysis of variance, receiver operator characteristic (ROC) curves, and Spearman correlation with 95% CI is used. P <0.05 is considered significant. Results: Aminotransferase to Platelet count Ratio Index (APRI) score >1.815, PC/SD ≤909, and SAAG >1.1g/dl showed EV in liver cirrhosis (P < 0.05). The order of prediction with ROC curves shows APRI score > PC/SD > SAAG. In grading EV, APRI scores of 1.9-2.5 and >2.5 showed small and large EV, respectively (P < 0.05). Conclusions: APRI score may be used in PHC as an early intervention to grade EV and refer the patient to higher centers for definitive treatment. This would prevent the progression of varices to rupture and reduce mortality due to variceal bleeds in liver cirrhosis patients.

Association of stress and primary hypothyroidism.

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic-pituitary-thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease. Aim: To evaluate the relationship between stress and primary hypothyroidism. Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5-5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument. Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score. Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients.

Correlation Between Maternal Age and Cytokine (IL-6 and TGF-Beta) Levels in Colostrum.

BACKGROUND: Cytokines are small proteins that play an important role in cell signaling, particularly in inflammatory pathways. There are both pro- as well as anti-inflammatory cytokines that regulate this pathway and modulate the immune responses. Advancing maternal age is associated with systemic inflammation. The present study intends to evaluate the effect of advancing maternal age on cytokine (IL-6 and TGF-ß) levels in colostrum, the first breast milk secreted by mothers. METHODOLOGY: A total of 77 term deliveries were enrolled in the study. Colostrum specimens were collected and evaluated for cytokine IL-6 and TGF-ß levels. Colostrum IL-6 and TGF-ß levels were correlated with maternal age and were assessed using the Spearman rank correlation coefficient. Multivariate analysis was done using a linear regression model comprising age, parity, and mode of delivery. RESULTS: Mean colostrum IL-6 and TGF-ß levels were 113.3±73.1 pg/ml and 20.9±23.6 pg/ml, respectively. No significant correlation between maternal age and colostrum IL-6 levels was observed (r=0.137; p=0.314). However, there was a significant positive correlation between maternal age and colostrum TGF-ß levels (r=0.452; p<0.001). CONCLUSIONS: The findings of the study show a significant association between maternal age and colostrum TGF-ß levels. The impact of colostrum cytokine levels on neonatal growth and development in context with advancing maternal age needs to be evaluated.

Comparison of Demirjian and Cameriere methods and development of modified Cameriere and Demirjian formula more efficient for North Indian population.

Introduction: Accurate age estimation is of utmost importance in several branches of life, be it disaster victim identification (DVI), sports, fashion, education, and many more. Several studies/formulas have been proposed over the years from various parts of the world and amongst them, Cameriere's method of age estimation is now being accepted globally, and the related work is still one of the most thought about. Aim: The aim of this study was to access the relationship between dental age (DA) and chronological age using Cameriere and Demirjian age estimation method in the north Indian population and develop a population-specific regression formula and validate it in the north Indian population. Materials and Methods: Orthopantomograms (OPG) of 762 children of north India with age groups between 7 and 16 years were collected. Seven left permanent mandibular teeth were analyzed using both Cameriere and Demirjian's age estimation method. The resultant data were subjected to statistical analysis. Results: The mean differences between CAge and DAge with age were 1.21 (males), 0.14 (males) and 1.72 (females), 0.28 (females) respectively, which shows significant disparity, wherein Demirjian follows overestimation and Cameriere follows the underestimation trend. Therefore, we modified these methods using the linear regression model. Conclusion: The modified Demirjian and Cameriere formula after validation shows a better fit in the north Indian state of the Uttar Pradesh population.

Sampling rate influences measures of blood pressure variability in ambulatory blood pressure monitoring.

BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is a valuable tool in the diagnosis and management of hypertension and it is a good predictor of future cardiovascular events. Lack of normal threshold values of ABPM parameters and inconsistency in the sampling rate of recording are hurdles in its wider usage. The aim of the present investigation was to study the influence of sampling rate on ABPM. METHODS: ABPM was performed in 47 healthy subjects and the effect of different sampling rates was studied on ABPM parameters. RESULTS: When data were down-sampled, there was a trend towards decreased concordance and increased dispersion with less frequent recordings. Percent dispersion of MESOR, 24-h average, 24 h standard deviation (SD), awake hours average and sleep hours average of systolic BP (SBP) were around 10% for a sampling interval of 1 h. While average real variability (ARV), morning surge and percent dip in SBP exhibited more than 30% dispersion at a sampling interval of 30 min. CONCLUSION: 24-h average blood pressure (BP) is less sensitive to sampling rate whereas BP variability parameters such as ARV, morning surge and percent dip in SBP are highly sensitive. We suggest that for improving the accuracy of BP variability parameters, a higher sampling rate is desirable around the time of awakening (~2 h before and after the expected time of awakening). At other times, a lower sampling rate may be used for maximizing patient comfort without compromising measurement accuracy.

Association of cytokines levels with epidermal growth factor receptor mutation in lung cancer patients.

BACKGROUND: Lung cancer is one of the most frequent types of cancer and the leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase (TK) being highly expressed in lung cancers. Activation of EGFR through oncogenic mutations leads to upregulation of gene expression that may heighten the inflammatory response in certain situations. EGFR acts as a key regulator and a cellular hub for inflammatory cytokine signaling, thereby promoting tumor cell proliferation, invasion, migration, metastases, and survival. The aim of the present study is to determine the serum cytokines levels and EGFR mutation status in lung cancer patients to investigate the association between the EGFR mutation status and cytokines levels with lung cancer patients. MATERIALS AND METHODS: Blood and tissue samples of lung cancer patients were collected. The EGFR mutations of lung cancer patients were determined by the immunohistochemistry (IHC) and serum cytokines levels of lung cancer patients were determined using ELISA. RESULTS: Statistically significant association of EGFR mutations with adenocarcinoma subtypes and non-smokers were found (P < 0.05). Lung cancer patients with EGFR mutations had significantly higher tumor necrosis factor-alpha levels when compared to lung cancer patients without EGFR mutations (P < 0.01), and EGFR mutation status was not significantly associated with interleukin-6 levels (P = 0.24). CONCLUSION: EGFR mutation detection by the IHC method is a potentially useful tool to guide clinicians for personalized treatment of lung cancer patients of adenocarcinoma subtype, and cytokines are good biomarkers for the diagnosis, prognosis, and prediction of treatment responses in lung cancer patients as well as act as therapeutic targets. This study will provide biomarkers for lung cancer diagnosis and treatments.

Hospital-based study on demographic, hematological, and biochemical profile of lung cancer patients.

BACKGROUND: Lung cancer is considered as the most commonly diagnosed cancer. It is the leading cause of cancer-related mortality. Smoking and environmental pollutants act as important risk factors in majority of lung cancer cases (80%-90%). MATERIAL AND METHODS: This is a hospital-based study carried on in lung cancer patients of North India. Demographic profile of lung cancer patients was recorded. Hematological and biochemical profiles of lung cancer patients and healthy controls were compared. RESULTS: Highest proportion of lung cancer was found in the age group of 46-60 years. Lung cancer was seen in highest number in male gender (76.63%) and also in those patients belonging to the rural category (84.58%). In this study, only 3.98% lung cancer patients having the past history of cancer and 5.47% showing the family history of cancer. Significant differences were found in weight and body mass index (BMI) of lung cancer patients when compared to healthy control (P < 0.0001). Hemoglobin (Hb) was found lower in lung cancer patients as compared with healthy controls. Significant difference was also observed in Hb levels of these two groups (P < 0.000). The serum protein level was lower in lung cancer patients than healthy controls. A significant difference was also observed in the protein levels of these two groups (P < 0.0001). Serum alkaline phosphatase (ALP) levels were higher in lung cancer patients in comparison to healthy controls. A significant difference was also observed in serum ALP levels in lung cancer patients as compared with healthy controls (P < 0.0001). CONCLUSIONS: Significant difference between BMI, Hb, serum albumin, and total protein was found in this study. These biomarkers may be helpful in the diagnosis of lung cancer at early stage and also in the follow-up assessment of the effects of treatment.

A Study on Metabolic, Nutritional and Biochemical Profile of Tobacco Users With and Without Oral Precancer Lesions.

INTRODUCTION: The tobacco use and the dietary intake/levels of vitamin C and E, and the trace elements, iron, copper, zinc, and selenium are interrelated with the development of oral precancer. These micronutrients are necessary for maintaining good oral health. AIMS: To estimate the nutritional status, vitamin E, C and micronutrient level of zinc, iron, copper, and selenium, and basic vitals in all study groups. MATERIAL METHOD: The study sample is comprised of 384 subjects. There were three study groups, and in each study group, there were 128 subjects. Group A was tobacco users without oral precancer/dysplasia. Group B was tobacco users with oral precancer (H/P confirmed). Group C was healthy individuals with no history of tobacco or areca nut use and oral precancer. Data have been collected using a standard structured predesigned questionnaire for evaluation of the nutrition level of the subject; 5 mL blood has been collected for estimation of micronutrients; and basic vitals such as pulse rate and blood pressure have been examined using the digital machine. Questionnaire data will also be entered in the worksheet for the purpose of analysis. The analysis will be performed using the commercially available Statistical Package SPSS. RESULT: The serum level of zinc, iron, selenium, vitamin E and C was decreasing in Groups A and B, i.e., users with precancer and users without precancer as compared to Group C, i.e., controls. But serum copper level was increasing in Groups A and B, i.e., users with precancer and users without precancer, and the level was found to be decreased in Group C, i.e., controls. Later on, in the present study, basic vitals such as blood pressure and pulse rate of all the study subjects in all the three groups were clinically examined. No significant differences were found in blood pressure, pulse rate (radial pulse), and height in all groups. But the weight was slightly higher in Groups A and B as compared to Group C. DISCUSSION: Diet plays an aggressive role in the development of oral precancer. The deficiency of certain micro nutrients may lead to disease progression. We can say that a healthy diet comprising of vegetarian and plain food may lead to solving issues of oral health. CONCLUSION: The above-highlighted text shows that micronutrients play dominant role in maintenance of oral health and its deficiency may result in the growth of oral precancer. So involving diet rich in zinc, iron, selenium, vitamin E and C may help in maintaining healthy nation.

Study on prevalence and sociocultural aspects of tobacco use in India.

AIM: The present study focuses on the prevalence of tobacco use and aims to determine various sociocultural aspects of tobacco use in Indian population. MATERIALS AND METHODS: The study sample comprised 384 participants. There were three study groups, and in each study group, there were 128 participants. Group A was tobacco users without oral precancer, Group B was tobacco users with oral precancer, and Group C was healthy individuals with no history of tobacco or areca nut use and oral precancer. Both male and female adults in the age group of 18 years and above visiting the Outpatient Department of Oral and Maxillofacial Surgery at King George's Medical University were recruited for the study. The study participants were explained in detail about the study, and informed consent was obtained through them. Data have been collected using a standard structured predesigned questionnaire. The questionnaire consisted of the details of the demographic profile of the study participants, details of tobacco use, and the major social and cultural reasons which motivated them to consume tobacco. Data were extracted from the case sheet, and the data were entered into a worksheet for the purpose of analysis. The analysis was performed using the commercially available Statistical Package SPSS. CONCLUSION: The rate of tobacco prevalence is very high among the Indian population, and a number of social and cultural factors are responsible for its use. To curb this problem, more studies could be done to find the causes responsible for its use.

Association of inflammatory biomarkers with lung cancer in North Indian population.

BACKGROUND: Lung cancer is characterized by uncontrolled cell growth of the lung tissues. It is the leading cause of cancer-related deaths worldwide. OBJECTIVES: The study aimed to determine the circulating CRP, TNF-α, IL-6 and IL-8 levels in lung cancer and healthy control and also established association between these biomarkers with the smoking status as well as the stages of the disease. METHODOLOGY: 51 lung cancer patients and 51 healthy controls were enrolled in this case-control study. The serum levels of CRP, TNF-α, IL-6 and IL-8 were measured in lung cancer patients and healthy control groups. RESULTS: The levels of serum CRP, TNF-α, IL-6 and IL-8 were significantly higher in lung cancer patients when compared with controls(P<0.0001). The levels of these biomarkers were also significantly higher in stage iii/iv as compared to stage i/ii(P<0.001). Significant difference in the levels of these biomarkers were also found in smoker and non-smoker lung cancer patients as compared to controls(P<0.001). CONCLUSION: CRP, TNF-α, IL-6 and IL-8 are the promising biomarkers in the identification of lung cancer patients. The study also supports the association of inflammatory markers to lung cancer risk. Hence these findings suggest the levels of these biomarkers could be a useful tool for guiding the diagnosis of lung cancer.

Circadian variability in airways characteristics: A spirometric study.

Background: Chronic obstructive pulmonary disease (COPD) and Asthma patients exhibit exacerbation of symptoms in night hours and early morning. Temporal variability in airway caliber have been reported in past using peak expiratory flow rate which represents large airways caliber, while in COPD and Asthma, smaller airways are particularly affected. We studied circadian variability of airway caliber using Forced Expiratory Volume in the First Second (FEV1) and Mid Expiratory Flow rate. Methods: Male volunteers (18-26 years), having similar daily routine were recruited. Spirometry was performed at 5: 00, 8:00, 11:00, 14:00, 17:00, 20:00 and 23:00 h. Data from 104 subjects was analyzed for diurnal variability parameters viz., amplitude percent mean and standard deviation percent of mean. For circadian rhythm Cosinor curve was fitted and rhythm characteristics in terms of MESOR, Amplitude and Acrophase were determined. Results: Repeated measures ANOVA revealed significant differences in spirometric parameters measured at different time points during the day. In general, spirometric parameters follow a sinusoidal pattern and exhibit minimum values during night hours and maximum values during day time. FEV1 Cosinor rhythm was significant in 31% of subjects (Zero amplitude test). The distribution of acrophase revealed interindividual differences in chronophenotypes. Variability was minimum for FEV1% and maximum for FEF75 suggesting dynamic interplay of airway geometry and neuro-chemical influences. Conclusion: The presence of different chronophenotypes in normal subjects suggests that the nocturnal asthma may also be a different phenotype. Availability of portable spirometers and home monitoring thus may be required for ascertaining chronophenotype and tailoring chronotherapeutic interventions.

Enzymatic treatment for removal of hazardous aqueous arylamines, 4,4'-methylenedianiline and 4,4'-thiodianiline.

The search for an effective and sustainable treatment method to remove the recalcitrant atom-bridged bis-anilino compounds, 4,4'-methylenedianiline (MDA) and 4,4'-thiodianiline (TDA) from water is a major challenge and focus of this study. The escalating discharge of these two toxic and carcinogenic pollutants from industrial sources may pose a serious threat to the environment. Crude soybean peroxidase (SBP), isolated from soybean seed hulls (coats), catalyzes the oxidative polymerization of these aqueous pollutants in the presence of hydrogen peroxide. The effects of several process parameters, i.e., pH, hydrogen peroxide-to-substrate concentration ratio and SBP concentration, were investigated to optimize the performance of enzymatic treatment. The minimum effective SBP concentration required for removal of MDA was 0.70 U/mL, which was higher than that of TDA (0.15 U/mL). The reaction time course to achieve ≥95% removal of these compounds from water was determined under those optimum conditions. Identification of the transformed products was performed by means of high-resolution electrospray ionization mass spectrometry. The products generally observed were protonated oxidized oxidative dimers and higher oligomers (most commonly azo-coupled products). Michaelis constant, KM, and maximum reaction velocity, Vmax, obtained from the Michaelis-Menten (M-M) model revealed that TDA had a 65-fold lower KM than MDA (indicating TDA's higher affinity for SBP), and almost 5-fold higher Vmax than MDA. A pro-forma cost analysis is presented to assess the possibility of commercialization of enzymatic treatment as an alternative to conventional/traditional treatment methods.

EGFR Mutation Detection and Its Association With Clinicopathological Characters of Lung Cancer Patients.

BACKGROUND: Lung cancer is the most common type of cancer worldwide with an estimation of 1.82 million new cancer cases diagnosed; and it is the leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase identified as being highly expressed in cancer cells including lung cancers. The aim of the study is to determine the EGFR mutation status in non-small cell lung cancer (NSCLC) patients to investigate the association between the EGFR mutation status and clinicopathological characters of patients. METHODS: The tissue samples of the lung cancer patients were collected bronchoscopically. The EGFR mutations of 70 NSCLC patients were determined by the immunohistochemistry (IHC). RESULTS: EGFR mutations were present in 24 cases (34.29%), including 19 (79.13%) cases of exon 19 and five (20.83%) cases of exon 21 mutation. EGFR mutations were frequently associated with adenocarcinoma and non-smoker. Statistically significant association of EGFR mutations with adenocarcinoma subtypes and non-smokers was found (P < 0.05); and no significant association of EGFR mutation with the age of the patient (P = 0.4647) and the stage (P = 0.4578) of the tumor was found. When we compared between these two mutations, no significant association with age (P=0.614) and smoking status (P=0.127) was found in this study. CONCLUSIONS: EGFR mutations were significantly associated with female sex, non-smoker and adenocarcinoma subtypes. The analysis of EGFR mutation by the IHC method is a potentially useful tool to guide clinicians for personalized treatment of NSCLC patients of adenocarcinoma subtype.

The effect of elapsed time on cardiac troponin-T (cTnT) degradation and its dependency on the cause of death.

PURPOSE: The aim of the present study is to evaluate the effect of elapsed time on cardiac troponin-T degradation and its dependency on the cause of death. METHODS: The cases included in this study were divided into six groups depending upon the cause of death without any prior history of disease that died in the hospital and their exact time of death was known. The analysis involves extraction of the protein, separation by denaturing gel electrophoresis and visualization by Western blot. RESULTS: Western blot data shows the rate of degradation of cTnT into lower molecular weight fragments with respect to time. In cases of control group the greatest amount of protein breakdown was observed within the first 64 h while in MI cases within first 6 h, the original band of cTnT (42 kDa) decreased markedly into seven major fragments, with 25 kDa & 20 kDa fragments being the most prominent. In burn group, at 41.40 h blot shows maximum fragmentation. In electrocution group the greatest amount of protein breakdown was observed within the first 50 Hrs. Within asphyxia cases, the original band of cTnT (42 kDa) decreased markedly into many major and minor fragments which continues up to 210 Hrs while the original band of cTnT (42 kDa) in poisoning cases decreased markedly into many major & minor fragments up to 140 h but after it blot shows only intact protein of very less intensity with few minor fragments. CONCLUSION: It can be observed that in case of death due to MI, the intact cTnI fragmented at a much faster rate than in burn, electrocution, control, poisoning and asphyxia group. Thus, the rate of fragmentation of intact cTnT into lower molecular weight fragments depends upon the cause of death.

Temperature-Dependent Postmortem Changes in Human Cardiac Troponin-T (cTnT): An Approach in Estimation of Time Since Death.

Estimation of time of death is an indispensible requirement of every medico-legal autopsy, but unfortunately, there is not a single method by which it could be determined accurately. This study focused on the temperature-dependent postmortem degradation of cardiac troponin-T and its association with postmortem interval (PMI) in human. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE), and visualization by Western blot using cTnT-specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc (Universal Hood). The results indicate a characteristic banding pattern among human cadavers (n = 6) and a pseudo-linear relationship between percentage of cTnT degradation and the log of the time since death (r > 0.95), which can be used to estimate the postmortem interval. The data presented demonstrate that this technique can provide an extended time range during which PMI can be more accurately estimated.

The effect of elapsed time on cardiac troponin-T (cTnT) degradation and its relation to postmortem interval in cases of electrocution.

BACKGROUND: The estimation of postmortem interval (PMI) is of paramount importance for the police in their investigation when arriving at the scene of a questionable death. The aim of present study is to evaluate the effect of elapsed time on cardiac Troponin-T degradation and its association with PMI in cases of death due to electrocution. METHODS: Cardiac tissue samples were collected from medico-legal autopsies, after informed consent from the relatives. The cases included were the subjects of electrocution without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involves extraction of the protein at room temperature for different time periods (∼5, 26, 50, 84, 132, 157, 180, 205 and 230 Hrs), separation by SDS-PAGE and visualization by Western blot using cTnT specific monoclonal antibodies. RESULTS: The results specify a characteristic banding pattern amongst human cadavers (n = 5), a pseudo-linear relationship between percent cTnT degraded and the time since death (R(2) = 0.87, p = 0.0001) was observed. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc (Universal Hood II). CONCLUSIONS: The post-mortem Troponin-T fragmentation observed in this study reveals a sequential, time-dependent process with the potential for use as a predictor of PMI in cases of electrocution.

The effect of elapsed time on the cardiac Troponin-T (cTnT) proteolysis in case of death due to burn: A study to evaluate the potential forensic use of cTnT to determine the postmortem interval.

BACKGROUND: After the death of an organism, intracellular enzymes cause protein to degrade into smaller fragments as the time passes, if these fragments can be isolated and visualized, and if the fragmentation is proved to be measurable and quantifiable, it can be a good sign of the post-mortem interval (PMI). The aim of this study is to evaluate the effect of PMI on Troponin-T protein degradation in cardiac tissues of cadavers through quantitative analysis of Troponin-T degradation by easily electrophoretic method and its association with PMI in case of deaths due to burn. METHODS: An efficient extraction protocol to analyze the banding pattern of cTnT in post-mortem tissue was developed. The analysis involves extraction of the protein (at different PMI (~7.30, 18.20, 30.30, 41.20, 41.40, 54.30..................88.40h), from the heart muscles of cadavers (burn cases), separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. RESULTS: The results specify a characteristic banding pattern amongst human cadavers (n=9), a pseudo-linear relationship between percent cTnT degraded and the time since death (r=0.87, p=0.0001). The area of the bands within a lane was quantified by scanning and digitizing the image using commonly available scanners. CONCLUSIONS: The present research used a simple, easy, applicable and highly informative electrophoresis method that make it an ideal for the busy forensic laboratory. The post-mortem Troponin-T fragmentation observed in this study reveals a sequential, time-dependent process with the potential for use as a predictor of PMI in cases of burning. This result shows a potential for use as a future applied method of evaluating time since death.

Association of diabetic autonomic neuropathy with red blood cell aldose reductase activity.

OBJECTIVE: Activation of polyol pathway based on increased activity of aldose reductase (AR) has been implicated in the development of diabetic complications including diabetic autonomic neuropathy (DAN). The relationship between DAN and hyperglycemia-induced activation of polyol pathway is still uncertain. In the present study, we investigate the association between aldose reductase activity and diabetic autonomic neuropathy by measuring AR level in red blood cells (RBC). METHOD: In this study, 145 subjects with diabetes with or without DAN and 32 subjects without diabetes have been included. All subjects have been investigated for autonomic function tests and RBC aldose reductase activity. DAN was defined if results of any 2 of the tests of parasympathetic function were abnormal. RBC aldose reductase level was determined spectrophotometrically and expressed as unit/g of hemoglobin. The values were expressed as mean ± standard deviation, and ANOVA test has been applied for comparison between groups. RESULTS: RBC aldose reductase activity was found to be significantly higher in people with diabetes with autonomic neuropathy in comparison to people with diabetes without autonomic neuropathy and healthy individuals without diabetes. Aldose reductase (AR) level ranges from 0.8 units/g Hb to 14.2 units/g Hb. The mean AR level was 8.6±2.95 units in subjects of DM with autonomic neuropathy, while mean AR level was 4.1±1.78 units and 2.0±0.89 units in people with diabetes without neuropathy and normal healthy individuals, respectively (p<0.001). CONCLUSIONS: High aldose reductase activity is associated with the presence of autonomic neuropathy in subjects of type 2 DM.

Epidemiology & preventive aspects of railway suicides and fatalities related to trespassing accidents.

PURPOSE: Suicide and trespass are major contributors to risk on the railway, resulting in around 170-180 fatalities per year in Lucknow region, as well as associated major disruption to the rail network. Lucknow is the capital city of the state of Uttar Pradesh in India. METHODS: The analysis included train-pedestrian fatalities during 2007-2012. The data for 2007-2012 were collected from the autopsy reports of the university, case sheets from the hospital, the general prosecutor's investigations report and the inquest reports from police. RESULTS: The results show that the majority of victims were males. Half of the suicide victims were 20-39 years old. Accidents happened most frequently in situations when a person was walking on the tracks/in front of train (22.7%) or were crossing the tracks illegally (20.9%). Among all train-pedestrian fatalities, about half of the victims (42.8%) were intoxicated by alcohol. Female suicide victims suffered from mental health problems more frequently (55.8%) than male suicide victims. CONCLUSION: Overall, there is no reason to believe that train-pedestrian fatalities are unavoidable. By contrast, the effective prevention of railway suicides and accidents should be based on a systems approach involving effective measures introduces by several organisations such as government, railway organisations, various authorities (such as public health, education, enforcement, urban planning) and communities. Same measures can often be used to prevent both trespassing and suicides, even though their effectiveness may depend on the target group. In addition, there are measures specifically targeted to prevent either trespassing or suicides.

Identification of a person with the help of bite mark analysis.

Forensic dentistry is an essential part of Forensic science, mainly involves the identification of an assailant by comparing a record of their dentition (set of teeth) with a record of a bite mark left on a victim. Other uses in law for dentists include the identification of human remains, medico-legal assessment of trauma to oral tissues, and testimony about dental malpractice. While the practice of human identification is well established, validated and proven to be accurate, the practice of bite mark analysis is less well accepted. The principle of identifying an injury as a bite mark is complex and, depending on severity and anatomical location, highly subjective. Following the identification of an injury as a bite mark, the comparison of the pattern produced to a suspect's dentition is even more contentious and an area of great debate within contemporary odontological practice. Like fingerprints and DNA, bite marks are unique to an individual - such as distance and angles between teeth, missing teeth, fillings and dental work. This type of impression evidence can be left in the skin of a victim and also can be in food, chewing gum and other miscellaneous items such as pens and pencils. The advent of DNA analysis and its recovery from bite marks has offered an objective method of bite mark analysis.