Glycated albumin (GA) and inflammation: role of GA as a potential marker of inflammation.

AIMS: Abnormal levels of glycated albumin (GA) are associated with the onset of both diabetes and inflammation. Although inflammation has long been associated with diabetes, this article aims to explore the underlying mechanisms of this relationship as it pertains to the role of GA. METHODS: We have reviewed 52 research articles since the year 2000. Common search terms used were "(inflammatory mediator) and GA" or "inflammation and GA". The findings have been organized according to diabetic complications with respect to the interactions of GA and inflammatory mediators. Glycated albumin and specific inflammatory mediators have been reported to play various roles in the pathogenesis of insulin resistance, atherosclerosis, coronary artery disease, retinopathy, and nephropathy. In the case of nephropathy and recently retinopathy, there is considerable evidence for GA in concert with inflammation playing a direct role in organ pathology. There is copious literature detailing GA's involvement in stimulating inflammatory markers and certain pro-inflammatory cytokines. A recent clinical study has shown GA to be a marker for inflammation in non-diabetic rheumatoid arthritis patients with the significance of standard inflammatory markers. CONCLUSIONS: The clinical utility of GA measurement may likely reside in its versatility as both a mediator of inflammation as well as a marker to track hyperglycemia and other diabetes complications. Further understanding of the role GA plays in glycemic and inflammatory diseases could lead to its acceptance as an independent bio-inflammatory marker.

The Impact of COVID-19 on the Psychological Well-Being of Surgeons in Pakistan: A Multicenter Cross-Sectional Study.

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic left a profound and pervasive impact on the healthcare infrastructure on a global scale. Since its onset, the pattern of reported cases and its associated mortality had shown variability with intermittent peaks causing a significant effect on the psychological well-being of the surgeons of Pakistan. The aim of this study was to assess the effects of the COVID-19 pandemic on the mental well-being of surgeons in Pakistan. Methods This multicenter cross-sectional study was carried out to assess the impact of COVID-19 on the psychological well-being of surgeons in Pakistan. The validated Self-Reporting Questionnaire-20 (SRQ-20) tool was circulated electronically via Google Forms (Google, Inc., Mountain View, CA, USA) in the practicing surgical fraternity across all five regions of Pakistan, i.e., Sindh, Punjab, Baluchistan, Khyber Pakhtunkhwa (KPK), and Azad Jammu and Kashmir (AJK). Results This study showed that the female gender, having fewer years of working experience, non-satisfaction with the available personal protective equipment (PPE), and working in the public sector were the factors affecting the psychological well-being of surgeons during the pandemic. Conclusion Considering the continuous rise in new cases during the ongoing pandemic, the mental health of surgeons working in low- and middle-income countries (LMIC) such as Pakistan has been significantly affected. There is an undeniable need to pay close attention to their psychological well-being. Measures need to be undertaken to ensure their physical and mental health and wellness.

Prevalence and diversity of avian hematozoan parasites in Asia: a regional survey.

Tissue samples from 699 birds from three regions of Asia (Myanmar, India, and South Korea) were screened for evidence of infection by avian parasites in the genera Plasmodium and Haemoproteus. Samples were collected from November 1994 to October 2004. We identified 241 infected birds (34.0%). Base-on-sequence data for the cytochrome b gene from 221 positive samples, 34 distinct lineages of Plasmodium, and 41 of Haemoproteus were detected. Parasite diversity was highest in Myanmar followed by India and South Korea. Parasite prevalence differed among regions but not among host families. There were four lineages of Plasmodium and one of Haemoproteus shared between Myanmar and India and only one lineage of Plasmodium shared between Myanmar and South Korea. No lineages were shared between India and South Korea, although an equal number of distinct lineages were recovered from each region. Migratory birds in South Korea and India originate from two different migratory flyways; therefore cross-transmission of parasite lineages may be less likely. India and Myanmar shared more host species and habitat types compared to South Korea. Comparison between low-elevation habitat in India and Myanmar showed a difference in prevalence of haematozoans.

Prevalence and evolutionary relationships of haematozoan parasites in native versus introduced populations of common myna Acridotheres tristis.

The success of introduced species is frequently explained by their escape from natural enemies in the introduced region. We tested the enemy release hypothesis with respect to two well studied blood parasite genera (Plasmodium and Haemoproteus) in native and six introduced populations of the common myna Acridotheres tristis. Not all comparisons of introduced populations to the native population were consistent with expectations of the enemy release hypothesis. Native populations show greater overall parasite prevalence than introduced populations, but the lower prevalence in introduced populations is driven by low prevalence in two populations on oceanic islands (Fiji and Hawaii). When these are excluded, prevalence does not differ significantly. We found a similar number of parasite lineages in native populations compared to all introduced populations. Although there is some evidence that common mynas may have carried parasite lineages from native to introduced locations, and also that introduced populations may have become infected with novel parasite lineages, it may be difficult to differentiate between parasites that are native and introduced, because malarial parasite lineages often do not show regional or host specificity.

Global phylogeographic limits of Hawaii's avian malaria.

The introduction of avian malaria (Plasmodium relictum) to Hawaii has provided a model system for studying the influence of exotic disease on naive host populations. Little is known, however, about the origin or the genetic variation of Hawaii's malaria and traditional classification methods have confounded attempts to place the parasite within a global ecological and evolutionary context. Using fragments of the parasite mitochondrial gene cytochrome b and the nuclear gene dihydrofolate reductase-thymidylate synthase obtained from a global survey of greater than 13000 avian samples, we show that Hawaii's avian malaria, which can cause high mortality and is a major limiting factor for many species of native passerines, represents just one of the numerous lineages composing the morphological parasite species. The single parasite lineage detected in Hawaii exhibits a broad host distribution worldwide and is dominant on several other remote oceanic islands, including Bermuda and Moorea, French Polynesia. The rarity of this lineage in the continental New World and the restriction of closely related lineages to the Old World suggest limitations to the transmission of reproductively isolated parasite groups within the morphological species.

Postural variation of exophthalmometry in Graves' ophthalmopathy.

30 patients with Graves' ophthalmopathy were subjected to exophthalmometry in the upright and supine positions to determine if the difference in exophthalmometer readings in these two situations are significantly different and would help in distinguishing the early and late Graves' ophthalmopathy patients. The cases were divided into two groups (of 15 patients each) of early Graves' ophthalmopathy (Grades 0,1,2) and late Graves' ophthalmopathy (Grades 3,4,5) according to the American Thyroid Association classification. In addition, 15 age and sex matched normal individuals who served as controls, also underwent similar investigation. Contrary to earlier observations, the results showed statistically insignificant increase in exophthalmometer readings when going from the erect to the supine position. It was concluded that postural change in exophthalmometer readings neither helps in distinguishing normal subjects from patients of Graves' ophthalmopathy nor can it differentiate between various grades of Graves ophthalmopathy.

Neovascularization: topical effects of streptococcus thermophilus and low level laser therapy in treatment of diabetic wound in rats

Background: Diabetic wound is a major socioeconomic debilitating problem in this society. Various treatment options are available but still it requires better treatment option. In diabetes mellitus the oxygenation to the tissues is reduced. In this study effects of low level laser therapy were compared with topical application of Streptococcus thermophilus on diabetic wounds that induces formation of new blood vessel and free radical scavenging system, a comparative study to get better treatment option for diabetic wounds.Methods: 18 male rats were selected and divided randomly into three groups. Diabetes was induced in all the rats by using the Alloxan monohydrate at a dose of 120mg/kg of the body weight. Group A was treated with normal saline, group B was treated with low level laser therapy and group C was treated with Streptococcus thermophilus topically. Skin tissues were collected on day three and seven, slides were prepared for microscopic examination to observe the new blood vessels formation.Results: Mean number of new blood vessel formation was observed in group B compared with group A and C. Significant vasculogenesis was seen in group B when treated with Low level laser therapy.Conclusions: In the group of low level laser therapy new blood vessel formation was seen with better wound healing. It means LLLT provides better oxygenation to the tissues by generation of new blood vessels compared with Streptococcus thermophilus and normal saline.

Anti-inflammatory effects of topical lactobacillus acidophilus and antibiotic in wound repair on the basis of microscopic parameters: a comparative study in rats

Background: Wound treatment still a task for medical professionals, according to the time advancement. We need to elaborate further new interventions to cope up this common factor of community. The objective of the study was to assess the anti-inflammatory topical role of Lactobacillus acidophilus with antibiotic in wound repair of rats based on of microscopic parameters. This comparative study was conducted in the Department of Anatomy Al-Tibri Medical Collage and Hospital Isra University Karachi Campus from December 2018 to April 2019.Methods: Total 18 male of wistar rats were randomly selected for this study. The study comprised of three topical groups Control, Antibiotic and Lactobacillus acidophilus groups respectively.Results: The samples were taken from the wound site for the preparation of microscopic slides, to count the numbers of neutrophils, lymphocytes and macrophages for the evaluation of anti-inflammatory process in both groups on day 3 and 7. Data obtained were analyzed by SPSS version 20 by applying One Way ANOVA and post hoc Tukey’s test.Conclusions: The results were shown potent anti-inflammatory effects of Lactobacillus acidophilus group in comparison with other conventional therapy. The study concludes that the topical application of Lactobacillus acidophilus had remarkable anti-inflammatory effects in wound management.

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

Chromium chains as polydentate fluoride ligands for lanthanides.

Hexametallic chromium(III) chains can act as fluoride donor ligands to lanthanide ions giving {(Cr(6))Ln(x)}(n) complexes; preliminary spectroscopic studies are reported.

Foraging technique and prey-handling time in black-necked stork (Ephippiorhynchus asiaticus).

The foraging technique and prey-handling time of the black-necked stork (Ephippiorhynchus asiaticus) was studied in Dudhwa National Park, India, from January 1996 to June 1997. The habitat in which the storks foraged played an important role in selecting a particular technique to procure food. Black-necked storks mostly foraged using a tactile technique (>90%), but sometimes foraged visually. When the water level was estimated to be less than 60 cm, the storks foraged using tactile techniques. There was no difference in the feeding techniques of male and female storks. Foraging attempt rates varied between the sexes in summer (May) and during late winter (February) in 1997. The search time for prey increased when the water level was high and fish were widely distributed. Decreases in water level resulted in concentration offish in certain areas and this contributed to high fish-catching rates by black-necked storks. Males had a higher success rate offish capture than females. However, females captured longer fish than males. Prey-handling time increased in both sexes as fish length increased. Fish 4-6 cm long were most frequently taken by the foraging storks.

A review of glycated albumin as an intermediate glycation index for controlling diabetes.

INTRODUCTION: This article reviews glycated albumin (GA) as a potential intermediate-term glycation index to fill the gap between self-monitoring of blood glucose (SMBG) and hemoglobin A1c testing in diabetes management. The introduction gives an assessment of available short-, medium-, and long-term glycemic indicators. METHODOLOGIES AND UTILITY: Methods of GA measurement are summarized, and the variance of normal and diabetic GA values are discussed. Greatest uniformity in GA measurement is generally associated with immunoassay and the newer affinity chromatography methodologies utilized by reference laboratories. Utility of GA measurement includes its value as a marker for glycation, its substantial relationship to diabetes complications such as nephropathy and coronary artery disease, and as an unambiguous indicator of glycemic control in diabetes patients undergoing hemodialysis. Studies support the utility of GA in detecting short-term changes in glycemic control, and GA testing has been strongly recommended for gestational diabetes. RESULTS AND DISCUSSION: The results of a survey with mailings to over 3500 diabetes care professionals primarily in the United States are outlined and analyzed (margin of error: +/-6.5%, 95% confidence). Respondents strongly supported the need for a test for intermediate glycemic control as well as the utility of a rapid GA test as a monthly glycemic indicator. CONCLUSIONS: Such a test, as yet unavailable, could increase compliance and enhance empowerment among diabetes patients. It also has the potential to reduce the number of recommended SMBG tests, which may result in significant health care cost savings.

Laser ablation of unwanted hand veins.

BACKGROUND: Many patients express dissatisfaction with prominent and bulging hand veins. Abolishing these veins with sclerotherapy requires higher concentrations of sclerosing agents than are used for leg veins and often results in a tender, phlebitic cord. Phlebectomy is another treatment option. Endovenous occlusion and shrinkage techniques have been used successfully to treat varicose veins of the lower extremities. The authors demonstrate a new and unique endovenous laser technique to abolish unwanted hand veins. METHODS: Fifty-four hands (28 patients) with prominent hand veins were treated using a 600-microm laser fiber. The Dornier MedTech 940-nm diode laser system was used. The laser fiber was introduced through a 4-French sheath, which tracked as a coaxial system over an 0.018-inch guidewire. Initial entry into the treated vein was accomplished with a 20-gauge angiocatheter percutaneously. On average, four veins were treated in each hand. Tumescent anesthesia was infiltrated around the laser fiber/sheath unit before activating the laser, and all procedures were performed in an office setting. A compressive dressing was used postoperatively. RESULTS: All but one of the unwanted hand veins were cannulated successfully. The uncannulated vein was treated with sclerotherapy and eventually required phlebectomy. Hand swelling occurred in all treated hands and lasted 2 weeks or less. There was one skin burn of approximately 3 mm at a laser exit site. All 28 patients were satisfied with their results during follow-up, which ranged from 2 weeks to 31 months. CONCLUSIONS: This is the first report of endovenous treatment of unwanted hand veins. Laser ablation of unwanted hand veins can be performed in an office setting. These cosmetically conscious patients were satisfied with their results.

Postural variation of exophthalmometry in Graves' ophthalmopathy.

30 patients with Graves' ophthalmopathy were subjected to exophthalmometry in the upright and supine positions to determine if the difference in exophthalmometer readings in these two situations are significantly different and would help in distinguishing the early and late Graves' ophthalmopathy patients. The cases were divided into two groups (of 15 patients each) of early Graves' ophthalmopathy (Grades 0,1,2) and late Graves' ophthalmopathy (Grades 3,4,5) according to the American Thyroid Association classification. In addition, 15 age and sex matched normal individuals who served as controls, also underwent similar investigation. Contrary to earlier observations, the results showed statistically insignificant increase in exophthalmometer readings when going from the erect to the supine position. It was concluded that postural change in exophthalmometer readings neither helps in distinguishing normal subjects from patients of Graves' ophthalmopathy nor can it differentiate between various grades of Graves ophthalmopathy.