Immunological aspects and gender bias during respiratory viral infections including novel Coronavirus disease-19 (COVID-19): A scoping review.

The human immune system is not adequately equipped to eliminate new microbes and could result in serious damage on first exposure. This is primarily attributed to the exaggerated immune response (inflammatory disease), which may prove detrimental to the host, as evidenced by SARS-CoV-2 infection. From the experiences of Novel Coronavirus Disease-19 to date, male patients are likely to suffer from high-intensity inflammation and disease severity than the female population. Hormones are considered the significant pillars of sex differences responsible for the discrepancy in immune response exhibited by males and females. Females appear to be better equipped to counter invading respiratory viral pathogens, including the novel SARS-CoV-2, than males. It can be hypothesized that females are more shielded from disease severity, probably owing to the diverse action/influence of estrogen and other sex hormones on both cellular (thymus-derived T lymphocytes) and humoral immunity (antibodies).

Appraisal of Minerals, Fasting Blood Glucose, and Lipid Parameters in Obese and Nonobese Premenopausal Women.

Introduction Menopause is an important milestone in the lives of women. Despite it being a natural phenomenon, menopause brings a lot of changes in a woman's life, which significantly affects their health and well-being. Menopause involves the cessation of hormone production necessary for menstrual cycles and fertility of females. The absence of these hormones may disturb the homeostasis of minerals, blood glucose, and lipid parameters and predispose women to several health conditions affecting different organs. Obesity has been identified as one of the several conditions that influence the health of women. Therefore, assessing women's health before menopause may improve understanding of their well-being and predict problems during and after menopause. The present study evaluated the activities of calcium, magnesium, phosphorous, fasting blood glucose (FBG), and lipid parameters in obese and nonobese premenopausal women. Methods The present study included 90 obese and 110 nonobese premenopausal women attending the General Medicine and Obstetrics and Gynaecology Departments of Gandhi Medical College and Hospital (GMC&H), Secunderabad, Telangana, India. The body mass index (BMI) was measured in all the study participants to put them under obese and nonobese categories. Blood samples were collected from all the study participants for the estimation of the activities of minerals like calcium, magnesium, phosphorous, FBG, and lipid parameters including total cholesterol (TC), triglycerides (TG), very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Results The results demonstrated a significant difference in the activities of lipid parameters (TC-obese (158.90 ± 20.20 mg/dl) versus nonobese (148.7 ± 18.6 mg/dl), p < 0.05; TG-obese (143.1 ± 58.2 mg/dl) versus nonobese (118.40 ± 55.80 mg/dl), p < 0.01; VLDL-obese (28.30 ± 11.50 mg/dl) versus nonobese (23.30 ± 11 mg/dl), p < 0.05; LDL-obese (92 ± 30.30 mg/dl) versus nonobese (73.90 ± 26.10 mg/dl), p < 0.01; HDL-obese (61.60 ± 12.50) versus nonobese (65.30 ± 11.25 mg/dl), p < 0.01), FBG (obese (106.80 ± 32.20 mg/dl) versus nonobese (88.50 ± 42.60 mg/dl); p < 0.01)), and magnesium (obese (1.79 ± 0.36 mg/dl) versus nonobese (2.42 ± 0.67 mg/dl); p < 0.01)). However, the activities of calcium (obese (9 ± 0.54 mg/dl) vs. nonobese (8.9 ± 0.58); p > 0.05)) and phosphorous (obese (3.84 ± 0.53 mg/dl) versus nonobese (3.75 ± 0.46 mg/dl); p > 0.05)) was found to be similar in obese and nonobese premenopausal women.  Conclusions The results suggest that obese premenopausal women revealed lowered activities of magnesium that can predispose them to chronic diseases like cardiovascular diseases. In addition, obese women showed higher activities of FBG that predisposes them to type 2 diabetes mellitus (T2DM). There was significant variation in the lipid parameters among obese and nonobese women. However, serum calcium and phosphorous were similar in obese and nonobese premenopausal women.

Clinical Trials and Clinical Research: A Comprehensive Review.

Clinical research is an alternative terminology used to describe medical research. Clinical research involves people, and it is generally carried out to evaluate the efficacy of a therapeutic drug, a medical/surgical procedure, or a device as a part of treatment and patient management. Moreover, any research that evaluates the aspects of a disease like the symptoms, risk factors, and pathophysiology, among others may be termed clinical research. However, clinical trials are those studies that assess the potential of a therapeutic drug/device in the management, control, and prevention of disease. In view of the increasing incidences of both communicable and non-communicable diseases, and especially after the effects that Coronavirus Disease-19 (COVID-19) had on public health worldwide, the emphasis on clinical research assumes extremely essential. The knowledge of clinical research will facilitate the discovery of drugs, devices, and vaccines, thereby improving preparedness during public health emergencies. Therefore, in this review, we comprehensively describe the critical elements of clinical research that include clinical trial phases, types, and designs of clinical trials, operations of trial, audit, and management, and ethical concerns.

Clinical Research: A Review of Study Designs, Hypotheses, Errors, Sampling Types, Ethics, and Informed Consent.

Recently, we have been noticing an increase in the emergence and re-emergence of microbial infectious diseases. In the previous 100 years, there were several incidences of pandemics caused by different microbial species like the influenza virus, human immunodeficiency virus (HIV), dengue virus, severe acute respiratory syndrome Coronavirus (SARS-CoV), middle east respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2 that were responsible for severe morbidity and mortality among humans. Moreover, non-communicable diseases, including malignancies, diabetes, heart, liver, kidney, and lung diseases, have been on the rise. The medical fraternity, people, and governments all need to improve their preparedness to effectively tackle health emergencies. Clinical research, therefore, assumes increased significance in the current world and may potentially be applied to manage human health-related problems. In the current review, we describe the critical aspects of clinical research that include research designs, types of study hypotheses, errors, types of sampling, ethical concerns, and informed consent.

Mitochondrial Deoxyribonucleic Acid (mtDNA), Maternal Inheritance, and Their Role in the Development of Cancers: A Scoping Review.

Mitochondrial DNA (mtDNA) is a small, circular, double-stranded DNA inherited from the mother during fertilization. Evolutionary evidence supported by the endosymbiotic theory identifies mitochondria as an organelle that could have descended from prokaryotes. This may be the reason for the independent function and inheritance pattern shown by mtDNA. The unstable nature of mtDNA due to the lack of protective histones, and effective repair systems make it more vulnerable to mutations. The mtDNA and its mutations could be maternally inherited thereby predisposing the offspring to various cancers like breast and ovarian cancers among others. Although mitochondria are considered heteroplasmic wherein variations among the multiple mtDNA genomes are noticed, mothers can have mitochondrial populations that are homoplasmic for a given mitochondrial mutation. Homoplasmic mitochondrial mutations may be transmitted to all maternal offspring. However, due to the complex interplay between the mitochondrial and nuclear genomes, it is often difficult to predict disease outcomes, even with homoplasmic mitochondrial populations. Heteroplasmic mtDNA mutations can be maternally inherited, but the proportion of mutated alleles differs markedly between offspring within one generation. This led to the genetic bottleneck hypothesis, explaining the rapid changes in allele frequency witnessed during the transmission of mtDNA from one generation to the next. Although a physical reduction in mtDNA has been demonstrated in several species, a comprehensive understanding of the molecular mechanisms is yet to be demonstrated. Despite initially thought to be limited to the germline, there is evidence that blockages exist in different cell types during development, perhaps explaining why different tissues in the same organism contain different levels of mutated mtDNA. In this review, we comprehensively discuss the potential mechanisms through which mtDNA undergoes mutations and the maternal mode of transmission that contributes to the development of tumors, especially breast and ovarian cancers.

The Activities of Zinc and Magnesium Among Alcohol Dependence Syndrome Patients: A Case-Control Study From a Tertiary Care Teaching Hospital in South India.

Introduction Alcohol dependence syndrome (ADS) is a medical condition characterized by regular and excessive consumption of alcohol. ADS is a brain disorder wherein people consume alcohol despite knowing the physical, social, and financial consequences. Zinc and magnesium are microelements that are essential in the proper functioning of human physiological and biological processes. However, the homeostasis of these microelements' is disturbed among ADS patients. The present study aims to assess Zinc and magnesium activities among ADS patients and age-matched controls. Methods The study included 100 ADS patients and an equal number of the control group and was conducted between August and September 2021. The study was performed after acquiring approval from the institutional ethics committee. All the study cases were patients attending the department of Psychiatry, RVM Institute of Medical Sciences & Research Centre who were diagnosed with ADS. Both groups used the colorimetric method on ERBA Chem 5+ semi autoanalyzer to estimate serum zinc and magnesium levels. Results Among the 100 cases of ADS, 84 (84%) were males, and 16 (16%) were females. Patients were between the age group of 20 and 68 (mean: 42.8 years). Of the 100 controls, 84 (84%) were males, and 16 (16%) were females with a mean age of 43.1 years. The activities of Zinc among ADS patients and the control group were 88.53±18.7 µg/dL and 144.9±38.47 µg/dL (p<0.0001), respectively. The activities of magnesium among the ADS patients and the control group were 1.96±0.46 mg/dL and 2.88±0.4 mg/dL (p<0.0001), respectively.  Conclusions The activities of Zinc and magnesium have been noted to be significantly lower among ADS patients. Because both these microelements play a vital role in human cells' metabolic and physiologic activities, therapeutic interventions to compensate for such deficiencies while managing ADS patients may prove beneficial.

Serum Activities of Ferritin Among Controlled and Uncontrolled Type 2 Diabetes Mellitus Patients.

Background Diabetes mellitus (DM) is a metabolic disorder characterized by the cells' inefficient utilization of blood glucose. DM occurs in two types: type 1 DM (T1DM) and type 2 DM (T2DM). DM results in increased blood sugar levels attributed to the non-functioning of the insulin-producing islet cells of the pancreas (type 1 DM) and insulin resistance, among other causes. Despite the initiation of treatment, in some people, diabetes remains uncontrolled and, over some time, could cause damage to other organs of the body, including the eyes, heart, and kidneys, among others. Recently, it was observed that iron metabolism and increased activity of serum ferritin (hyperferritinemia) could influence the development of T2DM. This study aims to assess the activities of ferritin among controlled and uncontrolled T2DM patients and compare them with the control group who were non-diabetic. Methods The study included 30 controlled and uncontrolled T2DM patients and an equal number of controls. The study was conducted between September and October 2021, and all patients included were those attending the General Medicine outpatient department attached to the RVM Institute of Medical Sciences and Research Centre, Siddipet, Telangana, South India. Blood glucose activities were estimated by the glucose oxidase-peroxidase (GOD-POD) method using the Randox Daytona plus analyzer, and serum ferritin was measured by the chemiluminescence method using the Beckmann Coulter Access 2 instrument. Results The mean age of the cases and the controls was 56.5 years and 46.7 years, respectively. Serum ferritin activities among people with controlled diabetes (73.3±56.6 ng/ml) (p=0.0003) and uncontrolled diabetes (269.8±347.1 ng/ml) (p=0.0006) varied significantly as compared to the controls (40.853±15.55). Glucose activities among controls (82.9±7.4 mg/dl), controlled T2DM patients (120.9±28.6 mg/dl), and uncontrolled T2DM patients (316.06±145.41 mg/dl) also showed significant differences. Conclusion Hyperferritinemia is evident among uncontrolled T2DM patients. However, increased serum ferritin activities were also noted among controlled T2DM patients as compared to normal activities observed in the non-diabetic control group.

Assessment of SARS-CoV-2-Infected Patients and Their Clinical Outcomes During the Third Wave in India: A Single-Center Observational Study.

Background The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that emerged from the Chinese mainland has spread throughout the world affecting the normal lives of the people. Both developed and developing nations have been equally affected and coronavirus disease-19 (COVID-19) resulted in the death of millions of people worldwide. The virus is undergoing mutations and is evolving into variants that are responsible for wave after wave. This study was carried out to assess the clinical outcomes of people infected with the novel virus during the third wave of the COVID-19 pandemic in India. Methods The study was carried out between November 2021 and January 2022 and included 100 consecutive patients attending the hospital attached to the BLDE (Deemed to be University) Shri B.M. Patil Medical College, Bijapur, Karnataka, South India. All patients included in the study returned a positive report in a real-time polymerase chain reaction (RT-PCR). The patient details collected included age, sex, cycle threshold (Ct) values for envelope (E)/nucleocapsid (N), and Orf1b (open reading frame 1b) genes, hospitalization status, vaccine status, C-reactive protein (CRP), D-dimer, interleukin-6 (IL-6), and final clinical outcome. The data were entered into Microsoft Office Excel sheets, and statistical inferences were drawn using SPSS 24 (IBM Corp., Armonk, NY). Results Of the 100 patients included in the study, only 14 (14%) patients were vaccinated. The patient's mean age was 34.22±17.50. Among the vaccinated patients, the majority had taken COVISHIELD™ (85.71%) compared to COVAXIN® (14.29%). Only 14% of patients were symptomatic, and the mean Ct values among all the patients were 29.92±3.74 (E gene/N gene) and 27.6±4.78 (Orf1B gene). Eight (8%) patients were hospitalized, and all the patients recovered from the infection. Among the hospitalized patients, six (75%) were vaccinated. The mean age of the hospitalized patients was 43.8±14.25 years. The mean CRP, D-dimer, and IL-6 concentrations among the hospitalized patients were noted to be 22.375±16.58 mg/L, 654.325±577.24 ng/mL, and 5.075±2.15 ng/mL, respectively. Conclusion The study results demonstrate that despite unvaccinated status, most patients in the third wave had only suffered from asymptomatic infection. Moreover, people who developed a clinical infection and those who required hospitalization had an uneventful recovery irrespective of their vaccination status.

Assessment of Breastfeeding, Weaning, and Complementary Feeding Practices Among Women Attending a Tertiary Care Teaching Hospital in South India.

Introduction Infants depend exclusively on mothers' milk for nutrition in their early months of life. However, some infants are given cow/buffalo milk during insufficiency. After six months, the children are supplemented with complementary food, including solid food, to meet the nutritional requirements of a growing infant, a process known as weaning. Therefore, it is important for mothers to have a clear understanding of the nature of food, and the nutritional requirements of the children. This study aimed to understand the knowledge, awareness, and practice of breastfeeding, weaning, and complementary feeding among women. Methods A cross-sectional questionnaire-based observational study was carried out between May and June 2021. The study included 150 women attending the outpatient department of pediatrics attached to Mahavir Institute of Medical Sciences (MIMS), Vikarabad, Telangana, India. After taking the informed consent, the researcher filled out a pre-validated questionnaire based on the subjects' responses. The data regarding socio-demographic details and information regarding knowledge, timing, practices of weaning, knowledge of nutritional requirements, and child feeding practices were collected as a pre-test. An educational briefing of the essentials of child feeding practices, weaning, and dietary requirements was undertaken using chalk and board and audio-visual aids, among others. In the post-test, the knowledge of mothers regarding weaning practices, the importance of weaning, and understanding of the nutritional requirements and their inclusion in a child's diet was assessed. The quantitative data were represented as percentages. The Chi-square test was applied to find out the statistical significance of the results obtained from the study. Results Of the 150 women who participated in the study, the majority belonged to the age group of 18-23 years (66.7%). Most women were illiterate (34%) and only 12% were graduates. More than 70% of the participants belonged to the middle and lower middle class. The majority of participants (96.7%) had carried out exclusive breastfeeding for the first six months, and 63.35% of mothers had initiated weaning their child between the age of 6-12 months. Only 37.4% of mothers started breastfeeding within hours after the delivery. A combination of all foods (36%), rice/wheat (29%), processed food (18.8%), fruits and vegetables (9.2%), and pulses (6.7%) were chosen for weaning. Many felt that eggs and meat supplementation can be done between 12-18 months. Conclusion The knowledge of breastfeeding and best practices of weaning and complementary feeding habits significantly affects the child's growth and overall health. The women in this study had a moderate level of understanding regarding the aspects of breastfeeding, weaning practices, and complementary dietary requirements during weaning.

Polycystic Ovarian Syndrome: Prevalence, Predisposing Factors, and Awareness Among Adolescent and Young Girls of South India.

Introduction Polycystic ovarian syndrome (PCOS) is a leading cause of infertility among women throughout the world. PCOS is an endocrine abnormality that presents as hyperandrogenemia, anovulation, and/or polycystic ovaries. The exact causes of PCOS are not entirely understood. However, PCOS may be hereditary and associated with abnormalities such as high body mass index (BMI) and obesity, among others. This study is carried out to assess the prevalence and awareness among adolescents and young girls belonging to South India. Methods This was a prospective study that included 250 adolescent and young girls aged between 13 and 25 years. Demographic details including age, educational status, and family income were collected from all the participants after obtaining informed consent. BMI was measured in all the participants. A pre-test was conducted to assess the level of awareness followed by a 30-minute informative briefing on PCOS. All participants were asked to fill up a post-briefing questionnaire. The data collected were processed using statistical software SPSS 11.0, and the chi-square test was applied to find out the significance of the results. Results Of the total 250 participants included, the mean age was 16.96 years and most participants (78%) belonged to the age group of 13 to 19 years. Most (78%) of the study participants had normal BMI (18-24.9 kg/m2), 17.6% were underweight (BMI < 18), and 4.4% were overweight (BMI > 25). A PCOS prevalence rate of 6.8% was noted among the study participants. A majority (78.4%) of the study participants were unaware of PCOS, and 6.8% were being treated for PCOS. The source of knowledge of PCOS was majorly teachers (37%), followed by doctors (31.5%), the internet (11%), and friends (7.5%). Lack of information and publicity (63%) were found to be the most significant reason for low levels of awareness. Conclusion PCOS is a common health problem among adolescents and young girls. Most study participants were unaware of the symptoms and management of the condition. Therefore, the disease burden noted in this study does not necessarily depict the real prevalence. Increasing awareness programs will facilitate improved understanding, increased diagnoses, and effective management of PCOS.

Research Question, Objectives, and Endpoints in Clinical and Oncological Research: A Comprehensive Review.

Clinical research is a systematic process of conducting research work to find solutions for human health-related problems. It is applied to understand the disease process and assist in the diagnosis, treatment, and prevention. Currently, we are experiencing global unrest caused by the coronavirus disease (COVID-19) pandemic. The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has been responsible for the deaths of more than 50 million people worldwide. Also, it has resulted in severe morbidity among the affected population. The cause of such a huge amount of influence on human health by the pandemic was the unavailability of drugs and therapeutic interventions to treat and manage the disease. Cancer is a disease condition wherein the normal cell function is deranged, and the cells multiply in an uncontrolled manner. Based on recent reports by the World Health Organization (WHO), cancer is the second leading cause of death globally. Moreover, the rates of cancers have shown an increasing trend in the past decade. Therefore, it is essential to improve the understanding concerning clinical research to address the health concerns of humans. In this review, we comprehensively discuss critical aspects of clinical research that include the research question, research objectives, patient-reported outcome measures (PROMs), intention-to-treat and per-protocol analysis, and endpoints in clinical and oncological research.

Mortality Rates of Coronavirus Disease 2019 (COVID-19) Caused by the Novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2).

Background The significance of the global prevalence and incidence of coronavirusdisease 2019 (COVID-19) is a measure of its severity. However, without statistical data, one cannot understand the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. This study, based on good data, enables us to know how the disease is spreading, what impact the pandemic has on the lives of people around the world, and whether the countermeasures that countries have been taking are successful for controlling and preventing the disease. Therefore, this study is undertaken to estimate the infection fatality rates (IFRs) and case-fatality rates (CFRs) in various countries and regions of the world. Methods COVID-19-related data were collected from various countries belonging to different World Bank categories based on economies (low-income, low-middle income, upper-middle income, and high-income countries) and the World Health Organization's (WHO's) regional classification of countries (the Americas, European, African, South-East Asia, Eastern Mediterranean, and Western Pacific regions). The data were collected from the WHO's dedicated website on COVID-19, and statistical methods like mean, standard deviation, p-value, and percentages were used to calculate the IFR and CFR. Results Mexico (8.94%) reported the highest IFR among all the countries. The low-income countries reported increased IFR (2.46±1.91) as compared to the other groups. The European region (7.3%) and the American region (5.3%) recorded the highest CFRs. The South-East Asian region reported the lowest CFR (1.1%). Conclusions The low-income group countries showed higher rates of IFR and lower CFRs. Lower IFRs and increased CFRs were noted among the high-income group countries and the American and European regions respectively. The varied IFRs and CFRs could be attributed to multiple factors that include climatic conditions, living environments, age, sex, comorbidities, among others.

The Association of Pulmonary Tuberculosis, Abnormal Glucose Tolerance, and Type 2 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study.

Introduction Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is the second leading infectious cause of death worldwide. The higher prevalence of pulmonary TB in patients with type 2 diabetes mellitus (T2DM) is a well-known fact. The inverse relationship is also being increasingly recognized. Very few studies are available on the correlation of glycemic parameters with grades of sputum acid-fast bacilli (AFB) positivity and disease severity. Hence, this study is undertaken to determine the prevalence of impaired glucose tolerance (IGT), new-onset T2DM, and to correlate glycemic parameters with sputum positivity grades in pulmonary TB patients. Methods The is a cross-sectional study that included 93 patients with confirmed pulmonary TB, who presented to the General Medicine and Pulmonary Medicine departments of a tertiary care teaching hospital in southern India. All the patients included in the study underwent oral glucose tolerance (OGTT; 75 g) and glycated hemoglobin (HbA1c) tests. The results were analyzed and interpreted using statistical applications (SPSS software version 21, IBM Corp., Armonk, NY). Results Among the 93 patients included in the study, 73 (78.4%) were males and the mean age was 42.5+1.5 years. The OGTT revealed abnormal results in 44 (47.3%) patients. Thirteen (14%) patients showed IGT and 31 (33.3%) had newly been detected with T2DM. The mean HbA1C of the study participants was noted to be 6.413%. Conclusion The prevalence of IGT and T2DM among pulmonary TB patients was noted to be 14% and 33.3%, respectively. The grade of sputum positivity and the severity of the disease did not correlate with the serum of HbA1c levels.

Implant-Associated Infections: A Review of the Safety of Cardiac Implants.

Cardiac implantations are among the most critical, and life-saving patient management procedures. Most cardiac implantations are performed to correct abnormalities in the conduction and the rhythm of the heart. Because the implants are intended for long-term use ranging from months to years, the failure of an implant is considered a major setback both in the patients as well as surgeons' perspectives. Implant failures can have multifactorial reasons, amongst which infectious causes need to be adequately addressed. This review attempts to evaluate the nature of implants, etiology, predisposing factors, infection control, and preventive strategies for cardiac implant-associated infections.

Activities of Serum Magnesium and Thyroid Hormones in Pre-, Peri-, and Post-menopausal Women.

INTRODUCTION: Females go through a complex hormonal variation once they reach menarche. The menstrual cycle repeats every month regularly and is dependent on the normal functioning of the hypothalamus, pituitary, and ovarian hormones. The overall wellness of the females during the menstrual cycle depends greatly on nutritional status. It is common that women develop menstrual cycle-related symptoms and are routinely prone to thyroid dysfunction. The present study is carried out to assess the activities of Mg and thyroid hormones in pre-, peri-, and post-menopausal women. METHODS: A total of 165 women were recruited in the study after satisfying the inclusion criteria. An equal number of age-matched subjects were included as controls. All the subjects included in the study were selected from the patients attending various out-patient departments of the Prathima Institute of Medical Sciences, Karimnagar, Telangana, India. Blood samples from each subject were collected and analyzed by a semi-automated analyzer for the activities of Mg, and thyroid hormones tetra-iodothyronine (T4), tri-iodothyronine (T3), and thyroid-stimulating hormone (TSH). RESULTS: There was a statistically significant relationship between the serum Mg activities and the thyroid hormones between the study subjects and the control group. The activities of the serum Mg (1.72±0.33) in relation to the TSH (5.09±7.54) in the cases were found statistically significant (p <0.001) when compared to the serum Mg (1.8±0.20) in relation to the TSH in the control group (2.41±2.05). The activities of Mg were noted to fall in women through the peri (1.70±0.43), and postmenopausal age (1.60±0.34). There was a significant increase in the activities of TSH in women of premenopause (4.27±5.76), perimenopause (5.65±8.53), and postmenopausal age (7.19±11.07).  Conclusion: From the results of the present study, it can be concluded that the women reaching menopause could suffer from hypomagnesemia and inturn may develop thyroid and other hormonal disorders.

Modified Conventional Teaching: An Assessment of Clinical Biochemistry Learning Process Among Medical Undergraduate Students Using the Traditional Teaching in Combination with Group Discussion.

BACKGROUND: Clinical biochemistry is a branch of organic chemistry which involves a detailed study on the normal functioning of living cells in relation to the disease. The subject is not only volatile but also complicated. Also, teaching biochemistry to medical undergraduates is really a challenging job. Routine didactic lectures alone may not be enough for students while learning clinical biochemistry. METHODS: This study included 90 first-year medical undergraduate students. They were grouped as three groups of 30 students each. The routine conventional classroom teaching method was followed by a group discussion session. The topics were informed in advance so that they were provided with adequate time to prepare and be mentally ready for the session. The group discussion was preceded by a set of 10 multiple-choice questions (MCQs), and a final assessment of five MCQs following the discussion. RESULTS: There was only minor difference in the marks obtained by various student groups after the group discussion with Group B students (5.5 ± 1.54; p < 0.001) performing better than the other two groups. Students also scored evenly in the final assessment using MCQs with Group A (2.7 ± 1.36; p < 0.001) performing better than the other two groups. Prior to the group discussion session, 33% of the students in all the groups scored more than 75% of marks. The overall performance of all the students after the final assessment using MCQs revealed that 60% of the students scored more than 75% marks. CONCLUSION: The study results confirm the fact that the modified conventional teaching method appears to be better than traditional teaching. The student performances had significantly improved with such kind of education process. The results also highlight the importance of increased student efforts, probably including group discussions and revisions to improve understanding and subject retention.

Evaluation of the Activities of Thyroid Hormones Among Pre- and Post-menopausal Euthyroid Women: A Cross-sectional Study from a Tertiary Care Teaching Hospital in India.

Introduction Aging brings about several changes in humans that include both physiological and anatomical changes. As individuals' age, the activity of the thyroid gland and its hormones decline, causing significant metabolic disorders. Most thyroid gland disorders have been noted among young and middle-aged women. Very little is known regarding the activities of thyroid hormones among older aged women. Methods The study included 350 young to middle-aged pre-menopausal women between 25 and 49 years and 350 older post-menopausal women above 50 years of age. The study was conducted in the department of biochemistry, Prathima Institute of Medical Sciences (PIMS), Nagunur, Karimnagar, Telangana, India. The subjects included in the study were euthyroid (not having any signs and symptoms of thyroid disorder) and were not on any medication. The thyroid profile, including thyroid stimulating hormone (TSH), tri-iodothyronine (T3), and tetra-iodothyronine (T4), was analyzed in all the study subjects using the chemiluminescence immunoassay (CLIA) technique on a completely automated Abbott i1000SR Architect Plus instrument (Abbott Core Laboratory, Illinois , US). Results There was no statistically significant difference in thyroid hormone activities in the two age groups compared, as noted by the unpaired student's 't' test. The mean serum TSH levels in the older post-menopausal women (3.39+2.45) were found to be higher than those noted in pre-menopausal women (2.60+1.31). The activities of T3 and T4 showed no difference in both groups (p=0.8397). Conclusion The study results clearly indicate an increase in the activities of TSH among the older-aged post-menopausal women.

Atherogenesis in Psoriasis: Evaluation of the Serum Activities of Non-high-density Lipoprotein Cholesterol and Other Lipids Among Newly Diagnosed Psoriasis Patients.

Introduction  Psoriasis is a chronic inflammatory skin disorder which commonly affects people aged between 15-25 years with a 2-3 % prevalence rate throughout the world. Psoriasis is a systemic inflammatory disease associated with severe co-morbidities that include cardiovascular risk. Although changes in the atherogenic lipids among psoriasis patients is already documented, very little is known about their role in atherogenesis among the new onset cases of psoriasis. Hence, this study is undertaken to assess the activities of non-high-density lipoprotein cholesterol (non-HDL-C) and other lipids among newly diagnosed psoriasis patients. Methods The study included 25 new onset cases of psoriasis patients aged between 20-60 years (mean age 38.2 years) attending the Dermatology outpatient department (OPD) of the Chalmeda Anandrao Institute of Medical Sciences (CAIMS), Karimnagar, Telangana, India, a tertiary care teaching hospital. An equal number of healthy individuals were included as controls. Blood was collected from all the subjects included in the study and was analyzed for various lipid parameters that included total cholesterol (TC), HDL-C, and triglycerides. The non-HDL-C and low-density lipoprotein cholesterol (LDL-C) were later calculated manually by using the standard formulae. The data were tabulated using Microsoft Excel and was analyzed for their statistical significance using the Student t-test. Results The results demonstrated a statistically significant difference in the lipid parameters between the cases and controls. Among the parameters measured, the pro-atherogenic lipids including the LDL-C and non-HDL-C activities among the cases (LDL-C 171.46±17.13, p=0.0002; non-HDL-C 213.27±20.17, p ≤ 0.0001) and controls (LDL-C 91.04±11.41, p=0.0002; Non-HDL-C 119.0± 12.28, p ≤ 0.0001) were found to be statistically significant. The ratios of non-HDL-C to HDL-C and total cholesterol to HDL-C both among the cases (7.10±0.1, 8.13±1.2) and control groups (3.05±0.30, 4.03±0.42) were also showing a statistically significant difference. Conclusion The results clearly demonstrate the significance of the evaluation of lipids among newly diagnosed cases of psoriasis patients. The activities of different lipoproteins including the non-HDL-C and LDL-C revealed an increase among the psoriasis patients. The ratios of non-HDL-C to HDL-C and TC to HDL-C also showed significant variability. Further, to establish their clinical utility in the development of cardiovascular disease (CVD), and to manage appropriately, a regular follow-up of such parameters both before and after initiation of treatment is required.

Probable Potential Role of Urate Transporter Genes in the Development of Metabolic Disorders.

Metabolic disorders are a group of interrelated conditions which increases the risk of developing heart diseases, stroke, and diabetes. These usually occur as a consequence of deficiency of enzymes involved in biochemical reactions in the body. The dietary habits, lack of physical exercise, stress, and genetic susceptibility leads to an increased risk of developing metabolic disorders. A diet rich in processed food items containing high calories aggravates the production of a purine metabolite, the uric acid (UA). UA functions as an antioxidant, protects against inflammation, aging, and cancer. It exists as urate ions in the circulation and blood level of UA is maintained by a balance between its production in the liver and its excretion by the renal tubules. The regular excretion of UA through the kidneys is necessary to maintain optimum blood levels of UA (3-7 mg/dl). There are various transporters of uric acid present around the renal tubules, which help in reabsorption of UA into the blood. These urate transporters (UT) are proteins coded in the genes. Mutations in these genes may prompt disturbances in UA reabsorption, and could lead to the development of hyperuricaemia, insulin resistance, endothelial dysfunction, diabetes and other metabolic diseases. This paper reviews eight such genes coding for UTs and attempts to unravel the link between the activities of UA, UTs, and the consequences during mutations in the genes coding for the UTs in the development of metabolic disorders. The genes reviewed included SLC2A9, SLC17A1, SLC22A12, SLC16A9, GCKR, LRRC16A, PDZK1, and ABCG2.

Dialysis: A Review of the Mechanisms Underlying Complications in the Management of Chronic Renal Failure.

Chronic renal failure (CRF) is the most prevalent, worldwide public health problem of the elderly population. The main cause of CRF is a damaged kidney. There are five stages of CRF based on the glomerular filtration rate (GFR), and stage 5 (GFR < 15 ml/min/1.73m2) is often called an end-stage renal disease (ESRD). In CRF, there is an accumulation of toxins and excess water due to compromised renal function. Dialysis is the preferred way to treat ESRD and remove accumulated toxins from the body. The cardiovascular risk associated with dialysis is 10 to 20 times higher in patients undergoing dialysis than in normal people. The inflamed kidneys and the process of dialysis also affect endothelial function, aggravating the risk of hypertension and cardiac problems. Therefore, both physicians and patients should be aware of the consequences of undergoing dialysis. There is an urgent need to educate CRF patients regarding facts about the disease, medications, dietary habits, and various measures required to manage the condition and lead a normal life. This paper attempts to delineate the mechanisms that could result in cardiovascular and other complications among CRF patients undergoing dialysis.