bluuebunny/crossref_metadata_2025 huggingface dataset:
Disease Assessment in Psoriasis
Authors: Manchanda Yashpal , De Abhishek , Das Sudip , Chakraborty Disha
Published: August 2024

Researchers are making all out efforts worldwide, to find a serological marker to monitor the disease severity and/or measure efficacy of the drug. There are many potential molecular targets being investigated as a candidate marker. However, till date there has been no significant breakthrough. Thus, various scoring systems have been devised to evaluate the disease severity in psoriasis. In spite of constant revisions of the scores being currently used, from time to time. None of the scores yet satisfy all the validation criteria desired of an ideal scoring system. And this is partly also because of the fact that the psoriasis has such a huge range of clinical variants. Nevertheless, in the recent past, significant progress has been made in this direction.
Biologics and Biosimilars in Psoriasis
Authors: Ahmed Sk Shahriar , De Abhishek , Das Sudip , Manchanda Yashpal
Published: August 2024

Psoriasis is a chronic, debilitating, relapsing, inflammatory dermatosis, which affects approximately 2-3% of the population. The burgeoning research on pathogenesis of psoriasis has opened up new directions in management of this common condition. The introduction of biologics has given additional elements to the arsenal of psoriatic disease treatments. TNF-α inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, CD-6 inhibitor proved highly efficient and have a good safety profile in numerous clinical trials. Biosimilar drugs are structurally almost similar to their reference biologic and are also made from living organism. Long-term follow-up and post-marketing surveillance are required to understand, long-term efficacy, adverse events of these powerful potent molecules.
Dermatological Symptoms Among Polyester Dyeing and Printing Workers in Mumbai
Authors: Paste Vaishali , Tiwari Rajnarayan R. , Kamath Ramachandra
Published: August 2024

Background:

Textile is one of the important sectors in the Indian economy. The use of synthetic chemicals is maximum during the wet processing technique, which consists of dyeing, printing and finishing.

Aims and Objectives:

This study was conducted to find out the prevalence of occupational dermatological symptoms among the workers employed in the dyeing and printing unit of the textile industry.

Materials and Methods:

A cross-sectional study, with a sample of 242 workers, was conducted in three different dyeing and printing factories. The workers were interviewed using a semi-structured questionnaire adapted from the Nordic Occupational Skin Questionnaire.

Results:

The prevalence of dermatological symptoms on the hands was found to be 51.7%. The various pattern of lesions included redness in 0.4% to itching in 26% of dyeing and printing workers. Those working for >5 years had 2.21 times higher risk as compared to those working for ≤5 years Odds Ratio (OR): 2.21; 95% Confidence Interval (CI): 1.19–4.11). Similarly, those working in the dyeing section were at 2.94 times higher risk as compared to those working in the printing section (OR: 2.94; 95% CI: 1.58–5.47).

Conclusion:

The workers working in the printing and dyeing industry were at risk of developing skin lesions, which can partly be attributed to reactive chemicals used and partly to poor handling practices of the workers.
Patient Needs in Psoriasis Treatment and their Influencing Factors
Authors: Ding Wei , Yao Manxue , Wang Yuting , Wang Miaomiao , Zhu Yueqian , Li Yan , Li Zonghui , Li Ling , Ma Wenxia , Liu Ming , Zhou Naihui
Published: August 2024

Background:

The management and treatment of psoriasis has rarely considered patient needs, which are numerous, multi-dimensional and are of great importance to improving treatment outcomes.

Objectives:

This study aimed to evaluate and compare the patients' needs for psoriasis treatment and identify factors predicting the need to make patient-centred decisions about treatment.

Materials and Methods:

This nationwide multicentre cross-sectional study included subjects between October 2020 and August 2021. The status quo of the needs in psoriasis treatment and their influencing factors were analysed mainly using the Chi-square test and binary logistic regression.

Results:

Information on sociodemographic and clinical characteristics were obtained. Factor analysis of a specially designed questionnaire showed that rapid skin clearance, reduced treatment expense and fewer hospital visits or treatment time were the first three patient needs in psoriasis treatment. Several influencing factors were important including the sociodemographic characteristics of gender, marital status, education level and family history, special location of skin lesions, dermatology life quality index (DLQI), Investigator's Global Assessment modified 2011 (IGA mod 2011), condition of the episode, clinical type of psoriasis, seasonal exacerbation and therapy.

Conclusions:

Patients with psoriasis pursued a wide range of treatment goals, with the most desired being rapid skin clearance, reduced treatment expense and time-saving. Paying attention to sex, marital status, education level, the special location of skin lesions and the DLQI will help dermatologists develop patient-centred treatment, meet the patient's needs and eventually improve the treatment outcomes.
Unilateral Syndactyly, Hemihypertrophy, and Hyperpigmentation with Mosaic 2q35 Deletion
Authors: Ali Akhtar , Kumar Ajeet , Dubey Pawan K , Pandey Vivek , Singh Ankur
Published: August 2024

Pigmentary mosaicism (PM) is a clinical condition of dyspigmentation with chromosomal abnormality. PM presents with both cutaneous and extracutaneous manifestation. Hypomelanosis of Ito and linear and whorled nevoid hypermelanosis are syndromic disorders in which PM is one of the manifestations. We present a case of a 1-year-old child with a unique constellation of symptoms of unilateral syndactyly, hemihypertrophy, and skin hyperpigmentation. Karyotype from peripheral blood was normal. We found genetic aberration (mosaic 2q35 deletion) in the present case from fibroblast cultured from the affected area. This unique constellation of symptoms was previously reported once but genetic study was not done from the affected tissue. This case highlights the need of considering fibroblast culture-based genetic study rather than doing simple karyotype from peripheral blood. Genetic study also established the molecular basis of symptoms in the above case.
Genital Psoriasis
Authors: Yi Ooi Shin , Huan Khor Yek , Har Loo Chai , Ali Norazlima Mohd , Chiang Tan Wooi
Published: August 2024

Background:

Genital psoriasis is often under-recognized and the exact burden is unknown in Malaysia.

Objectives:

To identify the prevalence of genital psoriasis, its clinical features, risk factors, and impact on quality of life and sexual health.

Methods:

This prospective, observational study was conducted in the dermatology clinic of our hospital from 1st September 2020 until 31st March 2021, involving all adult patients with psoriasis. The genital examination was performed and the subjects were interviewed using questionnaires.

Results:

A total of 262 patients were recruited, with a male to female ratio of 1.5:1 (mean age of 51 years old). They comprised 42.0% Chinese, followed by 36.6% of Malay, 21.4% of Indians and others. Up to 46.1% of patients had a current or history of genital psoriasis. The most common area involved for males was the scrotum (44.1%) and labia majora (62.5%) for female patients. Itching (79.2%) was the most frequent symptom encountered. Chinese patients had 2.67 times odd (CI 1.55-4.61) of having genital psoriasis compared to non-Chinese patients. Other independent risk factors included flexural involvement, male gender, and Type 1 psoriasis. Genital psoriasis was associated with greater impairment on quality of life and sexual health (mean total Dermatology Life Quality Index: 8.8 vs 6.5, P = 0.006), International Index of Erectile Function (mean: 48.5 vs 57.0, P = 0.011) and revised version of Female Sexual Distress Scales (mean: 20.7 vs 11.4, P = 0.022).

Conclusions:

Genital psoriasis is common and it has a profound impact on patients.
Cytokine Profiles and the Relationship of Disease Severity in Patients with Psoriasis
Authors: Wang Qingqing , Yan Dong , Zheng Shuting , Li Min , Li Jialin , Fu Xiuyu , Fu Dandan , Hu Hua , Song Xiangfeng , Tian Zhongwei
Published: August 2024

Background:

Psoriasis is a chronic skin disease characterized by hyperproliferation of keratinocytes and increased inflammation. Previous studies have detected the levels of cytokines in the serum of patients with psoriasis, yet few multi-cytokine combination studies have been reported.

Objective:

The aim of the study was to compare the levels of cytokines in the serum between patients with psoriasis and healthy controls, elucidate which factors influence the psoriasis progression.

Methods:

A total of 39 psoriasis patients and 30 healthy volunteers were enrolled. The venous blood was collected and the levels of 13 inflammatory cytokines were measured by human inflammation panel 1 kit. The severity of the disease was determined according to the psoriasis area and severity index (PASI) score.

Results:

Compared with healthy controls, the levels of nine cytokines (IFN-γ, TNF-α, IL-1β, IL-6, IL-10, IL-12P40, IL-18, IL-17A and IL-23) were significantly increased, while the level of MCP-1 decreased in psoriatic patients. In addition, except for MCP-1, IL-10 and IL-12P40, these cytokine levels were positively correlated with the PASI score. Furthermore, there were higher serum lever of IFN-γ, TNF-α, IL-1β, IL-6, IL-17A, IL-18 and IL-23 in active psoriasis than healthy controls and retrograde psoriasis.

Conclusions:

Increased serum levels of IFN-γ, TNF-α, IL-1β, IL-6, IL-17A, IL-18 and IL-23 in psoriatic patients were associated with PASI and the stage of disease, which suggested that these cytokines play an important role in the pathogenesis of psoriasis. The detection of these cytokines can better observe the disease activity of psoriasis and optimize the treatment strategy.
Guillain–Barré Syndrome
Authors: Kumar Sanjeev , Rani Priyanka , Sharma Janardan , Rai Anand Kumar
Published: August 2024

Background:

Guillain–Barré syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy with different subtypes, clinical features, and demographics. Nerve conduction study is important in differentiating axonal and demyelinating form of GBS. Diagnosis of various subtypes is essential as they have different pathophysiology and prognosis.

Objective:

The study was aimed to evaluate the different subtype spectrum of GBS in our patient population cohort and to look for the clinical features, demographics, and electrophysiological profile variations among the patients with GBS.

Materials and Methods:

We evaluated clinical spectrum and electrodiagnostic parameters of the admitted patients in Department of Neurology of our tertiary care center between September 2019 and April 2022 with clinical diagnosis of GBS. It was a quantitative descriptive cross-sectional study.

Results:

Out of 49 study participants, 63.82% patients had axonal form while 36.2% of patients had acute inflammatory demyelination polyneuropathy by applying Hadden criteria. Statistically lower single breath count (SBC) (median 10.5; P < 0.0001) at admission was observed in ventilated patients compared to nonventilated patients of GBS.

Conclusion:

Axonal form is the most common subtype of GBS in our study cohort. SBC at admission could be an important bedside tool to predict requirement of ventilatory support in admitted patients of GBS.
Curcuma longa (Curcumin) Abrogates Hyperhomocysteinemia and Oxidative Stress in a Rat Model of Colon Cancer
Authors: Waly Mostafa I , Al Subhi Lyutha
Published: August 2024

Background:

Hyperhomocysteinemia is involved in the pathogenesis of oxidative stress, a well-known etiological factor for different types of cancer, including colon cancer. Although Curcuma longa (curcumin) is a well-known antioxidant shown to prevent oxidative stress in different experimental models, yet its preventive role against hyperhomocysteinemia has not been addressed in experimental model for colon cancer.

Objective:

This study aimed to assess the protective role of C. longa (curcumin) as a natural antioxidant against the development of hyperhomocysteinemia-mediated oxidative stress and its associated carcinogenesis in rat colon.

Methods:

Forty-eight adult male Sprague Dawley rats were divided into four groups (12 rats/group): control, curcumin-supplemented group which received a daily dose of 200 mg curcumin/kg body weight, azoxymethane (AOM)-induced colon cancer group, and AOM group + curcumin supplementation. At the end of the experiment, 16 weeks, rats were sacrificed and colon tissues were collected to measure homocysteine level, oxidative stress markers [glutathione (GSH), total antioxidant capacity (TAC), lipid peroxides, and nitric oxide], and antioxidant enzymes (catalase, glutathione peroxidase, glutathione reductase, and superoxide dismutase). Colon histological sections were also examined for any histopathological changes.

Results:

The study results revealed that the colon tissue of the AOM-injected group had higher levels of homocysteine and markers of oxidative stress (GSH depletion, impairment of TAC, and inhibition of antioxidant enzymes) as compared to the control group, P < 0.05. Curcumin supplementation in the AOM + curcumin group significantly alleviated antioxidant enzymes activities as well as hyperhomocysteinemia, P < 0.05. AOM has also caused a significant increase in the size and numbers of aberrant crypt foci, marker lesions of colon tumors.

Conclusion:

Hyperhomocysteinemia results in the generation of reactive oxygen species, and thereby contributing to the oxidative stress-associated colon cancer pathogenesis. Curcumin as a functional food might be used as a preventative nutritional strategy against colon dysfunction that leads to cancer process.
Impact of Osteoprotegerin and RANKL on Non-ST-segment Elevation Myocardial Infarction
Authors: Rada Feryal Hashim
Published: August 2024

Objective:

Osteoprotogerin and receptor activator of nuclear factor kappa-B ligand (RANKL) formed an alliance that joining between bone remaking and vascular reforming. The aim of this study is to quantify the blood concentrations of osteoprotogerin and of RANKL in diabetic patients with myocardial infarction and to evaluate their relationship with other perilous factors in reference to healthy subjects.

Methods:

A total of 76 diabetic patients with myocardial infarction of non-ST-segment raising aged 50 to 60 years and their matched 60 healthy control aged 45 to 55 years were randomly selected from Al-yarmook Hospital and evaluated for inclusion in this case–control study. Blood levels of osteoprotogerin and RANKL were assessed using high-sensitive enzyme-linked immunosorbent assay.

Results:

The outcomes of this study elucidated increment in the blood concentrations of osteoprotogerin and RANKL in those patients. Apparently, significant positive correlation directed between osteoprotogerin level with age and onset of diabetes. Otherwise, lipid profile, and inflammatory markers exhibited no significant correlation with osteoprotogerin level.

Conclusion:

Upraised blood levels of osteoprotogerin and RANKL in diabetic patients with non-ST-segment raising myocardial infarction may be of a consequence of diabetic complication on vascular cell.
Histomorphological Evaluation of Chronic Gastritis and an Attempt to Prognosticate Gastric Intestinal Metaplasia with Selective Mucin Gene Expressions in Indian Population
Authors: Moorthy Pooja E , Raghavan Vijayashree , Kanna Rajesh
Published: August 2024

Introduction

Intestinal metaplasia (IM) is a well-established precancerous lesion. MUC2 and MUC5AC are mucin genes that have been studied in gastric IM to classify and determine which type of metaplasia will progress to malignancy. H.pylori, an important causative organism for gastric carcinoma, can be detected using anti-H. pylori antibodies (AHA) in case of suspicion when routine histochemical stains are negative.

Aim

This study aims to determine the expression of MUC2 and MUC5AC in gastric IM in chronic gastritis to differentiate complete and incomplete IM and to predict and prognosticate its role in the possible evolution of malignancy. This study also aims to determine the expression of AHA in Giemsa negative cases with mild to severe activity.

Materials & Method

A total of 345 gastric biopsy cases were included in the study. About 35 cases with IM on histology were subjected to Alcian Blue (AB) at pH 2.5 and markers MUC2 and MUC5AC to classify IM. To further subclassify the type II and type III IM, AB with periodic acid–Schiff at pH 1.5 was used. About 45 out of 171 Giemsa negative cases with activity were subjected to AHA.

Results

51.43% cases had complete IM and 48.57% had incomplete IM. And, 25.7% were type II and 22.8% were type III IM. About 20 out of 45 Giemsa negative cases showed AHA positivity, indicating sensitivity as high as 70.15%.

Conclusion

MUC2 and MUC5AC expression are good parameters in the progression of IM togastric cancer (GC) and can be used as a good prognostic marker for GC. Detection and eradication of H. Pylori using AHA with appropriate treatment will reduce the risk of developing gastric carcinoma.
Food Consumption Pattern and Body Mass Index of Adolescents − A Descriptive Study
Authors: Lakshmi E.
Published: August 2024

Context:

Adolescence is a period of growth spurt. During this crucial period, food intake patterns are set in place and these patterns can have vital impact on lifetime nutritional status and health of the individuals.

Aim:

The present study aimed to assess food consumption pattern of adolescent girls and to associate the same with the body mass index (BMI).

Materials and methods:

A quantitative research approach and a descriptive design were adopted for the study. Nonprobability purposive sampling technique was used to select 217 adolescents (girls) in the age group of 13 to 18 years after obtaining informed consent. Researcher-designed questionnaire was developed to collect the data on demographic profile. A food frequency questionnaire was used to elicit information regarding food consumption pattern (general and fast food) for over four months during the period of study from December 2018 to February 2019. The height and weight were measured using inch tape and weighing scale. The BMI was calculated and compared with BMI classification of World Health Organization.

Statistical analysis:

Descriptive statistical measures such as percentage distribution, mean, and standard deviations were used for variables. Chi-squared test of significance was used to predict the association between BMI and food intake.

Results:

The percent adequacy of food intake presented a deficit in the intake of green leafy vegetables (−31.05%), fruits ([FIGURE DASH]46.34%), milk and milk products (−21.44%). BMI revealed that a higher percentage (45.16%) of adolescent girls were under weight.

Conclusion:

There was no significant association (χ
2 = 0.46, P = 0.99) between BMI and food intake.
Evaluation of Neurocognitive Disorder in Patients with Type 2 Diabetes Mellitus
Authors: Preetam K , Talkad Chandrashekar Nagesh Kumar , Krishnappa Rashmi
Published: August 2024

Background:

Diabetes mellitus (DM) is a syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin or both. In India, an estimated 40 million people suffered from diabetes in 2007 and are expected to rise to 70 million by 2025 as per the Indian Diabetes Study 2011. Individuals with type 2 diabetes are at 60% greater risk for development of dementia compared to those without diabetes. For vascular dementia, but not for nonvascular dementia, the additional risk is that it is greater in women.

Aim and Objective:

To assess cognitive impairment among type 2 DM patients.

Methods:

In this cross-sectional study, 67 patients with type 2 DM and 66 control attending Put patient department (OPD) services between October 2018 and September 2020 were included. Both these groups were scored on the Montreal Cognitive Assessment (MoCA). The scores ranged from zero to 30. The scores of ≥26 were considered normal. A score of ≤22.1 in these people was considered as mild cognitive. Categorical data were represented in the form of frequencies and proportions. Chi-square test or Fischer exact test were used as test of significance for qualitative data. Correlations were performed with Pearson correlation coefficient. The P-value < 0.05 was considered as statistically significant after assuming all the rules of statistical tests.

Results:

Age and duration of diabetes had positive correlation with MoCA score which was not statistically significant. The body mass index (BMI) and waist circumference had negative correlation with MoCA score which was not statistically significant. Hemoglobin A1C (HbA1c) had negative correlation with MoCA score which was statistically significant.

Conclusion:

Older individuals with longer duration of DM and higher HbA1c levels showed higher cognitive impairment with MoCA score correlation. This study also highlights the early screening for all DM patients with easily available MoCA scores. Thus, helping in early recognition of mild cognitive impairment and preventing it from proceeding to dementia.
Mental and Physical Performance of Adult during the COVID-19 Pandemic and Use of Dietary Supplements
Authors: Tomer Abhilasha , Sarkar Amlan Kanti , Chitme Havagiray R.
Published: August 2024

Background:

Life during the COVID-19 pandemic was miserable, most of the people were in a panic situation either because of being affected by COVID-19 or losing their near and dear ones. Majority of Indian population was in the trauma condition impacting physical and mental health directly or indirectly either due to the infection or repeated lockdowns.

Aim:

The present study was carried out to gain knowledge of people’s physical and mental health such as anxiety, depression, and stress during the period of the pandemic in the year 2021.

Material and methods:

The standard questionnaires were used to conduct the online survey using google form. The questionnaire contains five sections and collects the information on anxiety, stress, depression, and physical activities. The survey started on May 23, 2021, and ended on June 2, 2021 by circulating the link through emails, WhatsApp, and messages.

Result:

A total of 291 people participated in this survey process and all responses were analyzed, out of which 165 were men and 126 were women. It was calculated that 59.4% of men and 40.6% of women were affected by COVID-19. Total 49.5% of people affected by COVID-19 were in favor of improvement in physical and mental performance while taking dietary supplements. Whereas 19.8% denied the statement and 28.7% of people saw slight changes in their health status.

Conclusions:

During the pandemic people were mostly affected by anxiety, depression, stress, and physical health and to cope with these situations dietary supplements surely be the utilitarian for the society. Through this study, it was found that if a person includes both exercise and nutraceutical products in their lifestyle, there will be a chance of living a sustainable and healthy life.
To Evaluate the Implementation and Impact of an Antimicrobial Stewardship at a Tertiary Care Teaching Hospital in India
Authors: Kumari Sweta , Bagati Kavita Dhar , Sadasivam Bala Krishnan , Babu Gudise Chitti
Published: August 2024

Background:

Antimicrobial stewardship programs refer to antibiotic policies, antibiotic management programs, and antibiotic control programs. According to the Centers for Disease Control and Prevention (CDC) Project ICARE, all hospitals reported having an antibiotic formulary, and 91% used at least one other antimicrobial control strategy.

Materials and Methods:

The present study is a retrospective and observational study. All information was noted and surveyed sporadically. Any deviations from the agreed criteria were communicated, discussed, and documented. Antibiotic stewardship started from an inpatient setting. In the first phase, the patient pool from inpatient was addressed. For the prospective audit, two components had been recognized to have an evidence level 1. These were multidisciplinary rounds of infectious diseases patients and the use of antimicrobials.

Result:

In Medicine ward, the most common class of drugs was beta-lactam; in beta-lactam, a combination of piperacillin/tazobactam, amoxicillin/clavulanic acid, and macrolides was used with a mean dose of 1408.18 g. While in orthopedics, most common drugs for prophylaxis use were found to be cephalosporins (cefazolin first generation) with a mean dose of 937.07 ± 741.81 g to reduce surgical site infections. Prophylactic use of beta-lactam (amoxicillin/clavulanic acid) was prescribed for the most of the cases of Ears, Nose and Throat (ENT) surgery with mean dose of 1019.63 g as well as in pediatrics with mean dose of 579.47 g.

Conclusions:

Antimicrobial stewardships have a significant impact on the reduction of targeted and empiric antibiotic use, healthcare costs, and antimicrobial resistance in inpatient settings.
The Use of Spilanthes acmella Extracts as a Local Anesthetic Agent in Dentistry: A Review
Authors: Shivananda S. , Doddawad Vidya Gowdappa , Vidya C.S. , Sanjay C.J. , Shetty Akhil , Kalgeri Sowmya Halasabalu , Bhat H.Hari Kishore
Published: August 2024

Spilanthes acmella, which is commonly known as the toothache plant, has been used as ayurvedic medicine in dentistry for a long time. It is found to have anti-microbial, analgesic, and local anesthetic action. This medicinal plant has been studied for its local anesthetic applications in humans and animals. In this review paper, we have discussed the merits, limitations, safety, and potential future applications of using S. acmella as a local anesthetic drug.
Prevalence and Risk Factors of Cognitive Impairment and its Effect on Quality of Life
Authors: Al-Hindawi Ahmed , Al Tabaa Louai Wael , Gebril Ali Ahmed Ali , Waly Yousef , Shelig Mohamed , Hussain Muhammed , Al-Sabti Ali
Published: August 2024

Objectives:

Examine the prevalence of cognitive impairment within Wave 1 of the Irish Longitudinal Study on Aging (TILDA) cohort and its relationship with comorbidities and lifestyle factors. The effect of cognitive impairment on quality-of-life scores was also investigated.

Methods:

A secondary cross-sectional analysis of data from Wave 1 of the TILDA cohort was undertaken.

Results:

Prevalence of cognitive impairment ranged between 5.8% and 51.2%, depending on the instrument used (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA], respectively). Having hypertension (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.36–2.08), being a past or current smoker (OR 1.25; 95% CI 1.01–1.55) and having low physical activity (OR 2.04; 95% CI 1.64–2.53) increased the odds of being classified as cognitively impaired (MMSE <25). Similarly, being obese (OR 1.31; 95% CI 1.17–1.47), having hypertension (OR 1.42; 95% CI 1.27–1.57), and having diabetes (OR 1.71; 95% CI 1.40–2.09) increased the odds of cognitive impairment (MoCA <26). High cholesterol was associated with a protective effect (OR 0.79; 95% CI 0.63–0.98) under MMSE <25 classification while, problematic alcohol behavior reduced the odds of being classified as cognitively impaired using MoCA <26 by 35% (OR 0.65; 95% CI 0.55–0.76). Depression was not associated with increased odds of cognitive decline. Lastly, mean quality of life (QoL) scores decreases as severity of cognitive impairment increases from normal to moderate cognitive impairment (P < 0.001).

Conclusions:

Several modifiable risk factors for cognitive decline were identified, including smoking, low physical activity, hypertension, diabetes, and obesity. Policies aimed at reducing the prevalence of these risk factors in the population might reduce the impact of cognitive decline on public health.
Dietary Approaches and Nutritional Complexities of Autism Spectrum Disorder
Authors: Ahmad Abdul Momin Rizwan , Intikhab Anosh , Abid Juweria , Iqbal Sehar
Published: August 2024

Background:

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by poor social interaction, repetitive behavior, learning difficulties, cognitive issues, and unusual eating patterns. Different factors including genetic and environmental variables have been identified to increase the risk of developing ASD.

Objective:

The main objective of the present review is to investigate the dietary approaches and modifications to reduce the intricacies related to ASD.

Results:

Studies included in this review suggested that abnormalities in the gut microbiota are involved in the pathogenesis and severity of the disease. Medical nutrition therapy for ASD consists of excluding harmful food components such as gluten, casein, processed foods, and excessive sugars and increasing the consumption of omega-3 fats, vitamins and minerals, probiotics, and antioxidants. Furthermore, awareness regarding food labels might help to avoid food allergens in diet.

Conclusion:

Active dietary treatments including the use of dietary supplements and elimination of processed foods appear to reduce the complexities of ASD. Furthermore, support of health care professionals and adopting public health approaches might help to prevent adverse outcomes related to ASD. Future research is required to determine the prevalence of ASD and related outcomes in low/middle income countries as this area is highly neglected.
Effect of Morinda citrifolia L. Mouthwash on Periodontal Health in Type 2 Diabetes Mellitus Patients − A Randomized Controlled Trial
Authors: Shashikumar Pratibha , Nisha Swet , Das Debanjan , Debanth Krishnendu , Kanthal Lakshmi Kanta , Pattanayak Suman
Published: August 2024

Introduction:

Patients with diabetes mellitus need regular dental visits for maintenance of periodontal health. The treatment regimen usually consists of nonsurgical periodontal therapy (NSPT) in gingivitis and mild to moderate periodontitis, followed by oral hygiene reinforcement and maintenance therapy. Recently, the use of herbal/traditional medicine as an adjunct to NSPT has been tried as a beneficial agent in achieving better periodontal health status in diabetic patients. The present study evaluated the effect of Morinda citrifolia L. mouthwash in the maintenance of periodontal health in patients with type 2 diabetes with chronic periodontitis (ChP).

Materials and methods:

Systemically healthy subjects without periodontitis were recruited as control (group A) (n = 24). Twenty-four subjects with ChP were allotted in group B. A total of 48 patients with ChP and type 2 diabetes mellitus were enrolled and randomly allocated as group C (n = 24) and group D (n = 24). The subject was instructed to rinse with M. citrifolia mouthwash twice daily. Clinical periodontal outcomes measured were plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), probing depth (PD) at baseline, 1 month, and 3 months posttherapy. Salivary total antioxidant capacity (TAOC) was also measured at baseline and 3 months.

Results:

Clinical parameters PI, GI, CAL, BOP, and PD reduced significantly in groups B, C, and D posttreatment 3 months follow-up. However, the intergroup comparison did not show any significant difference (P > 0.05). Salivary TAOC level was higher in groups B, C, and D when compared with healthy control group A and it was significantly reduced in all the three groups B, C, and D post 3 months therapy (P < 0.05). Intergroup comparison of salivary TAOC levels between groups B, C, and D did not show any significant difference (P > 0.05).

Conclusion:

The daily rinsing with M. citrifolia mouthwash did not show any added benefits in ChP with type 2 diabetes mellitus; however, its further nutritional benefits need to be assessed by larger multicenter interventional studies.
In Vitro Ameliorative Effects of Sinapic Acid on Parkinson Related Neurotoxicity in SHSY5Y Cell Lines
Authors: Prabhakar Preeja , Ahmed Bakrudeen Ali , Chidambaram Saravana Babu , Kumar Arun , Pandian Arjun
Published: August 2024

The neuroprotective effects of polyphenols have been reported in the prevention of the early onset or delay of the progression of various neurodegenerative diseases, including Parkinson disease (PD). Neuroinflammation, oxidative stress, and mitochondrial dysfunction play significant roles in the pathophysiology of PD. Sinapic acid (SNP) is a naturally occurring polyphenol belonging to a group of hydroxycinnamic acids, which has gained importance owing to its beneficial effects, including antioxidant and anti-inflammatory properties. The present study aimed to develop an insight into the effects of sinapic acid on mitigating the inflammatory markers, oxidative stress, and deranged mitochondrial dynamics in human neuroblastoma cells (SHSY5Y) intoxicated with MPP+. The modulating variations of SNP on apoptosis, mitochondrial membrane potential (MMP), intracellular reactive oxygen species (ROS), and expression of proteins like PARKIN, PINK1, DJ-1, Bax, and BCl2 were analyzed in MPP+ induced PD-like toxic conditions. Pre-treatment with SNP decreased the levels of ROS and improved MMP. Also, SNP down-regulated the expression of PARKIN1, caspase-3, and DJ-1, along with a reduction in the expression of inflammatory markers such as IL-1β and TNF-α. Further, SNP was observed to increase the levels of BCl2, an anti-apoptotic protein, and the activity of superoxide dismutase (SOD), an enzymatic antioxidant. Based on the above results, the authors concluded that SNP exhibited neurotherapeutic potential in PD-like neurotoxic conditions. The present study reported the preclinical and mechanistic approach to identify the exact mechanism of action of SNP in PD.
Lifestyle modification and nutrition in preventing prehypertension and hypertension — Narrative review
Authors: Kota Vijay , Kumar Sunil , wanjari Anil k , Acharya Sourya
Published: August 2024

Hypertension is related with various cardiovascular diseases, such as end-stage renal disease, coronary heart disease, stroke, and cardiac failure. In order to achieve overall control of blood pressure (BP) and reduce high BP related cardiovascular and kidney diseases, avoiding prehypertension becomes a top concern. There are various risk factors like obesity, excessive sodium intake, alcohol intake, and no physical activity. Numerous studies have indicated that conducting intervention toward these modifiable factors can lower BP and possibly stop hypertension from forming. Therefore, current national recommendations and guidelines include dietary adjustments, regular isotonic exercise, and a sodium-reduced diet (less than 100 mmol/d), as well as weight loss in cases of obesity. This review article highlights about halting the progression of prehypertension to hypertension in lifestyle modification and nutrition.
Salivary microbial dysbiosis may predict lung adenocarcinoma
Authors: Roy Partha , Sarma Anupam , Kataki Amal Ch. , Rai Avdhesh Kumar , Chattopadhyay Indranil
Published: August 2024

Background:

Adenocarcinoma is a more common type of Non-small cell lung cancer (NSCLC). Lung cancer showed a statistically significant increment in the Kamrup Urban district of Assam, Tripura, Sikkim, and Manipur of India. The goal of our pilot study is to identify non-invasive microbial biomarkers to detect lung adenocarcinoma (LAC).

Material and Methods:

DNA extraction from saliva samples of five LAC patients and five healthy controls was performed by Qiagen DNeasy blood and tissue kit using Lysozyme (3mg/ml) treatment. 16S rRNA genes of distinct regions (V3-V4) were amplified from saliva DNA by PCR. Paired-end sequencing targeting the V3-V4 region of the 16S rRNA gene has been performed on the Illumina MiSeq platform. Raw sequences were analyzed using the QIIME(Quantitative Insights Into Microbial Ecology) software package.

Results:

Our preliminary results showed that Rothia mucilaginosa, Veillonella dispar, Prevotella melaninogenica, Prevotella pallens, Prevotella copri, Haemophilus parainfluenzae, Neisseria bacilliformis and Aggregatibacter segnis were significantly elevated in saliva of LAC which may serve as potential non-invasive biomarkers for LAC detection. Functional prediction analysis showed that bacterial genes involved in glycosyltransferase, peptidases, amino sugar, and nucleotide sugar metabolism, starch and sucrose metabolism were significantly enriched in LAC.

Conclusion:

These salivary bacteria may contribute to the development of LAC by increasing expression of glycosyltransferase and peptidases. However to understand their role in pathobiology, studies are required to perform in large cohort.
Role of CTLA4 immunohistochemistry in the diagnosis of colon cancers
Authors: Narayanan Vishnu , Pavithra V , Dhanapal Divya , Sundaram Sandhya , Narayanan C. D
Published: August 2024

Background:

There are a wide range of diagnostic markers for colorectal cancers like detection of mutated KRAS, TP53, and APC genes. However, genetic and immunological factors have also been attributed to the cancer prognosis. The present study was carried out to evaluate the expression of CTLA-4 in colorectal cancers.

Methods:

This cross-sectional study was carried out among 30 resected specimens of colorectal cancer. Paraffin blocks were made on samples from tumor areas along with adjacent normal areas. Immunohistochemistry for CTLA-4 was done on the sections along with controls. Gross findings were recorded from the blocks. Blocks with section containing normal epithelium and tumor were chosen for immunohistochemistry.

Results:

Overexpression of CTLA-4 was observed in 43.3% of the tumors. There was a significantly high tumor infiltration among those specimens showing overexpression of CTLA-4. The observed difference was statistically significant (P < 0.05). On comparing the grade of the tumor with intensity of CTLA4 uptake, it was observed that majority of the well-differentiated tumors (66.7%) had an intensity of 1+ whereas majority of the poorly differentiated tumors had an intensity of 3+ (66.7%).

Conclusion:

The present study has demonstrated overexpression of CTLA-4 in colorectal cancer specimens, and also highlighted the potential scope for anti-CTLA-4 agents like Ipilimumab in cancer therapy. The need for further evaluation to examine five-year survival with such immunotherapies is essential to document candid therapeutic recommendations for colorectal cancers.
Morphological study of the spectrum of lesions encountered in the heart and coronaries on autopsy
Authors: Siddiqui Md Ibrahim , Mahanta Anita A , Umesh S R , Neeha Saara , Andola Sainath K
Published: August 2024

Background and Objectives:

This research study has been carried out to study the various morphological changes in the heart in medicolegal autopsies and to compile data for the frequency of heart diseases found in autopsy cases.

Methods:

The present study comprised 430 medicolegal autopsy cases. Details of the cases were entered in a proforma prepared for the study. The heart was fixed in 10% formalin, and then, opened along the flow of blood. The findings were based on gross and microscopic examinations.

Results:

Out of 430 adult hearts, 211 (49.0%) cases showed 253 cardiac lesions; 35 (8.1%) cases of coronary atherosclerosis and 196 (45.5%) aortic atherosclerosis were noted; 7 cases of ischemic lesions (1.6%) were identified; 12 (2.7%) cases of hypertrophy; 2 cases of valve calcification; and 1 of cardiomyopathy were noted.

Conclusion:

In the present study, among medicolegal autopsies, atherosclerotic disease was the most frequently encountered lesion followed by hypertrophy. The incidence of atherosclerosis was found to be 47.6%. This study shows the high prevalence of atherosclerosis in the population.
Differential expression of CK7, CK20, CDX2 in intestinal and pancreatobiliary types of preriampullary carcinoma
Authors: Sree Udayagiri D. , Prayaga Aruna K. , R. Reddy V. Venkat , Rukmanghadha N. , Chowhan Amit K. , Phaneendra B. V.
Published: August 2024

Context:

Incidence of periampullary carcinoma is low, approximately 0.5–2% of all gastrointestinal malignancies. Histologic subtyping has a prognostic bearing. The purpose of this study is to differentiate periampullary carcinomas based on immunohistochemistry (IHC) by using cytokeratin 7 (CK7), cytokeratin 20 (CK20), caudal type homeobox 2 (CDX2).

Aims:

To analyze the usefulness of IHC as single/panel of markers that included CK7, CK20, and CDX2.

Settings and Design:

This was a prospective study done from January 2017 to September 2018.

Subjects and Methods:

A total 50 pancreaticoduodenectomy specimens were evaluated and classified as intestinal (INT) and pancreaticobiliary (PB) types based on their morphological and immunohistochemical features, respectively. The morphologic subtypes, expression of IHC markers were correlated with different histologic parameters.

Statistical Analysis:

Chi-square test was used to study the association between different IHC markers with histologic parameters. Probability (P) values <0.05 were regarded as statistically significant.

Results:

The expression of CK7, CK20, CDX2 were studied in 50 cases to classify them as INT and pancreatobiliary subtypes. CK7 has high sensitivity (88.2%), CDX2 has high specificity (96.4%), CK20+/CDX2+ has both high sensitivity (94.2 percent) and specificity (89.2 percent) in differentiating INT from pancreatobiliary subtypes. The morphologic subtypes showed correlation with two variables (tumor grade, pathologic T stage). CK20 and CK20/CDX2 expression showed a positive correlation with tumor grade, pathologic T staging, and lymphovascular invasion.

Conclusions:

In conclusion, morphological classification can significantly discriminate histologic types, IHC plays a moderate role. However, the combined expression of CK20 and CDX2 is helpful in subtyping.
Anaplasia in childhood rhabdomyosarcoma
Authors: Ahuja Manisha , Tomar Reena , Thakur Shruti , Mallya Varuna , Mandal Shramana , Khurana Nita , Sarin Y. K.
Published: August 2024

Background:

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Anaplasia is a rare phenomenon seen in childhood RMS. The most common histologic subtype was Embryonal followed by Alveolar and spindle subtype.

Design:

A total of 11 cases of pediatric RMS were selected from January 2017 to June 2019 presenting at various sites. Out of 11 cases, 2 were further diagnosed as Embryonal, 2 as Alveolar, 2 as Pleomorphic, 1 as Spindle subtype and rest 4 as RMS-NOS based on morphology. All cases were positive for Desmin. The presence of cells with lobated, hyperchromatic nuclei at least three times larger than the tumor cell (anaplastic cells) was selected as the main criterion to diagnose Anaplasia.

Results:

Out of the total 11 cases, anaplasia was seen in 7 cases. Out of these seven, five cases showed Focal Anaplasia (FA) (71.4%) and 2 cases showed Diffuse Anaplasia (DA) (28.6%). Out of 2 cases of Embryonal RMS one exhibited focal anaplasia (50%). One case of Spindle RMS showed diffuse anaplasia, 2 cases of pleomorphic RMS showed focal anaplasia. Out of 3 cases of RMS- NOS, 2 exhibited focal anaplaisa and one displayed Diffuse anaplasia. Both Alveolar RMS had no features of anaplasia.

Conclusion:

Presence of Anaplasia is a frequent observation in pediatric RMS. Anaplasia is often under reported in pediatric RMS. Pathologist should be more aware of this rare phenomenon.
Primary hepatic lymphoma- A diagnostic dilemma
Authors: Reddy Purushotham , Vernekar Sunita S. , Sneha P
Published: August 2024

Primary non-Hodgkin lymphoma of liver is a very rare malignancy. Here we report the case of a 50 year old female who presented with dull ache in the right hypochondrium and decreased appetite since 1 month. CT scan of abdomen and pelvis showed an enlarged liver with an ill- defined soft tissue lesion arising from left lobe measuring 13 × 9 cm suggestive of primary hepatic neoplasm. CT scan of chest, abdomen, and pelvis and whole body positron emission tomography showed no involvement of bone marrow, lymph nodes, spleen, or any other organ. Her liver function tests, alpha fetoprotein and carcinoembryonic antigen levels were normal. Serology was negative for viruses. Pathological examination favored diagnosis of Burkitt's lymphoma. Cytogenetic studies for MYC translocation t (8;14) is suggested for confirming the diagnosis since Ki 67 index is > 70% and not nearly 100% which is characteristic of Burkitt's lymphoma.
Solitary tubercular renal cyst in a postpartum lady masquerading as an infected giant renal cyst with urosepsis
Authors: Sivanandam Subramanian Ekambaram , Poonkodi Manohar , Venkatesh Ulaganathan , Karthikeyan Aswathaman , Karthikeyan Vilvapathy Senguttuvan
Published: August 2024

Renal tuberculosis presenting as renal cyst is rare. Diagnosing renal tuberculosis in pregnancy is usually delayed due to its atypical presentation. We present a 28-year-old postpartum lady who delivered a healthy baby one month back, with history of intermittent fever and chills. She had high spiking fever (102° F), tachycardia (130/min) and computed tomography showed a 16 × 10 cm right renal cyst. Percutaneous drainage was done, 2 litres of thick pus drained and culture was sterile. After three weeks, deroofing and marsupialization of cyst was done. Biopsy revealed granulomatous inflammation composed of epitheliod histiocytes with central incipient necrosis suggestive of tuberculosis. She was treated with anti-tubercular drugs. As the infant was healthy and had no evidence of tuberculosis, no treatment was initiated. The mother is on follow up for 2 years. This case highlights the rare presentation of renal tuberculosis in puerperium.
Evaluation of immunocytochemistry on destained giemsa stained smears as an alternative to conventional technique
Authors: Kushwaha Pritika , Pandey Toshali , Agarwal Radhika , Singh Meeta , Jain Shyama , Mishra Anurag
Published: August 2024

Introduction:

Protocol for immunocytochemical (ICC) staining in May-Grünwald Giemsa (MGG)–stained smears has been difficult to establish. It is the need of the hour to be able to use prestained slides for ICC in specific cases to deliver timely diagnoses and reduce inconvenience to patients.

Aims and Objectives:

To evaluate and compare the use of MGG-stained smears for the purpose of ICC, after de-staining and saline rehydration to that of routine standard ICC.

Materials and Methods:

A prospective study was conducted on 40 FNAC samples: 25 cases of breast disease and 15 cases of reactive lymphoid hyperplasia known to express pancytokeratin and leukocyte common antigen (LCA)/CD45, respectively. Air-dried smears of each case were stained by standard MGG stain and after the report was dispatched, one smear was selected and sent for ICC. The smears were analyzed to determine the overall result and grade each smear semi-quantitatively with respect to staining-intensity, stain-localization, staining-uniformity, counter-staining, and background-staining.

Observations and Results:

The proposed protocol was inferior to conventional ICC in all the parameters, more pronounced in pancytokeratin than LCA/CD45. Only 8% of air-dried smears stained for pancytokeratin showed optimal stain intensity (as opposed to 44% of wet-fixed smears), whereas only 14.3% of air-dried smears were optimally stained for LCA (as opposed to 85.7% of wet-fixed smears).

Conclusion:

The proposed protocol of de-stained Giemsa smears as an alternative to conventional technique for ICC was unsuccessful in giving satisfactory results.