bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors and outcome of placenta previa: accrete in a tertiary health care center of Punjab, India
Authors: Pal Davinder , Bhagat Nisha , Arora Ritu
Published: January 2019

Background: The aim of this study was to identify and evaluate risk factors associated with placenta accrete (PA) and its clinical outcome.Methods: A descriptive, case control study was conducted in department of obstetrics and gynecology, GMC Amritsar in which authors retrospectively reviewed data of 180 patients of placenta previa (PP) over 5 years, categorized as PA (cases; n=23) or no PA (control; n=157). Furthermore, these groups were compared as to maternal demographics, intrapartum and postpartum complications and neonatal outcomes. Stepwise logistic regression analysis was done to evaluate the extent to which exposure variable contributed to the incidence of PA including advanced maternal age (AMA), parity, location of placenta and previous caesarian section (CS).  Primary aim was to identify and quantify the various risk factors of PA and secondary aim measured incidences of PP, PA and fetomaternal outcome.Results: The cumulative incidence of PA over 5 years was 2.98 per 1000 deliveries. Accrete rate increased with number of CSs at 4.76% in patients with no previous CS versus 45.94% in ≥1 CS (p < 0.003). Anterior PP (AOR 10.128  CI 2.406 -42.632; p <0.001) and number of previous CSs (AOR 36.405, 95% CI 2.743 -483.24, p =0.006) were significant risk factors for PA. AMA (OR >30 years: 4.326 95% CI 0.724 -25.856; p =0.108), parity (AOR 1 vs 0: 2.526 95% CI 0.242-26.41; p=0.439), prior uterine curettage (AOR ≥1 vs 0: 11.143 95% CI 0.522-9.726; p=0.278) although had association with PA but was not statistical significant. Caesarian hysterectomy was done in 95.65% patients of PA while only 1 patient of PP required hysterectomy (p<0.001). Neonatal outcome was similar in both groups.Conclusions: Prior caesarian and anterior PP emerged out as significant predictors of PA. Other risk factors like AMA, multiparous, history of prior uterine curettage, central PP have incremental risk of having PA and such patients should be managed diligently to lower feto-maternal morbidities and mortalities.
Predictors of maternal outcome in women on mechanical ventilation in an obstetric intensive care unit: an observational study
Authors: Soni Tanu , Tiwari Priyadarshini
Published: January 2019

Background: Present study was designed to note the indications for and the complications and outcome of women on mechanical ventilation in our obstetric intensive care unit, and in addition to look for the applicability and correlation of Sequential Organ Failure Assessment (SOFA) scores for the prediction of outcome in these women.Methods: A prospective observational study was conducted in the obstetric intensive care unit of our teaching hospital which included all women requiring mechanical ventilation in the study period. The diagnosis of the woman on admission, the clinical course and outcome along with total maximum sequential organ failure assessment (SOFA) score and SOFA score for each system were noted. Women were divided into two groups, survivors and non-survivors. Student t test and chi square test were used for analysis.Results: The foremost indication for mechanical ventilation was hypertension in pregnancy namely eclampsia and pre-eclampsia, followed by obstetric hemorrhage and then by hepatic failure. Maternal mortality rose significantly as the number of days of mechanical ventilation increased (p value <0.05). The total SOFA score correlated highly significantly with the outcome (p<0.0001).Conclusions: In women with eclampsia and pre-eclampsia suffering from respiratory failure, survival is inversely correlated with the number of days of mechanical ventilation. The total SOFA score is highly predictive of the woman’s outcome and all individual organ system scores also significantly correlate with outcome except for the score of coagulation system.
Endoscopy in the management of a rudimentary non-communicating functional horn
Authors: Shah Nitin H. , Joshi Aditi V. , Mourya Sunita
Published: January 2019

Mullerian anomalies are developmental malformations of the female reproductive tract, often diagnosed late. They are classified into numerous types like a septate uterus, bicornuate or unicornuate uterus etc. A rudimentary non-communicating functional horn is a rare variant of a unicornuate uterus. It may present with a wide spectrum of symptoms like severe dysmenorrhea, infertility, lump in abdomen or rarely maybe diagnosed with a ruptured ectopic in the horn. The diagnosis of this entity is a difficult and challenging. Authors present a case of a young adolescent diagnosed with this Mullerian anomaly, the role of hysteroscopy in confirmation of diagnosis and the management of the patient by laparoscopy successfully. The patient was completely relieved of her symptoms post-surgery.
Efficacy and superiority of an innovative method (IM) of intravenous (IV) fluid drip drop rate calculation using IV set and its comparison with conventional methods (CM)
Authors: Patel Dhruvkumar M. , Patel Mukundkumar V. , Sharma Kamal H. , Kaklotar Jignesh C. , Patel Greshaben R. , Patel Maitri M.
Published: January 2019

Background: Almost every indoor patient requires some form of intravenous (IV) fluids and its infusion rate should be proper as recommended for best treatment outcomes. To overcome the same, a simple, quick and easily applicable new method for drip drop rate calculation is proposed, which is user-friendly at bedside and doesn’t require mathematical skills or help.Methods: Author compared this novel innovative method (IM) of IV fluid drip drop rate method for both regular macro and micro drop infusion set against conventional mathematical calculation method (MC) of infusion in various IV fluid indoor orders and assessed for time-to-initiation of treatment (TI) required and its accuracy. Ten resident doctors and ten nursing staff participated to grade both conventional and novel methods by using pre-printed forms of various parameters like time consumption, comfort level, accuracy and applicability in ward and these both methods were scored on a scale of 1 to 10.Results: Conventional method (CM) required 14.23±1.10seconds, while novel method (IM) required average 3.63±0.73seconds for calculation of drop rate. Average grading for conventional method was 3.63±0.49 and for novel method was 7.84±0.6 out of 10.Conclusions: Novel method of IV fluid drip drop rate formula is easy, quick and superior in comparison to conventional method and it doesn’t require any additional instrumental help. It is good alternative to conventional formula for IV drip drop rate calculation in absence of infusion pump.
Proton pump inhibitor: a risk factor for spontaneous bacterial peritonitis in Indian cirrhotics decompensated with ascites
Authors: Rajender Akash , Choudhary Priyanka , Mathur Saumya , Bhargava Rajat , Upadhyay Shalini , Nepalia Subhash
Published: January 2019

Background: Spontaneous bacterial peritonitis (SBP) is common complication of cirrhosis caused by bacterial translocation. Bacterial colonization and overgrowth may occur in GI tract on suppression of gastric acid secretion. Beta-blockers have been postulated to reduce intestinal permeability. There is no significant Indian study to evaluate association of PPI with SBP in cirrhotic ascites. We aimed to assess the effect of PPI in cirrhotic patients decompensated with ascites.Methods: A retrospective case control study (January 2016 to April 2018), evaluated subjects with cirrhosis and ascites. Two study groups of cirrhotic subjects with and without SBP were formed. In each of the two study groups, 143 subjects, were enrolled by matching for age, year of admission, Child-Pugh-Turcotte (CTP) class after considering the inclusion and exclusion criteria. PPI use and various other correlates were compared in both study groups. SPSS ver 24.0 was used for statistical analysis.Results: About 69.23% subjects were using PPI prior to admission in SBP group, which was significant compared to only 31.47% in cirrhotics without SBP (p 0.003). On multivariate analysis PPI use was an independent risk factor for SBP (OR 2.24, 95% CI: 1.01-4.24; p value 0.033) and beta blocker use was protective (OR 0.58; 95% CI: 0.4-0.8; p 0.001).Conclusions: PPI use doubles the risk of development of SBP in cirrhotics decompensated with ascites. In contrast, Beta blockers use significantly lowers the risk of SBP.
Evaluation of intermittent hemodialysis conducted off-site on patients with renal insufficiency admitted in the intensive care unit of a developing country
Authors: Simour Aïcha , Dendane Tarek , Abidi Khalid , Belayachi Jihane , Madani Naoufel , Iraqi Amina , Abouqal Redouane , Zeggwagh Amine A.
Published: January 2019

Background: In most developing countries, the renal replacement therapy (RRT) in ICU is not performed locally. We designed this study to assess the intermittent hemodialysis (IHD) offsite intakes on survival in critically ill patients admitted with renal failure.Methods: We prospectively analyzed all patients admitted to medical ICU with Acute Renal Failure (AKF) or Chronic Renal Failure (CKF) from February 2011 to September 2013. Patients were divided into two groups: those that received IHD in Hemodialysis Unit (IHD+) and those who did not (IHD-). Every patient IHD+ was matched to a patient IHD - using propensity score.Results: 202 patients were included: 151 with ARF and 51 with CRF. 116 patients were matched (age: 48±18 years; 46F/70M; median serum creatinine: 51mg/l; IQR: 32-90 mg/l). The total number of dialysis sessions was 112 for 58 patients (1.8±1.4 session/patient). The median delay to initiate IHD was 5.5h (IQR: 2-8h) and median duration of transportation was 10 min (IQR: 10-15min) with 23.6% transportation incidents. Significant hypotension with tachycardia were reported during IHD. ICU mortality rate was the same in the both groups (58.6%). In multivariate analysis, CRF (RR=2.69; p=0.006), serum creatinine >50mg/l (RR=3.54; p=0.007) and requirement for vasopressors infusion (RR=1.8; p=0.041) were independent predictive factors for receiving IHD.Conclusions: Our study doesn’t show an improvement in survival in ICU patients who receive IHD offsite. The probability to require IHD offsite increases with CRF and the use of vasopressors.
Clinical profiling of subclinical hypothyroidism at presentation at tertiary care center
Authors: Mishra Sanjay , Gupta Arjit
Published: January 2019

Background: Subclinical hypothyroidism (SCH) is defined as serum thyroid-stimulating hormone (TSH) level above upper limit of normal despite normal levels of serum free thyroxine, stable over a period of one month in the absence of any non thyroidal illness. Present study is aimed at evaluating prevalence of SCH in developing countries and evaluating the clinical spectrum of these patients highlighting the importance of treatment of SCH.Methods: Total number of 120 patients with established SCH was enrolled for the study over 3 years. The values were measured by third generation non-isotopic immunochemiluminiscence method using the standard protocol as indicated in the kit.Results: Patients were aged 15-50 years old. The most common manifestation was generalized weakness, lethargy and tiredness (60%) followed by generalized body ache (52.5%). 46.7% % of the patients had complaints of weight gain. Triglyceride levels and serum cholesterol levels were deranged in 28.3% of all cases. Body mass index was increased in 28.3% of all patients with obesity in only 2 patients. 15 patients (11.7%) were found to be anaemic with increased MCV and MCH/MCHC, attributable to hypothyroidism.Conclusions: These symptoms caused significant debilitated life style and poor outcome in SCH patients. Treatment of these patients can help in improving their lifestyle and perform better on daily basis.
Which is a better marker for overweight: waist height ratio or waist circumference?
Authors: Anwar Sanam , Aleem Bushra , Rashid Hajir H. , Moslhey Ghadeer J.
Published: January 2019

Background: The global prevalence of obesity has been increasing. Body mass index, waist circumference and waist height ratio have been widely used for nutritional assessment. Waist height ratio has the advantage of taking into account abdominal obesity as well as height associated with body fat accumulation or distribution. The objective of this study was to suggest cut off points for waist circumference and waist height ratio to identify overweight in Omani adults.Methods: Weight, height, waist circumference and waist height ratio were measured for all participants. Pearson’s correlation was used to determine correlation of BMI with waist circumference and waist height ratio. ROC curve was used to identify AUC and specific cut off point for anthropometric indicators.Results: The largest proportion of overweight was picked up by waist height ratio across both the genders. Correlation of BMI with waist height ratio was stronger (r=0.699) than correlation with waist circumference (r=0.589) for both the genders. Maximum AUC was for waist height ratio in males (AUC=0.833, 95% CI=0.791-0.875). The specific cut off point for waist circumference in males and females was 89.5cm and 87.6cm respectively. The specific cut off point for waist height ratio in males and females was 0.53 and 0.57 respectively.Conclusions: Maximum participants were found overweight by waist height ratio followed by waist circumference and the least by BMI. The higher cut off points should be used in this population for identifying overweight people.
An observational study to compare adenosine deaminase level among diabetes patients
Authors: Sharma Vivek , Bhattacharya Sangeeta , Sarkar Poornima Dey , Garima Gini , Gour Neeraj , Chaudhary Meenakshi
Published: January 2019

Background: Obesity is a complex disorder that involves some degree of over-consumption1 coupled with a metabolic derangement. As ADA has been putatively associated with inflammation, and adipose tissue inflammation is the hallmark of insulin resistance in obese T2DM patients. This study attempted to compare serum ADA in T2DM subjects.Methods: This observational cross-sectional study was conducted in the Department of Biochemistry at MGM Medical College and MY Hospital. All the patients and controls were clinically examined, and routine biochemical tests were analyzed for all subjects. ANOVA has been applied to assess the variance between groups.Results: Mean age of controls was 56.91 years where as mean age in the group of a subject with Obesity with diabetes was 40.91 years and with Obesity without diabetes was 48.10 years. ADA level was more among diabetes patients having obesity than diabetes patients having no obesity and controls.Conclusions: This is very much evident through this study that ADA may be treated as prognostic predictor of diabetes either linked to obesity or not, though more studies are warranted in same direction to make this finding conclusive and acceptable biochemical evidence.
Wilsons disease and autoimmune liver disease overlap syndrome: a clinical study
Authors: R. Ramasubramanian , Y. Jaipaul , Rejoice Poppy , A. Shafique , Anandan Heber
Published: January 2019

Background: The coexistence of Wilson’s disease and autoimmune liver disease in a same patient is a rare entity. Combined treatment with steroid and D-penicillamine may be effective. Aim of the study was analyse the clinical, histological, laboratory profile for patients with chronic liver disease with aim of finding the etiology of the disease.Methods: It is an observational study. Common clinical presentations were evaluated. Laboratory investigations done include complete blood count, renal and liver function tests, prothrombin time, viral markers for hepatitis A, B, C and E, USG abdomen and pelvis, portal Doppler studies and upper GI endoscopy. Specific tests include ANA, AMA, ASMA, Anti LKM-1Ab, serum ceruloplasmin and 24hrs urinary copper were done. Liver biopsy was done in selected patients.Results: Commonest clinical presentation was abdominal distension (80%), abdominal pain (30%), pedal edema (60%), splenomegaly (40%) and upper GI bleed (40%). Laboratory investigation revealed anemia (50%), thrombocytopenia (70%), prothrombin time prolongation in (60%), normal liver function in 60%, abnormal liver function in (40%). Autoimmune markers revealed ANA strong positivity in (40%), mild positivity in (60%). AMA, ASMA, Anti-LKM-1 were negative in all cases (100%). Liver biopsy showed features of autoimmune liver disease and Periportal copper deposition in 80% of cases.Conclusions: Coexistence of Wilson’s disease and autoimmune liver disease is a rare entity and medical treatment with steroids and D-penicillamine simultaneously to be started in these patients.
Operative management of chondrosarcoma in pelvic region: case series
Authors: Wiratnaya I Gede Eka , Wirabhawa Made , Sandiwidayat Komang Septian , . Aakash
Published: January 2019

Chondrosarcoma is the second most frequent malignant bone tumour after osteosarcoma. It most often occurs in the pelvis. Treatment of pelvic chondrosarcoma is a difficult problem for the musculoskeletal oncologist. We report 3 patient with chondrosarcoma in pelvic region that undergoing internal hemipelvectomy. First patient, male 28 y.o. with chondrosarcoma in left iliac wing 11.2cm x 10.8cm x 9.2cm. Second, woman, 47 y.o with chondrosarcoma in right superior and inferior pubic rami 13.7cm x 11.5cm x 14.2cm with soft tissue mass around extended to medial part of proximal thigh. Already done A wide excision of the tumor was performed and we use non-vascularized fibular graft (NVFG) to fill the defect. Last patient, pregnant woman 22 y.o. (16weeks gestational age) with chondrosarcoma in right pubic rami 9.8cm x 11.4cm x 13cm. We already done internal hemipelvectomy without terminating the fetus. The second and third patient confirmed with the histopathology result with chondrosarcoma grade II, and the first patient with chondrosarcoma grade I. After 3month post operatively, all of the patients have no pain, no urinary tract complain. The first patient can ambulatory full weight bearing with no crutches or walker. Second patient ambulatory partial weight bearing with crutches. The last patient ambulatory with wheel chair during the pregnancy. Since chondrosarcomas are unresponsive to chemotherapy or radiotherapy, surgical resection was the only therapeutic solution for these patients. It also reinforce the need of a correct diagnose and collaboration between specialities in the treatment of oncological patients.
A unique solution to improve an amblyopic child’s adherence to patching
Authors: Alharkan Dora H.
Published: January 2019

Amblyopia should be treated in early ages to have better outcomes. Stimulation of suppressed eye and depriving light stimulus to the good eye is the main principal of the amblyopia treatment. Adherence to the patching for the treatment of amblyopia in children remains challenging. This could be due to poor cooperation of child or ill-fitting patch. Younger children can be motivated to mimic cartoon figures to improve their adherence to patching. Amblyopia treatment is a team work of parents and optometrist who not only select the mode of management but improve the acceptance of child for patching.  We present a child with mild anisometropia and hypermetropia-induced esotropia and amblyopia who was non-compliant to patching. An innovative idea by the parents using a Ninja Turtle patch on the prescribed spectacle was very well accepted by the child and both esotropia and amblyopia improved within four months of the patching treatment. The vision in the affected eye improved from 20/200 to 20/20 with refractive error correction and patching. We share this low-cost child-friendly patching technique that parents invented that can be used to improve adherence to patching by young children during amblyopia therapy. This parent’s innovation enabled to improve adherence and thus address amblyopia in patched eye and regain vision.
Role of Ki67 protein in colorectal cancer
Authors: Mulyawan I Made
Published: January 2019

Colorectal cancer has become one of the most frequent malignancy and the leading cause of death from cancer globally. Global Burden Cancer in 2013 had placed colorectal cancer in third place morbidity level and forth most lethal cancer globally. Understanding prognostic marker is essential to increase prognosis prediction in patients with colorectal cancer, especially in patient with the later stages. Several studies have reported the prognostic value of Ki67 expression in patient with colorectal cancer. Ki67 protein expression is associated with proliferative activation from intrinsic cell population in malignant tumor cells, where Ki67 can be used as a marker for tumor aggressivity. Expressions from protein Ki67 are associated with proliferative activities from intrinsic cell population in malignant tumor cells, where Ki67 can be used as marker from tumor cell’s aggressivity. Several diagnostic applications for pKi67 has already been explained, where Ki67 is significantly higher in malignancy compared to normal tissue. pKi67 is also increased along with the decrease of tissue differentiation, and it correlates with the presence of metastasis that can not be seen and tumor clinical phase. Prognostic value from Ki67 had been investigated in many studies with their potential as reliable marker in breasts, soft tissue, lungs, prostate, cervix, and central nervous system. Positive expression from Ki67 in colorectal cancer shows a better prognosis in patient who received surgical treatment and adjuvant radiochemotherapy, but not in a patient who received only a surgical treatment.
Manoeuvres for management of diabetes
Authors: Hansdak Amod
Published: January 2019

Type 2 diabetes is the scourge of our times. Globally there are over 425 million diabetics which is projected to rise to 629 million by 2045, suffering devastating consequences resulting in significant morbidity and mortality.1-3Bringing blood sugars down can be challenging. Dietary control, lifestyle modifications and exercise can help but these can be difficult to implement.4 Medically, drugs are the usual method of bringing blood sugar levels under control but they come with their attendant risks and ongoing costs.5 Apart from drugs, the main arsenal against diabetes is exercise but due to one reason or another it is not very popular or practical. In the absence of antidiabetic medications and episodic exercises there seems to be no alternative left. So, when a person is unable to exercise or is not on hypoglycaemic agents, he is rendered defenceless against the deleterious effects of raised blood sugar levels. Regardless, muscles form the frontline defence against diabetes since muscles are the main modifiable factor in utilization of glucose by the body which they can do even in the absence of insulin.6,7 Hence, muscles need to be the first line agents to fight diabetes. However, the muscles need to be activated when the blood sugars are high, that is, within minutes or hours after meals rather than exercising in the morning or evening when the blood sugar may be relatively low. The question is ‘How do we get the muscles to start using up glucose right when it enters the blood stream?’ This is where the manoeuvres described below can help since these can be done almost anytime and anywhere. Following are the proposed manoeuvres:Calf contractions: Alternate contractions of calf muscles of each leg while sitting, giving a good squeeze to the calf muscles. Alternatively, one or both calves can be contracted and held for some time. This manoeuvre can be done even while lying in bed.Pectoral pressure: One or both pectorals can be contracted and held for 30-60 seconds-longer the better. The strength of contractions will depend on one’s motivation and ability. Alternatively, moderate contractions can be maintained for a longer duration.Shoulder squeezes: The back has some of the strongest muscles which can be used to ‘pulverise’ the sugars. In this method the person can sit slightly bent forwards and the shoulders are pulled back and held in that position for 30-60 seconds.These manoeuvres can be done either singly or combined with other manoeuvres described or with dietary modifications, regular exercises or medications for greater efficacy.Of course, like the antidiabetic medications, these manoeuvres need to be titrated, especially when combined with hypoglycaemic agents, otherwise they can lead to hypoglycaemia.8 Even without antidiabetic medication they have the ability to cause hypoglycaemia, if done excessively. Once the muscles get used to these manoeuvres it will be easier for them to use glucose and keep blood sugars down.
A study of prevalence and pattern of congenital heart disease at Sopore, Kashmir, North India
Authors: Naik Suhail , Irshad Mohd. , Kachroo Aliya , Ahmad Mudasir
Published: January 2019

Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and ASD (atrial septal defect) in 20.2%. Tetralogy of Fallot was the commonest cyanotic heart disease (8.0%). Maximum numbers of children with heart disease were diagnosed in the age group 6 weeks to 6 years.Conclusions: For better estimation of prevalence of congenital heart diseases, more elaborate community-based studies are needed. Such community based studies can be easily done by collecting and analyzing data collected from screening programs like RBSK. Such community based screening programs helps in detecting silent cardiac ailments, their prevalence and pattern, and early therapeutic intervention. A few prevalence studies have been carried out piecemeal in different locations of India; and more such studies can be easily done by collecting and analyzing data collected under RBSK screening program.
In vitro selection for Fusarium oxysporum f. sp. conglutinans resistance in brassica vegetables
Authors: Abeyawardana Oushadee A. J. , Koudela Martin
Published: January 2019

Background: Fusarium wilt is an issue of concern in economically and nutritionally important Brassica vegetable cultivation. Thus, it deserves measures against the adverse production impact caused by Fusarium wilt.

Methods: In this study, development of resistance to F. oxysporum f. sp. conglutinans in six white head cabbage cultivars, by in vitro chemical mutagenesis and selection, through direct and indirect organogenesis was examined. 6 day and 10 day old hypocotyl, shoot tip and calli, from 6 day old hypocotyl explants, were subjected to chemical mutagenesis treatment (DMSO (4% v/v) + EMS (0.3% v/v) for two hours at 28±2°C) were incubated in MS shoot induction medium (MS+ NAA (0.2 mg/l), BAP (3 mg/l), GA3 (0.01 mg/L) and AgNO3 (0.5 mg/l)). Shoots developed from hypocotyl and shoot tip explants (in the MS shoot induction medium and then in MS + NAA (0.2 mg/l), BAP (3 mg/l), GA3 (0.01 mg/l) for shoot development) and calli following mutagenesis treatment were screened for Fusarium resistance subjecting to 15% and 20% Fusarium culture filtrate for 30 and 60 day selection periods for each strength respectively.  

Results: Developed plantlets from all six cultivars tested, showed resistance to Fusarium culture filtrate in the in vitro conditions with different survival frequencies ranging between 12.5% to 84.0% from hypocotyl and 0.0% to 86.7% from shoot tip explants among cultivars indicating development of resistance to Fusarium by in vitro chemical mutagenesis.

Conclusions: Direct organogenesis, and 10 day old hypocotyl and 6 day old shoot tips are potential explants for successful application of in vitro chemical mutagenesis for Fusarrium resistance development in in cabbage.

 
A study of pattern of non-venereal genital dermatoses in female patients at a tertiary care center
Authors: Sivayadevi P. , Anandan Heber
Published: January 2019

Background: Nonvenereal genital dermatoses are responsible for considerable concern for the patients as any genital lesion, or related-symptom is often misinterpreted as being sexually transmitted. To the physician, it may create confusion from venereal dermatoses and cause diagnostic challenge. The study is aimed to determine the clinical pattern and relative frequency of nonvenereal genital dermatoses in sexually active female patients.

Methods: The study was conducted as a prospective, observational study in sexually active female patients who presented with genital lesions, after excluding venereal diseases. A detailed history and dermatological examination along with skin biopsy in selected cases to aid in diagnosis was done, and the results were tabulated and analysed.

Results: This study included 100 female patients with nonvenereal genital lesions. A total of 23 genital dermatoses were noted. Most of the patients belonged to 25-40 years of age group. Infections and infestations were responsible for 39% of cases of which vulval candidiasis was the most common disorder. Other dermatoses noted include lichen sclerosus et atrophicus, lichen simplex chronicus, psoriasis, lymphangioma circumscriptum, epidermoid cyst, seborrheic keratosis, vulval intraepithelial neoplasia, vitiligo, angioedema of vulva and vestibular papillomatosis.

Conclusions: This study underscores the importance of considering non-venereal dermatoses in the differential diagnosis of genital lesions, thus avoiding the misbelief that all genital lesions are sexually transmitted.
Modifications of pulse therapy in pemphigus: a retrospective study of 72 patients
Authors: Bhuptani Neela V. , Chauhan Khushbu P. , Jadwani Monal M. , Raja Pooja
Published: January 2019

Background: Pulse therapy defines as the administration of supra-pharmacologic doses of drugs in an intermittent manner to enhance the therapeutic effects and reduce the side effects. Dexamethasone-Cyclophosphamide pulse (DCP) therapy is known since 1986 but there are certain limitations due to side effects of cyclophosphamide.

Methods: A retrospective study was carried out where 72 patients of pemphigus were treated with modified pulse therapy like DCP, DAP, DMP from 2006-2016. Modifications were made in DCP therapy protocol and substitution of cyclophosphamide with either azathioprine or methotrexate in few patients.

Results: Male to female ratio observed was 1:0.7. Majority of them belonged to age group of 31-40 years (41.66%) followed by 41-50 years (33.3%). Maximum number of patients had pemphigus vulgaris (86.1%) followed by pemphigus foliaceous (12.5%) and IgA pemphigus (1.38%). Good response was observed in patients who took pulse therapy regularly.

Conclusions: Modifications to the original DCP therapy protocol were found to be very effective, useful and it shortened the duration of phase I. Side effects were minimal and manageable.
A retrospective study of systemic manifestations in systemic lupus erythematosus in a tertiary care centre
Authors: Budhrani Deepmala , Raja Pooja , Jadwani Monal , Chauhan Khushbu , Patel Bharti , Bhuptani Neela V.
Published: January 2019

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. Other than cutaneous manifestations, thorough examination and investigations for systemic involvement should also be done. The objective is to study the prevalence of various systemic manifestations in SLE patients in a tertiary care hospital.

Methods: A retrospective study was conducted from April 2009 to August 2018 on the patients who fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria for SLE. A total of 63 cases of SLE were extracted from the case record for the study. Each case was subjected to detailed history, examination, investigations including complete blood count, liver function test, renal function test, blood sugar, urine routine examination, ECG, X-ray of chest and involved joints, USG abdomen, pulmonary function test. Ours being a resource limited set-up, ANA, ENA profile and echocardiography were done whenever patient could afford.

Results: In present study of 63 cases of SLE 94% were females. Mean age was 30 years. Various systemic involvement was present, amongst them musculoskeletal system was the most common system involved with 60 (95%) patients, followed by hematological system 48 (76%), renal system 37 (59%), neuropsychiatric system 29 (46%), gastrointestinal system 28 (44%), reproductive system 27 (43%), cardiovascular system 25 (40%). Other systems with ophthalmic involvement 23 (21%), hepatobiliary system 22 (35%), respiratory system 17 (27%), endocrine involvement 13 (28%) and malignanacy was present in 2 (3%) cases.

Conclusions: SLE is protean in its manifestations. Thorough knowledge about the systemic involvement will help in tailoring the treatment in case of SLE.
Transgeniczne myszy jako model w badaniach wpływu wielonienasyconych kwasów tłuszczowych na organizm
Authors: Stepanow Kamila , Ogłuszka Magdalena , Lepczyński Adam , Poławska Ewa , Pierzchała Mariusz
Published: January 2019

The mouse is a popular animal model employed for studying metabolic alterations. The generation of fat-1 transgenic mice by Professor JingX. Kang and collaborators has revolutionised the omega-3 research. Fat-1 mice are able to convert omega-6 fatty acids to omega-3 fatty acidsdue to gene fat-1 from Caenorhabditis elegans that encodes an omega-3 fatty acids desaturase. This mice model can endogenously synthesizeomega-3 PUFA without ALA intake and the balancing quantity and quality of various confounding factors of different diets. Next, noveltransgenic mice â âOmega mice” with the expression of the fat-1 and fat-2 transgenes were created to produce both omega-6 and omega-3PUFA from a diet containing saturated fat or carbohydrates with essential fatty acids deficiency. Both transgenic mice are utilities for studyingmolecular mechanisms of omega-3 fatty acids and their metabolites in tumorigenesis and inflammatory disorders.
Początki molekularnych nauk o życiu â Kontekst Polski
Authors: Barciszewski Jakub , Szymański Maciej , Malesa Aleksandra , Olszewska Daria , Markiewicz Wojciech , Barciszewski Jan
Published: January 2019

Different scientific disciplines such as physics, genetics or biochemistry crossed over into molecular biology in the last century. The Polish state didnât existed at the beginning of XX century, but the territory for a large number of scientists was not a limitation in delineating new routes, making fundamental discoveries or training the new generation of distinguished people of sciences. We want to tell the story of roots of molecular biology from the Polish perspective and outline its importance, by bringing closer the most essential discoveries of elite scientists in different fields of life science, associated with Poland and its territory.
Stulecie Instytutu Biologii Doświadczalnej im. Marcelego Nenckiego PAN â siła idei i wola działania
Authors: Kuźnicki Leszek
Published: January 2019

The Institute was founded in 1918, shortly after the re-establishment of Poland as an independent country. It was based on three pre-existing laboratories affiliated with the Scientific Society of Warsaw. The formation and development of the Institute was supported in part by a donation of Nadine Sieber-Shumova, a close co-worker of Marceli Nencki from Berne and St. Petersburg. Over the next two decades the Institute grew to become the leading biological research centre in Poland. The outbreak of World War II interrupted a period of its intensive expansion and achievement of scientific excellence in the field of experimental biology. After the turmoil of the war, during which over a dozen of the Instituteâs staff lost their lives, and its premises (including most of its 30.000 volume library)were destroyed, the surviving staff members(Jan Dembowski, Stefania Dembowska, Jerzy Konorski, Liliana Lubińska, Włodzimierz Niemierko and Stella Niemierko) re-established the Nencki Institute. In 1952, the Institute was incorporated into the newly founded Polish Academy of Sciences, and the Instituteâs director, Prof. Dembowski, became the first President of the Academy. During the period of 1953-55, a newly erected building at 3 Pasteur Street in Warsaw became the final home of the Nencki Institute. The research goals of the Nencki Institute are to arrive at molecular, cellular and systematic explanations of excitability, movement, development, memory, learning, behaviour, ageing and disease. All those tasks need to be both intellectually satisfying and relevant to problems of human health. Institute edit journal Acta Neurobiologiae Experimentalis. Directors from1947: Jan Dembowski, Włodzimierz Niemierko, Jerzy Konorski, Kazimierz Zieliński, Maciej Jan Nałęcz, Jerzy Duszyński, Adam Szewczyk. At present Agnieszka Dobrzyń.
Udział lipidów w regulacji prozapalnych szlaków sygnałowych indukowanych przez lipopolisacharyd
Authors: Kwiatkowska Katarzyna , Ciesielska Anna
Published: January 2019

Lipopolysaccharide (LPS, endotoxin) is the component of the outer membrane of Gramnegative bacteria which upon infection induces the bodyâs inflammatory reaction facilitating eradication of pathogens. However, exaggerated reactions to LPS can lead to potentially deadly sepsis while chronic, low-grade inflammation is linked with the development of several metabolic diseases, like type 2 diabetes. These processes are initiated by the binding of LPS to CD14 protein and the TLR4/MD2 receptor complex located in the plasma membrane of immune cells and also by the activation of a cytoplasmic multi-protein complex called the inflammasome. Recent studies have shown that lipids of the plasma membrane and endomembranes are important regulators of LPS-triggered signaling pathways. In this review we summarize those data emphasizing the role of phosphatidylinositols and modification of proteins by palmitoylation. Dysregulation of the lipid-dependent steps of the LPS-induced signaling can lead to excessive production of cytokines during sepsis and metabolic diseases linked withendotoxemia.
Aneksyna A6, białko wiążące cholesterol i nukleotydy, uczestniczące w naprawie błon biologicznych i w transporcie pęcherzykowym
Authors: Bandorowicz-Pikuła Joanna , Seliga Agnieszka Kinga
Published: January 2019

Annexins, calcium- and membrane-binding proteins, have been extensively studied at the Nencki Institute since early 1990s, in terms of their structure, potential ligands and functions in the organism, with emphasis on mineralization processes in norm and pathology. The results of recently performed studies have revealed that annexins are playing essential roles in membrane organization. In this review we characterize the largest member of the annexin family of proteins, annexin A6 (AnxA6), in respect to its cholesterol and nucleotide binding properties, as well as intracellular pH sensing and ability to change membrane permeability to ions. Furthermore, we discuss biological functions of AnxA6 such as participation in membrane lateral organization, cell membrane repair and regulation of vesicular transport.
Molekularne podłoże chorób spowodowanych mutacjami w genach kodujących podjednostki syntazy ATP
Authors: Kucharczyk Róża , Baranowska Emilia , Rytka Joanna
Published: January 2019

Syntaza ATP jest ostatnim enzymem systemu OXPHOS, odpowiedzialnym za syntezę ATP. Mutacje zarówno w genach jądrowych jak i mitochondrialnych, kodujących podjednostki enzymu (17 białek), prowadzą do chorób neurodegeneracyjnych. Dwie podjednostki tego enzymu, 8 (ATP8, inna nazwa A6L) i a (ATP6), kodowane są w genomie mitochondrialnym przez geny MT-ATP8 i MT-ATP6. 17 mutacji związanych z chorobami zidentyfikowano w pięciu genach jądrowych kodujących podjednostki enzymu. 58 mutacji zostało opisanych w genach MT-ATP8 i MT-ATP6, 36 z nich zostało zdeponowanych w bazie danych MITOMAP. Dla większości z nich zarówno patogenny charakter jak i mechanizm choroby nie są znane. W tej pracy podsumowujemy aktualną wiedzę na temat molekularnych podstaw chorób spowodowanych nieprawidłowym funkcjonowaniem syntazy ATP. Opisujemy mutacje w genach kodujących podjednostki enzymu oraz dane biochemiczne uzyskane w badaniach komórek pacjentów, modeli komórkowych i drożdżowych, a ponadto badania wykorzystujące drożdże mające na celu selekcję leków i poznanie ich mechanizmu działania. Mutacje w podjednostkach 8 i a wprowadziliśmy do ostatnio opublikowanej struktury domeny błonowej enzymu i dyskutujemy ich strukturalne i funkcjonalne konsekwencje.
Choroby peroksysomalne
Authors: Stradomska Tresa J.
Published: January 2019

Peroksysomy to wielofunkcyjne organelle, które spełniają kluczową rolę w licznych procesach biochemicznych dostosowując się dynamicznie do aktualnych wymogów fizjologicznych komórki. Zaburzenie struktury peroksysomów na skutek mutacji i dysfunkcji genów PEX lub innych genów kodujących białka biogenezy czy pojedyncze peroksysomalne białka funkcyjne stanowi podłoże patogenetyczne chorób peroksysomalnych. Proces β-oksydacji bardzo długołańcuchowych kwasów tłuszczowych (VLCFA) jest unikalnym szlakiem metabolicznym zlokalizowanym wyłącznie w peroksysomie. To warunkuje, że VLCFA jest głównym biomarkerem w diagnostyce chorób peroksysomalnych. Choroby peroksysomalne prezentują szerokie spektrum objawów klinicznych od neonatalnego, ciężkiego Zespołu Zellwegera z dysmorfią, dysfunkcją wielonarządową do późnoobjawowej adrenoleukodystrofii występującej u dorosłych, sprzężonej z chromosomem X. Dzięki zastosowaniu wysokospecjalistycznych technik analitycznych jest to stale powiększająca się grupa rzadkich chorób genetycznych.
Gene editing
Authors: Węgleński Piotr
Published: January 2019

Development of the gene engineering techniques has raised worries that they will be used for construction of organism endangering humansand environment. In 1975 at the Asilomar conference, geneticists from many countries decided that genetic engineering brings more benefitsthan threats. In last years a new CRISPR-Cas technique emerged . It allows to make the precise changes in genomes, e.g. to inactivate particulargenes or to replace mutated genes by their wild-type alleles. Inactivation in mice of genes corresponding to those whose mutations causethe genetic diseases in man allows to get model organisms for studying the etiology of given disease and for working out the methods of itscuring. This technique can be applied for repairing genes whose mutations result in metabolic diseases and cancer. Some voices were raisedthat the technique can be potentially used for the âimprovement” of man, what would create many ethical and social problems. Geneticists,ethicists and lawyers gathered in 2015 at the Washington conference, discussed these problems and proposed rules for their solving.
Can Capital Structure Affect the Financial Performance of Banks in Turkey?
Authors: Tuncay Merve
Published: January 2019

The aim of this study is to investigate the determinants of banks’ financial performance in terms of the capital structure. Annual financial statements of 11 banks traded in Borsa Istanbul are employed for the period of 2006-2016. Return on assets, return on equity and earnings per share are chosen for financial performance measures. The independent variables related to the capital structure are capital adequacy, equity-to-asset, and financial leverage ratios. In addition, macroeconomic variables and bank-specific variables are also considered as control variables for the analysis. The data are analyzed by the panel data regression analysis as it provides more informative finding and less multicollinearity among variables than time series and cross-sectional analyzes.

The Hausman test results indicate that the random effects model is appropriate for the whole dependent variables. According to the findings; while equity-to-asset ratio affects return on assets positively, amongst the control variables specific to firms, firm size, asset quality and asset growth variables have significant effects on return on assets. It is found no significant effect of independent variables on return on equity, however, it is seen that asset quality has a negative and significant effect. Inflation and interest rates have a significant effect on both variables. Finally, it is seen that equity-to-asset ratio has a positive and significant effect on earnings per share. Only the effect of asset quality on earnings per share is found to be significant among the control variables. Findings of the study are consistent with the previous studies. In addition, the M&M views are not supported by the findings related to return on assets and earnings per share but the return on equity.
Pembelajaran Kreatif untuk Mewujudkan Anak-Anak Yang Cerdas, Kreatif, dan Berkarakter
Authors: Kurniawan Heru
Published: January 2019

Creative learning is learning that rests on four fundamental base, namely fun children learning design; learning to obtain more good values, but it is directed to produce learning products: intellectual works, creative performance, and educational activities; learning that is always appreciated by the teacher in the form of the value and the publication; and learning that can improve the child's motivation to learn. With four foundations above, this creative learning can create intelligent children. They are the children who are able to resolve the issue of learning in accordance with the breadth of his knowledge; a creative child, the child can actualize ideas, concepts, and feelings in concrete; and children who have personality and good character in their daily lives.
Pengubahan Organisasional Madrasah Sukses Berbasis Nilai-Nilai Religius Kepala Madrasah (Studi Kasus Pada Madrasah Ibtidaiyah Negeri I Malang)
Authors: Walid Muhammad
Published: January 2019

The success of madrasah can simply reflect values and beliefs owned by the leader of madrasah on what to achieve by the school. Additionally, values and beliefs are potentially influential on leadership practice of madrasah leader for the advancement of madrasah, started from the leadership processes and procedures. For the research focus is centered on the “process of phenomena” of how religious values of madrasah leader can organize the change of madrasah to be successful and is aimed at obtaining deep comprehension on the phenomena, this research purposively employs qualitative approach. Besides, this research uses case study in which the religious values data of excellent madrasah leader in controlling the madrasah transformation comprise complex, holistic, natural and multi-interpreted events. There are three technniques to collect the data, known as participant observation, indepth interview and study documentation. The data are analyzed by testing, categorizing, tabulating, or recombining of empirical proofs to construct initial propositions of research. The concluding remarks of this research exemplify that values and beliefs that underpin madrasah leader’s belief to control revolution in Islamic Elementari School (MIN) I Malang is strongly believed by madrasah leader in which the school processes are its articulation form. The religious beliefs and values of MIN 1 Malang leader are optimism, confidence, sincerity and tawakkal (trust in God) that are combined by four traits of prophet Muhammad, namely siddiq (honesty), tabligh (openly human relations), amanah (trustworthiness) and fathanah (intelligence).