The DUSP domain of pseudophosphatase MK-STYX interacts with G3BP1 to decrease stress granules

Mitogen activated protein kinase phosphoserine/threonine/tyrosine-binding protein (MK-STYX) is a dual specificity (DUSP) member of the protein tyrosine phosphatase family. It is a pseudophosphatase, which lacks the essential amino acids histidine and cysteine in the catalytic active signature motif (HCX5R). We previously reported that MK-STYX interacts with G3BP1 [Ras-GAP (GTPase-activating protein) SH3 (Src homology 3) domain-binding-1] and reduces stress granules, stalled mRNA. To determine how MK-STYX reduces stress granules, truncated domains, CH2 (cell division cycle 25 phosphatase homology 2) and DUSP, of MK-STYX were used. Wild-type MK-STYX and the DUSP domain significantly decreased stressed granules that were induced by sodium arsenite, in which G3BP1 (a stress granule nucleator) was used as the marker. In addition, HEK/293 and HeLa cells co-expressing G3BP1-GFP and mCherry-MK-STYX, mCherry-MK-STYX-CH2, mCherry-MK-STYX-DUSP or mCherry showed that stress granules were significantly decreased in the presence of wild-type MK-STYX and the DUSP domain of MK-STYX. Further characterization of these dynamics in HeLa cells showed that the CH2 domain increased the number of stress granules within a cell, relative to wild-type and DUSP domain of MK-STYX. To further analyze the interaction of G3BP1 and the domains of MK-STYX, coimmunoprecipitation experiments were performed. Cells co-expressing G3BP1-GFP and mCherry, mCherry-MK-STYX, mCherry-MK-STYX-CH2, or mCherry-MK-STYX-DUSP demonstrated that the DUSP domain of MK-STYX interacts with both G3BP1-GFP and endogenous G3BP1, whereas the CH2 domain of MK-STYX did not coimmunoprecipitate with G3BP1. In addition, G3BP1 tyrosine phosphorylation, which is required for stress granule formation, was decreased in the presence of wild-type MK-STYX or the DUSP domain but increased in the presence of CH2. These data highlight a model for how MK-STYX decreases G3BP1-induced stress granules. The DUSP domain of MK-STYX interacts with G3BP1 and negatively alters its tyrosine phosphorylation- decreasing stress granule formation.

Effectiveness of immunotherapy versus BRAF/MEK inhibitors in treatment-naïve BRAF-mutant advanced melanoma: A single institution retrospective analysis

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Background: Skin cancer is the most common type of cancer in the US. Melanoma constitutes about 1% of all skin cancers, but it accounts for most of skin cancer related deaths. In 2017, 85,000 new cases of melanoma were reported while 8000 people died. BRAF is the gene encoding for B-Raf protein; a serine/threonine-protein kinase involved in cell growth and survival. Activating mutations in BRAF are present in approximately 50% of melanomas. Therapeutics in melanoma have been rapidly evolving. Currently, advanced melanoma with a mutation in the BRAF gene has two different modalities for first-line treatment; immunotherapy which mediates checkpoint inhibition versus targeted therapy with BRAF + MEK inhibitors. The aim of our study was to compare effectiveness of immunotherapy versus BRAF/MEK inhibitors as first line treatment for metastatic BRAF-mutant advanced melanoma. Methods: A retrospective study of all patients aged ≥ 18 years, diagnosed with metastatic melanoma at our center between 1/1/2011 and 05/30/2021 was carried out. Patients who had BRAF negative melanoma or other active malignancies were excluded. Our primary endpoint was difference in overall survival and progression-free survival between two treatment groups. Secondary endpoint was to compare baseline characteristics associated with treatment options. Results: A total of 308 patients were diagnosed with advanced melanoma during the study period. N = 106 (34%) were found to have BRAF mutation. Of these, 88 (83%) received single-agent or combination immunotherapy while 18 (17%) received BRAF/MEK inhibitors. In immunotherapy group, 13 (14.7%) patients received combination immunotherapy while 75 (85%) got single agent treatment. 60 (56.6%) were males. Median age was 61 (89-21) years. Mean BMI at presentation was 29.5 ± 6.8 kg while mean LDH was 407 U/L. Mean age in immunotherapy and BRAF/MEK inhibitor group was 59.5 and 54.4 years, respectively. Differences between immunotherapy and BRAF/MEK inhibitors groups were observed in duration (months) between initiation of treatment and progression of disease (10.3 vs 7.23), death at time of last follow-up (21% vs 63%), remission at time of last follow up (37% vs 16%), and progression at time of last follow up (38% vs 16%). At the time of analysis, the mean follow-up was 28 ± 23.7 months in the immunotherapy group and 24 ± 23.3 months in the BRAF/MEK inhibitor group. Overall, at a mean follow up of 27.3 ± 23.5 months, no significant difference was found between the two treatment groups in unadjusted models in terms of overall survival (p 0.67) and progression free survival (p 0.16). Conclusions: Patients receiving first-line immunotherapy showed no significant survival benefit versus those receiving BRAF/MEK inhibitor therapy. This contrasts with other studies showing survival benefits in patients receiving immunotherapy as first line agent.

Clinical characteristics and outcomes of extrapulmonary small cell cancer: A retrospective analysis of the SEER database

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Background: Extrapulmonary small cell cancer (EPSCC) accounts for only 5-10% of small cell carcinoma, with the rest consisting of small cell lung cancer (SCLC). The incidence of this entity has been rising due to better diagnosis, however it is not well described and data is limited. We performed a Surveillance, Epidemiology and End Results (SEER) database analysis to further characterize the biology and clinical aspects of this entity, in comparison to SCLC. Methods: The Surveillance, Epidemiology and End Results (SEER) 18 database was used to obtain data on age, gender, ethnicity, survival, and tumor characteristics of n = 9,712 US patients diagnosed with EPSCC between 2000-2018 and these were compared to n = 118,514 patients with SCLC diagnosed during the same period. Results: Among the EPSCC cohort 58.1 % were males while in the SCLC cohort 50.3% were males. Median age of diagnosis was 65.50 years for EPSCC and 66.81years for SCLC. Among the EPSCC patients, 75.9 % were Caucasians, 9.2 % were African-Americans, and 8.8% were Hispanics. Amongst SCLC patients, Caucasians made up 83.1% of the patients, while African-Americans made up 8.6% and Hispanics made up 4.5 % of the patients. Most common sites for EPSCC were urinary bladder (20.2%), prostate (7%), cervix uteri (6.2%), pancreas (4.5%), rectum (3%), and ovaries (2.6%). Median OS for EPSCC was 8 months (95% CI: 8 - 8), while median overall survival for SCLC was 7 month (95% CI: 7 - 7). Hazard ratio for death for EPSCC: 0.77 (95% CI: 0.75 - 0.79), p < 0.001. The survival at 12 months, 24 months and 60 months was 36%, 22%, and 13 % for EPSCC and 29%, 13%, and 5% for SCLC. There were no significant gender or racial differences in overall survival (OS). Conclusions: EPSCC has better overall and 5-year survival as compared to SCLC. There are no significant differences in survival outcomes in EPSCC patients based on location of primary, gender or race.

Increasing person-centeredness in psychosis inpatient care: staff experiences from the Person-Centered Psychosis Care (PCPC) project

Background

Interventions to increase person-centeredness in hospital care for persons with psychotic illness are needed. Changing care delivery is however a complex venture, requiring staff to reconsider their mindsets and ways of working. A multidisciplinary educational intervention for hospital staff at four wards was launched to increase person-centeredness in the care of patients with schizophrenia and similar psychoses. This study aims to explore staff experiences of working to increase person-centeredness.

Methods

A heterogenic sample of staff (n = 23) from all participating wards were recruited for six focus group interviews. Semi-structured questions covered staff perceptions of person-centered care and the process of increasing person-centeredness. Transcribed data was analyzed using thematic analysis according to Braun and Clarke.

Results

Staff viewed person-centered care as an approach rather than a method. They described central aspects of person-centered care, such as recognizing the patient as a capable person who can participate in her/his care. Statements further showed how these core features were put into practice. Changes related to the intervention were presented in terms of evolving patient and staff roles, improved contact with patients, more flexible care routines, and a more positive ward climate. Neither psychotic symptoms nor involuntary status were considered barriers for person-centered care, but organizational factors beyond staff control seemed to impact on implementation.

Conclusions

After implementation, participants displayed good understanding of the core concepts of person-centered care in both thinking and action. They attributed several improvements in the care milieu to an increased level of person-centeredness. Psychotic behavior and involuntary treatment did not present major barriers to person-centered care. Findings suggest person-centered care is feasible in the psychosis inpatient setting and could improve quality of care.

Trial registration

The study is part of a larger study evaluating the intervention Person-Centered Psychosis Care (PCPC). It was registered retrospectively at clinicaltrials.gov, identifier NCT03182283.

Photocatalytic hydrogen evolution over cyanine-sensitized Ag/TiO2

Sensitization of TiO₂ by dyes such as cyanine and their derivatives is used as a technique to improve potency for the production of hydrogen gas as an alternative green fuel. These dyes shift the spectrum of TiO₂ from the UV region to the visible region, enabling it to harvest as much sunlight as possible. Herein, four different derivatives of cyanine (labelled C1, C2, C3, and C4) were prepared and doped in Ag/TiO₂via the impregnation method. The properties of the prepared photocatalysts were studied by XRD, SEM-EDS, FTIR, and UV-visible spectroscopy. The sensitized photocatalysts exhibited a similar morphology, nanoscale particle size, and good absorbance in the visible region. The rate constant for the photocatalytic activity of Ag/TiO₂ showed a great enhancement for hydrogen evolution after sensitization from 0.088 to 0.33 μmol min⁻¹. Doping of the C2 derivative in Ag/TiO₂ promoted the photocatalytic and sonophotocatalytic rates of H₂ production by 7.5 and 9 times, respectively. Also, the amount of photocatalyst had a significant effect on the photocatalytic activity of the sensitized Ag/TiO₂, where 0.14 g was the optimum dose, giving the maximum yield at both the initial rate and 300 min. One of the important factors causing the efficiency to reach high levels is the inhibition of photogenerated electron/hole recombination. This was achieved by adding a small quantity of methanol, which increased the rate by 9 times. The stability of the prepared photocatalysts was tested, which gave good results even after their 5th use. All the results confirmed that the sensitization of metal oxides is a promising solution in industry to produce clean energy (H₂) in high quantities over highly stable photocatalysts.

Comparison between photo- and sonophotocatalytic hydrogen production.

Reduced Leukoaraiosis, Noncardiac Embolic Stroke Etiology, and Shorter Thrombus Length Indicate Good Leptomeningeal Collateral Flow in Embolic Large-Vessel Occlusion

BACKGROUND AND PURPOSE

Acute leptomeningeal collateral flow is vital for maintaining perfusion to penumbral tissue in acute ischemic stroke caused by large-vessel occlusion. In this study, we aimed to investigate the clinically available indicators of leptomeningeal collateral variability in embolic large-vessel occlusion.

MATERIALS AND METHODS

Among prospectively registered consecutive patients with acute embolic anterior circulation large-vessel occlusion treated with thrombectomy, we analyzed 108 patients admitted from January 2015 to December 2019 who underwent evaluation of leptomeningeal collateral status on pretreatment CTA. Clinical characteristics, extent of leukoaraiosis on MR imaging, embolic stroke subtype, time of imaging, occlusive thrombus characteristics, presenting stroke severity, and clinical outcome were collected. The clinical indicators of good collateral status (>50% collateral filling of the occluded territory) were analyzed using multivariate logistic regression analysis.

RESULTS

Good collateral status was present in 67 patients (62%) and associated with independent functional outcomes at 3 months. Reduced leukoaraiosis (total Fazekas score, 0-2) was positively related to good collateral status (OR, 9.57; 95% CI, 2.49-47.75), while the cardioembolic stroke mechanism was inversely related to good collateral status (OR, 0.17; 95% CI, 0.02-0.87). In 82 patients with cardioembolic stroke, shorter thrombus length (OR, 0.91 per millimeter increase; 95% CI, 0.82-0.99) and reduced leukoaraiosis (OR, 5.79; 95% CI, 1.40-29.61) were independently related to good collateral status.

CONCLUSIONS

Among patients with embolic large-vessel occlusion, reduced leukoaraiosis, noncardiac embolism mechanisms including embolisms of arterial or undetermined origin, and shorter thrombus length in cardioembolism are indicators of good collateral flow.

Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan

Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.

Immune checkpoint inhibitors in the treatment of cancer

BACKGROUND

Immunotherapy drugs, known as immune checkpoint inhibitors (ICIs), work by blocking checkpoint proteins from binding with their partner proteins. The two main pathways that are specifically targeted in clinical practice are cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1) that showed potent immune-modulatory effects through their function as negative regulators of T cell activation.

METHODS

In view of the rapid and extensive development of this research field, we conducted a comprehensive review of the literature and update on the use of CTLA-4, PD-1 and PD-L1 targeted therapy in the treatment of several types of cancer including melanoma, non-small-cell lung carcinoma, breast cancer, hepatocellular carcinoma, hodgkin lymphoma, cervical cancer, head and neck squamous cell carcinoma.

RESULTS

Based on the last updated list released on March 2019, seven ICIs are approved by the FDA including ipilimumab, pembrolizumab, nivolumab, atezolizumab, avelumab, durvalumab, and cemiplimab.

CONCLUSION

This review also highlighted the most common adverse effects caused by ICIs and which affect people in different ways.

Antidiabetic Activity of Momordica charantia L. and Mechanism of Insulin Secretion of 1-Butanol Soluble Part on Type 2 Diabetic Model Rats

The in vivo effects of fruit pulp juice (MC-PJ) of Momordica charantia and its 1-butanol soluble part (MC-BP) and aqueous soluble part (MC-AP) on blood glucose of type 2 diabetic rats were studied. In vitro insulin secretion in response to MC-BP and MC-AP from whole perfused pancreas was measured. For elucidating the mechanism of insulinotropic action, the insulin secretory activity of MC-BP in the presence of 11 mM glucose, 50 μM verapamil (Ca++ channel blocker), 8 mM diazoxide (K+ ATP channel opener) and 10 mM theophylline (cAMP phosphodiesterase inhibitor) were studied. Serum glucose was measured by glucose oxidase-peroxidase method and rat insulin was assayed by specific ELISA. In the in vivo study, MC-BP significantly opposed the rise of serum glucose compared to control at 105 min (p<0.05). Although the MC-AP and MC-PJ lowered the serum glucose both at 60 and 105 min, these were not statistically significant. In the in vitro study, only MC-BP produced 22-fold increase in insulin secretion from the perfused pancreas at nonstimulatory glucose level, which was significant (basal vs. MC-BP, 0.071±0.009 vs. 1.563±0.150 ng/ml, p<0.001). The MC-BP also enhanced the insulin secretion from the glucose-stimulated pancreas (p<0.001). The MC-BP induced insulin secretion was not affected in presence of diazoxide and verapamil. The obtained results also showed that MC-BP enhanced the insulin secretory effect of theophylline (p<0.001). The findings indicate that MC-BP has stimulatory effects on physiological pathways of insulin secretion which may underlie its reported antidiabetic action. Dhaka Univ. J. Pharm. Sci. 19(2): 111-117, 2020 (December)

Evaluation of preventive procedures followed by the medical staff against covid-19 in the Syrian Arab Republic: A cross-sectional study

Objectives:

This study was oriented to investigate the current situation of Syrian medical staff working in different fields and their response regarding the preventive procedures.

Material and Methods:

Questionnaire was designed according to the World Health Organization guidelines and recommendations, addressing the preventive measures, which must be followed by healthcare workers to protect themselves and their community against COVID-19. The participation in the study was average as 1339 participants from medical staff (596 males and 743 females) have filled the questionnaire.

Results:

The results displayed high percentages of commitment in general regarding preventive measures followed (health rules, personal protective equipment, and disinfection) for all healthcare workers. The proportions of responses were varied depending on job nature. In addition, the highest range of percentage of self-evaluation was 50–75% for all medical staff.

Conclusion:

Based on the filled information, the study showed relatively good commitment to the preventive procedures by healthcare workers to control COVID-19 and prevents its spread in the community.

Superoxide Dismutase in Extender Improves the in vitro Quality and in vivo Fertility of Cryopreserved Water Buffalo (Bubalus bubalis) Spermatozoa

BACKGROUND

Superoxide dismutase (SOD) as an antioxidant in semen extender may be used for the cryopreservation of buffalo spermatozoa and in vivo fertility.

OBJECTIVE

This study was aimed to evaluate the effects of SOD (SOD1, 100 IU/mL; SOD2, 200 IU/mL; SOD3, 300 IU/mL) and control (0.0) in Tris citric acid extender on in vitro quality and in vivo fertility of cryopreserved water buffalo bull spermatozoa.

MATERIALS AND METHODS

Semen collection was carried out on a weekly basis (four bulls, three replicates, and n = 24 ejaculates). The conventional freezing of semen loaded straws (0.5 mL) was undertaken by placing them horizontally on a steel rack inside a Styrofoam box for 10 min containing liquid nitrogen (LN2) vapours, and plunging into a liquid nitrogen tank (-196 °C) for storage, followed by thawing at 37 °C for 30 s and analysis by computer-assisted sperm analyzer (CASA) and other assays.

RESULTS

At post-dilution, the acrosome integrity (ACR-I, %) was significantly improved (P < 0.05) in extender supplemented with SOD3 as compared to other experimental groups. In addition, DNA integrity (DNA-I, %) was significantly higher (P < 0.05) in SOD1 and SOD3 compared to SOD2 and control. At post-thawing, the mean values of sperm progressive motility (PM, %), average path velocity (VAP, µm/s) and straight line velocity (VSL, µm/s) were significantly higher (P < 0.05) in extender supplemented with SOD3 compared to the control. At post-thawing, mean values of subjective motility (SM, %), plasma membrane integrity (PMI, %) and ACR-I were significantly higher (P < 0.05) in extender supplemented with SOD3 compared to the control. At post-thawing, sperm DNA-I was significantly higher (P < 0.05) in extender supplemented with all SOD doses compared to the control in a dose-dependent manner. The in vivo fertility rate (%) was significantly higher with SOD3 compared to the control (68.2 % vs. 49.5 %).

CONCLUSION

The supplementation of SOD3 (300 IU/mL) in Tris citric acid extender improves both in vitro quality and in vivo fertility of buffalo bull spermatozoa.

Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink

Gaining full benefits from osteoporosis medications requires long-term treatment. Investigating the real-world persistence of women receiving osteoporosis medications in the UK, we found that most patients stop treatment within a year. To prevent osteoporotic fragility fractures, long-term treatment persistence must be improved.

INTRODUCTION

Persistence with osteoporosis therapies has historically been poor. To treat this chronic and progressive disease, it is essential that patients receive the full benefit of these medications. We estimated persistence and compliance with osteoporosis therapies in a large sample of postmenopausal women in the UK.

METHODS

Data were obtained from the Clinical Practice Research Datalink for all women aged 50 years and over or women with early menopause, who received at least one prescription in primary care for any licensed osteoporosis therapy between January 1, 2010 and December 31, 2015. Persistence and compliance at 24 months (primary objective) and at 5 years (exploratory objective) were estimated in three patient cohorts: "All Patients," "Naïve Patients," and "Drug-Specific."

RESULTS

The All Patients cohort included 72,256 women. Persistence with any therapy was 56.1%, 43.6%, 36.4%, and 31.0% at 6, 12, 18, and 24 months, respectively, and 23.2% and 13.1% at 3 years and 5 years, respectively. Patients were generally more persistent and compliant if evaluated from their first exposure to osteoporosis therapy (Naïve Patients cohort). In the drug-specific analysis, 64% of patients receiving denosumab (administered subcutaneously every 6 months) were persistent at 24 months compared with 28% and 23% of those taking oral bisphosphonates and intravenous bisphosphonates, respectively.

CONCLUSIONS

Only about one in three patients who received osteoporosis therapy continued to be on treatment after 2 years. There is a need to improve persistence with osteoporosis therapy, especially for high-risk patients.

Understanding patients' experience living with diabetes type 2 and effective disease management: a qualitative study following a mobile health intervention in Bangladesh

BACKGROUND

In 2017, 425 million adults worldwide had diabetes; 80% were living in low and middle-income countries. Bangladesh had 6.9 million adults with diabetes; death from diabetes comprised 3% of the country's total mortality. This study looked at different factors (personal, familial, social, and financial) affecting both the life of patients with diabetes type 2 and the management of the disease. It also explored patient's perception of the mobile health intervention in the context of disease management and helped to explain the findings obtained from the quantitative part of this study.

METHOD

The study was a mixed-method, sequential explanatory design. A mobile health project (interactive voice call and call center) was implemented in Dhaka district, Bangladesh from January to December, 2014. Patients received treatment at the outpatient department of Bangladesh Institute of Health Science Hospital, Dhaka, Bangladesh, were included in intervention and control groups of the main study following a Randomized Control Trial. Among them, a total of 18 patients (9 + 9) were selected purposefully for the qualitative study, which was conducted in July, 2015. The sample was selected purposefully considering the age, sex, socio-economic status and proximity of living due to the political instability of the country during the data collection period. The interviews were transcribed and analyzed applying investigator triangulation.

RESULTS

Most patients stated that diabetes has affected their lives. In general, both groups´ evaluation of mobile health services were good and both regarded the recommendations for medication, diet, physical exercise, and other lifestyle behaviors (use of tobacco and betel nuts) as helpful. The cost of overall treatment (medications, physician consultations, laboratory investigations), the lack of availability of safe public places for physical exercise and unfavorable weather conditions (heat, rainfall) were mentioned as barriers to the overall management of the disease.

CONCLUSION

A patient-centered mobile health intervention supported by a collaborative patient-provider relationship, a strong family support system, available public spaces for exercise and the introduction of a functional public health insurance system could be beneficial for the better management of diabetes.

Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER

OBJECTIVE

To describe treatment outcomes of children and adolescents enrolled in the Pediatric Obesity Weight Evaluation Registry, a consortium of multicomponent pediatric weight management programs in the US.

STUDY DESIGN

This multicenter prospective observational cohort study, established in 2013, includes youth (2-18 years of age) with obesity enrolled from 31 Pediatric Obesity Weight Evaluation Registry (POWER) sites over a 2-year period and followed up to 12 months. Weight status was evaluated by the percentage of the 95th percentile for body mass index (%BMIp95). Associations of weight status outcomes with patient characteristics and program exposure were analyzed with multivariable mixed effects modeling.

RESULTS

We included 6454 children and adolescents (median age, 11 years; IQR, 9-14 years; 53% white, 32% Hispanic; 73% with severe obesity) who were enrolled in POWER. Median changes in %BMIp95 for this cohort were -1.88 (IQR, -5.8 to 1.4), -2.50 (IQR, -7.4 to 1.8), -2.86 (IQR, -8.7 to 1.9), at 4-6, 7-9, and 10-12 of months follow-up, respectively (all P < .05). Older age (≥12 years), greater severity of obesity, and Hispanic race/ethnicity were associated with better improvement in %BMIp95. A 5-percentage point decrease in %BMIp95 was associated with improvement in cardiometabolic risk factors.

CONCLUSIONS

Overall, treatment in pediatric weight management programs is associated with a modest median decrease in BMI as measured by change in %BMIp95. Further studies are needed to confirm these findings, as well as to identify additional strategies to enhance the effectiveness of these multicomponent interventions for youth with severe obesity.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02121132.

Association of Serum Vitamin D (25OHD) Level with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Acute exacerbations of COPD is characterized by a change in the patients baseline dyspnoea, cough and/or sputum that is beyond normal day to day differences and guides to a change in standard medications in a patient with COPD. Vitamin D influences the innate & adaptive immune system, and exerts pleiotropic antimicrobial and anti-inflammatory responses. Vitamin D deficiency is frequent among COPD patients but its contributory role in disease exacerbations is widely debated. This study was aimed to assess relationship between reduced serum vitamin D (25-OHD) level with COPD severity and acute exacerbation. This observational cross-sectional study was carried out in the department of Respiratory Medicine, NIDCH, Mohakhali, Dhaka, Bangladesh from October 2016 to September 2017. Consecutive 80 hospital admitted patients with acute exacerbation of chronic obstructive pulmonary disease diagnosed on the basis of clinical history & pulmonary function tests and 78 age & sex matched controls were investigated for serum vitamin D (25-OHD) level. Among the COPD patients, 37% had Vitamin D deficiency (<20ng/ml) and 28.75% had Vitamin D insufficiency (20-29ng/ml). Mean vitamin D (25-OHD) level of COPD patients (25.82±10.62ngm/ml) was found to be significantly lower than healthy controls (32.57±11.32ngm/ml). Vitamin D deficiency was found, by Pearson correlation test, to be significantly associated with severity of COPD. Multivariate analysis showed that age (in years), FEV1 (percent predicted), frequent exacerbators (≥2 in the last year), and smoking (>40 pack year) were significantly associated with Vitamin D deficiency. Acute exacerbation of chronic obstructive pulmonary disease patients was found to have vitamin D deficiency and vitamin D deficiency was significantly associated with severity of COPD. Vitamin D deficiency was also associated with frequent disease exacerbation.

Cartilage oligomeric matrix protein forms protein complexes with synovial lubricin via non-covalent and covalent interactions

OBJECTIVE

Understanding the cartilage surface structure, lost in arthritic disease, is essential for developing strategies to effectively restore it. Given that adherence of the lubricating protein, lubricin, to the cartilage surface is critical for boundary lubrication, an interaction with cartilage oligomeric matrix protein (COMP) was investigated. COMP, an abundant cartilage protein, is known to be important for matrix formation.

DESIGN

Synovial fluid (SF) from arthritic patients was used to detect possible COMP-lubricin complexes by immunological methods. Recombinant (RC) COMP and lubricin fragments were expressed to characterize this bonding and mass spectrometry employed to specifically identify the cysteines involved in inter-protein disulfide bonds.

RESULTS

COMP-lubricin complexes were identified in the SF of arthritic patients by Western blot, co-immunoprecipitation and sandwich ELISA. RC fragment solid-phase binding assays showed that the C-terminal (amino acids (AA) 518-757) of COMP bound non-covalently to the N-terminal of lubricin (AA 105-202). Mass spectrometry determined that although cysteines throughout COMP were involved in binding with lubricin, the cysteines in lubricin were primarily focused to an N-terminal region (AA 64-86). The close proximity of the non-covalent and disulfide binding domains on lubricin suggest a two-step mechanism to strongly bind lubricin to COMP.

CONCLUSION

These data demonstrate that lubricin forms a complex network with COMP involving both non-covalent and covalent bonds. This complex between lubricin and the cartilage protein COMP can be identified in the SF of patients with arthritis conditions including osteoarthritis (OA) and rheumatoid arthritis (RA).

Freezability of water buffalo spermatozoa is improved with the addition of catalase in cryodiluent

BACKGROUND

Catalase enzyme is usually distributed in mammalian seminal plasma, where it decomposes hydrogen peroxide into water and oxygen and enhances sperm survivability.

OBJECTIVE

To evaluate the effect of catalase (0, 100, 200 or 300 IU/ml) added in tris-citric acid (TCA) based extender on motion characteristics, viability and DNA integrity of bubaline spermatozoa at post dilution (PD) and post thawing (PT) stages of cryopreservation.

MATERIALS AND METHODS

Collection of semen was done in four Nili-Ravi bulls with an artificial vagina (42 degree C). Qualified semen samples from each bull were further subdivided into four aliquots for dilution with the experimental TCA extender containing either 0.0 (T1), 100 IU (T2), 200 IU (T3) or 300 IU (T4) catalase (activity12660 U/mg).

RESULTS

At PT, mean computer progressive motility, average path velocity, straight line velocity, curvilinear velocity, visual motility and DNA integrity were higher (P < 0.05) in catalase fortified treatment groups as compared with control. Regarding plasma membrane integrity and supra-vital plasma membrane integrity, at PT the mean values were higher (P < 0.05) in T4 as compared with control. At PD and PT, mean acrosomal integrity of buffalo bull spermatozoa was higher (P < 0.05) in T4 group as compared with control.

CONCLUSION

Addition of catalase at a concentration of 300IU/ml in TCA cryodiluent improved the freezability of water buffalo spermatozoa.

Positive influence of short message service and voice call interventions on adherence and health outcomes in case of chronic disease care: a systematic review

BACKGROUND

Chronic diseases have emerged as a serious threat for health, as well as for global development. They endenger considerably increased health care costs and diminish the productivity of the adult population group and, therefore, create a burden on health, as well as on the global economy. As the management of chronic diseases involves long-term care, often lifelong patient adherence is the key for better health outcomes. We carried out a systematic literature review on the impact of mobile health interventions -mobile phone texts and/or voice messages- in high, middle and low income countries to ascertain the impact on patients' adherence to medical advice, as well as the impact on health outcomes in cases of chronic diseases.

METHODS

The review identified fourteen related studies following the defined inclusion and exclusion criteria, in PubMed, Cochrane Library, the Library of Congress, and Web Sciences. All the interventions were critically analysed according to the study design, sample size, duration, tools used, and the statistical methods used for analysing the primary data. Impacts of the different interventions on outcomes of interest were also analysed.

RESULTS

The findings showed evidence of improved adherence, as well as health outcomes in disease management, using mobile Short Message Systems and/or Voice Calls. Significant improvement has been found on adherence with taking medicine, following diet and physical activity advice, as well as improvement in clinical parameters like HbA1c, blood glucose, blood cholesterol and control of blood pressure and asthma.

CONCLUSIONS

Though studies showed positive impacts on adherence and health outcomes, three caveats should be considered, (i) there was no clear understanding of the processes through which interventions worked; (ii) none of the studies showed cost data for the m-health interventions and (iii) only short term impacts were captured, it remains unclear whether the effects are sustained. More research is needed in these three areas before drawing concrete conclusions and making suggestions to policy makers for further decision and implementation.

Elevated levels of serum uric acid and insulin resistance are associated with nonalcoholic fatty liver disease among prediabetic subjects

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of insulin resistance and serum uric acid (SUA) levels seemed to be elevated during this disorder. There is a paucity of data regarding the association of SUA with NAFLD in prediabetes. In this context, the present study has been undertaken to investigate this association.

METHODS

In a cross-sectional analytical design, a total of 110 prediabetic subjects [M/F; 63/47, age in ranges, 45 (25-68)] were recruited in the study and divided into non NAFLD (n = 62) and NAFLD (n = 48) group after examined with ultrasonogram. Insulin resistance (HOMA-IR) was calculated by homeostasis model assessment.

RESULTS

NAFLD subjects had significantly higher levels of SUA compared to non NAFLD subjects (6.10 ± 1.42 vs. 5.38 ± 1.14, p = 0.004). They also had significantly higher levels of HOMA-IR (2.4 ± 1.09 vs. 1.4 ± 0.45, p < 0.001). In binary logistic regression analysis, HbA1c (OR = 3.505, p = 0.002), SUA (OR = 1.514, p = 0.023) and HOMA-IR (OR = 1.478, p = 0.029) were found to be significant determinants of NAFLD after adjusting the effects of BMI and triglyceride (TG). In multiple linear regression analysis, SUA showed significant positive association with HOMA-IR (ß = 0.355, p = 0.027) and TG (ß = 0.325, p = 0.033) after adjusting the effects of BMI and HbA1c.

CONCLUSIONS

Increased levels of serum uric acid are significantly associated with NAFLD and this association seemed to be mediated by insulin resistance among prediabetic subjects.

CRP (C-reactive protein) in Early Pregnancy Predictor for Development of GDM

This case-control study was done to find out whether elevated serum CRP in early pregnancy is a predictor of GDM and conducted under joined supervision of Obstetrics & Gynecology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital and Biomedical Research Group (BMRG), BIRDEM, from August 2005 to November 2007. Pregnant mothers at their first 16 weeks of gestation without any medical disorder of pregnancy were included in the study. For the purpose of this study blood samples were again collected for OGTT at their 16weeks, 24-28 weeks and 32 weeks of pregnancy to detect GDM. After confirmation of GDM, C-reactive protein and C-peptide were done from the preserved fasting serum sample at the end of this study to compare GDM with control group. A total of 297 patients were included in this study. Among them 145(48%) patients completed follow up, 59(20%) lost from follow-up and 11(4%) patients had abortion; 82(28%) are due for follow up 31(10%) pregnant patients developed GDM subsequently. Finally 28 GDM patients were taken as cases and 71 were control matched for their gestational age and parity. At earlier weeks of gestation, hsCRP could predict (PPV) development of GDM in 59% with NPV 84%, sensitivity 61% and specificity 83%. C-peptide in the 50th percentile could predict (PPV) development of GDM in 58% with NPV 96%, sensitivity 72% and specificity 93%. The present data indicates that hsCRP and C-peptide both is sensitive markers in predicting GDM.

Cardiovascular risk assessment among rural population: findings from a cohort study in a peripheral region of Bangladesh

OBJECTIVES

The incidences of non-communicable diseases including cardiovascular diseases (CVDs) is increasing in Bangladesh. The reasons for this increasing trend need to be explored. The aim of this study is to assess the risk of CVDs among a peripheral rural Bangladeshi population and to explore the sociodemographic, anthropometric and clinical variables associated with increased risk.

STUDY DESIGN

Cohort study.

METHODS

From a cohort of 190,471 individuals of all ages, originally included in a diabetic eye disease program initiated in 2008-2009, a purposive sub-cohort of 66,710 individuals, aged 31-74 years was recruited. During 2011-2012 these participants were assessed for CVDs using the WHO's risk assessment tool designed for primary care settings in low resource societies. Participant characteristics associated with higher risk were explored using univariable and multivariable regression analysis.

RESULTS

Out of all (95.5% participation rate) participants 1170 (1.84%) were found to be at high risk for CVD. The prevalence of hypertension (HTN), pre-HTN, obesity, underweight and self-reported DM were 8.9%, 15.2%, 9.6%, 7.8% and 0.5% respectively, among the study population. In multivariable regression analysis female sex, older age, temporary housing structure (i.e., tin shed), extremes of BMI (both underweight and obese) and central obesity were associated with higher risk for CVDs.

CONCLUSIONS

The prevalence of CVD risk factors and high CVD risk individuals in this cohort was found to be lower than previous studies. It may be the effects of urbanization are yet to reach this relatively traditional rural population. This study adds to the literature on use of the WHO risk assessment tool.

Fine mapping for double podding gene in chickpea

For the first time, fine mapping for sfl locus was carried out using a battery of new STMS and SNP markers. The target region was delimited to 92.6 Kb where seven annotated genes were found that could be candidate genes for the simple/double podding trait in chickpea. Four recombinant inbred populations (RIP-1, RIP-7, RIP-11, and CPR-01) were used to map the double podding gene (sfl) in chickpea. In RIP-1, the gene was initially mapped on linkage group (LG) 6 between the two sequence-tagged microsatellite site (STMS) markers TA120 and TR1. Eight new STMS markers were added onto LG6 in the target region and sfl locus was finally located between CAGM27819 and CAGM27777 markers within an interval of 2 cM. Seven out of the eight markers were mapped in RIP-7 and its reciprocal RIP-11 confirming the location of the sfl locus to a 4.8 cM interval flanked by TR44 and CAGM27705. Furthermore, using a high-density single nucleotide polymorphism (SNP) map of CPR-01, sfl was mapped to the same genomic region in a 5.1 cM interval between TR44 and the SNP scaffold1646p97220. Five pairs of near isogenic lines (NILs) and eight recombinant inbred lines (RILs) were used to refine this region in the chickpea physical map. Combining data from linkage analysis in four RIPs, marker physical positions and recombination events obtained in both pairs of NILs and selected RILs, sfl could be placed within a genomic window of 92.6 Kb. Seven annotated genes were extracted from this region. The regulator of axillary meristem-predicted gene could be a candidate gene for the simple/double podding gene. This study provides additional set of markers flanking and tightly linked to sfl locus that are useful for marker-assisted selection.

Toll-like receptor 4 blocker as potential therapy for acetaminophen-induced organ failure in mice

Acetaminophen (APAP, 4-hydroxyacetanilide) is the most common cause of acute liver failure in the United States. In addition to exhibiting hepatotoxicity, APAP exerts a nephrotoxic effect may be independent of the induced liver damage. Toll-like receptors (TLRs) have been suggested as a potential class of novel therapeutic targets. The aim of the present study was to investigate the potential of the TLR-4 blocker TAK-242 in the prevention of APAP-induced hepato-renal failure. Four groups of C57BL mice were studied: Vehicle-treated/control (VEH), APAP-treated (APAP), N-acetyl cysteine (NAC)-pretreated plus APAP (APAP + NAC) and TAK-242-pretreated plus APAP (APAP + TAK) groups. Mice were clinically assessed then perfused 4 h later. Liver and kidney tissues were collected and examined histologically using basic hematoxylin and eosin staining to detect signs of necrosis and inflammation. Plasma samples were collected to measure the levels of alanine transaminase, aspartate transaminase and serum creatinine. In addition, liver and kidney tissues were assayed to determine the levels of reduced glutathione. The results of the present study indicate the potential role of TLR-4 in APAP-induced organ toxicity. In the APAP + TAK and APAP + NAC groups, histopathological examination indicated that pretreatment with TAK-242 or NAC afforded protection against APAP-induced injury. However, this protective effect was more clinically evident in the APAP + TAK group compared with the APAP + NAC group. The various biochemical parameters (serum enzymes and reduced glutathione) revealed no significant protection in either of the pretreated groups. Therefore, the present study indicated that the TLR-4 blocker had protective effects against acute APAP toxicity in liver and kidney tissues. These effects were identified clinically, histologically and biochemically. Furthermore, the TLR-4 blocker TAK-242 exhibited antioxidant properties in addition to anti-inflammatory effects.

Assessment of Short Term Cardiovascular Risk Among 40 Years and Above Population in a Selected Community of Kathmandu, Nepal

BACKGROUND

Cardiovascular disease (CVD) risk assessment is effective for identifying whether people are at low or high risk of CVD events. It is also useful for determining the intensity of intervention. People with low risk of CVD can take more benefit by lifestyle modifications, whereas people at high risk need pharmacological intervention in addition. But, there is dearth of related study in Nepal. Therefore, this study aimed to assess short term CVD risk prediction in selected community of Kathmandu, Nepal.

METHODS

We conducted a cross-sectional study in Sitapaila Village Development Committee, Kathmandu, Nepal between November 2014 and April 2015. We, first selected the household randomly to enroll 347 participants with 18 to 70 years of age, and later assessed the short term CVD risk prediction among ≥ 40 years age group using WHO/ISH chart.

RESULTS

The mean age of respondents was 52 years. The majority of participants were female (58.4%), homemakers (45.2%), from Newar ethnic group (31.9%), and without formal education (42.8%). Smoking was present in 21.7% of respondents, diabetes in 19.9 %, and hypertension in 53.6%. The ≥10% CVD risk was seen in 14.6% (95% CI: 9.2, 20) of the respondents. It was significantly associated with age (p<0.001), education (p=0.027), smoking (p = 0.002), cholesterol level (p = 0.021), systolic hypertension (p <001), and diabetes (p = 0.019).

CONCLUSIONS

The study population is in high risk of developing CVDs in near future. Lifestyle modifications and pharmaceutical interventions to manage the risk factors among study population are highly recommended.

Serum levels of high sensitivity C-Reactive protein and its association with lipidemic status in Bangladeshi healthy adults

Background: Metabolic diseases are affecting human health all over the world. These chronic disease states are associated with high sensitive CRP. The present study aims to measure hsCRP and lipid levels in a group of healthy adults to work out the normal hsCRP levels and explore its relationship to lipidemic and anthropometric variables.Materials and Methods: A total of 149 adults, age 30-60 yrs, healthy subjects were recruited in this study. Vital statistics were taken along with measurement of blood glucose, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein and hsCRP levels. Data were analyzed using statistical Package for Social Program (SPSS) for Windows version 10.Results: Mean (±SD) hsCRP was 2.46±1.89 (mg/l) with a cut off value of 3mg/l. Of the total 149 subjects 102 (66.4%) and 47 (31.5%) subjects had hsCRP level below and above the cutoff respectively. Triglyceride was significantly higher (p=0.033) and HDL was lower in subjects with high hsCRP. Total cholesterol and LDL was almost similar in both groups. Binary logistic regression showed significant negative association between hsCRP and HDLc (p=0.029) and but the model excluding HDL-c showed significant positive association (p=0.03) with triglyceride.Conclusion: About one-third of healthy Bangladeshi adults may have chronic subclinical inflammation and thus may have a risk of cardiovascular disorders. More than one-third healthy Bangladeshi adults have one or more type of dyslipidemia and the subclinical chronic inflammation in healthy Bangladeshi adults has a positive association with their serum triglyceride and negative association with their HDL-cholesterol levels.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11591 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 644-648

Genotype CC of rs12979860 is providing protection against infection rather than assisting in treatment response for HCV genotype 3a infection

Recent discovery of single-nucleotide polymorphisms located in the upstream region of interleukin-28B (IL28B) has shown association with interferon (IFN) treatment response especially in hepatitis C virus (HCV) genotype 1-infected patients. Pakistan, being the country with second highest prevalence of HCV with predominantly 3a genotype infection, bears a significant disease burden. The present study was conducted to evaluate the effect of rs12979860 genotypes on treatment response in HCV-3a-infected patients. This study shows that the CC genotype is providing protection against infection to HCV. But once infected, the CC genotype patients show viral persistence following IFN therapy. The TT genotype is assisting the 3a patients in viral clearance after IFN treatment. To our knowledge, this is the first study showing rs12979860 genotype association with IFN response in Pakistani HCV-3a-infected patients.

Central Obesity Plays an Important Role for the Development of Type 2 Diabetes in Bangladeshi Women

Background: Diabetes mellitus coexists at a greater frequency with hypertension, obesity, central obesity, and dyslipidemia. Obesity has been identified as the most important modifiable risk factor in the aetiology of type-2 diabetes mellitus. Central obesity has been shown to be the most pathogenically important in the causation of metabolic disorders including type-2 diabetes. Aims: To determine the association of central obesity with type 2 diabetes in Bangladeshi women. Subjects and Methods: A total of 60 type 2 diabetic female subjects along with 60 healthy female subjects were recruited in this study. Anthropometric indices were measured using standard techniques. Serum glucose was measured using glucose-oxidase method, insulin was measured using ELISA and thyroid hormones were measured using chemiluminescence based automated Immulite Auto analyzer (DPC, USA). Insulin secretory capacity and insulin sensitivity were estimated using fasting glucose and fasting insulin by HOMA-CIGMA software. Results: Waist circumference of the control (89±8) subjects was significantly (p=0.046) lower than the diabetic (94±11) subjects. Waist-hip ratio of the control subjects was significantly lower compared to diabetic subjects. Fasting plasma insulin level in control subjects (7.6±2.2) was significantly (p=0.009) lower compared to diabetic subjects (11.8±9.8). Plasma lipid profile and thyroid hormone status in control and diabetic subjects were not found significantly different. Insulin secretory capacity (HOMA %B) and insulin sensitivity (HOMA%S) in control subjects (93±21, 95±39 respectively) were found to be significantly higher com-pared to diabetic subjects (45±32, 67±42 respectively). In age-adjusted binary logistic regression analysis, waist circumference was found to be significantly associated with diabetes. In multiple linear regression analysis TSH was found to be significantly associated with waist circumference. Conclusion: Waist circumference may be an independent indicator for the development type 2 diabetes in Bangladeshi women which may have influenced by thyroid stimulating hormone (TSH). DOI: http://dx.doi.org/10.3329/bjms.v13i3.19149 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.278-284

Neuropathic changes in young type 2 diabetes mellitus related to high serum t-PA

Background and Aims: A substantial number of diabetic patients, diagnosed at relatively younger age, who don’t fit to typical type 2 and type 1 class of diabetes. These patients usually present with very high level of glycemia. The uniqueness of this group of patient provide the opportunity to explore the pathophysiology of nerve functional status at an early stage of diabetes. The present study was aimed to determine markers of endothelial dysfunction and evaluate nerve functional status of a group of newly diagnosed clinically uncomplicated young diabetic patients. Material and Methods: A total number of 32 (male-13 and female-19) newly diagnosed young (diabetes diagnosed under 30 yrs) were consecutively recruited from BIRDEM Out-patient department and 30 age-, BMI-matched healthy subjects with no family history of diabetes up to second generation served as controls. Serum fructosamine was measured by reduction test with NBT method. Serum C-peptide, endothelin-1 and tissue plasminogen activator (t-PA) by ELISA and von Willebrand factor (vWF) by Radial Immunodiffusion (RID) methods. Urinary albumin measured by immunoturbidimetry method. Nerve functional status was evaluated by nerve conduction velocities (NCV), distal latencies (DL), compound muscle action potential (CAMP), F wave latencies (FWL), nerve action potential (SNAP) for motor and sensory nerve as appropriate following the standard protocol. Results: Severe hyperglycemia in the diabetic group was reflected in their mean (SD) fasting C-peptide and fructosamine level. Altered endothelial dysfunction, as evidenced by significantly high tissue plasminogen activator (t-PA) (p<0.001) in the diabetic group. Albumin creatinine ratio (ACR) was almost similar in the two groups. Ulnar distal latency was similar in both the groups. But its CAMP and NCV were significantly lower in the diabetic group (p<0.02-0.001). Ulnar F wave latency were significantly higher (p=0.016) in the diabetic group. Ulnar sensory conduction parameters did not show any difference between two groups. Peroneal motor and sural sensory functional status of the diabetic subjects showed similar trend like that of ulnar motor and sensory status. Peroneal nerve motor NCV was significantly negatively correlated with fasting glucose [r=- 0.456, p=0.001]. Peroneal motor distal latency was significantly correlated with fasting fructosamine [r=0.439, p=0.012]. Fasting fructosamine showed significant negative correlation with motor peroneal NCV [r=-0.572, p=0.001], motor ulnar NCV [r=-0.468, p=0.007], both ulnar and sural sensory NAP (p=0.02 for both]. On the basis of F wave latency 53% of diabetic subjects had diabetic neuropathy and markedly higher t-PA compared to nonneuropathy groups (p=0.001). Conclusions: The data suggest that (i) Young type 2 diabetic subjects had endothelial dysfunction at the time of diagnosis even in the presence of normoalbuminuria state; (ii) Motor nerve conduction parameters are affected more than the sensory component; (iii) F wave latencies are more frequently and early to be involved in these subjects and linked to high serum t-PA. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18302 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.190-197

Mapping and identification of a Cicer arietinum NSP2 gene involved in nodulation pathway

For the first time the putative NSP2 gene in chickpea has been identified using pairs of NILs differing for the Rn1 / rn1 nodulation gene that was located in LG5 of chickpea genetic map. An intraspecific cross between the mutant non-nodulating genotype PM233, carrying the recessive gene rn1, and the wild-type CA2139 was used to develop two pairs of near-isogenic lines (NILs) for nodulation in chickpea. These pairs of NILs were characterized using sequence tagged microsatellite site (STMS) markers distributed across different linkage groups (LGs) of the chickpea genetic map leading to the detection of polymorphic markers located in LG5. Using this information, together with the genome annotation in Medicago truncatula, a candidate gene (NSP2) known to be involved in nodulation pathway was selected for mapping in chickpea. The full length sequence obtained in chickpea wild-type (CaNSP2) was 1,503 bp. Linkage analysis in an F3 population of 118 plants derived from the cross between the pair of NILS NIL7-2A (nod) × NIL7-2B (non-nod) revealed a co-localization between CaNSP2 and Rn1 gene. These data implicate the CaNSP2 gene as a candidate for identity to Rn1, and suggest that it could act in the nodulation signaling transduction pathway similarly to that in other legumes species.

Plasma total homocysteine is not associated with peripheral neuropathy in a groups Bangladeshi type 2 diabetic subjects

Aims: The present study was undertaken to explore the relationship of plasma homocysteine in the pathogenesis of neuropathy in diabetic patients.Subjects and Methods: Forty two type 2 diabetic patients [22 with neuropathy (DN group) and 20 without neuropathy (DNN group)], age range between 35-70 years had relatively controlled glycemia and duration of diabetes 7-15 years, were studied. Motor and sensory nerve conduction velocities and action potential amplitudes of peripheral nerves were determined by following standard protocol. HbA1c was estimated by modified HPLC (BIO-RAD Variant, USA). Serum C-peptide was measured by enzyme linked immunosorbentassay (ELISA), plasma total homocysteine by Fluorescent Polarization Immunoassay (FPIA). Results: Age, BMI and blood pressure of the study subjects were. Duration of diabetes between DN and DNN groups was comparable. DN group had significantly higher fasting glucose levels (9.8±3.8, mmol/l) compared to the DNN group (6.9±1.8, p=0.004). This trend was also reflected in the HbA1c level: 8.7± 2.1 vs 7.2±1.6 in DN group and DNN group respectively (p=0.009). The two diabetic groups had relatively higher absolute C-peptide level compared to the controls (p=ns). DN and DNN groups had significantly higher plasma homocysteine level compared to the Controls. But between the two diabetic groups no significant difference was observed. Ulnar and peroneal motor nerve conduction velocities and compound muscle action potentials in the diabetic neuropathy group significantly lower compared to diabetic counterpart and the controls. Ulnar and sural sensory nerve conduction velocities and action potentials were significantly lower in the diabetic neuropathy group compared to the diabetic counterpart and the controls. Plasma homocysteine did not show any correlation with nerve conduction velocities  and action potential amplitudes.Conclusions: The data concluded that (i) Diabetic neuropathy may not  be related to hyperhomocysteinemia in type 2 diabetic patients of Bangladeshi origin; (ii) Hyperglycemia, even at milder level, is related to neuronal dysfunction in these subjects; and (ii) Hyperinsulinemia don't seem to be prerequisite for neuropathy in these subjects. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12607 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12  

Daily life for young adults who care for a person with mental illness: a qualitative study

This study describes the daily life and management strategies of young informal carers of family members or friends with mental illness. Twelve young adults (three men and nine women; 16-25 years old) in Sweden were voluntarily recruited between February and May 2008. Data collected through eight individual semi-structured interviews and one focus group interview were analysed using qualitative content analysis. The findings revealed nine subthemes that were further grouped into three main themes: showing concern, providing support and using management strategies. Participants lived in constant readiness for something unexpected to happen to the person they cared for, and their role in the relationship could change quickly from family member or friend to guardian or supervisor. Supporting a friend was considered as large a personal responsibility as supporting a family member. Their management strategies were based on individual capacities and their ability to step aside should the situation become too demanding. These young informal carers need support in caring for the mentally ill. As the internet becomes increasingly fundamental to daily life, support could be provided most effectively through person-centred web sites.

Glycemic index determination of vegetable and fruits in healthy Bangladeshi subjects

INTRODUCTION

Fruits and vegetables are an important part of the diet especially for their complex carbohydrates, dietary fibre and micronutrients. The present study investigated the glycemic index (GI) of a vegetable [carrot (Daucas carota)] and fruits [banana (Chapa kola) Musa Sp. and plum (Bau kul) Zizyphus mauritiana] of Bangladeshi origin.

METHODS

Fourteen healthy Bangladeshi subjects, comprising 7 males and, 7 females, with mean age of 26 +/- 3 years, BMI 22 +/- 3 kg/m2, waist-hip ratio of 0.89 +/- 0.01 and 0.84 +/- 0.04 respectively for males and females. Under a cross-over design, they consumed equi-carbohydrate amounts (25 g of total available carbohydrate) of the test foods and two times glucose as reference food (25 g of total carbohydrate), with a run in period of 7 days between the consecutive items. Serum glucose levels were determined at 0, 30, 60, 90, and 120 min. The GIs was calculated.

RESULTS

The carrot, banana and plum samples showed significantly lower serum glucose values (incremental area under the curve 30.4 +/- 12.6, 37.3 +/- 19.2 and 41.8 +/- 20.7 respectively) than glucose (132.7 +/- 36.0). The carrot showed a lower GI value than banana and plum respectively (23 +/- 9, 30 +/- 18 and 32 +/- 15).

CONCLUSION

The vegetable and fruit samples tested of Bangladesh origin were shown to have comparatively low GI values.

Phytoestrogen intake and cardiovascular risk markers in Bangladeshi postmenopausal women

Menopause is the transitional event of female life creating a considerable degree of clinical and psychological as well as social problem and it is known to affect the risk markers of cardiovascular diseases. Hormone replacement therapy (HRT) was though to be a cornerstone in the management of menopause, but evidences accumulated in the recent past have raised serious questions regarding its safety and usability. In this context, phytoestrogens are getting increasingly more attention for therapeutic (as an alternate of HRT) and dietary interventions. Menopause is a special problem for women in developing countries and intake of phytoestrogens can be highly useful also from the economic point of views. The nutraceuticals of specific vitamins, minerals and especially phytoestrogens supplementations are a vital component of the strategy to reduce health problem. The present study was aimed to assess the association of phytoestrogens and risk markers of cardiovascular diseases in postmenopausal women. A total of 111 postmenopausal subjects [age, (years, M±SD) 52±5.35] were studied. The dietary intake of phytoestrogens by study subjects was calculated by a specific food frequency questionnaire (FFQ). Serum fasting homocysteine was measured by AxSYM system. Serum glucose was estimated by glucose-oxidase method. Serum total cholesterol, triglyceride and HDL-C were estimated by enzymatic-colorimetric method LDL-C was estimated by the Friedewald's formula. The intake of total phytoestrogens, isoflavones and lignans (mean±SD, mg/day) were 7.65±3.33, 0.32±0.16, 7.32±3.28 respectively in postmenopausal women. The intake of diadzein, genistein, formononetin, biochanin A (mean±SD, mg/day) were 0.085±0.035, 0.168±0.101, 0.074±0.052 and 0.001±0.0008 respectively. The intake of matairesinol and secoisolaiciresinol (SILR) (mean±SD, mg/day) were 0.022±0.006 and 7.30±3.28 respectively. The total phytoestrogens (r=-0.19, p=0.03) and SILR, one specific type of lignans (r=-0.19, p=0.04) consumption in this study were inversely significantly associated with serum glucose level. The dietary formononetin, one specific type of isoflavones was negatively significantly associated with LDL-cholesterol (r=-0.18, p=0.04). There was no significant relationship found between phytoestrogen intake and serum homocysteine level (r=-0.11, p=0.23). Phytoestrogens containing food intake should be encouraged for reducing risk markers of cardiovascular disease in postmenopausal women.