Prevalence and risk factors of hypertension with thyroid dysfunction among indian adults: Synthesis from national family health survey (2015-16)

Background

Thyroid dysfunction (TD) is considered a common cause of secondary hypertension (HT). Therefore, correcting TD may help in quicker and sustained achievement of desired blood pressure goals. However, there is a paucity of literature from India which estimates the relationship of HT with TD.

Objectives

The objective of the study was to estimate the prevalence of TD with HT and to identify associated factors among Indian population.

Materials and Methods

The survey data of the National Family Health Survey 4 (NFHS-4), conducted in India during 2015-2016, were analyzed using R statistical software for estimating the relationship between a history of HT and TD among women (N = 687246) aged 15-49 years and men (N = 108492) aged 15-54 years. Descriptive statistical tests and logistic regression were applied.

Results

Among the persons suffering from the TD, the prevalence of HT was 32.8%, which was significantly higher than the prevalence of HT (21.9%) in euthyroid individuals. Further, the prevalence of TD was higher among hypertensive adults (2.5%) compared to nonhypertensive (1.5%).

Conclusions

The study reported a higher prevalence of TD among the hypertensive persons and higher prevalence of HT among cases of TD. Therefore, screening for thyroid disorders should be routinely considered for better management of HT.

Feasibility of Including Hands-On Microteaching in the Medical Faculty Development Program in India: A Mixed-Methods Study

Background Medical faculty development programs (FDPs) often lack hands-on training in teaching skills. Microteaching, a short, focused teaching practice, could be a feasible way to bridge this gap. This study aimed to explore the feasibility of including hands-on microteaching in a medical FDP in India. Methodology This mixed-methods study involved fresh medical faculty members who never attended FDP on the basics of medical education technologies, stakeholders, and students from a recently established autonomous medical institute of national importance in India. Participants completed a pre-test survey on their teaching skills and received a hands-on microteaching session during an FDP. After the session, participants completed a post-test survey and provided feedback on the feasibility and acceptability of hands-on microteaching in the program. Program evaluation was done by application of Kirkpatrick's Model levels one, two, and three. Results According to the Kirkpatrick Model of Evaluation level one (Reaction), the participants reported improved teaching skills and greater confidence in their ability to teach after the microteaching session. They also reported that hands-on microteaching was an effective way to learn teaching skills and receive feedback. Stakeholders opined that microteaching is a very effective tool for improving teaching skills and should be a part of FDP. Evaluation at level two (Learning) shows that there was a significant improvement in the mean score of post-tests. As per level three (Behaviour Change) evaluation, the majority of the students informed that there is observable improvement in the effectiveness of teaching of faculties in the past two months, i.e., since the participation of faculty in hands-on microteaching in FDP. Conclusions Hands-on microteaching could be a feasible and effective way to enhance the teaching skills of medical faculty members in India. The study findings suggest that including hands-on microteaching in FDPs could help bridge the gap between theoretical knowledge and practical teaching skills.

Status of drug resistant tuberculosis among patients attending a tuberculosis unit of West Bengal: A record based cross-sectional study

Context:

Tuberculosis (TB) is one of the main causes of death due to infectious diseases worldwide. Multidrug resistance/rifampicin resistance (MDR/RR) TB remains a public health crisis. India has the highest burden of tuberculosis and multidrug resistant TB (MDR TB) in the world. There is wide geographical variation in the epidemic and its trends that can be updated by regular reporting and sound surveillance systems. The current study tries to fill this gap by analyzing the data of TB patients from a Tuberculosis Unit, studying socio-demographic and clinical profile from December 2017 to November 2019 in Nadia district of West Bengal.

Aims:

The aims of this work were to study socio-demographic and clinical profile of TB patients attending Tuberculosis Unit of West Bengal, and to find out factors associated with drug-resistant TB.

Settings and Design:

Record-based study from Tuberculosis Unit.

Methods:

Records of all patients who undergo CBNAAT in TU are stored as monthly unit. We randomly selected 10 months from a period of December 2017 to November 2019 by using lot method. Data of all patients undergoing CBNAAT at Kalyani – Gayeshpur Tuberculosis Unit during randomly selected 10 months were accessed.

Statistical Analysis Used:

Monthly data was entered in Microsoft Excel and descriptive tests of significance, proportions and Chi-square were applied.

Results:

There was male preponderance for testing of tuberculosis. Seven percent of the TB suspects were HIV positive. The positivity rate of MTB by CBNAAT was 23%. Four percent of the samples were Rifampicin resistance. Tobacco consumption, contact with TB case and Diabetes were common risk factors of TB. Most of the information was missing in the records.

Conclusions:

Most of Rifampicin Resistant cases showed very low Ct value in CBNAAT. Previous history of TB treatment and positive HIV status was significantly associated with RR TB. There is a need to capture complete information on the records of presumptive TB cases.

Internet addiction among medical undergraduates in a medical college of West Bengal- a cross-sectional study

Background: The era of 21st century is burdened with internet usage worldwide specially in the developing countries such as India. Internet addiction has been related to physical, social, psychological impairment. Aim& Objectives: To find out the prevalence of internet addiction among the medical students and the effect of internet addiction on health status among them. Settings and Design: This was an observational descriptive study of cross-sectional design conducted in a tertiary medical college of West Bengal. Material & Methods: All the undergraduate medical students were approached and interview was done using interview schedule consisting of sociodemographic characteristics, Young’s criteria of internet addiction test and Duke’s health profile screening test. Statistical analysis used: Data was analysed using SPSS version 20&presented in percentages, mean with standard deviation, ANOVA with Tukey’s Post-hoc test. Results: Total of 201 participants responded giving a response rate of about 50%. The distribution of respondents as per Young’s criteria of internet addiction which showed that majority of the respondents were mild addicted (58.7%) & moderate addicted (15%).Comparison of Duke health profile score across various internet addicts where physical health score differs significantly among the non-addicted (81.42+20.02) vs mildly addicted (67+20.36)& moderately addicted (63.31+ 20.15) participants (p=0.00). Mental health score also differs considerably among the non-addicts (78.16+18.36) vs mildly addicts (67+18.28) & moderately addicts (61.87+18.33) (p= 0.00). Conclusions: A good number of medical students were addicted to internet that requires timely remedial action. Educational institutions had to formulate strategies so that proper action could be taken.

Classification models for anticancer activity

Despite significant research in understanding of neoplastic diseases, the success rate for oncology drugs is relatively very low. A major challenge before the scientific community is to design new chemical entities that will be highly selective for cancer cells so as to minimize side effects. Classification models (CMs) models play a prominent role in prediction of the biological properties of newly designed compounds before their synthesis and prevent non-optimal use of resources. Though correlation models far outnumber classification models for development of various therapeutic agents but the significance of classification models for development of anti-cancer agents can not be underestimated. Various techniques employed for development of classification models for anti-cancer activity have been briefly reviewed. Moreover, successful use of some of these classification techniques for the development of models for anti-proliferative activity has been illustrated using a data set comprising of 53 analogues of N-Benzoylated phenoxazines and phenothiazines. Resulting classification models with high degree of accuracy can play a vital role in providing lead structures for the development of novel anti-proliferative agents for cancer chemotherapy.

Predicting biological activity: computational approach using novel distance based molecular descriptors

Four novel distance based molecular descriptors termed as superpendentic eccentric distance sum indices 1-4 (denoted by:∫P-1EDS, ∫P-2EDS, ∫P-3EDS and ∫P-4EDS) as well as their topochemical counterparts (denoted by:∫cP-1EDS, ∫cP-2EDS, ∫cP-3EDS and ∫cP-4EDS) have been conceptualized and developed in the present study. The sensitivity towards branching, discriminating power, and degeneracy of the proposed novel descriptors were investigated. Utility of these indices was investigated for development of models through decision tree and moving average analysis for the prediction of human corticotropin releasing factor-1 receptor binding affinity of substituted pyrazines. A wide variety of 46 2D and 3D molecular descriptors including proposed indices was employed for development of models through decision tree and moving average analysis. The calculation of most of these descriptors for each compound of the dataset was performed using online E-Dragon software (version 1.0). An in-house computer programme was also employed to calculate additional topological descriptors which did not figure in E-Dragon software. The decision tree classified and correctly predicted the input data with an impressive accuracy of 92% in the training set and 71% during cross-validation. A total of three descriptors, identified by decision tree, were subsequently utilized for development of suitable models using moving average analysis. These models predicted human corticotropin releasing factor-1 receptor binding affinity with an accuracy of ≥85%. The statistical significance of models was assessed through sensitivity, specificity and Matthew's correlation coefficient. High discriminating power, high sensitivity towards branching amalgamated with negligible degeneracy offer proposed descriptors a vast potential for use in the quantitative structure-activity/property/toxicity relationships so as to facilitate drug design.

Models for prediction of (V)600(E)BRAF and melanoma cells growth inhibitory activities of pyridoimidazolones

Targeted inhibition of activated BRAF mutation has emerged as a most promising and putative therapeutic approach for the anticancer drug development. In the present study, an in-silico approach using decision tree and moving average analysis has been applied to a data set comprising of 43 analogues of pyridoimidazolones for development of models for prediction of both (V)600(E)BRAF and melanoma cells (BRAF WM266.4) growth inhibitory activities. A decision tree was mainly employed for determining the importance of molecular descriptors (n=46). The value of majority of these descriptors for each analogue in the dataset was computed using E-Dragon software (version 1.0). The decision tree learned the information from the input data with an accuracy of 98% and correctly predicted the cross-validated (10-fold) data with accuracy up to 79%. A total of three non-correlating descriptors, identified best by the decision tree analysis, were subsequently utilized for development of suitable models using moving average analysis. These proposed models resulted in the prediction of (V)600(E)BRAF inhibitory activity (IC50) and melanoma cells growth (SRB GI50) inhibitory activity with an overall accuracy of ≥90%. The statistical significance of models/descriptors was assessed through intercorrelation analysis, sensitivity, specificity and Matthew's correlation coefficient.

Models for cannabinoid-1 receptor antagonistic activity of substituted 2-(3-pyrazolyl)-1,3,4-oxadiazoles

Antagonism of cannabinoid receptor-1 has emerged as a most promising therapeutic target for the development of anti-obesity drugs. In the present study, an in silico approach using decision tree, random forest and moving average analysis has been applied to a data set comprising of 76 analogues of substituted 2-(3-pyrazolyl)-1,3,4-oxadiazoles for development of models for prediction of antagonistic activity of cannabinoid receptor-1. A total of 46 2D and 3D molecular descriptors of diverse nature were employed for decision tree and random forest analysis. The values of majority of these descriptors for each analogue involved in the dataset were computed using E-Dragon software (version 1.0). Random forest correctly classified the analogues into active and inactive with an accuracy of 95%. A decision tree was also utilized for determining the importance of molecular descriptors. The decision tree learned the information from the input data with an accuracy of 99% and correctly predicted the cross-validated (10 fold) data with an accuracy up to 90%. Finally, three molecular descriptors of diverse nature (including best descriptor identified by decision tree analysis) were subsequently used to build suitable models using moving average analysis. These models resulted in the prediction of cannabinoid receptor-1 antagonistic activity with an accuracy of 95-96%. High predictability of proposed models offer vast potential for providing lead structures for the development of potent cannabinoid receptor-1 antagonists for the treatment of obesity.

Epidemiological investigation of cholera outbreak in a periurban slum colony in Chandigarh

An investigation was carried out in a periurban slum colony in Chandigarh in September 1999 following a report of two microscopically confirmed cases of cholera admitted in Govt. Medical College Hospital, Chandigarh. Rapid survey in the colony covering a population of 1404 found that there were 14 cases of diarrhoea in the colony with attack rate of 9.97/1000 population. Majority (70%) of cases were females and 62% cases were under five years of age. Health education, ORS packets and medications were distributed to cases. Water sampling was also done and it was found that water from one of the hand pump was positive for V. cholerae 01 biotype El Tor serotype Ogawa. Closing of that hand pump and chlorination of drinking water in other parts of slum was recommended to higher health authorities, which was done immediately. Surveillance for diarrhoeal diseases was found to be poor. Provision of safe drinking water, improving sanitation and strengthening of disease surveillance is necessary for control of cholera and other diarrhoeal diseases in slum areas.

Comparative histopathology of scabies versus nodular scabies

Comparative histopathology was studied in 25 cases of scabies versus 25 cases of nodular scabies which were selected from Dermato-Venereology out patients. Salient differences observed were that in scabies lifting of stratum corneum at places was seen in all 100% cases, spongiosis in 100%, spongiotic vesicles in 28%, burrows in 56%, mite in 40% and vasculitis in 28% whereas in nodular scabies acanthosis was seen in 100%, pseudo epitheliomatous hyperplasia in 8%, burrows in 48%, mite in 24% and vasculitis in 84%. In nodular scabies, dermal infiltrate in 32% cases was arranged as lymphoid follicles with admixture of plasma cells and eosinophils.

Ocular-systemic interrelationships in acquired immunodeficiency syndrome

We analysed the correlation between ophthalmic and systemic findings in 125 subjects with AIDS and 50 subjects with AIDS-related complex (ARC). Positive eye findings were defined as the presence of cotton-wool spots (CWS) or cytomegalovirus (CMV) retinitis. The presence of positive eye findings was significantly more frequent in AIDS than in ARC (P = 0.0001). Both lowest haematocrit and lowest T-helper cell count were significantly lower in AIDS than in ARC, and also lower in subjects with positive eye findings than in those with negative eye findings. No association was found between ocular findings and the following: risk factors for human immunodeficiency virus (HIV) transmission; positive titres for CMV, herpes simplex, Epstein-Barr virus (EBV), and toxoplasmosis; systemic infections; and intake of azidothymidine (AZT). Patients with AIDS and CWS were similar to patients with AIDS and CMV retinitis in viral serology, haematocrit, T-helper count, and survival. Positive eye findings, low haematocrit, and low T-helper count are poor prognostic signs for survival in AIDS.

Half-life of cotton-wool spots in the acquired immunodeficiency syndrome

Cotton-wool spots are a hallmark of human immunodeficiency virus (HIV) retinopathy in the acquired immunodeficiency syndrome (AIDS). We analysed the half-life of cotton-wool spots in AIDS in a prospective study, and found the average time to disappearance to be 6.9 weeks. HIV retinopathy differs from diabetic retinopathy in having a smaller size cotton-wool spot and a much shorter half-life, suggesting a patchy involvement of the retinal capillaries in AIDS and a widespread capillary disease in preproliferative and proliferative diabetic retinopathy.