Ginger and turmeric lipid-solubles attenuate heated oil-induced oxidative stress in the brain via the upregulation of NRF2 and improve cognitive function in rats

In this study, we elucidated the modulatory potentials of lipid-solubles from ginger and turmeric that may migrate to oils during heating on the brain antioxidant defense and cognitive response in rats. Male Wistar rats were fed with control diet [including native canola oil (N-CNO), and native sunflower oil (N-SFO)], or experimental diets [including heated canola oil (H-CNO), heated sunflower oil (H-SFO), heated canola oil with ginger (H-CNO + GI), heated canola oil with turmeric (H-CNO + TU), heated sunflower oil with ginger (H-SFO + GI), heated sunflower oil with turmeric (H-SFO + TU)] for 90 days. Memory parameters [Morris water maze, elevated plus maze, novel object recognition test, T-maze (spontaneous alteration)], locomotor skills (open field test and rotarod test), antioxidant defense enzymes, reactive oxygen species, NOS2, ICAM-1, and NRF-2 level in the brain were assessed. Compared to their respective controls, heated oil-fed rats, but not those fed oils heated with ginger or turmeric, showed significant (p < 0.05) reduction in the memory, motor coordination skills, antioxidant defense enzymes, and NRF-2 activation in the brain. Compared to their respective controls, the brain NOS-2 and ICAM-1 were significantly (p < 0.05) increased in heated oil-fed rats, but not those fed oils heated with ginger or turmeric. Chronic intake of repeatedly heated oil causes brain dysfunction by inducing oxidative stress through NRF-2 downregulation. Lipid-solubles from ginger and turmeric that may migrate to oil during heating prevent the oxidative stress and cognitive dysfunction triggered by heated oils in rats.

     

High-resolution ultrasonography in carpal tunnel syndrome: role of ancillary criteria in diagnosis and response to steroid injection

Clinical Rheumatology - (1) Development and validation of a composite ultrasound score (cUSS) for the diagnosis of carpal tunnel syndrome (CTS). (2) To predict treatment response after local...     

Species-specific prevalence of vaginal candidiasis among patients with diabetes mellitus and its relation to their glycaemic status

OBJECTIVES: Non- C. albicans Candida species are increasingly being recognized as the cause of vulvo-vaginal candidiasis. These species are often less susceptible to antifungal agents. Patients with diabetes mellitus are at risk for vulvo-vaginal candidasis. We assessed the species-specific prevalence rate and risk of candidiasis in patients with diabetes mellitus and healthy controls. METHODS: Genital tract examination, direct microscopy and fungal cultures of discharge collected by high vaginal swab were undertaken among 78 consecutive patients with diabetes mellitus (mean (+/-sd) age 32+/-12 years and body mass index (BMI) 22.3+/-5.5kg/m(2)) and 88 age- and BMI-matched healthy females. Glycaemic control in the diabetic cohort was assessed by measuring total glycosylated haemoglobin. RESULTS: Candida species were isolated in 36 of 78 (46%) subjects with diabetes mellitus and in 21 of 88 (23%) healthy subjects (Chi-squared 9.11, P=0.0025). The predominant Candida species isolated in diabetics with vulvo-vaginal candidiasis were Candida glabrata (39%), C. albicans (26%) and C. tropicalis (17%). In contrast, in the control group, C. albicans, C. glabrata and C. hemulonii comprised 30% each, with none having C. tropicalis infection (for C. tropicalis: diabetic vs. control; 17% vs. nil, P=0. 05). Among the diabetic group, subjects with vulvo-vaginal candidiasis had significantly higher mean HbA1 when compared to those who had no such infection (12.8+/-2.6% vs. 9.7+/-1.7% respectively, P=0.001). The overall accuracy of direct microscopy and clinical examination for predicting vulvo-vaginal candidiasis was only 77% and 51%, respectively, in the diabetic group, and 83% and 65% in the control group. CONCLUSIONS: Patients with diabetes mellitus had a high prevalence rate (46%) of vulvo-vaginal candidiasis with relative risk of 2.45. The non- C. albicans species such as C. glabrata and C. tropicalis were the predominant species isolated among them. There seems to be a significant link between hyperglycaemia and vulvo-vaginal candidiasis.     

The thyrotropin reference range should remain unchanged

CONTEXT: Recent recommendations to decrease the upper limit of the TSH reference range from 4.5 to 2.5 mIU/liter, based on the high proportion of normal people whose serum TSH is less than 2.5 mIU/liter and the observation that those with TSH between 2.5 and 4.5 mIU/liter [upper reference range (URR)] have increased risk of progression to overt hypothyroidism (Whickham, 20-yr data), have not been subjected to critical analysis. STUDY SUBJECTS: The study subjects were from the Reference Group of NHANES III, 14,333 people more than 12 yr old, without known thyroid disease or antithyroid antibodies; 85% had TSH levels below 2.5 mIU/liter, and 2.3% had subclinical hypothyroidism (SCH). An additional 9.7% had URR TSH, representing 20.6 million Americans, who would also be identified as SCH if the upper TSH limit were decreased. Many with URR TSH do not have thyroid disease. INTERVENTION: The time of phlebotomy is important, because the TSH level varies throughout the day, with early morning values greater than later ones, and is accentuated by sleep deprivation, strenuous exercise, or working during the night or evening shifts. Repeated measurements in the same individual vary considerably over months. RESULTS: About half of those with URR TSH probably have thyroid disease, but most with thyroid disease, antithyroid peroxidase antibodies, have TSH below 2.5 mIU/liter. Those with URR TSH with thyroid disease probably have minimal thyroid deficiency, without any reported adverse health consequences or benefit of treatments with levothyroxine. CONCLUSION: Because routine levothyroxine treatment is not recommended for SCH, it is certainly not warranted in individuals with URR TSH. For all patients with URR TSH, it is reasonable to determine serum TSH every 1-2 yr.     

Bilateral ankle arthritis with mediastinal lymphadenopathy: a clinician's perspective

Aim: This study is a clinician's perspective of the association of bilateral ankle arthritis with mediastinal lymphadenopathy. Method: Forty‐three patients with bilateral ankle arthritis with mediastinal lymphadenopathy were included in a 14‐month prospective follow‐up study in our hospital. Complete history, examination and investigations were carried out. Result: There were 27 female and 16 male patients. Ankle arthritis with tuberculous mediastinal lymphadenopathy was associated in 58.13%, sarcoidosis in 32.5% and 9.3% were non‐specific. The patients were clustered in the spring‐summer months. Erythema nodosum was found in 14.3%, polyarticular presentation in 25%. Thirteen out of 43 patients (28.2%) had biopsy/fine needle aspiration (FNA), of which 69.23% had histopathological evidence of tuberculosis. Conclusion: The aetiology of bilateral ankle arthritis associated with mediastinal lymphadenopathy may be tuberculosis as opposed to sarcoidosis. There is a seasonal clustering of these cases. FNA of mediastinal lymphadenopathy is a fairly safe procedure and should be carried out when feasible, for confirmation of diagnosis.     

Prevalence of malnutrition in a tertiary care hospital in India

Introduction:

Malnutrition adversely affects clinical outcome of hospitalized patients. This observational prospective study was done to assess the prevalence of malnutrition and its grade among patients admitted in a mixed intensive care unit (ICU) of a tertiary care hospital in order to help devise a comprehensive nutrition program for the malnourished.

Materials and Methods:

A total of 500 sequential patients admitted to the ICU were screened on admission over a year period for malnutrition using the Subjective Global Nutritional Assessment (SGNA) score. Distribution of the degree of malnutrition according to co-morbidities was also documented.

Results:

Of the total, 198 (39.6%) patients were malnourished, including one patient qualifying as severely malnourished; 68% patients were male, however, there was no statistically significant difference between nutrition status between sexes. Hypertension, diabetes, and cancer were the three most commonly encountered co-morbidities among the malnourished. A total of 86% of all cancer patients admitted were malnourished against only 12% of trauma patients.

Conclusion:

This study showed that almost two-fifth of the patients admitted were malnourished in this tertiary care hospital and that there is an urgent need to develop a comprehensive nutritional care program in many such Indian ICUs.     

The long-term consequence of salivary contamination at various stages of adhesive application and clinically feasible remedies to decontaminate

Clinical Oral Investigations - To analyse the bond quality in dentine post-ageing after salivary contamination and decontamination at different stages of dental adhesive application. A total of...