Epigenetic effects of ethanol on liver and gastrointestinal injury

INTRODUCTIONEthanol actions are diverse and fascinatingly complex. Chronic ethanol causes injury to almost all organ systems including liver and gastrointestine (GI)[1] and has serious medical and public health implications[2]. Alcohol increases the risk …     

Temporal arteritis: A case series from south India and an update of the Indian scenario

Objective:

To study the clinical, pathological and prognostic profile of patients with temporal arteritis in India.

Materials and Methods:

The study was conducted in a tertiary care center from south India from 2005 to 2010 in the departments of neurology and medicine. The details of all patients that satisfied the ACR 1990 criteria for diagnosis of temporal arteritis were reviewed. The clinical presentation, laboratory parameters and biopsy findings of the patients were analyzed and compared with other studies from India done over the last decade.

Results:

A total of 15 patients were diagnosed with temporal arteritis. The male:female ratio was 1.5:1. The mean age of onset was 67.58 years. Mean time for detection after onset of symptoms was 2.56 months. Typical manifestations included headache (100%), temporal artery tenderness (100%), jaw claudication (20%), polymyalgia rheumatica (53%) and visual manifestations (20%). The erythrocyte sedimentation rate was elevated in all patients. Biopsy was done in 13 patients, with 11 of them being positive. All patients responded to steroids well, with most patients being symptom-free within the first 48 h of treatment.

Conclusions:

Temporal arteritis seems to be underdiagnosed in India, with all patients previously misdiagnosed, and with a mean time from symptom onset to diagnosis of 2.5 months. The clinical presentation of temporal arteritis in India appears to be similar to that of the West, with no gender preference and a slightly younger age group.     

Negative and positive regulation of astrocyte DNA synthesis by ethanol

Ethanol suppression of astrocyte mitogenesis is well recognized but ethanol, under some conditions, has also been shown to stimulate astrocyte proliferation. This study addressed the role of protein kinase C and other mitogenic factors as mechanisms responsible for the bidirectional effects of ethanol on astrocyte DNA synthesis. Ethanol treatment inhibited astrocyte DNA synthesis both at 4 hr (short term) and 24 hr (long term) in serum free medium. In contrast, when the medium contained serum, ethanol was less effective in inhibiting DNA synthesis at 4 hr and treatment with ethanol for 24 hr increased DNA synthesis. Protein kinase C activity was increased in cells treated with ethanol for either 4 or 24 hr. Ethanol inhibition of DNA synthesis in serum free medium was not reversed by down regulating protein kinase C. In contrast, downregulating protein kinase C activity by continuous treatment with phorbol myristic acetate partially reversed the effect ethanol had on DNA synthesis. Also, directly inhibiting protein kinase C with H-7 in cells maintained and treated in the presence of serum abolished the stimulatory effect ethanol had on DNA synthesis. It appears that the negative regulation of astrocyte DNA synthesis by ethanol occurs by protein kinase C and serum independent mechanisms whereas adaptive or stimulatory effects of ethanol on astrocyte DNA synthesis requires the interaction of protein kinase C with other factors present in serum. J. Neurosci. Res. 50:1010–1017, 1997. © 1997 Wiley-Liss, Inc.     

Do Nasal Surgeries Affect Mucociliary Clearance?

The study was conducted to assess the impact of different nasal surgeries on the nasal mucociliary clearance mechanism. Mucociliary function of the nasal mucosa of patients who were undergoing various nasal surgeries was assessed by the Saccharin test by placing 5 mg saccharin granule on the anterior end of the inferior turbinate 1 day prior to the surgery. The time required for the test subject to experience a sweet taste was measured in minutes. Post-operatively the test was repeated 6 weeks after the surgery and the test times were compared. A total of 60 patients were part of this study. Of the 60 cases, 19 cases had undergone only septoplasty, 13 cases had undergone only functional endoscopic sinus surgery (FESS), 25 cases had undergone septoplasty with FESS, 2 cases underwent septoplasty with bilateral partial inferior turbinectomy (PIT) and one case was submucous resection (SMR). Significant improvement in nasal mucociliary clearance was observed in all the patients after the procedures. Out of the 19 cases of septoplasty, 57.9 % showed improvement on the right side and 47.4 % on the left side. Out of the 13 cases of FESS, 61.5 % showed improvement on the right side and 69.2 % on the left side. Out of the 25 cases of FESS with septoplasty, 76.0 % showed improvement on both sides. The case of SMR did not show improvement. The 2 cases of septoplasty with PIT showed improvement. Statistically, highly significant improvement of test time was seen postoperatively as compared to pre-operatively. Among the surgical procedures, FESS with septoplasty showed better improvement as compared to the other procedures. Based on the study, we can conclude that nasal surgeries done for correction of septal deviation and rhino sinusitis significantly improves nasal mucociliary clearance mechanism thereby improving the physiological functions of the upper airway.     

Prevalence of Risk Factors of Non-communicable Diseases in a District of Gujarat,India

The study attempted to identify the prevalence and distribution of risk factors of non-communicable diseases among urban and rural population in Gujarat, India. Using the WHO stepwise approach, a cross-sectional study was carried out among 1,805 urban and 1,684 rural people of 15-64 years age-group. Information on behavioural and physiological risk factors of non-communicable diseases was obtained through standardized protocol. High prevalence of smoking (22.8%) and the use of smokeless tobacco (43.4%) were observed among rural men compared to urban men (smoking-12.8% and smokeless tobacco consumption-23.1%). There was a significant difference in the average consumption of fruits and vegetables between urban (2.18±1.59 servings) and rural (1.78±1.48 servings) area. Prevalence of overweight and obesity was observed to be high among urban men and women in all age-groups compared to rural men and women. Prevalence of behavioural risk factors, overweight, and obesity increased with age in both the areas. Twenty-nine percent of the urban residents and 15.4% of the rural residents were found to have raised blood pressure, and the difference was found to be statistically significant (p<0.01). For both men and women, the prevalence of overweight and obesity, hypertension, and lack of physical activities were significantly higher in the urban population while smoking, smokeless tobacco consumption, poor consumption of fruits and vegetables were more prevalent in the rural population. The results highlight the need for interventions and approaches for the prevention of risk factors of non-communicable diseases in rural and urban areas.Key words: Cross-sectional study, Non-communicable diseases, Risk factors, WHO STEPS     

Screening for gestational diabetes,Ahmedabad, India

ObjectiveTo implement a community-based screening and awareness-raising project for gestational diabetes in Ahmedabad, India.MethodsThe project took place between April 2016 and August 2019 in Ahmedabad. Medical college faculty members and medical officers trained 3582 paramedical staff on screening for gestational diabetes. These paramedical staff tested all pregnant women 24–28 weeks gestation, who were attending village health and nutrition days – also called mamta days – in urban and rural health centres for routine antenatal care, for gestational diabetes. An oral glucose tolerance test was used and blood sugar ≥ 7.8 mmol/L was the cut-off for gestational diabetes. Women with gestational diabetes were referred for counselling and treatment and all women were followed until 6 weeks after delivery.FindingsOf 53 522 pregnant women screened, 6786 (12.7%) had gestational diabetes and were referred for nutritional therapy or medication; 836 (12.3%) of these women started medication. There was no significant difference in the prevalence of stillbirths between women with gestational diabetes (0.8%; 54/6786) and women without (0.7%; 338/46 736; P-value: 0.51). Of the women on treatment, 38 had abnormal blood glucose after delivery and continued with the medication. Two women with gestational diabetes died; they had other associated co-morbidities – pre-eclampsia and anaemia.ConclusionWe found a high prevalence of gestational diabetes, indicating the need for gestational diabetes screening and implementation of this project on a larger scale. Gestational diabetes screening at the community level is operationally feasible using the existing human resources and infrastructure of the reproductive health programmes.