Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis

Introduction: We assessed cardiac function (CF) in celiac disease (CD) patients and the effect of gluten-free diet (GFD) on CF.

Methods: Prospective evaluation of CF using conventional and tissue doppler echocardiography in 50 CD patients (age 4.2?±?1.1 years) at diagnosis and after a year of GFD (group 1), 100 CD children (group 2; 47 compliant and 53 non-compliant) in follow-up and 25 healthy controls.

Results: Untreated CD (n?=?50) children had larger left ventricle end diastolic dimension (35.33?±?0.87 vs. 32.90?±?0.91 mm; p?=?.04), reduced (<55%) left ventricular ejection fraction (20% vs. 0%; p?=?.01) and a higher (>0.6) myocardial performance index (MPI, 66% vs. 0%; p ≤ .01) as compared to controls. Re-evaluation after one year with good dietary compliance showed changes in isovolumic relaxation time (72.5?±?4.2 vs. 50.62?±?2.69; p?=?.0001) and deceleration time (121.05?±?10.1 vs. 99.87?±?8.5; p?=?.02), reflecting improved cardiac diastolic function. GFD compliant patients had lower MPI than non-compliant (0.60?±?.03 vs. 0.66?±?.08; p?=?.04), reflecting improvement in load-independent echocardiographic parameters.

Conclusions: Subclinical cardiac dysfunction is common in CD children at diagnosis. Improvement

in echocardiographic parameters occurs with GFD and non-compliant children continue to have

persistent cardiac dysfunction.     

Curcumin recognizes a unique binding site of tubulin

Although curcumin is known for its anticarcinogenic properties, the exact mechanism of its action or the identity of the target receptor is not completely understood. Studies on a series of curcumin analogues, synthesized to investigate their tubulin binding affinities and tubulin self-assembly inhibition, showed that: (i) curcumin acts as a bifunctional ligand, (ii) analogues with substitution at the diketone and acetylation of the terminal phenolic groups of curcumin are less effective, (iii) a benzylidiene derivative, compound 7, is more effective than curcumin in inhibiting tubulin self-assembly. Cell-based studies also showed compound 7 to be more effective than curcumin. Using fluorescence spectroscopy we show that curcumin binds tubulin 32 ? away from the colchicine-binding site. Docking studies also suggests that the curcumin-binding site to be close to the vinblastine-binding site. Structure-activity studies suggest that the tridented nature of compound 7 is responsible for its higher affinity for tubulin compared to curcumin.     

Hepatocellular Carcinoma Presenting as an Incidental Isolated Malignant Portal Vein Thrombosis

Introduction  

Portal vein thrombosis is frequently associated with hepatocellular carcinoma (HCC). Tumor invasion into the portal vein by direct venous extension or metastasis occurs in up to 70% of HCC patients (Cedrone et al., Liver 16:94–8, 1996). However, presentation as an isolated malignant portal vein thrombosis without any evidence of obvious hepatoma-like lesions in the liver by imaging studies is extremely uncommon. We present an unusual case of HCC presenting as a malignant portal vein thrombus, proven on biopsy of the thrombus without any evidence of primary liver lesion. This, to our knowledge, is the first case of HCC presenting as an incidental isolated malignant portal vein thrombosis. The importance of doing delayed enhancement imaging studies to rule out malignant portal vein thrombosis is emphasized.     

Web-based nutrition education intervention improves self-efficacy and self-regulation related to increased dairy intake in college students

Dairy consumption declines substantially during young adulthood. Interventions that incorporate theory-based nutrition education can provide insight into factors associated with dietary choices. The aim of this experimental study was to improve outcome expectations, self-efficacy, self-regulation, and behavior related to dairy intake in college students using social cognitive theory. Students (n=294) enrolled in a personal health class were randomized to intervention (n=148) or comparison group (n=146). The 5-week intervention (March 2006 to April 2006) was conducted using an online course system; components included e-mail messages, posted information, and behavior checklists with tailored feedback. Multivariate analysis of covariance with age and sex as covariates (P<0.05) was conducted to measure change related to dairy intake and social cognitive theory variables. Ninety-two percent of participants (n=135 intervention, n=136 control) completed the study. Dairy intake from food records did not differ between groups at baseline; baseline intake for all participants (mean±standard error) was 0.45±0.05 servings/day for low-fat dairy products and 1.44±0.06 servings/day for total dairy products. Participants in the intervention group made greater increases in use of self-regulatory strategies (P=0.038) and self-efficacy for consuming three servings/day of dairy products (P=0.049), but not in outcome expectations or consumption of dairy products. A Web-based intervention designed to change dairy intake in college students was effective in modifying some social cognitive theory constructs; strategies that positively impact outcome expectations and social support through online interventions require further development.     

Unintended Pregnancy Among Low Income Urban Married Women in India

Introduction

The most common reason for demand for abortion in India is unintended pregnancy.

Aim

To obtain information from low income urban married women regarding incidence and cause of unintended pregnancy.

Methods

All pregnant married women belonging to low income group were selected for study. The incidence and cause of unintended pregnancy among low income group was noted. Comparison was done between education of the women and parity at which they came with unintended pregnancy also the reasons women gave for nonuse of contraception were compared with their education. Statistical analysis was done using EPI Info ver-5.0. Chi square test was used to test the significance of data.

Results

The total 7,146 women comprised the study group. The incidence of unintended pregnancy was 15.5 %. Educated women came with unintended pregnancy at lesser parity than illiterate women. The most common reason given by women for not using contraception was that they did not think they could become pregnant (42.6 %).

Conclusion

The incidence of unintended pregnancy in low income urban population is low because there are fewer pregnancies which were wanted. There is need to create awareness regarding use of contraception. Education plays a major role in improving the acceptance of contraception.     

An unusual cause of acute mitral regurgitation in TTK Chitra heart valve prosthesis

Structural failure of mechanical heart valve was a known feature when it was evolving in the 1960s and 1970s. With the advent of pyrolytic carbon and a better design, it is a rare entity with present valves. We report a case of disc fracture leading to acute mitral regurgitation in TTK Chitra heart valve prosthesis (CHVP) (TTK Healthcare Limited, India) heart valve, 6 years after its implantation in mitral position.     

Is Age-induced Decline in Immune Response Associated with Hypothalamic Glutamate Receptor Density and Dietary Protein?

Manipulation of dietary protein has been found to be the most useful dictator in the age-associated decline of neuroimmune activity in mammals. In the present study, we sought to clarify the effect of dietary protein on age-induced alterations of hypothalamic glutamatergic activity and immune response. The hypothalamic glutamatergic activity and immune response were found to increase and decrease, respectively, with the increase in age of rats from young (3 months) to old (18 months) maintained with normal (20%) protein diet. Intake of low (5%) protein diet (LPD) and high (40%) protein diet (HPD) under short-term period (7 days) failed to alter the age-associated loss of immune response and increase in hypothalamic glutamatergic activity. However, long-term (30 days) supplementation of LPD retarded the age-induced decline in immune response and increase in hypothalamic glutamatergic activity, whereas, HPD consumption under similar condition potentiated the age-related immunosuppression and increase in hypothalamic glutamatergic activity. These results suggest that (a) the age-associated immunosuppression may be inversely related to the hypothalamic glutamatergic activity and (b) consumption of diets having variable quantity of protein without variation of calorie content modulates immune response and hypothalamic glutamatergic activity depending upon age and duration of dietary supplementation.     

A rare case of coexistent carcinoma of the colon with tuberculosis

This is a case report of a 35-year-old female who presented with acute intestinal obstruction initially diagnosed as ileocaecal tuberculosis. She was submitted to exploratory laparotomy with a right hemicolectomy for a non-passable ileocaecal mass. Histopathology showed colon cancer with tuberculosis both in the colon as well as the mesenteric lymph node. In addition to its pathological rarity, this case is of particular interest, because it highlights the diagnostic dilemma and therapeutic challenge associated with such a condition.