Search

Introduction: Dyslipidaemia is an important risk factor for coronary artery disease. Oxidative damage to plasma lipoproteins ultimately results in the development of atherosclerosis. Since Hydrogen Sulphide (H2S) is a cytoprotective molecule in oxidative stress, decreased H2S levels may be a cause of dyslipidaemia. Aim: To determine the relationship between the serum levels of H2S with serum Triglycerides (TG), Total Cholesterol (TC), and High-density Lipoprotein Cholesterol (HDL-C) in cases of dyslipidaemia. Materials and Methods: A cross-sectional study was conducted between December 2022 and June 2023 in the Departments of Biochemistry and Medicine at KPC Medical College, Jadavpur, Kolkata, West Bengal, India. Serum lipid profile {TC, TGs, HDL-C, and Low-density Lipoprotein Cholesterol (LDL-C) (calculated by Friedewald’s equation)} and serum H2S were measured in 70 cases of dyslipidaemia {according to National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria} aged between 30 to 80 years and compared with an equal number of healthy volunteers as controls. The means of continuous variables were compared by independent t-tests and Mann-Whitney U tests. The Chi-square test was applied to compare gender distribution. Pearson’s and Spearman’s correlation coefficients were calculated for normal and non normal distributions, respectively. Results: The mean age of dyslipidaemic patients (54.54 years±11.19) was significantly (p=0.0017) higher than that of the controls (47.02 years±16.18). Among the 70 cases of dyslipidaemia, 38 participants were male and 32 were female, while among the healthy controls (n=70), 42 participants were male and 28 were female. The serum H2S levels in cases of dyslipidaemia (37.91±6.28 μmol/L) were significantly lower than in the healthy controls (58.52±12.92, p<0.01 μmol/L). A significant positive correlation was found between serum H2S levels and HDL-cholesterol (r=0.81, p<0.001), whereas a negative correlation was found between serum H2S and TG levels (r=-0.55, p<0.001). Conclusion: In the present study, dyslipidaemia was associated with decreased levels of serum H2S . Serum H2S was positively correlated with serum HDL and negatively correlated with serum TG levels. [ABSTRACT FROM AUTHOR]

La neumoconiosis es una enfermedad profesional que afecta a trabajadores con exposición ambiental a polvo orgánico e inorgánico, como en la minería, el granallado, la alfarería, la cantería y la agricultura. La respuesta inflamatoria del pulmón al polvo respirable provoca la formación de máculas, nódulos y fibrosis, y un contenido mayor de sílice en el polvo inhalado se asocia con un aumento en la fibrosis. La neumoconiosis mixta por polvo (MDP) se caracteriza por la exposición a polvos que contienen 10–20% de sílice, con imágenes pulmonares que muestran opacidades irregulares. La histopatología desempeña un papel vital en el diagnóstico de la MDP. Aunque tiene un pronóstico favorable, la enfermedad evoluciona lentamente, a lo largo de muchos años de exposición constante, y se caracteriza por un agravamiento de la disnea y la tos, que progresa gradualmente hasta convertirse en cor pulmonale. El único tratamiento eficaz es eliminar la fuente de exposición, por lo que es esencial reconocer la enfermedad de forma temprana para lograr un resultado favorable. Presentamos un caso de neumoconiosis mixta por polvo en un agricultor de Sudamérica que padecía asma. El paciente se presentó con agravamiento de la disnea y múltiples nódulos en ambos pulmones en el diagnóstico por imagen, y cor pulmonale. Tras un amplio estudio, se descartó cualquier neoplasia maligna y tuberculosis. El análisis de las muestras de biopsia de cirugía toracoscópica asistida por video (VATS) confirmó el diagnóstico de neumoconiosis mixta por polvo. El paciente presentaba una confluencia de nódulos irregulares en los lóbulos superiores de los pulmones, y el mayor medía 2.1 cm. Esto coincide con la definición de la Organización Internacional del Trabajo (OIT) de fibrosis masiva progresiva. Este hallazgo, junto con el cor pulmonale, indica un mal pronóstico, incluso luego de eliminar la exposición al polvo. Se administraron corticoides, que produjeron una mejoría sintomática, y se dio de alta al paciente para seguimiento con el neumólogo. [ABSTRACT FROM AUTHOR]

Angelman syndrome is a neurogenetic disorder with varying clinical presentations and symptoms as the individual ages. The goal of this study was to characterize changes over time in the natural history of this syndrome in a large population. We reviewed the medical records of the 53 patients who were born prior to 2000 and seen at the Angelman Syndrome Clinic at Massachusetts General Hospital to assess neurological, sleep, behavioral, gastrointestinal, orthopedic, and ophthalmologic functioning. The average age of this cohort was 24 years. Active seizures were present in 35%, nonepileptic myoclonus in 42%, and clinically significant tremors in 55%. Anxiety was present in 57%, increasing to 71% in those ages 26–43 years. In terms of sleep, 56% reported 8 hr of sleep or more, although 43% reported frequent nocturnal awakenings. Gastrointestinal issues remain problematic with 81% having constipation and 53% gastroesophageal reflux. The majority lived in a parent's home and remained independently mobile, though scoliosis was reportedly present in 30%, and 20% had reported low bone density/osteoporosis. The results of this study suggest that the prevalence of active seizures may decrease in adulthood but that the prevalence of movement disorders such as tremor and nonepileptic myoclonus may increase. Anxiety increases significantly as individuals age while defiant behaviors appear to decrease. Sleep dysfunction typically improves as compared to childhood but remains a significant issue for many adults. Other areas that require monitoring into adulthood include gastrointestinal dysfunction, and orthopedic/mobility issues, such as reported scoliosis and bone density, and ophthalmologic disorders. [ABSTRACT FROM AUTHOR]

Objective: Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in India.Design: Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' and derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).Results: From 45 712 abstracts screened, sixty-four cross-sectional, seven cohort, one qualitative and one case-control studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF practices were found in all studies. In twenty-nine of fifty-nine studies, CF was introduced between 6 and 9 months, with eight studies finding minimum dietary diversity was achieved in 6-33 %, and ten of seventeen studies noting minimum meal frequency in only 25-50 % of the study populations. Influencing factors included cultural influences, poor knowledge on appropriate CF practices and parental educational status.Conclusions: This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children. [ABSTRACT FROM AUTHOR]

Objective: Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in Pakistan.Design: Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).Results: From 45 712 results, seventeen studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF was found in all studies. Nine of fifteen studies assessing timing recorded CF introduced between 6 and 9 months. Five of nine observed dietary diversity across four of seven food groups; and two of four, minimum meal frequency in over 50 % of participants. Influencing factors included lack of CF knowledge, low maternal education, socio-economic status and cultural beliefs.Conclusions: This is the first systematic review to evaluate CF practices in Pakistan. Campaigns to change health and nutrition behaviour are needed to meet the substantial unmet needs of these children. [ABSTRACT FROM AUTHOR]

Atrial fibrillation is a common cardiac arrhythmia associated with debilitating complications, one of which is stroke. Anticoagulants (warfarin and the non-vitamin K antagonist oral anticoagulants) are recommended for stroke prophylaxis, their utilisation however requires stroke risk reduction to be balanced against hemorrhage risk. Current review of the literature suggests that despite the presence of risk stratification tools such as the CHADS2 and the newer CHA2DS2-VASc, clinicians often find it challenging to anticipate the risk-benefit ratio of anticoagulation. This results in both the underuse and overuse of anticoagulation in patients as well as uncertainty over whether to use anticoagulation in paroxysmal AF. This review looks at optimising anticoagulation by improving the assessment of bleeding risk and by improving the assessment of stroke risk. The percutaneous occlusion of the left atrial appendage is an emerging alternative to oral anticoagulation therapy. [ABSTRACT FROM AUTHOR]

Purpose To determine whether depressive symptoms are associated with ovulation or reproductive hormone concentrations in eumenorrheic women without a reported diagnosis of clinical depression. Methods A prospective cohort of 248 regularly menstruating women, aged 18 to 44 years (27.3 ± 8.2) were evaluated for depressive symptoms at baseline using the 20-item Center for Epidemiological Studies Depression (CES-D) scale and categorized dichotomously (<16, no depressive symptoms [92%] vs. ≥16, depressive symptoms [8%]). Serum concentrations of estradiol, progesterone, luteinizing hormone, and follicle-stimulating hormone were measured up to eight times per cycle for up to two menstrual cycles. Linear mixed models estimated associations between depressive symptoms and hormone concentrations, whereas generalized linear mixed models assessed their relationship with sporadic anovulation. Results No significant associations were identified between depressive symptoms and reproductive hormone levels (all P > .05) or the odds of sporadic anovulation (adjusted odds ratio, 1.1; 95% confidence interval, [0.02–5.0]), after adjusting for age, race, body mass index, perceived stress level, and alcohol consumption. Conclusions Despite reported associations between mental health and menstrual cycle dysfunction, depressive symptoms were not associated with reproductive hormone concentrations or sporadic anovulation in this cohort of regularly menstruating women with no recent (within 1 year) self-reported history of clinical depression. [ABSTRACT FROM AUTHOR]

Serious neurological complications of SARS-CoV-2 are increasingly being recognized. We report a novel case of HHV6 myelitis with parainfectious MOG-IgG in the setting of COVID-19-induced lymphopenia and hypogammaglobulinemia. The patient experienced complete neurological recovery with gancyclovir, high dose corticosteroids, and plasma exchange. To our knowledge, this is the first case of HHV6 reactivation in the central nervous system in the setting of COVID19 infection and the first case of MOG-IgG myelitis in the setting of SARS-CoV-2 and HHV6 coinfection. Patients with neurological manifestations in the setting of COVID19-related immunodeficiency should be tested for opportunistic infections including HHV6. Viral infection is a known trigger for MOG-IgG and therefore this antibody should be checked in patients with SARS-CoV-2 associated demyelination. [Display omitted] [ABSTRACT FROM AUTHOR]