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Malaria, dengue and leptospirosis are three tropical infectious diseases that present with severe hematological derangement causing significant morbidity and mortality, especially during the seasonal monsoons. During the course of these infectious diseases, circulating red blood cells are imperiled to the direct ill-effects of the infectious pathogen in the body as well as to the pro-inflammatory cytokines generated as a consequence of the infection. RBCs when exposed to such inflammatory and/or pathogenic milieu are susceptible to injuries such as RBC programmed eryptosis or RBC programmed necrosis. This research aimed to explore the Raman spectra of live red cells that were extracted from patients infected with malaria, dengue, and leptospirosis. Red cells were optically trapped and micro-Raman probed using a 785 nm Diode laser. RBCs from samples of all three diseases displayed Raman signatures that were significantly altered from the normal/healthy. Distinct spectral markers that were common across all the four groups were obtained from various standardized multivariate analytical methods. Following comprehensive examination of multiple studies, we propose these spectral wavenumbers as “Raman markers of RBC injury.” Findings in our study display that anemia-triggering infections can inflict variations in the healthy status of red cells, easily identifiable by selectively analyzing specific Raman markers. Additionally, this study also highlights relevant statistical tools that can be utilized to study Raman spectral data from biological samples which could help identify the very significant Raman peaks from the spectral band. This approach of RBC analysis can foster a better understanding of red cell behavior and their alterations exhibited in health and disease.

Background: Altered patterns of amino acid profiles are observed in various pathological conditions including nutrition related disorders, cancer, diabetes, urea cycle defects, mitochondrial respiratory chain disorders, and aminoacidopathies. Aim and Objectives: To develop a cost effective Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) method for the quantification of free amino acids in neonatal Dried Blood Spot (DBS) samples. Material and Methods: Free amino acids were extracted from neonatal DBS through elution with ice-cold methanol/2-mercaptoethanol. The extracted samples were then derivitized by using O-Pthalaldehyde (OPA)/2-mercaptoethanol, which resulted in the formation of OPA derivatives of amino acids. These derivatives were quantified by RP-HPLC. The developed method was validated according to the International Conference on Harmonization ICH Q2 (R1) Guidelines and applied to clinically confirmed aminoacidopathies. Results: A good linearity was observed from 2.5 to 1000 μM. The between run imprecision (on two different days) though varied over a wide range for different amino-acids, the Coefficience of Variation (CV) was found to be less than 5% (range; 0.1 to 5% for different amino acids) and the recovery was found to be around 82-125% (for spiked amino acids). The quantified concentration of amino acids in plasma and DBS sample were found to be almost similar except for few amino acids like glycine, tyrosine, alanine, methionine and lysine which showed higher values in dried blood spot samples. DBS amino acid concentrations determined by RP-HPLC showed concordance to the concentrations obtained through Tandem Mass Spectrometry (TMS) of DBS/plasma. Reference intervals of amino acids were established in term neonates. The proposed method was applied to the analysis of samples obtained from confirmed aminoacidopathies. Conclusion: The present approach with DBS offers a valid alternative to the plasma/serum aminoacid profiling in HPLC or DBS in Tandem mass method, with advantages like lower sample volume, feasibility, affordability, improved specificity and can be attempted in a simple diagnostic setup with acceptable accuracy and precision.

The skills that palliative care teams use every day at the bedside – symptom management, compassionate care, counselling of patients and families, calm and professional demeanour – are the same skills needed to treat patients with COVID-19. When it comes to humanitarian crises, the World Health Organization lists seven ethical principles that should direct palliative care. Unfortunately, many of these have been rendered impractical due to resource limitations and lack of training. Moreover, these ethical principles may guide individual patient encounters, but fall short when dealing with moral conflicts arising at a community or population level. We discuss how awareness of human rights can guide situations that call for tough decision-making in wake of this pandemic, and help us address some of these conflicts.

Introduction: Secreted frizzled related protein 4 (SFRP4) is a modulator of the Wnt pathway. Its secretion is regulated by interleukin-1β. Objectives: Primary objective was to assess the serum levels of SFRP4 in cases of T2DM and normoglycemic (NG) controls. Secondary objectives was to assess the association of serum levels of SFRP4 with chronic micro or macrovascular complications of T2DM. Methods: A case control study conducted after obtaining institutional ethical clearance. Included as cases were those diagnosed with T2DM. Excluded were those who were prediabetics, immunocompromised, endocrinopathies, pregnant and lactating women. Inclusion criteria for NG controls were age >18 years, consenting for participation attending out-patient department for routine care. Exclusion criteria for controls were same as for cases. Serum SFRP4 levels were determined by ELISA using Elabscience kit. Results: From October 2016 till June 2018, included were 98 T2DM cases and 48 NG controls. The mean age of cases was 52.73 yrs (SD: 10.09), and controls 49.92 yrs (SD: 12.344). The median levels of SFRP4 in cases was 1.36 ng/mL (IQR: 0.85, 2.67) and in controls 0.44 ng/mL (IQR: 0.27, 2.58) (p-value

الملخص: أهداف البحث: يجب أن يكون طلاب الطب في المرحلة الجامعية على دراية بالقيم الأخلاقية والإنسانية لتشريح الجثث. لذلك، قمنا بتصميم وتنفيذ وتقييم تأثير وحدة ''الجثة كمدرس'' التي درست القيم الأخلاقية لتشريح الجثث. طرق البحث: شملت هذه الدراسة المستقبلية متعددة الأساليب ٤٤٧ طالبا من السنة الجامعية الأولى للطب. ضمت الدراسة الطلاب الذين شاركوا في جميع الدورات الثلاث للوحدة. حيث كانت هناك محاضرات تفاعلية ومهام فردية ومسابقة لصناعة الملصقات. قدم الطلاب ثناء صامتا وصاغوا كلمات امتنانهم على جدار التقدير. كما عكس الطلاب أفكارهم في شكل مقالات وقصائد وملصقات. وقد تم تحليل هذه الانعكاسات النوعية لتوليد المواضيع. كما تم في نهاية الوحدة إجراء اختبار عبر الإنترنت لتقييم المعرفة التي اكتسبها الطلاب. وتم تسجيل النتائج المكتسبة وحسابها. النتائج: كانت الموضوعات الرئيسة التي تم تحديدها؛ الجثة كمدرس، والاعتراف والشكر، والترابط، والتعاطف. حصل ٣١٦ طالبا (٩٤.٣٢٪) على أكثر من خمسة من عشرة درجات. شعر الطلاب بقوة أن الوحدة نجحت في توعيتهم بالجوانب الأخلاقية والإنسانية للتعامل مع الجثث. الاستنتاجات: إن تطبيق نموذج تعليمي حول الجثة ينتج منهجا جديدا نحو توعية الطلاب. رأى الطلاب أن توعيتهم خلال أيامهم المبكرة من شأنه أن يسهم في رحلتهم لممارسة الاحتراف والقيم الإنسانية والتعاطف. Abstract: Objectives: The undergraduate medical students must be made aware of the ethical and humanistic values of cadaveric dissection. This study therefore designed, implemented, and evaluated the impact of the module ‘Cadaver as a Teacher’ (CrAFT) that examines the ethical values of cadaveric dissection. Methods: This prospective, multimethod study involved 447 first-year undergraduate medical students who had participated in all three sessions of the CrAFT module. Activities included interactive lectures, individual assignments, and a poster-making competition. Students offered a silent tribute and wrote words of gratitude down on a tribute wall. They also expressed their thoughts in the form of essays, poems, and collages. These reflections were qualitatively analysed to generate themes. At the end of the module, an online quiz was conducted to assess the knowledge gained by the students. Their scores were correspondingly recorded and calculated. Results: The major themes identified were: cadaver as a teacher, acknowledgement and thanksgiving, bonding, and empathy. Out of all the test takers, 316 students (94.32%) scored more than a five out of ten. The students strongly felt that the module effectively sensitised them towards the ethical and humanitarian aspects of handling cadavers. Conclusions: The implementation of an educational module about cadavers is a novel approach towards sensitising medical students. The students believed that sensitising them early on would have helped them establish a practice grounded in professionalism, human values, and empathy. الكلمات المفتاحية: جثة الإنسان, أخلاق, الإنسانية, انعكاس, احترافية, Keywords: Ethics, Human cadaver, Humanism, Professionalism, Reflection

Derangements in bilirubin metabolism and/or dysfunctions in the hepato-biliary system lead to the unhealthy buildup of bilirubin in blood, resulting in jaundice. During the course of this disorder, circulating red cells are invariably subjected to toxic effects of serum bilirubin and an array of inflammatory compounds. This study aimed to investigate the vibrational spectroscopy of live red cells in jaundice using micro-Raman spectroscopy combined with optical-trap. Red cells from blood samples of healthy volunteers and patients with jaundice were optically immobilized and micro-Raman probed using a 785 nm diode laser. Raman signatures from red cells in jaundice exhibited significant variations from the normal and the spectral-markers were obtained from multivariate analytical methods. This research gives insightful views on how different pathologies can act as “stress-milieus” for red cells in circulation, possibly impeding their normal functions and also exasperating anemia. Raman spectroscopy, an emerging bio-analytical technique, is sensitive in detecting molecular-conformations in situ, at cellular-levels and in real-time. This study could pave way in understanding fundamental red cell behavior in different diseases by analyzing Raman markers.

Aims: The aim was to evaluate the association between oxidative stress with the severity of endometriosis in blood and peritoneal fluid. Settings and Design: This study was a prospective observational study conducted in the department of obstetrics and gynecology in a tertiary center over 2 years in patients with endometriosis requiring laparoscopy. Methodology: Patients diagnosed with endometriosis and undergoing laparoscopy for infertility and/or chronic pelvic pain were included in the study. Out of the 64 patients recruited, only 55 patients formed the part of our study. Blood and peritoneal fluid was evaluated for oxidative stress parameters such as glutathione peroxidase, superoxide dismutase (SOD), and lipid peroxides. Results: The severity of endometriosis was assessed intraoperatively by the revised American Society for Reproductive Medicine scoring in all 55 patients who underwent laparoscopy into minimal (n = 3), mild (n = 7), moderate (n = 32), and severe (n = 17). Median activity of SOD and glutathione peroxidase was lowest in the severe stage of endometriosis, whereas the median activity of lipid peroxide was highest in the severe stage of endometriosis in both blood and peritoneal fluid samples. There was a statistically significant increase in oxidative stress with the severity of endometriosis. Conclusions: Oxidative stress might play a role in the disease process of endometriosis. Control of oxidative stress can be used as the latest treatment option for the management of endometriosis.

India, a country with the second largest population in the world, does not have a national newborn screening programme as part of its health policy. With funding support from the Grand Challenges Canada, a pilot newborn screening programme was implemented for the Udupi district of South India to study the need and viability of a national programme in India. Six disorders were selected for the study based on the availability of funding and recommendation from pediatricians in the district. Here, we report the observed incidence during the study. A cost-effectiveness analysis of implementing newborn screening in India was performed. It is evident from our analysis that the financial loss for the nation due to these preventable diseases is much higher than the overall expenditure for screening, diagnosis, and treatment. This cost-effectiveness analysis justifies the need for a national newborn screening programme in India.

Eryptosis is the suicidal destruction-process of erythrocytes, much like apoptosis of nucleated cells, in the course of which the stressed red cell undergoes cell-shrinkage, vesiculation and externalization of membrane phosphatidylserine. Currently, there exist numerous methods to detect eryptosis, both morphometrically and biochemically. This study aimed to design a simple but sensitive, automated computerized approach to instantaneously detect eryptotic red cells and quantify their hallmark morphological characteristics. Red cells from 17 healthy volunteers were exposed to normal Ringer and hyperosmotic stress with sodium chloride, following which morphometric comparisons were conducted from their photomicrographs. The proposed method was found to significantly detect and differentiate normal and eryptotic red cells, based on variations in their structural markers. The receiver operating characteristic curve analysis for each of the markers showed a significant discriminatory accuracy with high sensitivity, specificity and area under the curve values. The software-based technique was then validated with RBCs in malaria. This model, quantifies eryptosis morphometrically in real-time, with minimal manual intervention, providing a new window to explore eryptosis triggered by different stressors and diseases and can find wide application in laboratories of hematology, blood banks and medical research.

Introduction: Obesity and metabolic syndrome frequently coexist and are one of the major health problems around the globe and its prevalence is 25-30%. In India prevalence of metabolic obesity is ≥30%, among females who have higher levels as compared to males. There is a significant proportion of the population who are obese (BMI >25 kg/m²) but metabolically healthy, likewise some people with normal BMI status, but metabolically obese. In this study, we have evaluated the association between metabolic obesity and severity of Coronary Artery Disease (CAD) in stable angina patients. Aim: To assess the association of severity of angiographic CAD based on the Metabolically Obese (MO) status and Body Mass Index (BMI). Materials and Methods: Total 408 subjects with stable angina and with positive stress test were included in the study and severity of CAD was measured by SYNTAX score. Obesity was defined as BMI ≥25 kg/m2 , and normal weight was defined as BMI

Introduction: Glycosylated HaemoglobinA1c (HbA1c) is a time-integrated marker for glycaemic control. It also helps in predicting the risk of Coronary Artery Disease (CAD) among diabetic patients. Aim: To determine the association between HbA1c and severity of CAD in patients with stable angina. Materials and Methods: A total of 144 patients with the positive cardiac stress test and stable angina who are undergoing a Coronary Angiogram (CAG) were enrolled. The patients were classified into three groups according to baseline HbA1c level (Normal group 6.4%, n=29). One-way ANOVA test analysed baseline characteristics of the study population. The association between HbA1c level and the risk of CADs was calculated by Pearson correlation. A p-value less than 0.05 considered to be significant. Results: The subjects who were pre diabetic have 1.77 times more odds of having CAD than the patients who are normal OR (95% CI)=1.77 (0.84,3.73). Patients who have diabetes have 3.13 times more odds of having CAD than the patients who are normal OR (95% CI)=3.13 (1.20,8.16), p=0.02. Higher HbA1c levels were associated with higher incidence of CAD. Conclusion: The study concluded that there was a significant association between raised baseline HbA1c levels and occurrence of CAD in patients with positive cardiac stress test/ stable angina.

Introduction: Coronary Artery Disease (CAD) occurs due to atherosclerosis which results in progressive narrowing of coronary artery lumen. N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) has been used as a marker of heart failure. However, its role in stable coronary artery disease without left ventricular dysfunction is limited. Aim: To measure and compare the serum NT-proBNP levels in stable coronary artery patients and controls and to correlate serum NT-proBNP levels with severity of CAD. Materials and Methods: The present study was conducted in Department of Biochemistry in collaboration with Department of Cardiology Kasturba Medical College, Manipal after the approval from Institutional Ethics Committee. A written consent was obtained from 86 study subjects (controls 36, cases 50). Serum NT-proBNP was measured using ELISA kit. Severity of CAD was graded by angiogram based Gensini scoring system. Mann-Whitney U-tests and spearman’s correlations were used. Serum NT-proBNP was expressed in median and interquartile range. The p-value

Amaç: Epitelial ovarian karsinomunda proliferasyonunun başlangıç aşaması genellikle asemptomatiktir. Hastaların büyük kısmında hassas ve güvenilir belirteçlerin eksikliği nedeni ile hastalık teşhis aşamasında artık yayılmış bulunmaktadır. Güvenilir olarak kabul edilen serum belirteci CA-125’tir ancak evre I hastalarının sadece %50’sinde ve ilerlemiş evre hastaların %80’ninde saptanabilmesinden dolayı, CA-125’in hassasiyeti konusunda bir sınırlama mevcuttur. Bu çalışmada, tedavi öncesi ve tedavi sonrası over kanserli hastalarda CA-125 ve seruloplazmin’in (anjiyogenez belirteci) serum seviyeleri arasındaki korelason araştırılmış, kontroller ile karşılaştırılmış ve teşhis için anlamlı bir belirteç olduğu bulunmuştur. Materyal ve Metod: Çalışma 18-45 yaş arası over kanseri teşhisi alan hastalar ile yapılmıştır (vaka n=50, kontrol n=50). Kanser teşhisi, biyopsi ve histopatolojik değerlendirme sonucu konulmuştur. Tedavi öncesi ve tedavi sonrası serum seruloplazmin ve CA-125 seviyeleri değerlendirilmiş ve tedavi öncesi ile karşılaştırıldığında, bu belirteçlerin tedavi sonrası hastalarda anlamlı derecede düştüğü gözlenmiştir. Sonuç: Serum CA-125 seruloplazmin oranı tedavi öncesi over kanserli hastalarda kısmen artmıştır. Serum seruloplazmin seviyesi (p

Purpose: The initial stage of proliferation of epithelial ovarian carcinoma (EOCa) is usually asymptomatic. Due to the lack of sensitive and reliable markers in majority of patients the disease is widespread at the time of diagnosis. The reliable serum biomarkers currently accepted is CA125 but there is limitation in case of sensitivity of CA125 as it is detectable only in 50% of patients in stage I and 80% of patients with advanced stage. We have investigated a correlation between serum CA125 and ceruloplasmin (as a marker of angiogenesis) in ovarian cancer in pre-treatment and post-treatment patients, compared with controls and found to be a significant marker for diagnosis. Material and Methods: A study was done in age group between 18-45 years diagnosed with ovarian cancer. (cases: n=50, controls: n=50). Cancer was diagnosed based on biopsy and histopathological examination. Serum Ceruloplasmin and CA 125 were estimated in pre-treatment and post-treatment patients and statistically significant decrease of these biomarkers observed in post treatment when compared with pre treatment patients. Result: We found that serum CA 125 to ceruloplasmin ratio was moderately increased in pre-treatment ovarian cancer patient. The serum ceruloplasmin (p

Coronary artery disease (CAD) also known as coronary heart disease is one of the leading causes of death and disability worldwide. Genetic and environmental factors play an important role in the pathogenesis and progression of CAD. The aim of this study was to evaluate the combined contribution of 3 gene polymorphisms to the risk of CAD and gene–gene interaction in the south Indian population. In this case-control study, 200 cases of CAD and 200 healthy controls were recruited. We studied 3 well known genetic polymorphisms of MTHFR (C677T; rs1801133), PON1 (Q192R; rs662) and ACE (I/D: rs4646994) in relation to CAD in South Indian population. Polymerase chain reaction (PCR) was carried out and followed by the restriction fragment length polymorphism and agarose gel electrophoresis. Genotypes of MTHFR C677T, CT and CT+TT, and PON1 Q192R QR were associated with the risk of CAD (C677T CT+TT vs CC: odds ratio [OR] = 3.3, 95% confidence intervals [CI] = 1.8–6.2; p = 0.00001), (CT vs CC: OR = 3.2, 95%CI = 1.8–5.6; p = 0.00003), and (Q192R QQ vs QR: OR = 2.1, 95%CI = 1.1–3.9; p = 0.03). The allele frequencies for T vs C: OR = 3.1, 95%CI = 1.8–5.3; p = 0.00001 and R vs Q: OR = 1.3, 95% CI = 1.0–1.7 p = 0.03. Multifactor dimensionality reduction (MDR) analysis was carried out with the combination of three genes and the results indicate that MDR analysis showed that, PON1 gene polymorphism formed a significant model in predicting the CAD risk in south Indian population.

Pyridoxine dependent epilepsy is a condition where the affected infant or child has prolonged seizures (status epilepticus), which are nonresponsive to anticonvulsant therapy but can be treated with pharmacological doses of pyridoxine. If identified earlier and treated prophylactically with pyridoxine, severe brain damage due to seizures can be prevented. Alpha-amino adipic semialdehyde (AASA), piperidine-6-carboxylic acid (P6C), and pipecolic acid (PA) are known biomarkers of pyridoxine dependent epilepsy. We report the development and validation of a hydrophilic interaction liquid chromatography (HILIC) hyphenated with mass spectroscopy for the quantification of the above analytes from dried blood spot samples. The samples were extracted using methanol and analysed on a iHILIC fusion plus column with formic acid buffer (pH 2.5): acetonitrile (20:80) at a flow rate of 0.5 mL/min within 3 minutes. The method demonstrated a LOD of 10 ng/mL, LOQ of 50 ng/mL, linearity of r2 ≥ 0.990, and recovery of 92-101.98% for all analytes. The intra- and interday precision CVs were < 8% and 6%, respectively. Extensive stability studies demonstrated that the analytes were stable in stock solution and in matrix when stored at -80°C. We performed method comparison studies of the developed method with the literature reported method using normal samples and matrix matched spiked samples at pathological concentrations to mimic clinical validity. The Bland-Altman analysis for comparison of the analytical suitability of the method for the biomarkers in healthy and spiked samples with the literature reported method revealed a bias which suggested that the method was comparable. The newly developed method involves no derivatisation and has a simple sample preparation and a low run time enabling it to be easily automated with a high sample throughput in a cost-effective manner.

Background: Negative pressure wound therapy has emerged as an attractive treatment modality for the management and healing of chronic ulcers. Though numerous clinical studies are available, there is a lack of biochemical and histological studies evaluating the healing of chronic wounds. Materials and Methods: In the present study, a total 60 patients were divided into two groups: Limited access dressing (LAD) group (n = 30) and conventional dressing group (n = 30). Various biochemical parameters such as hydroxyproline, total protein and antioxidants such as reduced glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT) and oxidative biomarker malondialdhyde (MDA) are measured in the granulation tissue. Histologically amount of inflammatory infiltrate, angiogenesis, and collagen deposition are studied to assess wound healing. Results: Patients treated with LAD have shown significant increase in the mean (±standard deviation) hydroxyproline (77.3 ± 30.1 vs. 32.3 ± 16.18; P = 0.026), total protein (13.89 ± 9.0 vs. 8.9 ± 4.59; P = 0.004), GSH (7.4 ± 1.91 vs. 5.1 ± 1.28; P = 0.039), GPx (122.3 ± 59.3 vs. 88.7 ± 34.11; P = 0.030), CAT (1.80 ± 1.14 vs. 0.9 ± 0.71; P = 0.002) and decrease in MDA (13.4 ± 5.5 vs. 8.6 ± 3.8; P = 0.004). Histological study showed comparatively fewer inflammatory cells, increased and well organised collagen bundles, and more angiogenesis in the LAD group when compared with that with conventional dressing after 10 days of treatment. Conclusion: In the present study, we have found beneficial effect of newer intermittent negative pressure therapy in combination with moist environment (LAD) on chronic wound healing by increasing collagen deposition and angiogenesis; and reducing oxidative stress and inflammatory infiltrate.

Introduction: Amlodipine is a third generation dihydropyridine group of calcium channel blocker and having an excellent antihypertensive profile. Pedal Oedema (PE) is the major drawback of amlodipine therapy and the incidence of Amlodipine Induced Pedal Oedema (AIPE) has been found significantly high. Several neurohumoral factors influence the incidence of oedema. Aim: We aimed to compare the plasma levels of renin, vasopressin and atrial natriuretic peptide in hypertensive AIPE, non-oedema and cilnidipine treated patients. Materials and Methods: The present prospective, interventional study was conducted on 104 mild to moderate hypertensive patients (52 patients in each group), after due consideration of eligibility criteria. Plasma Renin (PR), Vasopressin (VAS), and the Atrial Natriuretic Peptide (ANP) was estimated by ELISA test and compared between the AIPE, Amlodipine Treated NonOedema (ATNE) in Phase I, and AIPE and Cilnidipine Treated (CT) Groups in Phase II. Results: The clinical and demographic parameters were matched. PR was significantly high in AIPE group than the ATNE, and it was significantly reduced after one month follow up with the substitution of cilnidipine. The median (IQR) value of PR was 4.87 (3.58, 6.63), 3.50 (1.44, 5.47) and 2.66 (1.02, 5.66) ng/ml in AIPE, ATNE, CT group respectively. VAS was significantly high in AIPE group than ATNE, and it significantly reduced after one month follow up with CT group. The median (IQR) value of vasopressin was 6.78 (2.55, 9.16), 2.58 (1.61, 5.73) and 2.50 (1.23, 5.00) ng/ml in AIPE, ATNE and CT groups respectively. There was no significant difference seen in plasma ANP levels between the groups. The p-value was

Introduction: Hypertension is a major health issue worldwide. Calcium Channel Blockers (CCBs) are the most commonly used antihypertensive agents. CCBs act on voltage-dependent calcium channels and they were categorized into two subclasses, Dihydropyridine (DHP) and non-Dihydropyridine (non-DHP) derivative. Amlodipine is a third generation L-type of DHP and Cilnidipine is a novel L/N-type of DHP CCB, both drugs have excellent pharmacological profiles with the unique actions. Aim: To study the clinical and biochemical profile in Amlodipine and Cilnidipine treated mild to moderate hypertensive patients. Materials and Methods: The present study was a crosssectional study. A total of 140 mild to moderate hypertensive patients (HTN classified according to Joint National Committee-8 (JNC-8) HTN guideline), 70 were in Amlodipine group (Group-A), and other 70 patients were in Cilnidipine group (Group-B). Group-A receiving Tab Amlodac 5 mg/day and Group-B receiving Tab Cilacar 10 mg/day, and both the group receiving respective medications since more than six months. Patients were enrolled into the study with due consideration of eligibility criteria. Demographic, clinical and biochemical parameters were noted and compared. Results: Demographic parameters are matched, there was no significant difference seen between two study groups. Systolic and Diastolic Blood Pressure (SBP and DBP) showed a significant difference (p

Background: Healing ability of nonhealing chronic ulcers can be assessed by estimating hydroxyproline, total protein and enzymatic antioxidants such as glutathione peroxidase (GPx), glutathione S-transferase (GST) in the granulation tissue. Materials and Method: A total of 34 patients were analysed from two groups: Limited access dressing (LAD) group (n = 17) and conventional dressing group (n = 17). Results: Patients treated with LAD that exerts combination of intermittent negative pressure and moist wound-healing had shown a significant increase in the hydroxyproline (P = 0.026), total protein (P = 0.004), GPx level (P = 0.030) and GST level (P = 0.045). Conclusion: Patients treated with LAD indicated significantly better anabolic effect on wound-healing compared to that of patients treated with conventional dressing.

Introduction: Hb Hope is a clinically asymptomatic βchain variant [beta136 (H14) Gly→Asp (GGT→GAT)]. It is more prevalent in Mediterranean region of the world than in Asian countries and extremely rare in India. Aim: To evaluate the interference of clinically silent and extremely rare variant; haemoglobin Hope (Hb Hope) on the final reported value of glycated haemoglobin (HbA1c) by high performance liquid chromatography (HPLC). Materials and Methods: Eight EDTA blood samples showed very high values of HbA1c (>50 gm%) when processed by Bio-Rad Variant II turbo (HPLC). These were further processed for by capillary electrophoresis to look for the abnormal haemoglobin. Glycated Hb was also measured by immunoturbidimetry. Results: On HPLC, single abnormally high peak was observed for all the samples in the chromatogram leading to very high glycated haemoglobin values while in immunoturbidimetric assay reportable values were obtained. Moreover, capillary electrophoresis showed the presence of haemoglobin Hope in all the samples. Conclusion: Hb hope might lead to overestimation and possible misinterpretation of glycated haemoglobin results. Hb Hope is extremely rare in India but the possibility of interference by such clinically silent variant should always be kept in mind while interpreting the HbA1c values.

The formation of new blood vessels is the ini-tial step in neovascularisation. The first stagein angiogenesis is the activation of endothelialcells. Copper ions stimulate proliferation andimmigration of endothelial cells. It has beenshown that serum copper concentration in-creases as the cancer disease progresses andcorrelates with tumour incidence and burden.Copper ions also activate several proangiogenicfactors, e.g., vascular endothelial growth fac-tor, basic fibroblast growth factor, andinterleukin 1. This review concerns a brief in-troduction into the basics of blood vessel de-velopment as well as the regulatory mecha-nisms of this process. The role of copper ionsin angiogenesis is discussed.

Introduction: The availability of the haemoglobin A1c test has been a major advance in diabetic care and its measurement has become an integral part for the management of diabetes. When glycated haemoglobin (HbA1c) is estimated by High Performance Liquid Chromatography (HPLC), one of the fractions that are eluted is known as “P3” fraction which is labelled as “degenerated haemoglobin”. The P3 fraction is not taken into account while estimating HbA1c or HbA values. Aim: To study the effect of P3 on the final reported value of HbA1c by HPLC and the significance of this fraction in the final chromatogram. The possibility that HbA1c fraction is under reported due to increase in P3 fraction was also examined. Materials and Methods: HbA1c, various fractions of HbA1 and P3 were estimated by HPLC method in 430 subjects. Patient data was divided into 3 groups on the basis of HbA1c% (group I - 12%). Result: P3% as well as P3 area increases as the HbA1c increases (p-value -

Introduction: Genetic and environmental factors play an important role in susceptibility to type 2 diabetes mellitus (T2DM). Several genes have been implicated in the development of T2DM. Genetic variants of candidate genes are, therefore, prime targets for molecular analysis. Aim: In this study, we have selected 3 candidate genes, namely, TCF7L2, SLC30A8, and IGF2, for assessing their association with T2DM in an Indian population. Materials and Methods: Five hundred individuals were enrolled in this case-control study- 250 T2DM patients and 250 healthy control individuals. Clinical characteristics were obtained for all subjects, and genotype analysis was performed by PCR-RFLP analysis. Results: Allele and genotyping frequencies, odds ratios, and 95% confidence intervals were calculated for 3 single nucleotide polymorphisms (SNPs), 1 each from TCF7L2 (rs7903146), SLC30A8 (rs13266634), and IGF2 (rs680) in T2DM patients. The rs7903146 and rs680 polymorphisms were found to be significantly associated with T2DM (p < 0.05), whereas the rs13266634 polymorphism was not (p > 0.05). The multifactor dimensionality reduction method identified the particular polymorphisms associated with an increased risk of disease. Conclusion: The present study indicated that the gene–gene interaction model successfully predicted T2DM risk based on TCF7L2 and SLC30A8 polymorphisms. These results provide strong evidence of independent association between T2DM and the 3 SNPs analysed herein.