Saturday, 21 April 2018

Therapeutic Use of Wheat Grass Juice for the Treatment of Anemia in Young Women of Ajmer City (Rajasthan, India)

Wheat grass juice isextracted from the cotyledons of the common wheat plant Triticum aestivum. It has been used therapeutically from years all around the world because of its healing properties. The juice from wheat grass is high in chlorophyll, active enzymes, vitamins and other important nutrients like Iron. The chlorophyll present in wheat grass and haemoglobin has similar structures except for the central moieties. Also the pH of wheat grass juice is 7.4 which are the same as that of blood. Therefore it is absorbed quickly in the blood and is often referred to as Green Blood. This juice is extensively used therapeutically for the management of diseases like Anemia, Thalassemia, Inflammatory Bowel diseases, etc.
According to the National Family Health Survey- 3, more than half of women (55 percent) aged between 15 to 49 years are Anaemic. Nutritional deficiency anaemia refers to a decrease in the concentration of haemoglobin in the blood due to poor dietary habits that causes deficiency of iron, proteins, vitamins like vitamin C, vitamin B12 along with folic acid. Deficiency of the above nutrients can affect the production of red blood cells. Anaemia is a wide spread public health problem which is associated with an increased risk of morbidity and mortality. India is among the countries with the highest prevalence of iron deficiency anemia in the world
The reduction in oxygen available to organs and tissues when haemoglobin levels are low is responsible for many of the symptoms experienced by anaemic people. The consequences of anaemia include general body weakness, frequent tiredness, and lowered resistance to disease. Anaemia can be a particularly serious problem for pregnant women, leading to premature delivery and low birth weight. It is of concern in children since anaemia is associated with impaired mental and physical development. Haemoglobin testing is the primary method of Anaemia diagnosis. Age is associated with the category of Anaemia, with older women being somewhat more likely to be moderately or severely anaemic than younger women. The rate of moderate-to-severe Anaemia (moderate and severe Anaemia combined) among women of age 35- 49 is almost three times as high as among girls of age 15-19.

Friday, 20 April 2018

Mechanisms of Twinning IX: Influence of Prior Lactation


The purpose of this study is to ascertain a physiological relationship between prior lactation and the probability of subsequent multiple pregnancies in humans, thereby lending support to the role of insulin-like growth factor in both phenomena. Data were collected in the present study to determine if there is a direct relationship between the extent of lactation in prior pregnancies and the chance of twin/triplet gestations subsequently. Positive results of such a study could support the proposed biochemical significance of insulin-like growth factor elevation in promoting multi-fetal pregnancies.
Cows with an enhanced tendency to twin have elevated levels of serum Insulin-like Growth Factor (IGF). IGF is a protein component of milk; bovine milk has a lower level of IGF than human milk, in general. Recent reports support the view that twinning in humans is also related in some way with IGF. Somatotropin-stimulated IGF augmentation often induces ovarian hyperstimulation in subfertile women undergoing in vitro fertilization. On the other hand, one small study found no significant difference in plasma follicle stimulating hormone (FSH) between mothers of Dizygotic (DZ) twins and mothers of singletons at any stage of the menstrual cycle.

Insulin-like growth factor, a 70-unit polypeptide, is a major mediator of FSH action on the ovary. IGF increases the sensitivity and responsiveness of ovaries to FSH. Variations in either FSH or IGF can modify the Spontaneous Twinning Rate (STR). The mitogenicly powerful synergistic combination of IGF and FSH enhances ovarian steroidogenesis, increases primordial follicle recruitment, and reduces ovum apoptosis, thus increasing the chance for double ovulation.  In humans, conceptions that occur while the mother is breast-feeding result in twin gestation rates (both monozygotic and dizygotic) nine times higher than in the general gravid population. Also, women who have ever lactated have a higher mean plasma IGF level than those who never lactated.

Human grand-multiparas (parity>4) more often breast-feed than women with fewer pregnancies. Also, elderly (age>40) grand-multiparas retain their fertility longer and conceive twins more often than do women of low parity. Thus, the current potential for twinning may be a function of lactation in prior pregnancies. By its cumulative effect, prolonged lactation might extend the period of enhanced availability of IGF.

Thursday, 19 April 2018

Development of a Comprehensive Psycho Social Care and Support Model for Children and Adolescents Living with HIV/AIDS in India


Globally, it was estimated that in the year 2008 there were 33.4 million people living with HIV, out of which children below 15 years constituted 2.1 million. It was estimated that India has an overall prevalence of 0.31%. Approximately 50,000 children below 15 years are infected by HIV every year. The increased access to antiretroviral treatment resulted in increased survival rates among the children infected with HIV/AIDS and also led to the improved quality of life of sero-positive children. This continues to have an increased impact on the mental health of children and adolescents living with HIV. Children with any chronic illness, in general, are found to be at greater risk of psychiatric problems, including depression, anxiety, and feelings of isolation. A major factor that distinguishes HIV/AIDS from other chronic or terminal illness is the stigma. Too often many HIV infected children and their families live in shame associated with AIDS. 

Illness is often kept as a secret. Parents delay disclosing child’s as well as their own HIV/AIDS illness status due to stigma and possible psychological consequences. Internalizing problems such as anxiety, withdrawn behaviour, depression and somatic complaints are more in younger children with HIV and externalizing problems such as rule breaking, aggressive behaviour, and conduct disorders are common among older adolescent living with HIV. Further, children with HIV/AIDS have additional factors in the complexity of their illness and treatment as well as in the adverse psychological circumstances and poverty in which many live. These children who know about their HIV status live in fear of their disease, and fear of loss of parents with HIV/AIDS. Moreover, given the nature of HIV transmission, if both parents infected with HIV, then many children become ‘double orphans’. Children not only have to endure the pain and loss of losing parents, and also have to face stigma and survive without the emotional support of their parents. Following the death of the parents most of these infected children end up in living in orphan homes for long term care and protection. This has immediate as well as longer term emotional consequences. As a result the mental health, needs and concerns of the children and adolescents with HIV infection need to be an essential part of their care even with advancements in HAART. 

When it comes to the disclosure of HIV/AIDS infection status to the children, there is no clear consensus among the practitioners and parents on when to disclose the HIV positive status to the child. Most of the disclosure guidelines address on illness aspect and treatment adherence and not on addressing the mental health impact of disclosure of HIV status to the child. Once the HIV diagnosis has been disclosed to the infected child, there is a need to monitor in every follow-up visit, the child’s level of functioning, behavioural changes, emotional and psychological adjustment by the health care provider. Moreover, health care providers who work directly with HIV infected children are not being trained with adequate skills to handle the psychosocial and mental health issues of children infected with HIV/AIDS. This adds to the woes of the children in vulnerable situations and affects their not address the psychological and mental health issues of children either infected or affected with HIV/AIDS. The existing services in the ART centers in India are more generic than specific needs of infected children and adolescents.

Wednesday, 18 April 2018

Food Patterns, Diabetes and Overweight/Obesity and Some Socio-Economic Indicatorsin the Italy Regions


Thepurpose of this study is to identify the differences in mortality due to type 2 diabetes (T2D), the increase of overweight and obesity in the different regions of Italy and their relation with change in dietary patterns within the framework of some economic indicators. In Italy in 2015, the total adult population (1000s) (20-79 years) were 44,704; the prevalence of diabetes in adults (20-79 years) was 7.9%. The number of deaths in adults due to this disease was 22,226. Cost per person with diabetes (USD) was 3,450.1. The number of undiagnosed cases of this disease in adults was (1000s) 1,324.3.

According to the International Diabetes Federation (IDF) the overall prevalence of T2D in 2015 was 8.8%, of which approximately 75% were people living in low and middle-income countries. The fastest increase of cases occurred in regions where the economy moved from low to middle-income. In low and middle-income regions, the number of people with diabetes will increase 150% over the next 25 years. Moreover, 318 million people live with impaired glucose worldwide. The IDF calculated that in the same year about 46.5% (193 million) patients were undiagnosed worldwide and one in seven births was affected by gestational diabetes. The disease caused 5 million deaths and resulting in 673 billion dollars being spent on care.

In 2015, 415 million people had diabetes worldwide. More than 59.8 million of those were in the EUR Region and over 3.5 million cases (adults 20-79 years) were in Italy. In this regard, structural social determinants should be considered, covering a wide and complex combination of socio-economic conditions and interacting cultural and other environmental elements. The conditions in which the population is born, grows, lives, works, and ages, as well as the type of systems used to combat the disease are those that determine inequality and social inequity. Political and economic forces in each region in turn influence these conditions. Analysis of health problems using social determinants is a framework of reference for research in various areas of public health and epidemiology. The field of knowledge and purpose of the DSS is to analyze inequities in the distribution of social goods and how avoidable inequalities are manifested in the state of health of social groups. Economic development has led to greater availability and diversity of the food in almost all countries and a gradual decree in food shortages, resulting in nutritional condition. There have also been improved living standards and increased access to services. However, these improvements differ between countries with low, medium and high income and between population groups within each country.

Tuesday, 17 April 2018

Monogenic, Polygenic and Multifactorial Obesity in Children: Genetic and Environmental Factors


Obesity is achronic disease that has increased alarmingly in recent years. It is considered a risk factor for the development of diseases such as type 2 diabetes, cardiovascular diseases, dyslipidemia, and some types of cancer. Two genetic profiles have been described: monogenic obesity, in which a single gene is mutated, usually leading to loss-of-function or haploinsufficiency, and polygenic obesity, which involves several polymorphic genes with complex interactions between genes and environmental factors. In the latter case, the frequency of polymorphisms can be very high, depending on the population analyzed. In both cases, the genes of interest are associated with changes in body composition through different mechanisms, including hyperphagia, energy expenditure, adipocyte differentiation and lipolysis. However, most studies have analyzed genes associated with obesity in other populations, and the results are often inconsistent, so it is important to study the context of obesity, such as genetics, biochemical biomarkers and environmental factors. Environmental factors include physical activity, nutritional status, and an intake of foods rich in fats and carbohydrates that favor obesity in children. In addition, several chemical compounds have been described as potential endocrine disruptors that increase BMI and produce obesity, and some biological agents can alter the homeostasis of adipose tissue. In this review, we analyzed the genetic and environmental factors that influence obesity, particularly in children.

OECD: Organization for Economic Cooperation and Development; BMI: Body Measured Index; LEP: Leptin; LEPR: Leptin Receptor; POMC: Proopiomelanocortin; PCSK1: Prohormone convertase 1/3; MC4R: Melanocortin 4 Receptor; SIM1: Single Minded Homologue 1; GWAS: Genome Wide Association Studies; PPARG: Peroxixome Proliferator-Activated Receptor γ; ADIPOQ: Adiponectin; FTO: Fat-Mass and Obesity Associated Gene; SNP: Single Nucleotide Polymorphism; CED: Chemical Endocrine Disrupters; DDE: Diphenyl-dichloro-Ethylene (DDE); BPA: Bisphenol A.

Obesity is a chronic disease of diverse etiology. In the genetic context, monogenic obesity is associated with loss-of-function mutations in a single gene. These mutations are very rare and are in some cases unique to a patient or several members of a family; in some populations with high rates of consanguinity, the mutations are more frequent. In polygenic obesity, there is an interaction between several polymorphic genes; in this case, the frequency is greater than 1% and varies by the population analyzed. In this type of obesity, the risk that is attributed to each allele is generally small, but the additive effect of several risk alleles can considerably increase susceptibility to obesity.

Monday, 16 April 2018

An Impact of Pelvic Magnetic Resonance Imaging to Radiotherapy Volume Definition in Patients with Intermediate- and High-Risk Prostate Cancer: A Population Based Study

Pelvic MRI (PMRI) is an important pre-radiotherapy (RT) evaluation procedure in patients with intermediate- and high-risk prostate cancer. We conducted a retrospective study to evaluate an influence of PMRI to delineation of RT clinical target volume (CTV).

Medical records of prostate cancer patients treated with intensity-modulated RT (IMRT) in single institution in 2009-2015 were retrieved and examined retrospectively. Initial risk group affiliation was defined using NCCN criteria. PMRI reports of patients with intermediate and high-risk prostate cancer were reviewed and risk group affiliation was re-defined in regards of T- and N-stage. CTVs for IMRT treatment plans were contoured. Accounting to information obtained from PMRI. Extra-capsular extension (ECE) and seminal vesicles invasion (SVI) were included to high-dose CTV. Regional pelvic lymph nodes (RPLN) were planned to treat in all high-risk pts. RPLN considered pathological by PMRI were included to separate CTV to receive RT dose higher than unaffected RPLN stations.

Between 2009 and 2013, 169 patients with intermediate and high-risk prostate cancer underwent PMRI at around 1 month before commencing IMRT. Initially, 89 patients were affiliated to intermediate-risk and 80 to high-risk group. In general, PTV-changes based on PMRI data required in 66 patients (39%). Thirty seven of 89 intermediate-risk patients (42%) were switched to high-risk group, necessitating irradiation of RPLN. ECE and SVI were included to high-dose CTV in 64 (38%) and 29 patients (17%) respectively. RPLN were thought pathological in 10 patients (6%), which justified contouring of a separate CTV for dose escalation.

In our retrospective series, PMRI-scans had a significant impact on RT target coverage decision in patients with intermediate and high-risk prostate cancer. However, a true value of this impact should be defined a large scale prospective clinical trial.

Friday, 13 April 2018

Whistleblower Issue and Its Relevance in Autism Research

On August 27, 2014, CDC scientist Dr. William Thompson admitted that he and other authors had omitted vital data from a 2004 study of possible connections between MMR vaccines and autism. Dr. Thompson also acknowledged a biologically plausible relationship between Thimerosal (a mercury-based preservative) in vaccines and autistic-like symptoms. He additionally reported that the CDC has withheld information about a relationship between Thimerosal and tic disorders. Whether or not a person thinks that the admissions made by this CDC scientist reflect the truth, admitting fraud in the CDC's neurodevelopmental disorders research is certainly newsworthy. Why then has the mainstream media been mostly silent on the issue? The coverage of this story has been mostly limited to the blogosphere. Some of the mainstream media's top stories have instead included: "Artists draws his dog in whimsical scenes" (ABC News, 9/17/14); "Is the tide changing for the NFL" (MSNBC, 9/17/2014); and "Vikings: Peterson must stay away", and "Final hours before Scotland's big vote" (CNN, 9/17/14).
Admittedly, this CDC whistleblower story is controversial. This is due, in part, to enormous and far-reaching liability ramifications, to the disturbing number of potentially affected children, and because those that could be held accountable hold powerful and authoritative governmental positions. We can only speculate if the mainstream media is simply not interested in this topic, or if their silence reflects a form of disagreement, or if possibly their lack of coverage is due to external pressure to extinguish the story. The limited mainstream media coverage of such a weighty scientific matter reveals the importance of scientists themselves having a public voice on critical public policy issues. Throughout history scientists speaking loudly about dangerous toxins have saved many lives and prevented untold pain and deformities. Clear examples are Pink disease (caused by mercury in teething powders), lead poisoning diseases (from lead-based paints and other products), and thalidomide causing birth defects. And also, of course, the discovery that mercury causes neurological damage. The mainstream media's silence here emphasizes the value of peer-reviewed science journals as an avenue for scientists to be a part of necessary public dialogues.
This story also raises the issue of the importance of transparency in research and the availability of public databases to independent researchers. The current datasets used by the CDC in their own research on vaccines and autism are not easily accessible to independent researchers. For example, one of the databases used by the CDC that reportedly showed no relationship between thimerosal and autism  is no longer available to anyone outside of the CDC to examine. Neuropsychiatric disorder research data transparency is especially important considering today's staggering numbers of neurodevelopmental disorders, which in the United States has increased to about 1 in every 6 children. This has predominately been an increase in autism and attention deficit/ hyperactivity disorders, but there has also been an increase in tic disorders. World-wide neuro developmental disorders today are causing heavy consequences on the affected individuals and their families. How this unfolds remains to be seen. However, assuming continued mainstream media silence, it is likely that this whistleblower story along with its potential implications will remain missing from the forefront of public discussion.