Abstract:

Introduction: Over the past decade, there has been lot of reports which prove the association of Diabetes Mellitus, which can cause potential neuronal impairment and cognitive deficits. It has been shown that Diabetes can cause dendritic atrophy in crucial brain structures like hippocampus and prefrontal cortex which are considered to the seat of memory and decision making. Most of the herbal extracts used for treatment of diabetes has focused mostly on the hypoglycaemic and anti-oxidant property and there are no studies which focused on its effect on altered dendritic architecture caused by Diabetes. This study was taken up to explore the effect of administration of Trigonella Foneum Graceum (Known as Fenugreek, Methi in Hindi) seed on diabetes induced dendritic atrophy in the Hippocampus of adult male Wistar rats.

Materials & Methods: Experimental diabetes was induced by administering single dose of Streptozotocin (60 mg/kg) through intraperitoneal dose. After inducing diabetes, treatment groups of rats were orally administered Tfg (1 g/kg) for 6 weeks. Following this, rats were sacrificed and the brains were removed, processed for the Golgi-Cox stain method, and analyzed by the Sholl’s method.

Results: Clearly, the rats with diabetes mellitus induced by streptozotocin showed a decrease in the dendritic length and branching points in both apical and basal dendrites of both CA1 and CA3 pyramidal neurons from all the analyzed segments. Interestingly, the Fenugreek treated rats showed the reversal of dendritic atrophy in most of the segments analyzed in both CA1 and CA3 pyramidal neurons.

Conclusion: The present study demonstrates that Fenugreek seed extract having a proven hypoglycaemic and anti-diabetic property also processes protection to the Hippocampal pyramidal neurons form Diabetes associated Neuronal atrophy.

Keywords: Fenugreek seed, Dendritic atrophy, Diabetes Mellitus, Golgi Cox staining.

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Abstract:

Introduction: Juvenile myoclonic epilepsy (JME) is a genetically determined common primary idiopathic generalized epilepsies (IGE) seen in 8-20 years of age and comprises between 4-10% of all types of epilepsy syndromes. Photic stimulation initiating the seizure precipitation is a characteristic feature of IGE, especially in JME. About 30% of JME patients were photosensitive. Bromodomain protein containing 2 (BRD2) gene is a transcriptional regulator highly expressive during the development of nervous system in the embryo. The human BRD2 gene has been shown to play a susceptibility role critically in common form of epilepsy as well as in other neural phenomena including photosensitivity.

Methods: Patients diagnosed as JME based on criteria of international league against epilepsy (ILAE) and age & sex matched controls, between age group 8-20 years were recruited. 5ml of peripheral venous blood was collected and stored to 4⁰C. DNA was extracted by Nucleospin blood kit method and analysed by 1% agarose gel then purified. Suitable primers for exon 3 and exon 13 were designed and synthesized at IIT Patna, India. Purified DNA samples were amplified with PCR at suitable annealing temperature (62⁰C for exon 3, 65⁰C for exon 13). Amplified PCR products were sequenced by using Applied Biosystems, Genetic analyser, 3130XL instrument, following Sanger’s method. Sequence analysis was conducted by using chromaspro, version 1.7.7. The sequence was compared by performing multiple sequence alignment using ClustalX tool, NCBI software Development Toolkit (Version 1.8.3, national center for biotechnology information, Bethesda, MD) to identify the mutations in the sequences. All the mutated sequences were deposited at NCBI- Genbank and got accession numbers.

Results: A total 40 JME participants and 40 controls were included for molecular analysis. Among total cases, 27 cases were positive to photosensitivity. In exon 3, one case had nucleotide changes at c.delA1890, c.A1892T, c.A1895T, c.G1896T, c.T1897c, c.T1898C, c.C1899T, c.G1900T, c.C1901T and c.A1902T leads to existence of stop codon after p.111 Pro>stop (Genebank-KX061434), In exon 13, 39 cases had mutations at various positions, but none of the mutation leads to the alteration in the protein sequence.

Conclusion: Mutations in BRD2 gene are found to be responsible for the functional alteration in bromodomain protein which leads to development of JME. Among 27 cases positive to photosensitivity, 20 cases had mutations in exon 3 and 13. Hence, c.G1707A, c.C4132T, c.G4133A, c.C4132T mutations of BRD2 may be responsible for photosensitivity, which may result functional impairments in JME.

Keywords: Juvenile myoclonic epilepsy, BRD2 gene, mutation.

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Abstract:

Introduction: The Bahamas is an archipelagic nation with an estimated population of 389,000, which is predominantly of African descent, around 85-90% of the population. The Ministry of Health has only reported on the incidence values of type 2 diabetes and prediabetes per surveyed year. However, no major research has been done to ascertain the underlying factors. This study therefore was designed to investigate if there is any relationship between dietary intake, obesity and the prevalence of type 2 diabetes in The Bahamas. In order to correctly understand the reason for obesity in The Caribbean, the cultural dimension must be understood. Most Caribbean people associate unhealthy native food with love and home-positive emotions. Another aspect to be explored would be the relationship between food that is fostered from childhood. This knowledge will aid in any form of community-based interventions.

In this regard, it should be a top regional and national priority to uncover key factors for this high rate of diabetes and offer preventative solutions. This paper will examine one possible effect - a native diet - on the prevalence of type 2 diabetes in the West Indian region, with a focus on The Bahamas.

Methods: The Bahamas can be separated into urban regions and family islands which are less developed. Therefore, each family island and different areas of the more urban regions would have to be visited. The Bahamas’ STEPS survey model would be employed, which is a stratified multi-stage cluster sample design with a population-based survey of adults aged 25-64 that were diagnosed with type 2 diabetes or prediabetes. A consent form to ensure informed consent will precede the questionnaire. Special consideration will be made to ask specific questions regarding common Bahamian dishes that are vastly unhealthy.

Results: As of 2017, the percentage of the population in The Bahamas that has been diagnosed with diabetes was 13.9%, and with the addition of prediabetic patients, the percentages have risen to 19%. Due to the relationship between diabetes and obesity, it can be surmised that the main cause for Bahamians contracting this metabolic disorder is a sedentary lifestyle coupled with a diet heavy in carbohydrates and seafood.

Conclusions: Since the Bahamian diet is a mixture of the diet of the American South and The Caribbean as a whole, an in-depth analysis would provide data that can be applied to other populations.

Keywords: Diabetes mellitus type 2, Bahamas, STEPS survey model.

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Abstract:

Introduction: A 64 detector CT was purchased by the Georgetown Public Hospital Corporation (GPHC) and came into use there in May of 2018. First Cardiac CT was completed by technologist at GPHC on the 5^th of July 2019 directed by a resident radiologist.

Methods: The sequence of events was confirmed by references in electronic media and official hospital logs and records. Images from GPHCs picture archiving and communication system PACS were also used to critique the quality of the test performed.

Results: The total radiation dose delivered was 33.9 mSv over two scans. The calcium scoring accounted for only 1.1mSv of the total dose. The final image quality was very good and without motion artefact and most importantly was good enough to rule out the diagnosis in question with certainty.

Conclusion: The test was completed by a team with minimal experience accomplishing excellent final image quality, though with increased radiation dose. This was achieved by having motivated staff, and experienced volunteers willing to advise remotely, and a very cooperative patient.

Keywords: GPHC, 64 detector CT, Cardiac CT.

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Abstract:

Introduction: Colorectal Cancer (CRC) has the highest mortality rate and is recorded to be the third most common cancer worldwide. The cause of colorectal cancer is multifactorial and multigenic. The gut has huge commensal microorganisms to maintain homeostasis by regulating various biological functions such as mucosal barrier, immunity, and metabolic processes. Accumulating evidence indicates that the gut bacteria play a crucial role in human health, and the dysbiosis of the gut microbiota is associated with various disorders, including obesity, diabetes, inflammatory bowel disease, and many types of cancer especially colorectal cancer. We conducted a systematic review to study the association between the gut microbiota dysbiosis and its risk for colorectal cancer.

Methods: The search was conducted in MEDLINE. Titles and abstracts were screened, full-text studied and information extracted for qualitative synthesis. The exposure was dysbiosis of microbiota in colon and the outcome was the colorectal cancer.

Results: Our search resulted in 186 studies. By applying several filters needed to our research, finally four studies were selected for synthesizing the qualitative data. These studies have shown that some of the gut microbiota such as anaerobic bacteria were significantly increased in CRC patients.

Conclusion: Although the available data suggest an association between dysbiosis of gut microbiota and colorectal cancer, it is limited; hence, more investigations are required to further confirm this. In the future, targeting the gut microbiota by changing food habits, life style, antibiotics and probiotics will probably be a powerful weapon in the battle against CRC.

Keywords: Colorectal cancer, Dysbiosis, Microbiota, Probiotics.

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Abstract:

Introduction: Colorectal cancer, A malignant tumor arising from the inner wall of the large intestine (the colon & rectum). Globally, colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the second leading cause of cancer death. Arising through three major pathways, including adenoma–carcinoma sequence, serrated pathway and inflammatory pathway, CRC represents an etiologically heterogeneous disease according to subtyping by tumor anatomical location or global molecular alterations.

Methods: This is observational study based on data from different articles and survey on colorectal cancer. The articles and surveys are American cancer Society: Cancer Facts and Figures 2019, Pan American Health Organization, Elizabeth Quamina Cancer Registry of TT, Brazilian National Cancer Institute (INCa) for 2016/2017, REVISTA DE GASTROENTEROLOGIA DE MEXICO.

The study included all the incident cases of colorectal between year 2012-2018.

Result: From analyzing the cases of colorectal cancer in different countries like Bahamas, Brazil, Colombia, Jamaica, Trinidad &Tobago and USA, findings show that in last two decades there is drastic increase in number of cases of colorectal cancer by various factors such as consumption of red meat, low dietary values in fruits and vegetables , smoking and high consumption is likely to drive increasing CRC incidence in Caribbean and other western countries. Furthermore, the rising incidence of CRC at younger age (before age 50 years) is an emerging trend.

Conclusion: Among the western countries growth of CRC now is lesser by the familial factors as the ‘rise’ of colorectal cancer in developed countries can be attributed to the increasingly ageing population, unfavorable modern dietary habits and an increase in risk factors such as smoking, low physical exercise and obesity.

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Abstract:

Introduction: Type 2 diabetes mellitus (T2DM) is a global metabolic disease characterized by impaired insulin secretion from pancreatic cells and insulin resistance (IR) in liver, muscle and adipose tissue, in the presence of appropriate environmental factors. Insulin is a key regulator of glucose homeostasis. IR leads to impaired glucose tolerance, and has an important role in the development of metabolic syndrome. Recently, a new protein called omentin has been identified as a novel specific adipokine in human adipose tissue, which could have a possible role in modulating insulin action^. The physiological role of omentin in glucose metabolism, omentin’s target tissues, receptors or relevant signal transduction pathways still not clear. The purpose of the present study is to evaluate serum omentin-1 levels in normoglycemic First Degree Relatives (FDR) of Type 2 diabetic patients compared with the controls.

Methodology: A total of 96 study participants were enrolled in the present study. Among them, 48 were FDRs of T2DM patients and remaining were age and sex matched healthy controls. Body mass index (BMI), waist circumference and biochemical parameters like, FBS, serum cholesterol, triglycerides and serum omentin-1 levels were measured in subjects and age matched controls. The subjects with endocrine disorders, cardiovascular diseases, hepatic or renal dysfunction were excluded.

Study design: Cross sectional comparative study.

Statistical Analysis: All values were expressed as mean ± SD. The results obtained were analyzed statistically using the unpaired student t-test to evaluate the significance of differences between the mean values. In all the cases probability value of p<0.05 will be considered as significant.

Results and Discussion: The present study observations were in accordance with other studies which suggest that omentin may be a positional candidate gene for type 2 diabetes susceptibility in humans. It also demonstrated that plasma omentin-1 levels were significantly decreased in obesity and diabetes and the circulating omentin-1 levels were lower in FDRs than the controls. To conclude, the current study demonstrated the significant difference in mean serum omentin-1 levels in normoglycemic first degree relatives of type 2 diabetes patients when compared with the controls.

Keywords: Diabetes, Insulin, Omentin-1.

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Abstract:

Introduction: Chronic Disease Research Centre and head of the Port of Spain non-communicable diseases (NDCs) Evaluation team, Dr Alafia Samuels indicated that Guyana and Trinidad and Tobago have the highest mortality for premature cardiovascular disease and diabetes in the Americas. (Guyana Chronicle, 2018).

Methods: The Current Investigation has a general objective to describe clinical and biochemical features of children, adolescents and young adults with recent onset type 2 diabetes mellitus. Retrospective study that included adolescents and adults between the ages of 13 and 28 with fasting glucose above 126 mg/dl, absence of antiGAD and C peptide above 1.5 ng/dl. Patients with previous diagnosis of type 1 diabetes, diabetes type MODY or drug associated diabetes were excluded.

Results: Mean age was 16 years; 59% were females, and 43% had at least one parent with type 2 diabetes. At the time of diagnosis, the body mass index was 42.8 kg/m2; 85% had acanthosis nigricans and 68% had Tanner stage IV or V. Initial treatment included oral hypoglycemic drugs in 75%, metformin was the most common drug used (64.3%). Only 41% of cases received insulin.

Conclusion: Children and adolescents with type 2 diabetes in this setting have a high frequency of obesity, acanthosis nigricans and family history of type 2 diabetes. In general, these patients have poorly metabolic control and receive metformin as initial treatment.

Keywords: Diabetes mellitus type 2, Obesity, Insulin resistance, Child, Adolescent, Young adult.

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Abstract:

Introduction: Prostate cancer is currently the sixth most common cancer site in the world, third of importance in men and is a major concern.

Methods: The Current Investigation has a general objective to determine the role of some genetic, hormonal, lifestyle and environmental factors in the risk of developing clinically manifested prostate cancer using information from Demerara Paradise Incorporated, a local health institution in Guyana. The study cases were determined from records of the Institution (n = 33) diagnosed during 2016-2017, with histological verification or cytological cancer of prostate, persons under 90 years. The controls (n = 108) were selected by age and records were obtained from the same hospital. The risk estimation was obtained through a conditional logistic regression.

Results: There was a statistically significant association between skin color and risk of prostate cancer (OR = 1.30, 95% CI: 0.92-1.84) or smoking habit (OR = 0.82, 95% CI: 0.58-1.16). A positive association of the risk of prostate cancer with venereal diseases was observed (p = 0.01), as well as with the age of onset of these diseases (p = 0.06). No differences were found regarding the age of onset of sexual intercourse (p = 0.111) or in the number of sexual partners (p = 0.48).

Conclusion: There was a significant association between the risk of prostate cancer and having suffered from a venereal disease, limited physical exercise between 45 and 50 years and the frequency of sexual intercourse more than 10 times a week.

Keywords: Prostate cancer, Risk factors, Relative risk, Cases and Controls, Multicentre study.

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Abstract:

Introduction: Diabetes mellitus has been major problem in developed and developing countries. The progression of disorder cause prolonged exposure of vascular tissues to hyperglycaemia resulting in long-term microvascular/ macrovascular complications in the health; and nephropathy is one of them.

Methods: The present study was designed to evaluate the role of N-acetylcysteine on microalbuminuria and HbA1c level in patients with diabetic nephropathy. A randomized, open controlled clinical trial which includes 58 diabetic nephropathy patients (50 men and 8 women) aged between 35–60 years who had diabetes for at least more than 5 years. The patients divided in to two groups such as positive control and N-acetylcysteine group. Each group contains 29 patients for evaluation of the parameters for four months follow-up for both control as well as N-acetylcysteine group.

Results: After 4 months of supplementation of N-acetylcysteine, it was found that, there is a significant decrease in values of microalbuminuria and HbA1c (Glycosylated haemoglobin) when compare to the positive control group.

Conclusion: The result of study concludes that, the N-acetylcysteine significantly lowers microalbuminuria and HbA1c in patients with diabetic nephropathy. Therefore, supplementation of N-acetylcysteine may prevent the diabetic nephropathy.

Keywords: Microalbuminuria, HbA1c, N-acetylcysteine.

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Abstract:

Introduction: An estimated 300,000 deaths each year are as a result of organophosphate toxicity. Organophosphate pesticides (OP’s) have been used in large amounts in agricultural settings and homes, allowing intoxication. This has been linked to the onset of neurotoxicity and cardiotoxicity.

Methods: Thirty-two adult wistar rats were grouped and exposed to dichlorvos and chlorpyrifos, two widely used OP’s, for a period of 14 days. They underwent behavioural tests for anxiety-like behaviour and spatial memory. The brain tissue was excised, and the amygdala and hippocampus were sectioned out. These were put through biochemical tests for oxidative stress and Acetylcholinesterase (AChE) activity. These parameters, along with the brain and body weight changes were compared with those of a control group. Comparisons were analysed using one-way analysis of variance (ANOVA) and subjected to post-hoc Bonferroni’s multiple comparison test.

Results: There was a significant decrease (p≤0.05) in the brain and body weights. In the behavioural tests for spatial working memory, a significant defect (p≤0.05) was seen, shown by Morris water maze test. Anxiety-like behaviours were also elevated, shown by changes (p≤0.05) in Open Field test and Elevated Plus Maze test. AChE activity was markedly decreased (p≤0.05) in the amygdaloid complex and the hippocampus. Oxidative stress markers, Nitric Oxide (NO) and Reactive Oxygen Species (ROS) were also markedly increased (p≤0.05) in both brain regions. A similar experiment, with cardiotoxicity focus showed atherogenic and atherosclerotic indices and morphological damages, including a deterioration in plasma lipid profiles and a rise in low density lipoprotein- cholesterol.

Conclusion: There is a significant increase in neurotoxic and cardiotoxic profiles with OP exposure which can lead to neurodegenerative and cardiovascular diseases.

Keywords: Organophosphates, Acetylcholinesterase, Hippocampus, Amygdala, Atherogenic, Atherosclerotic.

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Abstract:

Introduction: Serotonin (also known as 5-Hydroxytryptamine – 5HT) is commonly categorized as a neurotransmitter. 5HT has an enormous influence over many functions such as memory, anxiety and mood in the central nervous system. 5-HT has also been shown to act as a growth factor on many non-tumor cells such as vascular smooth muscle cells. In addition, 5-HT has been shown to promote cell proliferation in prostate and breast cancer cells. The effects of serotonin on ovarian tumor cell growth are yet to be characterized. Previous studies in the Lutgendorf lab have identified 5HT receptor expression levels in numerous ovarian cancer cell lines (e.g. least SKOV3 cells) compared to normal ovarian cells. The aim of this study was to characterize 5HT receptors more specifically the 5-HT2A receptor and to clarify the effect of 5HT on proliferation in neoplastic ovarian cells.

Method: Clonogenic survival assays were used to determine the effects of 5-HT and a specific 5-HT2A receptor agonist, DOI (2,5-dimethoxy-4-iodoamphetamine hydrochloride), on proliferation in neoplastic ovarian cells.

Results: At present the effect of 5HT showed no significant effects on cell proliferation on the ES2 ovarian cancer cell line.

Conclusion: Various studies reveals that only 1% of 5HT is usually found in the nervous system. The remainder is found in the periphery and is ascribed a several physiological functions. 5-HT receptors can be found on a variety of cells. Platelets have recently found to be the main transporter of peripheral 5-HT. Though current study did not signify the findings, future work includes repeating experiments, plating at a lower density and doing a western blot to identify protein expression within the sample.

Keywords: Serotonin, Ovarian Neoplasm, Brain, 5HT receptor.

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Abstract:

Introduction: Obesity is the excessive or abnormal accumulation of fat or adipose tissue in the body that may impair health. It is been expected that, by 2030, 38% of the population to be overweight and another 20% is obese. Hence, it is important that, the medical students to have adequate knowledge on obesity. Otherwise, poor knowledge and attitude on obesity lead to inconsistency and low efficacy of treatment and outcome.

Methods: To assess the level of obesity knowledge and attitude of second year medical students in TAU- COM, Georgetown, Guyana. A 14-item questionnaire was designed to obtain the knowledge and attitude of medical students on obesity. The study subjects were second year medical students (Both MD3 & MD4) studying at TAU- COM, Georgetown, Guyana, South America. All the students enrolled in the study were requested to fill up the questionnaire. Participation was voluntary and anonymous.

Results: More than 73% of the participants strongly agreed that, obesity is a chronic disease. Participants (50%) have opined that, weight reduction is helpful in prevention of complications in obesity. Almost half of the participants have recorded that, inactive life style, watching television excessively and lack of sleep lead to weight gain. Majority (76%) of the participants agreed that, weight around the waist is more dangerous than around hips. Significant (86%) number of students agreed "they feel comfortable when examining an obese patient" and "it is not difficult for them to feel empathy for the obese patient"; in addition, they believed that overweight people lack will-power and are lazier.

Conclusion: The result of study concludes that, most of the study participants had adequate knowledge and have moderate positive attitude toward obese patients.

Keywords: Medical student, Attitude, Knowledge, Obesity.

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Abstract:

Introduction: There are several reports regarding exercise induced analgesia and contradictory reports about gender difference. Aim of the study is to assess the effect of exercise on cold induced pain along with gender differences if any.

Methods: Normal adult male (n=23) and female (n=18) were selected for the study. The subjects were asked to immerse his/her dominant hand in ice cold water (20 to 40 ᵒC) and pain threshold (start of feeling pain) and pain tolerance time (total time up to which pain can be tolerated) were recorded. For exercise, bicycle ergometer was used. Initial load for exercise was 25 watts, which increases with 25 watts at 2 minutes intervals and exercise was continued until the heart rate reached the 60 to 75 % of the maximal heart rate.

Results: The result showed that there were significant increase in female in systolic blood pressure (169±13 mmHg Vs male 151±20 mmHg), Diastolic Blood Pressure (Female 91±13 versus male 83±13 mmHg), Heart rate (female 153±9.4 Vs male 135±14 beat per minute), and Respiratory Rate (female 39.5±3.3 per minute Vs 33± 3.3 per minute) than male in response to exercise. There was significant increase in all pain parameters just after exercise (Pain threshold from 14.25 ±10.2 sec to 20.83±13sec after exercise, p< 0.001; pain tolerance from 39.5 ±25 sec to 54.67±31 sec, p<0.001). Exercise had much effect on pain tolerance than pain threshold therefore pain duration also increased more after exercise (from 26.2±20 sec to 36.2±23.5 sec, p<0.01). Although analgesic effect of exercise was observed in both the sexes but it was more pronounced in females in comparison to males.

Conclusions: The effect of exercise on pain perception was significant in both male and female, the analgesic effect being more enhanced in female than male.

Keywords: Gender, exercise stress, respiratory and cardiovascular changes.

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