Table of Contents - Issue
Recent articles
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Idiopathic Subglottic Stenosis with Several Idiopathic Cervical and Mediastinal Lymph Nodes - Airway and Anaesthetic ManagementAuthor: Suhas MDOI: 10.21522/TIJPH.2013.SE.24.05.Art001
Idiopathic Subglottic Stenosis with Several Idiopathic Cervical and Mediastinal Lymph Nodes - Airway and Anaesthetic Management
Abstract:
This case report details the anaesthetic approach for a 60-year-old female with subglottic stenosis, who had experienced bronchospasm and hypotension during previous surgeries under general anaesthesia. The patient was scheduled for open hernioplasty, and hernioplasty complex airway anatomy and history of anaesthetic complications posed significant challenges. Following a comprehensive preoperative assessment, including video laryngoscopy and CT imaging, it was decided to use a Combined Spinal Epidural (CSE) block to minimize the risks associated with general anaesthesia. The surgery was performed successfully, with the patient remaining stable throughout the procedure and during the postoperative period. This case highlights the importance of a personalized anaesthetic plan, particularly in patients with difficult airway conditions and a history of adverse reactions to general anaesthesia. Regional anaesthesia, specifically CSE, proved to be a safe and effective alternative, allowing for a successful surgical outcome without complications. This report emphasizes the need to carefully consider anaesthetic options in complex cases to enhance patient safety and optimize surgical results.
Idiopathic Subglottic Stenosis with Several Idiopathic Cervical and Mediastinal Lymph Nodes - Airway and Anaesthetic Management
References:
[1]. Erich, Stoelben., 2024, [Idiopathic Subglottic Tracheal Stenosis]. Zentralblatt Fur Chirurgie, Doi: 10.1055/a-2241-0616
[2]. Fernández MA, Bartolomé E, Villegas FR., 2009, Revisión de las estenosis traqueales trasintubación: a propósito de un caso. Medica Intensiva, 33, 301-305.
[3]. M., Direder., Maria, Laggner., Dragan, Copic., K., Klas., Daniel, Bormann., Thomas, Schweiger., Konrad, Hoetzenecker., Clemens, Aigner., Hendrik, Jan, Ankersmit., Michael, Mildner., 2024, Transcriptional profiling sheds light on the fibrotic aspects of idiopathic subglottic tracheal stenosis. bioRxiv, Doi: 10.1101/2024.02.19.580975.
[4]. Alfie, Wright., Thomas, Leahy., 2024, Atracurium-Induced Bronchospasm with Flat Capnograph at Induction of General Anaesthesia: A Case Report. Cureus, Doi: 10.7759/cureus.54251.
[5]. Brandon, Miguel, Flores, Najera., Blanca, Isela, Martínez, Montoya., 2023, Incisional Hernias: A Complete Review of Literature. Journal of Medical Science and Clinical Research. Doi: 10.47191/ijmscrs/v3-i9-20.
[6]. R., H., Fortelny., U., Dietz., 2023, [Incisional hernias: epidemiology, evidence and guidelines]. Chirurgie. Doi: 10.1007/s00104-023-01999-3.
[7]. Alexandra, D., D'Oto., Hayley, B., Baker., Ted, Mau., Lesley, F., Childs., Kathleen, Tibbetts., 2023, Characteristics of Idiopathic Subglottic Stenosis in the Elderly. Laryngoscope. Doi: 10.1002/lary.30742.
[8]. Hannan, Chaudery., Paul, Efthymiou., Stefan, R, Cozma., 2024, Cervical Necrotising Fasciitis Leading to Critical Airway Compromise: A Case Report of Successful Airway Management with Awake Fibreoptic Intubation. Cureus. Doi: 10.7759/cureus.57126.
[9]. Bedana, Maharjan., 2024, Airway management of a patient with achondroplasia using awake fiberoptic intubation: A case report. Doi: 10.1016/j.jcadva.2024.100018.
[10]. C, Pezzano., Ilana, Harwayne-Gidansky.. 2023, Use of Flow-Volume Loops on a Mechanically Ventilated Pediatric Patient as a Diagnostic Tool for Fixed Airway Obstruction. Cureus. Doi: 10.7759/cureus.39765.
[11]. Drisana, Henry., Virendra, Modi., Vaidehi, Korde., Abhijit, V., Kshirsagar., 2024, Low dose thoracic segmental spinal anaesthesia with isobaric levobupivacaine: is it an option for a patient with severe heart disease undergoing emergency cesarean section? a case study. International Journal of Scientific Research. Doi: 10.36106/ijsr/6306706.
[12]. Chang, Hoon, Choi., Hae, Jin, Lee., 2007, Anticholinergic Relieves Bronchospasm Occurring during Spinal Anesthesia in an Asthmatic Patient - A case report -. Korean Journal of Anesthesiology. Doi: 10.4097/KJAE.2007.53.2.259.
[13]. Martin, Calineata., Lukas, Jennewein., Vanessa, Neef., Armin, Niklas, Flinspach., Frank, Louwen., Kai, Zacharowski., Florian, J, Raimann., 2023, Safety and Efficiency of Low-Dose Spinal Analgesia Compared to Epidural Analgesia in Treatment of Pain during Labour: A Case Control Study. Journal of Clinical Medicine. Doi: 10.3390/jcm12185770.
[14]. Lucy, Halliday., M., Kinsella., M., Shaw., Joshua, Cheyne., Scott, M., Nelson., Rachel, J., Kearns., 2022, Comparison of ultra‐low, low and high concentration local anaesthetic for labour epidural analgesia: A systematic review and network meta‐analysis. Anaesthesia. Doi: 10.1111/anae.15756.
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Unveiling the Enigma: Chronic Concealed Abruption Disguised as PlacentomegalyAuthor: Deepthi. PDOI: 10.21522/TIJPH.2013.SE.24.05.Art002
Unveiling the Enigma: Chronic Concealed Abruption Disguised as Placentomegaly
Abstract:
Here we present a case of Rh-negative Primigravida with 22 weeks gestation who presented to us with USG report of a live fetus with FGR, placentomegaly with oligohydramnios without any clinical symptoms and later diagnosed to be a case of chronic abruption oligohydramnios sequence (CAOS). Initially, all differentials of Placentomegaly like placental chorioangioma, placental mosaicism, chronic concealed abruptio placenta or placental tumours such as placental mesenchymal dysplasia were considered. Regular antenatal workup was carried out for the patient which revealed an incidental heart disease probably of rheumatic origin and the patient was managed accordingly. The patient was planned for termination of pregnancy in view of subsequent anhydramios in the midst of which the patient developed cardiac complications. The patient was stabilized and taken up for emergency hysterotomy which intraoperatively revealed retroplacental clots and altered blood as evidence of premature separation of placenta clinching the diagnosis of CAOS. Since CAOS can lead to fetal morbidity and mortality, decision-making has to be carried out regarding accelerating fetal lung maturity and neuroprotection or termination of pregnancy after carefully weighing out the fetomaternal outcomes.
Unveiling the Enigma: Chronic Concealed Abruption Disguised as Placentomegaly
References:
[1]. Weerakkody Y., 2024, Placentomegaly Radiology Reference Article Radiopaedia.org. In: Radiopaedia [Internet], Doi:10.53347/rID-13573.
[2]. Rohilla M, Siwatch S, Jain V, Nijhawan R., 2024, Placentomegaly and Placental Mesenchymal Dysplasia. BMJ Case Rep. 2012, bcr2012007777. Doi:10.1136/bcr-2012-007777.
[3]. Yonai NB, Mandel R, Shteel S, Lavie O, Goldberg Y. VP38.02: Severe Placentomegaly and Intrauterine Growth Restriction In A Persistently Hypoxemic Pregnant Woman with a Single Cardiac Ventricle. Ultrasound in Obstetrics & Gynecology. 2020;56: 222–223. Doi:10.1002/uog.22921.
[4]. Chigusa Y, Mogami H, Minamiguchi S, Kido A, Ishida A, Kurata Y, et al., 2022, Chronic abruption-oligohydramnios sequence (CAOS) revisited: possible implication of premature rupture of membranes. J Matern Fetal Neonatal Med;35: 6894–6900. Doi:10.1080/14767058.2021.1929159.
[5]. Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O., 2006, Clinical presentation and risk factors of placental abruption. Acta Obstet Gynecol Scand. 85: 700–705. Doi:10.1080/00016340500449915.
[6]. Fleming AD., 1991, Abruptio placentae. Crit Care Clin. 7: 865–875.
[7]. Mohanty GS, Katoch T, Siwatch S, Lamba DS, Sharma RR., 2023, Chronic Abruptio Placentae with Multiple Alloantibodies: An Obstetrician’s Challenge. Cureus. 15: e47762. Doi:10.7759/cureus.47762.
[8]. Nyberg DA, Cyr DR, Mack LA, Wilson DA, Shuman WP., 1987, Sonographic spectrum of placental abruption. AJR Am J Roentgenol.148: 161–164. Doi:10.2214/ajr.148.1.161.
[9]. Harris BAJ, Gore H, Flowers CEJ., 1985, Peripheral Placental Separation: A Possible Relationship to Premature Labor. Obstetrics & Gynecology. 66: 774.
[10]. Redline RW, Wilson-Costello D., 1991, Chronic peripheral separation of placenta. The significance of diffuse chorioamnionic hemosiderosis. Am J Clin Pathol. 111: 804–810. Doi:10.1093/ajcp/111.6.804.
[11]. Jain P, Yadav R, Jaiswal N, Agarwal K., 2021, Live Pregnancy with Chronic Abruption-oligohydramnios Sequence: A Case Report. JCDR. Doi:10.7860/JCDR/2021/50455.15773.
[12]. Braun P, Kazmi K, Nogués-Meléndez P, Mas-Estellés F, Aparici-Robles F., 2007, MRI findings in spinal subdural and epidural hematomas. Eur J Radiol. 64: 119–125. Doi:10.1016/j.ejrad.2007.02.014.
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Effective Management of a Total Thyroidectomy Case with Positive Cuff Leak Test: A Case ReportAuthor: Kishanth kumar SDOI: 10.21522/TIJPH.2013.SE.24.05.Art003
Effective Management of a Total Thyroidectomy Case with Positive Cuff Leak Test: A Case Report
Abstract:
Total thyroidectomy is frequently performed to treat various thyroid conditions, such as malignancies, large goiters, and Graves' disease. One of the possible complications after this surgery is airway obstruction, which can be evaluated intraoperatively using the cuff leak test (CLT). A positive CLT suggests significant airway edema or obstruction, which can lead to postoperative respiratory difficulties. Managing a patient with a positive CLT after thyroidectomy necessitates a multidisciplinary approach, including close monitoring, prompt intervention, and appropriate postoperative care. This case shows the management of a patient who developed a positive cuff leak test following a total thyroidectomy. Key strategies involved administering corticosteroids to mitigate airway edema, ensuring close observation in an intensive care unit (ICU), and considering reintubation or tracheostomy if airway obstruction persisted. The patient was successfully managed through conservative measures, avoiding the need for invasive airway procedures. This case underscores the importance of vigilance and timely intervention in the postoperative period to secure patient safety and achieve favorable outcomes after total thyroidectomy. The discussion highlights the necessity of tailoring care plans to the severity of the airway compromise and the overall clinical condition of the patient. This case adds to the understanding of airway management in thyroidectomy patients and the utility of CLT in guiding clinical decisions.
Effective Management of a Total Thyroidectomy Case with Positive Cuff Leak Test: A Case Report
References:
[1]. Widyanti, Soewoto., Meirisa, Ardianti. 2024, Tracheomalacia following a total thyroidectomy in a patient with a large non-toxic goiter: A case report. International Journal of Surgery Case Reports, Doi: 10.1016/j.ijscr.2023.109211
[2]. Luke, Burton, Jeremy, M., Loberger., Mark, Baker., Priya, Prabhakaran., Vidit, Bhargava 2023, Pre-Extubation Ultrasound Measurement of In Situ Cuffed Endotracheal Tube Laryngeal Air Column Width Difference: Single-Center Pilot Study of Relationship with Post-Extubation Stridor in Under 5 Years Old. Pediatric Critical Care Medicine, Doi: 10.1097/pcc.0000000000003377
[3]. Aziz, Salih, Abdul-Zahra, Sajid, Hameed, Abd, Al-Helfy, Bashar, Abass, Abdulhassan 2023, Incidence and Risk Factors of Post-Thyroidectomy Stridor. Diyala Journal of Medicine, Doi: 10.26505/djm.v25i1.1023
[4]. Koji, Kanno., Naoki, Fujiwara., Takuhiro, Moromizato., Shuichi, Fujii., Yuki, Ami., A., Tokushige., Shinichiro, Ueda 2023, Pre-Extubation Cuffed Tube Leak Test and Subsequent Post-Extubation Laryngeal Edema: Prospective, Single-Center Evaluation of PICU Patients. Pediatric Critical Care Medicine, Doi: 10.1097/PCC.0000000000003282
[5]. A case of unusual presentation of post-thyroidectomy airway compromise 2023. International Journal of Scientific Research, Doi: 10.36106/ijsr/3702754
[6]. Taha, Usman, Pasha., Gul, e, Lala, Haider., Syed, Muneeb, Ali., Syed, Mujahid, Gilani., Fazal, Rabbi., Kamal, Nasir., Sana, Umar., Sayyad, Ali. 2023, Preventing Laryngeal Edema Using Single Dose Methylprednisolone in Critically Ill Patients. Journal of Bashir Institute of Health Sciences, Doi: 10.53576/bashir.004.01.0105
[7]. P., M., Diggikar., Simranbir, Bhullar., Prashant, Gopal 2023, Post-extubation Stridor in a Case of Intracranial Bleed: Assessing Airway Patency Prior to Extubation Using Cuff Leak Test. Cureus, Doi: 10.7759/cureus.33632
[8]. Dawnette, Lewis., Dev, Darshan, Khalsa., Alexandra, Cummings., James, Schneider., Sareen, Shah. 2023, Factors Associated With Post-Extubation Stridor in Infants Intubated in the Pediatric ICU. Journal of Intensive Care Medicine, Doi: 10.1177/08850666231204208
[9]. Pre-Extubation Cuffed Tube Leak Test and Subsequent Post-Extubation Laryngeal Edema: 2023, Prospective, Single-Center Evaluation of PICU Patients. Pediatric Critical Care Medicine, Doi: 10.1097/pcc.0000000000003282
[10]. Laya, Amoozadeh, Mohammad‐Taghi, Beigmohammadi., Abbas, Alipour. 2024, Gargle test for successful extubation in critically ill patients underwent head and neck surgeries: A new test. Journal of Critical Care, Doi: 10.1016/j.jcrc.2024.154755
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Assessing the Utility of Pregnancy-Unique Quantification of Emesis Questionnaire's Score in Managing Women with Nausea and Vomiting of PregnancyAuthor: Deepthi PDOI: 10.21522/TIJPH.2013.SE.24.05.Art004
Assessing the Utility of Pregnancy-Unique Quantification of Emesis Questionnaire's Score in Managing Women with Nausea and Vomiting of Pregnancy
Abstract:
A lower quality of life and unfavorable pregnancy outcomes are linked to the severity of nausea and vomiting during pregnancy (NVP). This study used the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scale to compare the severity of NVP with the various demographic and maternal parameters among pregnant women. To analyse the association of severity of nausea and vomitting using a modified PUQE scale with the various demographic and maternal characteristics This was a cross-sectional study conducted on 380 pregnant women who were receiving antenatal care at a tertiary health care centre between January 2023 and March 2024. The severity of NVP was evaluated by the PUQE scale which was later compared with the various maternal characteristics. Statistical analyses were performed to determine the risk factors associated with NVP. Gestational age was significantly associated with increasing NVP. Most of the subjects in the moderate (45.2%) and severe (47.7%) PUQE group were gravida 1 while 43.9% were gravida 2 in the mild group. PUQE scale can be used to assess the severity of NVP thus aiding the healthcare professionals in providing required treatment.
Assessing the Utility of Pregnancy-Unique Quantification of Emesis Questionnaire's Score in Managing Women with Nausea and Vomiting of Pregnancy
References:
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[2]. Heitmann, K., Nordeng, H., Havnen, G. C., Solheimsnes, A., & Holst, L., 2017, The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again–results from a cross-sectional study. BMC Pregnancy and Childbirth, 17, 1-12.
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[4]. Koren, G., Boskovic, R., Hard, M., Maltepe, C., Navioz, Y., & Einarson, A., 2002, Motherisk—PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. American Journal of Obstetrics and Gynecology, 186(5), S228-S231.
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[7]. Vandraas, K. F., Vikanes, Å. V., Vangen, S., Magnus, P., Støer, N. C., & Grjibovski, A. M., 2013, Hyperemesis gravidarum and birth outcomes—a population‐based cohort study of 2.2 million births in the Norwegian Birth Registry. BJOG: An International Journal of Obstetrics & Gynaecology, 120(13), 1654-1660.
[8]. Birkeland, E., Stokke, G., Tangvik, R. J., Torkildsen, E. A., Boateng, J., Wollen, A. L., & Trovik, J., 2015, Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study. PloS One, 10(4), e0119962.
[9]. Choi, H. J., Bae, Y. J., Choi, J. S., Ahn, H. K., An, H. S., Yun, J. S., & Han, J. Y., 2018, Evaluation of nausea and vomiting in pregnancy using the Pregnancy-Unique Quantification of Emesis and Nausea scale in Korea. Obstetrics & Gynecology Science, 61(1), 30-37.
[10]. Kramer, J., Bowen, A., Stewart, N., & Muhajarine, N., 2013, Nausea and vomiting of pregnancy: prevalence, severity and relation to psychosocial health. MCN: The American Journal of Maternal/Child Nursing, 38(1), 21-27.
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[12]. Mitsuda, N., Eitoku, M., Yamasaki, K., Sakaguchi, M., Yasumitsu-Lovell, K., Maeda, N., & Suganuma, N., 2018, Nausea and vomiting during pregnancy associated with lower incidence of preterm births: the Japan Environment and Children’s Study (JECS). BMC Pregnancy and Childbirth, 18, 1-7.
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[23]. Koren, G., Madjunkova, S., & Maltepe, C. (2014). The protective effects of nausea and vomiting of pregnancy against adverse fetal outcome—A systematic review. Reproductive Toxicology, 47, 77-80.
[24]. Chortatos, A., Haugen, M., Iversen, P. O., Vikanes, Å., Eberhard-Gran, M., Bjelland, E. K., & Veierød, M. B., 2015, Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian Mother and Child Cohort Study. BMC Pregnancy and Childbirth, 15, 1-11.
[25]. Bolin, M., Åkerud, H., Cnattingius, S., Stephansson, O., & Wikström, A. K., 2013, Hyperemesis gravidarum and risks of placental dysfunction disorders: a population‐based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 120(5), 541-547.
[26]. Agampodi, S. B., Wickramasinghe, N. D., Horton, J., & Agampodi, T. C., 2013, Minor ailments in pregnancy are not a minor concern for pregnant women: a morbidity assessment survey in rural Sri Lanka. PloS One, 8(5), e64214.
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[28]. Aishwarya, R., Ethirajan, S., 2022. Gestational Age at Booking for Antenatal Care in a Tertiary Healthcare Facility: A Glance. International Journal of Infertility & Fetal Medicine, 13(3), 91-95.
[29]. Rezvi, F. B., Duraisamy, R., Chaudhary, M., 2020. Oral Status of Pregnant Women-A Hospital Based Study. Int J Dentistry Oral Sci, 7(10), 881-887.
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Twists and Turns: Navigating Clinicoradiological Presentations, Decision Making in Management and Histopathological Revelations of Adnexal TorsionAuthor: Deepthi PDOI: 10.21522/TIJPH.2013.SE.24.05.Art005
Twists and Turns: Navigating Clinicoradiological Presentations, Decision Making in Management and Histopathological Revelations of Adnexal Torsion
Abstract:
Adnexal torsion is a rare condition that can be potentially fatal if untreated. It has a varied clinical presentation and can affect any age group. Clinicians can diagnose and treat adenexal torsion more accurately if they are aware of the clinical and pathological characteristics of the patients. To analyze the clinical and pathological profile of adnexal torsion cases in Saveetha Medical College. The study was a retrospective analysis of hospital records which included all cases of adnexal torsion that underwent treatment between January 2023 to January 2024 in Saveetha Medical College. The majority (61.37%) of participants were in the reproductive age group (18-40 years). Abdominal pain was the most common symptom seen in 84.44% of patients. Majority of the women belonged to Para 2 (54.44%) and Para 1 (24.24%). Half the subjects underwent Vaginal delivery while the remaining underwent Caesarean section. A right-sided predominance was observed with most of them having one and two turns (32%). On histopathological examination, a simple serous cyst (25%) was the most predominant finding. Even though adnexal torsion is a rare clinical illness, it typically manifests as an emergency. A high degree of suspicion is necessary for the diagnosis because there are many possible clinical presentations. However, the diagnosis can only be confirmed on the operating table. The patient should be operated on as soon as possible to prevent complications and aid in conserving the ovary.
Twists and Turns: Navigating Clinicoradiological Presentations, Decision Making in Management and Histopathological Revelations of Adnexal Torsion
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[1]. Warner, M.A., Fleischer, A.C., Edell, S.L., Thieme, G.A., Bundy, A.L., Kurtz, A.B., et al., 1985. Uterine adnexal torsion: sonographic findings. Radiology, 154, 773–775.
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[4]. Vijayalakshmi, K., Reddy, G.M.M., Subbiah, V.N., Sathiya. S., Arjun, B., 2014. Clinico-pathological profile of adnexal torsion cases: a retrospective analysis from a tertiary care teaching hospital. J Clin Diagn Res, 8, OC04-07.
[5]. Verma, M., Bhuria, V., Chauhan, M., Nanda, S., Dahiya, P., Singhal, S.R., 2021. Adnexal torsion: a retrospective analysis from a tertiary care teaching hospital in northern india. Cureus, 13, e17792.
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[7]. Gupta, A., Gadipudi, A., Nayak, D., 2020. A five-year review of ovarian torsion cases: lessons learnt. J Obstet Gynaecol India, 70, 220–224.
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[9]. Balci, O., Icen, M.S., Mahmoud, A.S., Capar, M., Colakoglu, M.C., 2011. Management and outcomes of adnexal torsion: a 5-year experience. Arch Gynecol Obstet, 284, 643–646.
[10]. Mashiach, R., Melamed, N., Gilad, N., Ben-Shitrit, G., Meizner. I., 2011. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med, 30, 1205–1210.
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[17]. Aishwarya, R., Ethirajan, S., 2022. Gestational age at booking for antenatal care in a tertiary healthcare facility: a glance. International Journal of Infertility & Fetal Medicine, 13(3), 91-95.
[18]. Omani-Samani, R., Hollins Martin, C. J., Martin, C. R., Maroufizadeh, S., Ghaheri, A., Navid, B., 2021. The birth satisfaction scale-revised Indicator (BSS-RI): a validation study in Iranian mothers. The Journal of Maternal-Fetal & Neonatal Medicine, 34(11), 1827-1831.
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Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in a Suburban PopulationAuthor: Akshaya RadhakrishnanDOI: 10.21522/TIJPH.2013.SE.24.05.Art006
Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in a Suburban Population
Abstract:
Gestational diabetes mellitus (GDM) presents significant risks to maternal and neonatal health, with varying prevalence globally. Understanding its determinants in specific populations can guide targeted interventions and improve health outcomes. This study aimed to determine the prevalence of GDM and its associated risk factors in a suburban population. A cross-sectional study was conducted among 160 pregnant women attending suburban community health centers. Data on demographic, lifestyle, and clinical variables were collected. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Groups criteria. Statistical analyses included logistic regression to determine odds ratios (ORs) for potential risk factors. The prevalence of GDM in the study population was 15%. Significant risk factors for GDM included age ≥ 30 years (OR=2.5, 95% CI: 1.5-4.1, P=0.003), family history of diabetes (OR=3.1, 95% CI: 1.8-5.3, P=0.001), and a high sugar diet (OR=2.5, 95% CI: 1.4-4.3, P=0.001). A sedentary lifestyle and irregular meal patterns were also associated with increased GDM risk (OR=2.2 and 1.9, respectively). Overweight and obesity were strong predictors of GDM, with ORs of 2.3 and 3.5 for BMI ranges of 25-29.9 and ≥30, respectively. The study highlighted that both non-modifiable (age, family history) and modifiable (diet, lifestyle) factors significantly influence the risk of developing GDM in a suburban population. These findings suggest the necessity of targeted screening and preventive strategies that focus on modifiable lifestyle adjustments in at-risk groups.
Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in a Suburban Population
References:
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Risk Behaviour and Psychosocial Stressors of Clients Attending Integrated Counseling and Testing Centre (ICTC) of a Rural Community Health Centre, Tamil NaduAuthor: Lakshmi ThangaveluDOI: 10.21522/TIJPH.2013.SE.24.05.Art007
Risk Behaviour and Psychosocial Stressors of Clients Attending Integrated Counseling and Testing Centre (ICTC) of a Rural Community Health Centre, Tamil Nadu
Abstract:
India has the third largest HIV epidemic in the world, with an adult (15-49 years) HIV prevalence of 0.22%. Lack of knowledge and social taboos related to sex issues are major contributing factors to the spread of HIV/AIDS. The present study is aimed to assess risk behaviour and psychosocial stressors of voluntary attendees of ICTC, towards HIV/AIDS in a rural community health centre in Tamil Nadu. A total of 184 attendees at ICTC, either attending voluntarily or referred from different primary health centres were included. A pre-designed structured questionnaire was self -self-administered to each client to evaluate risky behaviour and psychosocial stressors about HIV/AIDS. Heterosexual risky behaviour 133(72.3%) was the most common risky sexual behaviour among the study subjects. Among primarily anticipated psychosocial stressors financial burden 60 (32.6%) was the most common concern among the attendees followed by the fear of Serious illness 58 (31.5%). The present study identifies the various risk behaviours which might be responsible for the occurrence of HIV infection among the study participants and the present study also brought out the various psychosocial stressors faced by the clients attending ICTC, so that counseling techniques to tackle such stressors can be incorporated in the training module of the counsellors to impart better counseling services. Health education can be given to the clients to reduce the risk behaviour and also to allay the misbeliefs regarding HIV/AIDS.
Risk Behaviour and Psychosocial Stressors of Clients Attending Integrated Counseling and Testing Centre (ICTC) of a Rural Community Health Centre, Tamil Nadu
References:
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[5]. National AIDS Control Organization. Sankalak: Status of National AIDS Response (Second edition, 2020) (p. 17). Available from URL:http://naco.gov.in/sites/default/files/Sankalak_Report.pdf
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[11]. Nayak, R. K., Kulkarni, R. D., Ajantha, G. S., 2019, Trend of clients attending an integrated councelling and testing centre of a tertiary care hospital in North Karnataka: A record based study. Int J Community Med Public Health, 6(7), 2977-2981.
[12]. Kumar, P. P., John, S., Cherian, A. V., Pandian, R. D., Anand, N., Rao, T. S., 2024, Awareness and knowledge of integrated Counseling and testing centres (ICTC) counsellors about depression among people with human immunodeficiency virus (HIV): A descriptive study from Karnataka. Industrial Psychiatry Journal, 33(1), 48-53.
[13]. Onubi, J., Adeola, O. A., Eseigbe, P., Elisha, A., Sheyin, G. O., Chima, A. A. G., 2024, Sociodemographic Factors Associated with Depression among People Living with Human Immunodeficiency Virus on Antiretroviral Therapy at a University Teaching Hospital in a Nigerian Cosmopolitan City. Exploratory Research and Hypothesis in Medicine, (000), 0-0.
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[18]. Sivamalar, S., Gomathi, S., Boobalan, J., Balakrishnan, P., Pradeep, A., Devaraj, C. A. Saravanan, S., 2024, Delayed identification of treatment failure causes high levels of acquired drug resistance and less future drug options among HIV-1-infected South Indians. Indian Journal of Medical Microbiology, 47, 100520.
[19]. Sivamalar, S., Gomathi, S., Boobalan, J., Balakrishnan, P., Pradeep, A., Devaraj, C. A. Saravanan, S., 2024, Delayed identification of treatment failure causes high levels of acquired drug resistance and less future drug options among HIV-1-infected South Indians. Indian Journal of Medical Microbiology, 47, 100520.
[20]. Sambandan, E., Thenmozhi, K., Santosh, G., Wang, C. C., Tsai, P. C., Gurrani, S Ponnusamy, V. K., 2024, Identification and simultaneous quantification of potential genotoxic impurities in first-line HIV drug dolutegravir sodium using fast ultrasonication-assisted extraction method coupled with GC–MS and in-silico toxicity assessment. Journal of Chromatography B, 1245, 124275.
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MicroRNAs and Apoptosis Signaling Pathways in Breast Cancer: From Molecular Insights to Clinical ApplicationsAuthor: Prakash BaluDOI: 10.21522/TIJPH.2013.SE.24.05.Art008
MicroRNAs and Apoptosis Signaling Pathways in Breast Cancer: From Molecular Insights to Clinical Applications
Abstract:
Breast cancer represents a global health concern, necessitating a deeper understanding of the intricate mechanisms underlying its pathogenesis and therapy resistance. This comprehensive review article explores the pivotal roles of microRNAs (miRNAs) and apoptosis signaling pathways in breast cancer biology. MiRNAs, as essential post-transcriptional regulators, modulate gene expression and play a central role in apoptosis regulation. We examine their involvement in breast cancer oncogenesis, metastasis, and therapy resistance, highlighting pro-apoptotic and anti-apoptotic miRNAs. Additionally, we delve into the core components of the apoptosis pathway, including initiator and executioner caspases and Bcl-2 family members, emphasizing their relevance in breast cancer. Further, we explore the crosstalk between miRNAs and major signaling pathways (PI3K/AKT, NF-κB, and p53) and discuss their clinical implications, including diagnostics, prognostics, and therapeutic interventions. While offering promising avenues for breast cancer management, this review also identifies research gaps and challenges in translating miRNA and pathway-based knowledge into clinical practice.
MicroRNAs and Apoptosis Signaling Pathways in Breast Cancer: From Molecular Insights to Clinical Applications
References:
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A Case of Retained Products of Conception Adherent to the Caesarean Scar Site with AV Malformation Managed with Uterine Artery EmbolisationAuthor: Deepthi PDOI: 10.21522/TIJPH.2013.SE.24.05.Art009
A Case of Retained Products of Conception Adherent to the Caesarean Scar Site with AV Malformation Managed with Uterine Artery Embolisation
Abstract:
Retained products of conception (RPOC) and uterine arteriovenous malformations (AVM) are uncommon but serious causes of abnormal uterine bleeding (AUB). This case involves a 29-year-old woman, Para 2 Live 2, with a history of two caesarean sections and two previous abortions, who experienced heavy menstrual bleeding following medical termination of pregnancy (MTP) and tubectomy. Initially managed conservatively with methotrexate, she presented again a month later with recurrent AUB. Ultrasound and Doppler imaging revealed a thickened endometrium with significant vascularity, indicating RPOC and uterine AVM. Her β-HCG levels were elevated (47.13) but trended downward upon repeat testing. Based on interventional radiology advice, she underwent bilateral uterine artery embolization (UAE) with gel foam. Following the procedure, the patient's symptoms improved significantly, with a noticeable reduction in both the frequency and intensity of her bleeding episodes. Her β-HCG levels continued to decline, and no further episodes of heavy bleeding were noted during the one-month follow-up. This case highlights the diagnostic challenges associated with RPOC and uterine AVM, particularly after abortion. Doppler ultrasound plays a key role in detecting vascular abnormalities. Uterine artery embolization is an effective and safe first-line treatment, reducing hemorrhage risk and the need for hysterectomy. Early identification and intervention are critical to prevent life-threatening complications and ensure a favorable outcome.
A Case of Retained Products of Conception Adherent to the Caesarean Scar Site with AV Malformation Managed with Uterine Artery Embolisation
References:
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[23]. Maleux, G., Timmerman, D., Heye, S., Wilms, G., 2006, Acquired uterine vascular malformations: Radiological and clinical outcome after transcatheter embolotherapy. European Radiology, 16, 299–306. Doi:10.1007/s00330-005-2799-5.
[24]. Salomon, L. J., de Tayrac, R., Castaigne‐Meary, V., Audibert, F., Musset, D., Ciorascu, R., et al., 2003. Fertility and pregnancy outcome following pelvic arterial embolization for severe post‐partum haemorrhage. A cohort study. Human Reproduction, 18, 849–852. Doi:10.1093/humrep/deg168.
[25]. Nijamudeen, S. S., 2020. A Study of Awareness on Artificial Insemination among Medical College Students. Indian Journal of Forensic Medicine & Toxicology, 14(3).
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A Case of CSF Rhinorrhoea Presenting as Recurrent MeningitisAuthor: Sriharsha TDOI: 10.21522/TIJPH.2013.SE.24.05.Art010
A Case of CSF Rhinorrhoea Presenting as Recurrent Meningitis
Abstract:
This case report describes a 40-year-old male patient who experienced recurrent meningitis with a history of CSF rhinorrhoea. The first episode of meningitis caused by Streptococcus pneumoniae was successfully treated with antibiotics. MRI cisternography confirmed the presence of CSF rhinorrhoea, demonstrating CSF leakage from the subarachnoid space through defects in the left fovea ethmoidalis and lateral lamella into the left frontal sinus and left anterior ethmoidal sinus. The patient was referred to a neurosurgeon for repair of the CSF leak, which was successfully performed via bifrontal craniotomy and anterior cranial fossa (ACF) base repair through an eyebrow approach. The patient recovered fully following antibiotic and steroid regimens, and subsequent follow-up after one year revealed no recurrence of the meningitis symptoms. This case highlights the importance of considering CSF rhinorrhoea as a potential cause of recurrent meningitis, and the need for prompt diagnosis and treatment to prevent complications.
A Case of CSF Rhinorrhoea Presenting as Recurrent Meningitis
References:
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In-Silico Molecular Interaction and Pharmacokinetic Evaluation of Remimazolam and Major Intravenous Anesthetics Targeting GABAA ReceptorsAuthor: Jaganathan RamakrishnanDOI: 10.21522/TIJPH.2013.SE.24.05.Art011
In-Silico Molecular Interaction and Pharmacokinetic Evaluation of Remimazolam and Major Intravenous Anesthetics Targeting GABAA Receptors
Abstract:
This study investigates the molecular interactions and pharmacokinetic properties of five intravenous anaesthetics Remimazolam, Midazolam, Propofol, Thiopental, and Etomidate with the γ-Aminobutyric acid type A (GABAA) receptor, a key mediator of inhibitory neurotransmission in the central nervous system. Using molecular docking analysis, we evaluated the binding affinities of these drugs to the GABAA neurotransmitter receptor. Remimazolam emerged as a promising candidate with a docking score of -6.9 kcal/mol, demonstrating strong and stable interactions with critical receptor residues such as THR96 and GLN65. Although Midazolam exhibited a slightly superior docking score of -7.1 kcal/mol, Remimazolam’s pharmacokinetic profile offers distinct advantages, including rapid onset, short duration of action, and a favourable safety profile with minimal risk of hepatotoxicity and skin sensitization. In comparison, Propofol, Thiopental, and Etomidate showed weaker binding affinities and raised safety concerns. These findings suggest that Remimazolam is a competitive and safer alternative to existing intravenous anaesthetics, particularly in outpatient settings and procedures requiring efficient anaesthetic management. This study contributes valuable insights into the clinical application of Remimazolam, reinforcing its potential as an effective choice in the realm of intravenous anaesthesia.
In-Silico Molecular Interaction and Pharmacokinetic Evaluation of Remimazolam and Major Intravenous Anesthetics Targeting GABAA Receptors
References:
[1]. Weir, C. J., Mitchell, S. J., Lambert, J. J., 2017, Role of GABAA receptor subtypes in the behavioural effects of intravenous general anaesthetics. Br J Anaesth. 119: i167–i175. Doi:10.1093/bja/aex369.
[2]. Ramasamy, K., Shanmugasundaram, J., Manoharan, R., Subramanian, V., Kathirvelu, P., Vijayaraghavan, R., 2022, Anti-neuropathic effect of 7,3′-dihydroxyflavone in paclitaxel induced peripheral neuropathy in mice involving GABAA, KATP channel and adenosine receptors. Neurochem Int. 159: 105388. Doi: 10.1016/j.neuint.2022.105388.
[3]. Marimuthu M., 2021, Dental impactions performed under general anaesthesia - A retrospective study on the frequency and implications, Int J Dent Oral Sci. 1793–1796. Doi:10.19070/2377-8075-21000355.
[4]. Keerthika S, Mani G., 2021, Knowledge, attitude and practice of dentists towards dental procedures under general Anesthesia in children. J Pharm Res Int. 83–93. Doi:10.9734/jpri/2021/v33i20B31361.
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[7]. Kilpatrick G. J., 2021, Remimazolam: Non-Clinical and clinical profile of a new sedative/anesthetic agent. Front Pharmacol. 12: 690875. Doi:10.3389/fphar.2021.690875.
[8]. Noor N, Legendre R, Cloutet A, Chitneni A, Varrassi G, Kaye A. D., 2021, A comprehensive review of remimazolam for sedation. Heal Psychol Res.;9: 24514. Doi:10.52965/001c.24514.
[9]. Dao V-A, Schippers F, Stöhr T., 2022, Efficacy of remimazolam versus midazolam for procedural sedation: Post hoc integrated analyses of three phase 3 clinical trials. Endosc Int open. 10: E378–E385. Doi:10.1055/a-1743-1936.
[10]. Dong L, Sun T, Yang J, Zhou Y, Liu X, Liu Z, et al., 2024, Remimazolam has similar anesthetic effect and superior safety compared to propofol in elderly patients: A meta‐analysis of randomized controlled trials. World J Surg. Doi:10.1002/wjs.12273.
[11]. Hoshino R, Ohashi N, Uta D, Ohashi M, Deguchi H, Baba H., 2024, Actions of remimazolam on inhibitory transmission of rat spinal dorsal horn neurons. J Pharmacol Sci. 155: 63–73. Doi: 10.1016/j.jphs.2024.04.002.
[12]. Masui K., 2024, Remimazolam: Its clinical pharmacology and evolving role in anesthesia and sedation practice. Curr Opin Anaesthesiol. 37: 344–351. Doi:10.1097/ACO.0000000000001384.
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A Brief Narrative Review on Prevalence of Diabetes in Tamil NaduAuthor: Vijayanchali S SDOI: 10.21522/TIJPH.2013.SE.24.05.Art012
A Brief Narrative Review on Prevalence of Diabetes in Tamil Nadu
Abstract:
The incidence of diabetes in Tamil Nadu has escalated significantly in recent decades, mirroring a wider national pattern observed throughout India. This narrative review synthesizes an extensive array of literature concerning the epidemiology, risk factors and health consequences associated with diabetes in Tamil Nadu, illuminating the complex interplay of various contributing elements. A key focus of this analysis is the examination of how genetic susceptibility interacts with rapid urban development, lifestyle modifications and socio-economic factors, culminating in a scenario that exacerbates the rising diabetes rates in the region. The review also investigates regional disparities, revealing marked differences in diabetes prevalence between urban and rural areas, as well as among diverse demographic segments, including age, gender and occupation. These disparities highlight the necessity for localized evaluations to enhance the understanding of diabetes distribution in varied contexts. Furthermore, the review identifies critical obstacles to effective diabetes management and prevention in Tamil Nadu such as limited access to healthcare, low public awareness and inadequate health promotion initiatives, which collectively impede efforts to address the diabetes epidemic. By scrutinizing these elements this review aspires to enrich the understanding of diabetes in Tamil Nadu and emphasizes the urgent need for targeted interventions that cater to the unique challenges faced by different communities. Such insights are vital for shaping public health strategies aimed at alleviating the escalating diabetes crisis in Tamil Nadu and fostering improved health outcomes throughout the state.
A Brief Narrative Review on Prevalence of Diabetes in Tamil Nadu
References:
[1] Geetha, R. V., 2020, Diabetes mellitus related knowledge and awareness-a survey among dental students. The Journal of Contemporary Issues in Business and Government, 26(2), 1582–1594.
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[4] Samyuktha, P. S., & Syam, S., 2024, Periodontal abscess as a clinical oral sign in patients with diabetes mellitus-an original study. Bulletin of Pioneering Researches of Medical and Clinical Science, 3(2–2024), 7–12.
[5] Sowmya, S., & Sangavi, R., 2024, Effectiveness of oral health education and interventions in improving oral health outcomes in Type II diabetes mellitus patients: A prospective study. Cureus, 16(4).
[6] Govindaswamy, S., & Dhivya, P. S., 2022, Prevalence and complications of diabetes mellitus in India-A systematic review.
[7] Kumar, A., Gangwar, R., Ahmad Zargar, A., Kumar, R., & Sharma, A., 2024, Prevalence of diabetes in India: A review of IDF diabetes atlas 10th edition. Current Diabetes Reviews, 20(1), 105–114.
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[9] Faiz, N., & Rajaraman, V., 2024, Estimation of inflammatory markers IL-1 And IL-6 level in completely edentulous diabetic patients. African Journal of Biomedical Research, 27(1S), 268–272.
[10] Smokovski, I., & Smokovski, I., 2021, Burden of diabetes prevalence. Managing diabetes in low income countries: providing sustainable diabetes care with limited resources, 1–12.
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[12] Kumaran, K. M., Vedapriya, D. R., Manoharan, A., & Nirupama, A. Y., 2023, Indian diabetic risk score screening of rural adults in Tamil Nadu. IHOPE Journal of Ophthalmology, 2(2), 31–35.
[13] Prasath, R., & Sinduja, P., 2023, Knowledge and Awareness on Various Treatment Modalities of Diabetes Mellitus-A Observational Survey.
[14] Selvavinayagam, T. S., Viswanathan, V., Ramalingam, A., Kangusamy, B., Joseph, B., Subramaniam, S., Sheela, J. S., Wills, S., Ramasamy, S., & Venkatasamy, V., 2024, Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020. Plos One, 19(5), e0298340.
[15] Kalaiselvi, S., Syed Ali, M., Anuradha, V., & Subhashini, A., 2023, A study on the association of diabetes and semen quality in and around Chennai, Tamil Nadu, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 12(4), 911.
[16] Tamilarasan, M., Kulothungan, K., Rizvana, S., & Thirunavukkarasu, S., 2023, A cross-sectional study of determinants of type 2 diabetes mellitus among professional drivers in the perambalur municipality area of Tamil Nadu, India. Cureus, 15(1).
[17] Prasanth, B. K., Eashwar, V. M. A., Mahalakshmi, K., & Ramachandran, K., 2023, Epidemiology of non-communicable diseases among transgender population residing in Chennai district, Tamil Nadu. Journal of Family Medicine and Primary Care, 12(4), 762–767.
[18] Anusuya, G. S., Ravi, R., Gopalakrishnan, S., Abiselvi, A., & Stephen, T., 2018, Prevalence of undiagnosed and uncontrolled diabetes mellitus among adults in South Chennai. Int J Community Med Public Health, 5(12), 5200–5204.
[19] Runtu, A. R., Enggune, M., Pondaag, A., Lariwu, C., Sarayar, C., Pondaag, L., Lolowang, N., Merentek, G., Lontaan, E., & Sumarauw, J., 2024, Penyuluhan KESEHATAN DIABETES MELLITUS dan Deteksi Kadar Gula Darah pada Lansia. Jurnal Pengabdian Kepada Masyarakat Nusantara, 5(1), 1492–1499.
[20] Varghese, J. S., & Ali, M. K., 2022, Diabetes prevalence, screening, diagnosis, treatment and control in India: A cross-sectional study of individuals aged 18 years and older. Circulation, 146(Suppl_1), A13817–A13817.
[21] Govindaswamy, S., & Dhivya, P. S., 2022, Prevalence and complications of diabetes mellitus In India-A systematic review.
[22] Premavathy, D., 2021, Survey on problems faced by dental patients having diabetes mellitus. Journal of Pharmaceutical Research International, 33(64B), 106–113.
[23] Theivasigamani, K., & Palaniappan, S. Kumar., 2023, Prevalence and incidence of type-2 diabetes mellitus among the rural population of Erode district of Tamil Nadu, South India.
[24] Divya, P. V, & Sukesh, K., 2023, Assessment of knowledge and prevalence of urinary tract infections among Kanyakumari population. Hindu, 800(365), 45–62.
[25] Govindaswamy, S., & Dhivya, P. S., 2022, Prevalence and complications of diabetes mellitus In India-A systematic review.
[26] Jabbar, P. K., Nair, A., Chellamma, J., Jayakumar, R. V, Ramesh, J., Gomez, R., Vishnu, G. G., Voise, S., Soumya, S., & Vijayakumar, K., 2023, Type 2 Diabetes and precursors in community dwelling asian Indian adult youth. Indian Journal of Endocrinology and Metabolism.
[27] Raghavi, S. S., Eashwar, V. M. A., Dutta, R., Jain, T., & Eashwar, V. M. A., 2023, A study on morbidity profile of residents of an old age home in an Urban Area of Kancheepuram District, Tamil Nadu.
[28] Sandhya, M., Manikumar, M., Augustina, S. J., & Kamalakannan, M., 2022, Prevalence of diabetes mellitus and depression status among pregnant women in rural population in Kancheepuram District. Journal of Datta Meghe Institute of Medical Sciences University, 17(4), 871–876.
[29] Priyadharshini, S. N., & Bhuvaneswari, K. N., 2024, Study on prevalence of glaucoma among adult patients attending ophthal-mology department in a tertiary care hospital, Kanchipuram. J Clin Images Med Case Rep, 5(3), 2947.
[30] Thendralan, V., & Priya, S., 2024, IJCM_315A: Pesticide exposure and diabetes mellitus-A community based analytical cross-sectional study among agricultural workers in Madurai east community block, Tamil Nadu. Indian Journal of Community Medicine, 49 (Suppl 1), S91.
[31] Santhosh, M., Juliet, A. H., & Nataraj, C., 2024, Novel prediction of diabetes disease with improved accuracy by comparing K-means with logistic regression. AIP Conference Proceedings, 3161(1).
[32] Sathiyabama, G., & Mareeshwaran, S., 2024, Efficacy of certain nursing interventions on neuropathy aching Among patients with diabetic mellitus. 2024 International Conference on Intelligent Systems for Cybersecurity (ISCS), 1–6.
[33] Mohanraj, S., Velmurugan, G., Dhivakar, M., Ramakrishnan, A., Cherian, M., Alexander, T., Thalappil, P., & Swaminathan, K., 2022, Gender differential prevalent of overweight and obesity, hypertension and diabetes in South India: A population-based cross-sectional study.
[34] Kandasamy, K., Rajagopal, S. S., Ramalingam, K., & Krishnan, K., 2018, Prevalence of diagnosed and undiagnosed diabetes in a rural community: A home-based screening. Prevalence, 11(5).
[35] Chu, H., Tamous, S., Kavvi, A., & Khan, A., 2024, Diabetes Health Education for South Jersey Communities.
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[37] Varghese, J. S., & Ali, M. K., 2022, Diabetes prevalence, screening, diagnosis, treatment and control in India: A cross-sectional study of individuals aged 18 Years and Older. Circulation, 146(Suppl_1), A13817–A13817.
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The Effect of Maternal Anaemia on Infant Birth Weight: A Comprehensive StudyAuthor: Vinod Kumar NelsonDOI: 10.21522/TIJPH.2013.SE.24.05.Art013
The Effect of Maternal Anaemia on Infant Birth Weight: A Comprehensive Study
Abstract:
The objective of the present study was to understand about the maternal anaemia on the low birth weight of the neonates and also how it effects the maternal health. This study was conducted at the postnatal ward of the Saveetha Medical College, Chennai, during the period of December 2022 and July 2023. A total of 237 deliveries were analysed for this study. Maternal anaemia is divided in four categories based on the haemoglobin levels: no anaemia (>10 gm%), mild (8-10 gm%), moderate (7-8 gm%), severe (<7 gm%). Neonates were assessed for the birth weight and other perinatal factors. Statistical analysis for this study is done by using the chi-square and correlation coefficients. C Among the 236 antenatal women included, 49.2% were found to be anaemic. The average haemoglobin level was 10.05 ± 2.27 g/dL, and the average birth weight was 3055.81 ± 540.63 g. Of the infants, 8.1% were classified as LBW. A significant correlation was found between maternal anaemia and LBW: 37.9% of LBW infants were born to mothers with severe anaemia (p < 0.001). A statistically significant weak correlation (r = 0.305, p < 0.001) was observed between haemoglobin levels and neonatal weight.
The Effect of Maternal Anaemia on Infant Birth Weight: A Comprehensive Study
References:
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[8]. Nair, M., Gireesh, S., Yakoob, R., Cherian, N. C., 2018, Effect of maternal anaemia on birth weight of term babies Int J Contemp Pediatr, 5(3),1019-1022.
[9]. Shanmugam, R., Tharani, M., Abullais, S. S., 2024, Black seed assisted synthesis, characterization, free radical scavenging, antimicrobial and anti-inflammatory activity of iron oxide nanoparticles. BMC Complement Med Ther 24(24):241.
[10]. Habeeb Rahuman, H. B., Dhandapani, R., Narayanan, S., Palanivel, V., Paramasivam, R., Subbarayalu, R., Thangavelu, S., Muthupandian, S., 2022, Medicinal plants mediated the green synthesis of silver nanoparticles and their biomedical applications. IET Nanobiotechnol. 16(4):115-144.
[11]. Wadhwa, R., Paudel, K. R., Chin, L. H., Hon, C. M., Madheswaran, T., Gupta, G., Panneerselvam, J., Lakshmi, T., 2021, Anti-inflammatory and anticancer activities of Naringenin-loaded liquid crystalline nanoparticles in vitro. J Food Biochem. 45(1): e13572.
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The Spectrum of RHD Management in Pregnancy on Assessing the Time of Diagnosis, Severity of Cardiac Lesions, and the ChallengesAuthor: Maghimaa MDOI: 10.21522/TIJPH.2013.SE.24.05.Art014
The Spectrum of RHD Management in Pregnancy on Assessing the Time of Diagnosis, Severity of Cardiac Lesions, and the Challenges
Abstract:
Rheumatic heart disease (RHD) poses a significant challenge during pregnancy, especially in low- and middle-income countries, where it affects millions of individuals, primarily young women of childbearing age. This autoimmune condition, often triggered by group A streptococcal infections, leads to chronic inflammation and scarring of heart valves, resulting in insufficiency and stenosis. Pregnancies complicated by cardiovascular diseases, including RHD, contribute to maternal mortality rates and present unique management dilemmas due to the physiological changes accompanying gestation. This case series presents three cases illustrating the complexities of managing RHD during pregnancy. Case 1 describes a gravid woman with a history of previous normal delivery and hepatitis B surface antigen positivity, requiring emergency intervention due to fetal distress and elevated blood pressure. Case 2 details the management of RHD in a woman with hypothyroidism presenting with labor pain at term gestation. Case 3 presents the challenges of managing RHD in a primigravida with a history of nephroureterectomy for ectopic ureter insertion. Understanding the pathological mechanisms and tailored management strategies for pregnant women with RHD is crucial for improving care and outcomes.
The Spectrum of RHD Management in Pregnancy on Assessing the Time of Diagnosis, Severity of Cardiac Lesions, and the Challenges
References:
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M6A RNA Methylation and Cancer Progression: Pathogenesis, Implications, and Therapeutic PotentialAuthor: Geetha ShanmugamDOI: 10.21522/TIJPH.2013.SE.24.05.Art015
m6A RNA Methylation and Cancer Progression: Pathogenesis, Implications, and Therapeutic Potential
Abstract:
N6-methyladenosine (m6A) is a prominent internal modification of eukaryotic messenger RNA (mRNA) and has garnered significant attention due to its regulatory role in various biological processes, particularly in cancer. As a dynamic and reversible modification, m6A is orchestrated by three key players: Writers, primarily methyltransferases like METTL3 and METTL14, add m6A marks to mRNA, influencing processes such as RNA stability and translation. Erasers, such as FTO and ALKBH5, remove these marks, enabling the fine-tuning of mRNA functions. Readers, including YTH domain-containing proteins (e.g., YTHDF1, YTHDF2), recognize and bind to m6A-modified mRNA, directing its fate in terms of degradation, translation efficiency, or cellular localization. In cancer, m6A modifications have been implicated in promoting tumor progression by affecting gene expression at the post-transcriptional level. The dysregulation of m6A machinery can lead to aberrant expression of oncogenes or tumor suppressors, thereby driving oncogenesis Furthermore, m6A modifications play a crucial role in modulating the tumor microenvironment (TME) and immune evasion. By altering the expression of cytokines, chemokines, and immune checkpoint molecules, m6A can influence immune cell infiltration and activation, impacting the anti-tumor immune response. This modulation of the TME not only aids in tumor progression but also presents challenges and opportunities for cancer immunotherapy. Given its profound impact on cancer biology, targeting the m6A machinery holds therapeutic potential. Small molecules or inhibitors designed to modulate m6A writers, erasers, or readers could offer new avenues for cancer treatment, making m6A a promising target in the fight against cancer.
m6A RNA Methylation and Cancer Progression: Pathogenesis, Implications, and Therapeutic Potential
References:
[1]. Ji, P., Wang, X., Xie, N., & Li, Y., 2018, N6-Methyladenosine in RNA and DNA: An epitranscriptomic and epigenetic player implicated in determination of stem cell fate. Stem Cells International, 2018, 3256524., https://doi.org/10.1155/2018/3256524
[18]. Quan, C., Belaydi, O., Hu, J., Li, H., Yu, A., Liu, P., Yi, Z., Qiu, D., Ren, W., Ma, H., Gong, G., Ou, Z., Chen, M., Sun, Y., Chen, J., & Zu, X., 2021, N6-Methyladenosine in cancer immunotherapy: an undervalued therapeutic target. Frontiers in Immunology, 12, 697026. https://doi.org/10.3389/fimmu.2021.697026
[20]. Zhou, H., Sun, Q., Feng, M., Gao, Z., Jia, S., Cao, L., Yu, X., Gao, S., Wu, H., & Li, K., 2023, Regulatory mechanisms and therapeutic implications of insulin-like growth factor 2 mRNA-binding proteins, the emerging crucial m6A regulators of tumors. Theranostics, 13(12), 4247–4265. https://doi.org/10.7150/thno.86528
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An Update on the Role of Omega-3 Fatty Acids in Metabolic Health and Insulin Resistance: A narrative reviewAuthor: Monisha PrasadDOI: 10.21522/TIJPH.2013.SE.24.05.Art016
An Update on the Role of Omega-3 Fatty Acids in Metabolic Health and Insulin Resistance: A narrative review
Abstract:
Insulin resistance and metabolic health are largely regulated by important pathways that omega-3 fatty acids influence. The molecular pathways by which Omega-3 fatty acids, specifically Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA), work is the main topic of concern in this narrative overview. Through modifying inflammatory responses, enhancing lipid metabolism, and impacting insulin signaling pathways, these fatty acids mainly increase insulin sensitivity. Studies have demonstrated that EPA and DHA can increase insulin sensitivity by downregulating the nuclear factor kappa B (NF-κB) pathway, reducing pro-inflammatory cytokines, and increasing the activation of peroxisome proliferator-activated receptors (PPARs). Furthermore, Omega-3s mitigate lipotoxicity and encourage the effective utilization of fatty acids as an energy source, all of which are critical for preserving insulin sensitivity. They also lessen ectopic fat accumulation. Additionally, the interaction between Omega-3s and membrane phospholipids enhances insulin receptor signaling and activity. Notwithstanding these advantages, further research is necessary to fully understand the unique impacts of certain Omega-3s, such as Alpha-Linolenic Acid (ALA), on these pathways as well as how they might interact with other dietary components and gut flora. We can more effectively utilize the therapeutic potential of omega-3 fatty acids to enhance metabolic health and combat insulin resistance by clarifying these pathways.
An Update on the Role of Omega-3 Fatty Acids in Metabolic Health and Insulin Resistance: A narrative review
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Exploring the Interplay Between Polyphenols, Gut Microbiota, and Polycystic Ovary Syndrome (PCOD): A Comprehensive ReviewAuthor: Monisha PrasadDOI: 10.21522/TIJPH.2013.SE.24.05.Art017
Exploring the Interplay Between Polyphenols, Gut Microbiota, and Polycystic Ovary Syndrome (PCOD): A Comprehensive Review
Abstract:
Polycystic Ovary Syndrome (PCOD) is a common endocrine disorder in women of reproductive age, marked by hyperandrogenism, insulin resistance, and chronic anovulation. Emerging research indicates that the gut microbiota significantly contributes to the pathophysiology of PCOD, affecting both metabolic and hormonal balance. Polyphenols, bioactive compounds found in various foods, have shown promise in modulating gut microbiota composition and function, offering potential therapeutic benefits for PCOD. This review examines the intricate interplay between polyphenols, gut microbiota, and PCOD, focusing on how polyphenols may influence PCOD pathogenesis through gut microbiota modulation. We explore the alterations in gut microbiota observed in PCOD patients and how polyphenols may help restore microbial balance, potentially improving metabolic and reproductive health. The review also discusses the underlying molecular mechanisms, such as the regulation of inflammatory pathways, oxidative stress, and insulin signaling, through which polyphenols may exert their effects. By synthesizing findings from preclinical and clinical studies, we highlight the potential of dietary polyphenols as a complementary strategy in PCOD management, while also underscoring the need for more research to determine the most effective dietary interventions and polyphenol formulations. Understanding the relationship between polyphenols and gut microbiota in the context of PCOD offers promising new avenues for developing microbiota-targeted therapies that leverage the beneficial effects of polyphenols to improve outcomes for women with this condition.
Exploring the Interplay Between Polyphenols, Gut Microbiota, and Polycystic Ovary Syndrome (PCOD): A Comprehensive Review
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Exploring the Spectrum: Hemoglobinopathies in Pregnancy and their Clinical ImplicationsAuthor: Vinod Kumar NelsonDOI: 10.21522/TIJPH.2013.SE.24.05.Art018
Exploring the Spectrum: Hemoglobinopathies in Pregnancy and their Clinical Implications
Abstract:
The present study aimed to investigate the maternal and fetal outcomes of pregnant women presenting to a tertiary healthcare facility with beta thalassemia trait, hemoglobinopathy E, and sickle cell trait. This retrospective study of a series of cases presented to a tertiary healthcare facility, Saveetha Medical College, Thandalam, Chennai between June 2023 and December 2023. The case series included nine pregnant women aged between 21 - 31 years with varying obstetric histories. Most were multigravida with 60.0% having previous caesarean sections. Gestational age at diagnosis ranged from 17 - 35 weeks with one case diagnosed preconception. Mean hemoglobin levels before correction were 8.5 gm/dL, rising to 10.3 gm/dL post-correction. Hematological parameters varied within normal ranges. HPLC revealed heterozygous hemoglobinopathy E, beta thalassemia trait or sickle cell trait in equal proportions. Most deliveries occurred at term, with varying modes of delivery including emergency caesarean sections and vaginal deliveries. Incidence of postpartum hemorrhage and preterm premature rupture of membranes was infrequent, though one case of each occurred. No instances of pre-eclampsia, foetal growth restriction, or maternal or foetal deaths were reported. Neonatal outcomes were generally favorable, with all babies born alive, mostly at term, and satisfactory APGAR scores. Two cases were born with low birth weight. Early and accurate diagnosis facilitated tailored interventions, ultimately lead to positive maternal and neonatal outcomes. These cases serve as poignant reminders of the importance of comprehensive antenatal care, genetic counselling, and specialised management strategies for individuals affected by hemoglobinopathies.
Exploring the Spectrum: Hemoglobinopathies in Pregnancy and their Clinical Implications
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Glutamine Synthase Expression Profiling and Selective Inhibitor for Burkholderia psuedomallei K96243: An In-silico ApproachAuthor: Gopalakrishnan V. KDOI: 10.21522/TIJPH.2013.SE.24.05.Art019
Glutamine Synthase Expression Profiling and Selective Inhibitor for Burkholderia psuedomallei K96243: An In-silico Approach
Abstract:
Melioidosis is a potentially fatal infection caused by the Gram-negative bacillus, Burkholderia pseudomallei following an encounter with contaminated soil or surface water. This study was to identify the highly expressed gene in Burkholderia pseudomallei and model the target protein's three-dimensional structure. Further, the study was intended to determine the better binding candidates from the existing drugs against the target protein for melioidosis. The highly expressed gene was identified by KEGG pathway and their target protein was modeled using homology modeling. The modeled structure was validated by PROCHEK and it can be further used for docking studies against existing antibacterial drugs using Argus Lab. The ADME properties of drugs were analyzed by the ADME/Tox WEB. The results revealed that, glutamine synthetase was highly expressed in Burkholderia pseudomallei and its 3D model was generated. The structure validation revealed that, the structure was reliable and reasonable. The docking studies revealed that the Chloramphenicol compound has higher docking score against the protein glutamine synthetase compared to other existing compounds. The acceptable range of the ADME and biological activity prediction of Chloramphenicol compound depicts better pharmacological properties and possible drug-likeliness. This study concluded that, the compound Chloramphenicol may be a better inhibitor for glutamine synthetase protein. This compound may lead to development of effective drug against Melioidosis.
Glutamine Synthase Expression Profiling and Selective Inhibitor for Burkholderia psuedomallei K96243: An In-silico Approach
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Adverse Maternal and Fetal Outcomes in Pregnancies Complicated by Diabetes Mellitus: A Case SeriesAuthor: Vinod Kumar NelsonDOI: 10.21522/TIJPH.2013.SE.24.05.Art020
Adverse Maternal and Fetal Outcomes in Pregnancies Complicated by Diabetes Mellitus: A Case Series
Abstract:
Pregnancy-related diabetes mellitus poses an increased risk of detrimental effects on the health of the mother and fetus. This case series aims to highlight the correlation between poorly managed diabetes and complications such as intrauterine fetal death (IUFD), preterm labor, macrosomia, and neonatal death. We analyzed cases of pregnant women with diabetes mellitus who experienced adverse outcomes within one year at our hospital. The cases were selected based on the seriousness of complications and gestational period at the time of occurrence. Three cases such cases were selected, IUFD was experienced by a 30-year-old woman with a gestational age of 36 weeks;a woman whose age was 29 years also experienced IUFD; whose gestational age was 37 weeks during the occurrence; and another case involved of a mother whose age was 34 and was at 3 months and 4 days of gestation, who underwent preterm delivery leading to neonatal death on the first postoperative day following the surgery. This critical nature of handling diabetes during pregnancy is emphasized in this case series to mitigate the adverse effects and the risks which include, IUFD, premature birth, macrosomia, and neonatal death. Along with continuous monitoring and glycaemic control, to avoid outcomes of complications caused by diabetes mellitus during pregnancy educating the patient is also very important.
Adverse Maternal and Fetal Outcomes in Pregnancies Complicated by Diabetes Mellitus: A Case Series
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[10]. Corrado, F., Pintaudi, B., D’Anna, R., Santamaria, A., Giunta, L., and Di Benedetto, A., 2016. Perinatal outcome in a Caucasian population with gestational diabetes and preexisting diabetes first diagnosed in pregnancy, Diabetes Metab., 42, 122–125.
[11]. Egan, A. M., Dow, M. L., and Vella, A., 2020. A Review of the Pathophysiology and Management of Diabetes in Pregnancy, Mayo Clin. Proc., 95, 2734–2746.
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[13]. Maslovich, M. M., and Burke. L. M., 2024. Intrauterine Fetal Demise, in StatPearls, 35, 2091–2098.
[14]. Bekiou, A., and Gourounti. K., 2020. Reduced Fetal Movements and Perinatal Mortality, Mater. Socio-Medica, 32, 227–234.
[15]. Lynch, T. A., Westen, E., Li, D., Katzman, P. J., Malshe, A., and Drennan, K., 2022. Stillbirth in women with diabetes: a retrospective analysis of fetal autopsy reports, J. Matern. Fetal Neonatal Med.,35, 2091–2098.
[16]. Dayal, S., and Hong, P. L., 2024. Premature Rupture of Membranes, in StatPearls, Treasure Island (FL): StatPearls Publishing. Accessed: Aug. 11, 2024.
[17]. Muche, A. A., Olayemi, O. O., and Gete, Y. K., 2020. Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia, BMC Pregnancy Childbirth, 20, 73.
[18]. Bouvier, D et al., 2019. Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited, J. Clin. Med., 8, 1987.
[19]. Yildiz Atar, H., Baatz, J. E., and Ryan, R. M., 2021. Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant, Children, 8, 281.
[20]. Li, Y., Wang, W., and Zhang, D., 2019. Maternal diabetes mellitus and risk of neonatal respiratory distress syndrome: A meta-analysis, Acta Diabetol., 56, 729–740.
[21]. Shanmugam, R., Tharani, M., Abullais, S.S., 2024. Black seed assisted synthesis, characterization, free radical scavenging, antimicrobial and anti-inflammatory activity of iron oxide nanoparticles. BMC Complement Med Ther 24(24), 241.
[22]. Habeeb Rahuman HB., Dhandapani R., Narayanan S., Palanivel V., Paramasivam R., Subbarayalu R., Thangavelu S., Muthupandian S., 2022. Medicinal plants mediated the green synthesis of silver nanoparticles and their biomedical applications. IET Nanobiotechnol. 16,115-144.
[23]. Wadhwa R., Paudel KR., Chin LH., Hon CM., Madheswaran T., Gupta G., Panneerselvam J., Lakshmi T., 2021. Anti-inflammatory and anticancer activities of Naringenin-loaded liquid crystalline nanoparticles in vitro. J Food Biochem. 45, 13572.
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Evaluating Antiplatelet Compliance in Recurrent Stroke PatientsAuthor: Samuel MDOI: 10.21522/TIJPH.2013.SE.24.05.Art021
Evaluating Antiplatelet Compliance in Recurrent Stroke Patients
Abstract:
Stroke is a leading cause of death and disability worldwide, with recurrent strokes posing a significant challenge in healthcare. Antiplatelet therapy, including agents such as aspirin and clopidogrel, is fundamental in reducing the risk of recurrent ischemic events. The present study aims to evaluate the current literature on adherence to antiplatelet therapy in recurrent stroke patients and also to identify key factors influencing adherence, explore innovative strategies to improve adherence rates and highlight areas for future research. In conclusion, our study highlights the importance of medication-related factors in the management of recurrent stroke patients. Optimizing antiplatelet therapy regimens, addressing barriers to medication adherence, and mitigating adverse events are crucial steps toward improving secondary stroke prevention strategies and enhancing patient outcomes. However, the effectiveness of these therapies is highly dependent on patient adherence, which remains suboptimal, leading to increased risks of recurrent strokes and other cardiovascular events.
Evaluating Antiplatelet Compliance in Recurrent Stroke Patients
References:
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[12]. Passacquale, G., Sharma, P., Perera, D., Ferro, A. 2022. Antiplatelet therapy in cardiovascular disease: Current status and future directions. British Journal of Clinical Pharmacology, 88(6), 2686-2699. doi:10.1111/bcp.15221.
[13]. Hilkens, N. A., Algra, A., Diener, H. C., Bath, P. M., Csiba, L., Hacke, W., Greving, J. P., 2021. Balancing benefits and risks of long-term antiplatelet therapy in noncardioembolic transient ischemic attack or stroke. Stroke. doi:10.1161/STROKEAHA.120.031755.
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A Review of Spondias pinnata (L.f.) Kurz's Phytochemical Constituents, Traditional Uses, and Pharmacological Activities: An Important Medicinal Plant in AyurvedaAuthor: Raju BalajiDOI: 10.21522/TIJPH.2013.SE.24.05.Art022
A Review of Spondias pinnata (L.f.) Kurz's Phytochemical Constituents, Traditional Uses, and Pharmacological Activities: An Important Medicinal Plant in Ayurveda
Abstract:
Spondias pinnata (L.f.) Kurz, commonly known as wild mango or hog plum, is a medicinal tree belonging to the family Anacardiaceae, extensively utilized in traditional systems and codified systems of medicines across the Indian subcontinent and Southeast Asia. Plant parts including roots, bark, leaves, fruits, and seeds are used for medicinal purposes to treat a variety of ailments. Phytochemical analysis has revealed that the presence of various bioactive compounds such as flavonoids, tannins, phenolic acids, saponins, and essential oils, which contribute to its pharmacological activities. Essential oil is rich in monoterpene and sesquiterpene compounds such as α-pinene, caryophyllene, and geraniol. Additionally, other phytoconstituents including β-sitosterol, gallic acid, caffeic acid, and alantolactone have been identified from different parts of the plant. Recent research highlights its antioxidant, anti-inflammatory, antimicrobial, and antidiabetic properties, further validating its traditional uses and suggesting potential for the development of novel therapeutic agents. This review provides a comprehensive overview of the phytochemical properties of S. pinnata, offering insights that may be valuable for future research and the establishment of effective natural drugs.
A Review of Spondias pinnata (L.f.) Kurz's Phytochemical Constituents, Traditional Uses, and Pharmacological Activities: An Important Medicinal Plant in Ayurveda
References:
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[10]. Salma Sameh, Eman Al-Sayed, Rola M. Labib, Abdel Nasser B. Singab, 2019, Comparative metabolic profiling of essential oils from Spondias pinnata (Linn. F.) Kurz and characterization of their antibacterial activities, Industrial Crops and Products, Volume 137, 468-474.
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Histone Demethylase (KDM3A) Regulation and Its Impact on Estrogen Receptor-Positive Breast Cancer ProgressionAuthor: Periasamy AnbuDOI: 10.21522/TIJPH.2013.SE.24.05.Art023
Histone Demethylase (KDM3A) Regulation and Its Impact on Estrogen Receptor-Positive Breast Cancer Progression
Abstract:
The histone demethylase-encoding gene KDM3A is a crucial modulator of estrogen receptor (ER) signaling, impacting the development of ER-positive breast cancer. Resistance develops despite the effectiveness of endocrine drugs that target ER signaling, necessitating a deeper understanding of the underlying molecular processes. This work investigated KDM3A depletion in ER-positive breast cancer cells to gain a better understanding of how it impacts estrogen-induced gene expression and its potential as a therapeutic target in endocrine-resistant breast cancer. We used the GEO dataset GSE68918, which contains gene expression profiles from MCF-7 cell lines treated with KDM3A RNA (siKDM3A) and scrambled RNA (siSCR), to find 845 differentially expressed genes (DEGs). Following KDM3A knockdown, 402 of these genes showed upregulation, and 444 showed downregulation. Significant downregulation was observed for BRCA1 and CCNB1, but a notable upregulation was observed for CEACAM6. This suggests that KDM3A is involved in signaling through estrogen receptors, repairing DNA, and regulating the cell cycle. A study of protein-protein interaction (PPI) networks showed that hub genes, including TOP2A, CCNA2, and CCNB1, are essential for KDM3A-related networks. Significant enrichment in the p53 signaling pathway, DNA replication, and cell division was found by Gene Ontology (GO) and KEGG pathway studies, highlighting the influence of KDM3A on important biological processes. These findings suggest that KDM3A could be a valuable therapeutic target in the management of breast cancer endocrine resistance. Future research should look at the therapeutic potential of KDM3A inhibitors to enhance the efficacy of treatment for endocrine-resistant breast cancer, particularly when combined with other forms of therapy.
Histone Demethylase (KDM3A) Regulation and Its Impact on Estrogen Receptor-Positive Breast Cancer Progression
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Prevalence and Predictors of Urinary Incontinence in South Indian Women: A Hospital-Based Analytical Cross-Sectional StudyAuthor: Geetha BirudalaDOI: 10.21522/TIJPH.2013.SE.24.05.Art024
Prevalence and Predictors of Urinary Incontinence in South Indian Women: A Hospital-Based Analytical Cross-Sectional Study
Abstract:
The present study assesses the prevalence of urinary incontinence and evaluates the risk elements related to QUID-derived urge and stress incontinence scores. This was a cross-sectional analysis of women attending the outpatient department and inpatient ward section of Obstetrics and Gynaecology at Saveetha Institute of Medical College Thandalam Chennai. This study included 299 women; the mean (SD) age was 54.4 years (7.7). The proportion of women with Normal and LSCS were 59.5% and 40.5%, respectively. The proportion of women drinking coffee was 74.2%, with recurrent urinary tract infection was 40.1%, with diabetes was 32,4%, with obesity was 37.8%, with a history of constipation was 70.2%, and history of pelvic surgery was 23.4%. The mean (SD) urge score among women with a normal vaginal delivery was 8.19 (2.78) and among those with LSCS was 4.57 (1.99); the difference (higher scores among women with NVD, in comparison with LSCS) was found to be statistically significant. The mean (SD) stress score among women with a normal vaginal delivery was 7.52 (2.78) and among those with LSCS was 4.26 (2.14); the difference (higher scores among women with NVD, in comparison with LSCS) was found to be statistically significant. Also, the results showed that women with coffee drinking, diabetes, hypertension, obesity, constipation, and without pelvic surgeries had significantly higher stress incontinence scores in comparison to their counterparts. The mean (SD) stress scores showed an increasing trend with age – the difference in stress scores by age groups was found to be a statistic.
Prevalence and Predictors of Urinary Incontinence in South Indian Women: A Hospital-Based Analytical Cross-Sectional Study
References:
[1]. Singh, U., Agarwal, P., Verma, M. L., Dalela, D., Singh, N., & Shankhwar, P. 2013, Prevalence and risk factors of urinary incontinence in Indian women: A hospital-based survey. Indian Journal of Urology, 29(1), 31–36.
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[12]. Townsend, M. K., Gousse, A. V., Laughlin, G. A., Wasserman, M., Liu, H., & Aragia, M. 2007, Incidence and Remission of Urinary Incontinence in Middle-aged Women. American Journal of Obstetrics and Gynecology, 197(2), 167.e1–167.e5.
[13]. Hannestad, Y. S., Rortveit, G., Daltveit, A. K., & Hunskaar, S. 2003, Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG: An International Journal of Obstetrics and Gynaecology, 110(3), 247–254.
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Hydrothermal Method of Synthesis of β-Ag2MoO4 Nanorods as a Peroxidase Mimetic for Glucose SensingAuthor: Vinitha PackirisamyDOI: 10.21522/TIJPH.2013.SE.24.05.Art025
Hydrothermal Method of Synthesis of β-Ag2MoO4 Nanorods as a Peroxidase Mimetic for Glucose Sensing
Abstract:
In this study, β-Ag₂MoO₄ nanorods were synthesized using a hydrothermal method, aiming to explore their potential as a sensing material for L-glucose detection. The synthesis process was optimized to produce uniform nanorods with high crystallinity and surface area, which is essential for enhancing sensor performance. The synthesized β-Ag2MoO4 nanorods characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM), confirmed the successful formation of β-Ag₂MoO₄ nanorods with desired morphological features. The vibrations existing in β-Ag2MoO4 nanorods were characterized by FT-IR and Raman spectroscopic studies. The electrochemical properties of the nanorods were evaluated, demonstrating their sensitivity and selectivity towards L-glucose. The nanorods exhibited a rapid response time, low detection limit, and excellent reproducibility, making them promising candidates for glucose sensors. This work underscores the potential of hydrothermally synthesized β-Ag₂MoO₄ nanorods in the development of advanced glucose sensing platforms, offering a new approach for the efficient and reliable monitoring of glucose levels in medical diagnostics.
Hydrothermal Method of Synthesis of β-Ag2MoO4 Nanorods as a Peroxidase Mimetic for Glucose Sensing
References:
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[2]. Bharathi, D., Wadaan, M. A., Mythili, R., & Lee, J. 2024, Synthesis of chitosan and gum arabic functionalized silver nanocomposite for efficient removal of methylene blue and antibacterial activity. Polymers for Advanced Technologies, 35(4), e6356.
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[5]. Tang, X., Li, H., Zhang, T., Zhong, J., & Du, H. 2022, P123-assisted hydrothermal synthesis of Ag2MoO4 with enhanced photocatalytic performance. Inorganic Chemistry Communications, 141, 109613.
[6]. Appiagyei, A. B., Asiedua-Ahenkorah, L., Bathula, C., Kim, H. S., Han, S. S., Rao, K. M., & Anang, D. A. 2023, Rational design of sucrose-derived graphitic carbon coated MnMoO4 for high performance asymmetric supercapacitor. Journal of Energy Storage, 58, 106383.
[7]. Tourchi Moghadam, M. T., Seifi, M., Jamali, F., Azizi, S., & Askari, M. B. 2022, ZnWO4-CNT as a superior electrode material for ultra-high capacitance supercapacitor. Surfaces and Interfaces, 32, 102134.
[8]. Sousa, G. da S., Nobre, F. X., Araújo Júnior, E. A., Sambrano, J. R., Albuquerque, A. dos R., Bindá, R. dos S., … de Matos, J. M. E. 2020, Hydrothermal synthesis, structural characterization and photocatalytic properties of β-Ag2MoO4 microcrystals: Correlation between experimental and theoretical data. Arabian Journal of Chemistry, 13(1), 2806–2825.
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[11]. Jayanthi, P., Duraimurugan, J., Prabhu, S., Siranjeevi, R., Mary Anjalin, F., and Bhuvaneswari, N. 2024, Enhanced electrochemical performance of CoMoO4/r-GO composites as electrode material for supercapacitor application. Diamond and Related Materials, 148, 111361.
[12]. Maity, S., Bain, D., Chakraborty, S., Kolay, S., & Patra, A. 2020, Copper Nanocluster (Cu23NC)-Based Biomimetic System with Peroxidase Activity. ACS Sustainable Chemistry and Engineering, 8(49), 18335-18344.
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[15]. Malathi, A., Priyadharsan, A., Handayani, M., Hasan, I., Divya, G., Sivaranjani, K., & Sivakumar, S. 2024, Boosted solar-driven photocatalysis: silver molybdate/reduced graphene oxide nanocomposites for methylene blue decomposition. Ionics, 30(3), 1603-1614.
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A Rare Case of Torsion of Hydrosalpinx Masquerading as Torsion of the OvaryAuthor: Deepthi PDOI: 10.21522/TIJPH.2013.SE.24.05.Art026
A Rare Case of Torsion of Hydrosalpinx Masquerading as Torsion of the Ovary
Abstract:
Isolated fallopian tube torsion is an infrequent but significant cause of acute pelvic pain, often difficult to diagnose pre-operatively due to its symptom overlap with other conditions such as ovarian cyst torsion and appendicitis. Hydrosalpinx, a condition typically asymptomatic, can present with acute pain when complicated by torsion. This case report highlights the diagnostic challenges and management strategies associated with hydrosalpinx torsion. A 35-year-old woman with a history of Polycystic Ovarian Disease (PCOD) and previous sterilization presented with acute right lower abdominal pain and vomiting. Initial ultrasound suggested a right ovarian hemorrhagic cyst, leading to a preoperative diagnosis of cyst torsion. However, diagnostic laparoscopy revealed a 6x4 cm gangrenous hydrosalpinx on the left with four complete twists, and significant congestion in the right fallopian tube, while the right ovary appeared normal. Surgical intervention included a left salpingo-oophorectomy and right partial salpingectomy. Histopathological examination confirmed the presence of a dermoid cyst in the left ovary and extensive congestion in the fallopian tube. Isolated fallopian tube torsion is exceedingly rare, with an estimated incidence of 1 in 1.5 million. This case emphasizes the importance of including hydrosalpinx torsion in differential diagnoses, particularly when clinical symptoms are inconsistent with radiological findings. Accurate and timely diagnosis is critical for appropriate management and to prevent potential complications.
A Rare Case of Torsion of Hydrosalpinx Masquerading as Torsion of the Ovary
References:
[1]. Varghese, S., Seldon, Y., Raperport, C., Rinne, N., Patel, K., Zaid, R. Z., 2024, Isolated fallopian tube torsion: A systematic review of case reports. European Journal of Obstetrics and Gynecology and Reproductive Biology. 296: 140–147. doi:10.1016/j.ejogrb.2024.02.050
[2]. Schwartz, B., Weerasooriya, N., Mercier, R., Gould, S., Saul, D., Berman, L., 2024, Factors Associated With Isolated Fallopian Tube Torsion in Pediatric Patients. Journal of Pediatric Surgery;59: 1538–1544. doi:10.1016/j.jpedsurg.2024.03.054
[3]. Yazawa, R., Yazawa, H., Anjyo, K., Inazuki, A., 2024, Four cases of isolated fallopian tube torsion successfully treated with laparoscopic surgery: A case series. Fukushima Journal of Medical Science; 70: 163–168. doi:10.5387/fms.23-00021
[4]. De Leon Palabrica, P. B., Mallen, M. T. B., Tan, G. A. C., 2023, Isolated fallopian tube torsion in an early adolescent. Philippine Journal of Obstetrics and Gynecology; 47: 325. doi:10.4103/pjog.pjog_69_23
[5]. Narayanan, S., Bandarkar, A., Bulas, D. I., 2014, Fallopian tube torsion in the pediatric age group: radiologic evaluation. J Ultrasound Med. 33: 1697–1704. doi:10.7863/ultra.33.9.1697
[6]. Dixit, K., Setty, J. P., Jassawalla, N., Srikanth., 2024, Journal of Postgraduate Gynecology & Obstetrics: Torsion Of A Hydrosalpinx – a Diagnostic Puzzle. Available: https://www.jpgo.org/2016/02/torsion-of-hydrosalpinx-diagnostic.html
[7]. Antoniou, N., Varras, M., Akrivis, C., Kitsiou, E., Stefanaki, S., Salamalekis, E., 2024, Isolated torsion of the fallopian tube: a case report and review of the literature. Clin Exp Obstet Gynecol. 31: 235–238.
[8]. Balasubramaniam, D., Duraisamy, K. Y., Ezhilmani, M., Ravi, S., 2020, Isolated Fallopian Tube Torsion: A Rare Twist with a Diagnostic Challenge That May Compromise Fertility. J Hum Reprod Sci;13: 162–167. doi:10.4103/jhrs.JHRS_143_19
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[10]. Martín-Vallejo, J., Garrigós-Llabata, E. E., Molina-Bellido, P., Clemente-Pérez, P. A., 2020, Isolated fallopian tube torsion associated with hydrosalpinx in a 12-year-old girl: a case report. J Med Case Rep.14: 165. doi:10.1186/s13256-020-02462-1.
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Dermoscopic and Histopathological Correlation in Cicatricial Alopecias: Unveiling Diagnostic and Therapeutic InsightsAuthor: Maghimaa MDOI: 10.21522/TIJPH.2013.SE.24.05.Art027
Dermoscopic and Histopathological Correlation in Cicatricial Alopecias: Unveiling Diagnostic and Therapeutic Insights
Abstract:
Trichoscopy is dermoscopic imaging of the scalp and hair. It is a non-invasive proven technique that aids in the diagnosis of alopecia. It enhances the visualization of abnormalities of follicular ostia, perifollicular skin, hair shafts and cutaneous blood vessels. In cicatricial alopecia, loss of follicular openings, atrophy and scattered follicular pustules or single hair follicles can be identified. Prompt diagnosis and timely therapeutic intervention are of extreme importance as permanent hair loss can lead to disorders related to self-esteem and psychosocial interactions. Trichoscopy helps in early diagnosis, monitoring of disease progression and determining the response to therapy. To determine the efficacy of trichoscopy as a valuable and superior non-invasive method over histopathological examination to diagnose cicatricial alopecias. This is a cross-sectional study conducted in our hospital from September 2023 to November 2023. Patients with cicatricial alopecia were selected. Demographic data and clinical variables in terms of site of alopecia, type, duration, size and lesion morphology were documented. Heine delta 30 dermoscope was employed. Both polarized and non-polarized versions were used for examination. In this study, 16 patients were enrolled. The causes of cicatricial alopecia were traumatic alopecia (6), lichen planopilaris (5), discoid lupus erythematosus (4) and acne keloidalis nuchae (1). Dermoscopy facilitated the identification of unique and characteristic features that helped in prompt diagnosis. This was correlated with histopathological findings. Trichoscopy of cicatricial alopecia demonstrates characteristic patterns. It is an accurate diagnostic method that reduces the number of unnecessary biopsies and hence it is crucial for the diagnosis and follow-up of patients.
Dermoscopic and Histopathological Correlation in Cicatricial Alopecias: Unveiling Diagnostic and Therapeutic Insights
References:
[1]. Kanti, V., Röwert‐Huber, J., Vogt, A., Blume‐Peytavi, U., 2018. Cicatricial alopecia. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 16(4), 435-461.
[2]. Olsen, E. A., Bergfeld, W. F., Cotsarelis, G., Price, V. H., Shapiro, J., Sinclair, R., ... Whiting, D. A., 2003. Summary of North American Hair Research Society (NAHRS)-sponsored workshop on cicatricial alopecia, Duke university medical center, February 10 and 11, 2001. Journal of the American Academy of Dermatology, 48(1), 103-110.
[3]. Villablanca, S., Fischer, C., García-García, S. C., Mascaró-Galy, J. M., Ferrando, J., 2017. Primary scarring alopecia: clinical-pathological review of 72 cases and review of the literature. Skin Appendage Disorders, 3(3), 132-143.
[4]. Whiting, D. A., 2001. Cicatricial alopecia: clinico-pathological findings and treatment. Clinics in dermatology, 19(2), 211-225.
[5]. Tan, E., Martinka, M., Ball, N., Shapiro, J., 2004. Primary cicatricial alopecias: clinicopathology of 112 cases. Journal of the American Academy of Dermatology, 50(1), 25-32.
[6]. Jain, N., Doshi, B., Khopkar, U., 2013. Trichoscopy in alopecias: diagnosis simplified. International journal of trichology, 5(4), 170-178.
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[8]. Puri, N., 2013. A clinical and histopathological study of cicatricial alopecia. Journal of Pakistan Association of Dermatologists, 23(3), 272-276.
[9]. Stefanato, C. M., 2010. Histopathology of alopecia: a clinicopathological approach to diagnosis. Histopathology, 56(1), 24-38.
[10]. Goyal, M., Khandpur, S., Ramam, M., Sharma, V. K., Singh, M. K., 2019. A study of the histopathological features of alopecias on transverse sections of scalp biopsies. Indian Journal of Dermatology, 64(1), 47-54.
[11]. Batchu, V. R., Panthalla, V. L., Kumar, P. K., Penchalaiah, K., 2022. A clinicopathological study on interface dermatitis. International Journal of Research, 8(5), 1.
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[13]. Petak, A., Boras, J., Bata, I., Ilić, I., Hohšteter, M., Šoštarić‐Zuckermann, I. C., 2023. Clinical and histopathological investigation of symmetrical alopecia with associated chronic pruritus in tufted capuchin monkeys (Sapajus apella apella). Journal of Medical Primatology, 52(4), 244-258.
[14]. Thakur, B. K., Verma, S., Raphael, V., 2015. Clinical, trichoscopic, and histopathological features of primary cicatricial alopecias: A retrospective observational study at a tertiary care centre of North East India. International journal of trichology, 7(3), 107-112.
[15]. Trachsler, S., Trüeb, R. M., 2005. Value of direct immunofluorescence for differential diagnosis of cicatricial alopecia. Dermatology, 211(2), 98-102.
[16]. Olszewska, M., Rudnicka, L., Rakowska, A., Kowalska-Oledzka, E., Slowinska, M., 2008. Trichoscopy. Archives of Dermatology, 144(8), 1007-1007.
[17]. Jain, N., Doshi, B., Khopkar, U., 2013. Trichoscopy in alopecias: diagnosis simplified. International journal of trichology, 5(4), 170-178.
[18]. Sperling, L. C., Cowper, S. E., 2006. The histopathology of primary cicatricial alopecia. In Seminars in cutaneous medicine and surgery, 25(1), 41-50.
[19]. Pinedo-Moraleda, F., Tristán-Martín, B., & Dradi, G. G., 2023. Alopecias: practical tips for the management of biopsies and main diagnostic clues for general pathologists and dermatopathologists. Journal of Clinical Medicine, 12(15), 5004.
[20]. Umar, S., Ton, D., Carter, M. J., Shitabata, P., 2023. Unveiling a shared precursor condition for acne keloidalis nuchae and primary cicatricial alopecias. Clinical, Cosmetic and Investigational Dermatology, 2315-2327.
[21]. Palmer, V., Valdebran, M., 2023. Central centrifugal cicatricial alopecia in the adolescent population: an overview of available literature. Life, 13(4), 1022.
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Airway Management Using LMA‐Evaluation of Two Insertional Techniques: A Prospective Randomised StudyAuthor: Pradeep, KDOI: 10.21522/TIJPH.2013.SE.24.05.Art028
Airway Management Using LMA‐Evaluation of Two Insertional Techniques: A Prospective Randomised Study
Abstract:
The laryngeal mask airway (LMA), originally conceived as a component of anesthesiologists' airway armamentarium, has now become an indispensable airway adjunct for a broad spectrum of healthcare providers, extending to paramedics managing out-of-hospital cardiac arrest scenarios. his randomized trial compares the success rates of the traditional digital technique versus the 180-degree rotational technique for LMA insertion in patients undergoing superficial surgeries under general anesthesia. After ethical approval and informed consent, 120 healthy adults (ASA grade I-II, ages 18-65) scheduled for superficial surgeries were enrolled. Based on a pilot study, 52 cases per group were needed, with an additional 15% to account for dropouts, resulting in 60 participants per group. Exclusion criteria included emergency surgery, obesity, reflux disease, and procedures requiring prone positioning or lasting over an hour. No significant demographic or clinical differences were found between Group A (standard technique) and Group B (180-degree technique). The success rates were similar between the two techniques. However, the 180-degree technique may provide better oropharyngeal leak pressure, improving airway sealing and ventilation.
Airway Management Using LMA‐Evaluation of Two Insertional Techniques: A Prospective Randomised Study
References:
[1]. Pennant, J.H., Walker, M.B., 1992. Comparison of the Endotracheal Tube and Laryngeal Mask in Airway Management by Paramedical Personnel, Anesthesia & Analgesia,74, 531-534.
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[3]. Yu, S.H., Beirne, O.R.,2010. Laryngeal Mask Airways Have a Lower Risk of Airway Complications Compared With Endotracheal Intubation: A Systematic Review. Journal of Oral and Maxillofacial Surgery, 68, 2359–2376.
[4]. Haghighi, M., Mohammadzadeh, A., Naderi, B., Seddighinejad, A., Movahedi, H.,2010. Comparing two methods of LMA insertion; classic versus simplified (airway). Middle East J Anaesthesiol,20,509–514.
[5]. Brimacombe, J., Berry, A., 1993. Insertion of the Laryngeal Mask Airway—A Prospective Study of Four Techniques. Anaesth Intensive Care, 21, 89–92.
[6]. Hwang, J., Park, H.P., Lim, Y.J., Do, S.H., Lee, S.C., Jeon, Y.T., 2009. Comparison of Two Insertion Techniques of ProSealTM Laryngeal Mask Airway. Anesthesiology, 110, 905–907.
[7]. Asai, T., Brimacom, J., 2000. Cuff volume and size selection with the laryngeal mask. Anaesthesia, 55, 1179–1184.
[8]. Tan, Y., Jiang, J., Wan, R., 2022. Contrast of oropharyngeal leak pressure and clinical performance of I-gelTM and LMA ProSealTM in patients: A meta-analysis. PLoS ONE, 17, e0278871.
[9]. An, J., Shin, S.K., Kim, K.J., 2013. Laryngeal Mask Airway Insertion in Adults: Comparison between Fully Deflated and Partially Inflated Technique. Yonsei Med J, 54, 747.
[10]. Shyam, T., Selvaraj, V., 2021. Airway management using LMA-evaluation of three insertional techniques-a prospective randomised study. J Anaesthesiol Clin Pharmacol, 37,108.
[11]. Na, H.S., Jeon, Y.T, Shin, H.J., Oh, A.Y., Park, H.P., Hwang. J.W., 2015. Effect of Paralysis at the Time of ProSeal Laryngeal Mask Airway Insertion on Pharyngolaryngeal Morbidities. A Randomized Trial. Langevin SM. editor. PLoS ONE, 10, e0134130.
[12]. Koo, B.W., Oh, A.Y., Hwang, J.W., Na, H.S., Min, S.W., 2019. Comparison of standard versus 90° rotation technique for LMA FlexibleTM insertion: a randomized controlled trial. BMC Anesthesiol, 19, 95.
[13]. Soh, C.R., Ng, A.S.B., 2001. Laryngeal Mask Airway Insertion in Paediatric Anaesthesia: Comparison between the Reverse and Standard Techniques. Anaesth Intensive Care, 29, 515–519.
[14]. Nakayama, S., Osaka, Y., Yamashita. M., 2002. The rotational technique with a partially inflated laryngeal mask airway improves the ease of insertion in children. Pediatric Anesthesia, 12, 416–419.
[15]. Park, J.H., Lee, J.S., Nam, S.B., Ju, J.W., Kim, M.S., 2016. Standard versus Rotation Technique for Insertion of Supraglottic Airway Devices: Systematic Review and Meta-Analysis. Yonsei Med J,57,987.
[16]. Aghamohammadi, D., Eydi, M., Hosseinzadeh, H., Amiri Rahimi, M., Golzari, S., 2013. Assessment of Mini-dose Succinylcholine Effect on Facilitating Laryngeal Mask Airway Insertion. Journal of Cardiovascular and Thoracic Research, 5, 17-20.
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Computational Design of Bioactive Epigallocatechin Gallate (EGCG) Analogues Targeting Heme Oxygenase-1 (HO-1) Pathway for Metabolic RegulationAuthor: Sarvesh SabarathinamDOI: 10.21522/TIJPH.2013.SE.24.05.Art029
Computational Design of Bioactive Epigallocatechin Gallate (EGCG) Analogues Targeting Heme Oxygenase-1 (HO-1) Pathway for Metabolic Regulation
Abstract:
Epigallocatechin-gallate (EGCG) is a flavone-based natural product that has a more significant impact on Diabetes and other cardiometabolic complications. This in silico based computer-aided drug design ensures the drug's Pharmacokinetic parameters and particular compounds towards the precise target. Based on the network data designed, EGCG were docked against PDB: 1N3U, using Dimethyl fumarate as the standard reference. Such desirable quality of modified EGCG will create a spark in the novel drug discovery of a bioenhancer. This slight evidence will support a higher quantum of drug discovery in semisynthetic chemistry toward Metabolic Complications.
Computational Design of Bioactive Epigallocatechin Gallate (EGCG) Analogues Targeting Heme Oxygenase-1 (HO-1) Pathway for Metabolic Regulation
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Curcumin Versus Curcumin-Iron Complex Docking in Tuberculosis Targets: A Insights on Synthesis & Molecular Docking StudyAuthor: Sarvesh SabarathinamDOI: 10.21522/TIJPH.2013.SE.24.05.Art030
Curcumin Versus Curcumin-Iron Complex Docking in Tuberculosis Targets: A Insights on Synthesis & Molecular Docking Study
Abstract:
In this contemporary state Natural products play a significant role in drug discovery. This research investigates a Curcumin-Iron complex (CuFe) as a potential new weapon against tuberculosis (TB). The study highlights the global burden of TB and the need for alternatives due to rising drug resistance. Curcumin, a promising compound from turmeric, suffers from poor absorption in the body. The researchers created CuFe and confirmed its structure using XRD analysis to address this. Using computer simulations, they then tested CuFe's binding to key targets in the TB bacteria. Excitingly, CuFe showed superior binding compared to curcumin and existing drugs. The discussion emphasizes the potential of plant-based medicines like curcumin, along with metal complexes, mentioning garlic and piperine as further avenues. The authors conclude that CuFe is a promising candidate, but further testing in animals and humans, along with studies on absorption and regulatory approval, is needed before it can be considered a viable TB treatment.
Curcumin Versus Curcumin-Iron Complex Docking in Tuberculosis Targets: A Insights on Synthesis & Molecular Docking Study
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[32]. Mjos, K.D., and Orvig, C., 2014. Metallodrugs in Medicinal Inorganic Chemistry. Chemical Reviews .; 114, 4540-4563. 10.1021/cr400460s.
[33]. Pawar, A., Jha, P., Chopra, M., Chaudhry, U., and Saluja, D., 2020. Screening of natural compounds that targets glutamate racemase of Mycobacterium tuberculosis reveals the anti-tubercular potential of flavonoids. Scientific Reports.; 10, 949. 10.1038/s41598-020-57658-8.
[34]. Sarangi, A., Das, B.S., Patnaik, G., Sarkar, S., Debnath, M., Mohan, M., and Bhattacharya, D.,2021. Potent anti-mycobacterial and immunomodulatory activity of some bioactive molecules of Indian ethnomedicinal plants that have the potential to enter in TB management. Journal of applied microbiology., 131, 1578-1599. 10.1111/jam.15088.
[35]. Irfan, M., Lee, Y. Y., Lee, K. J., Kim, S. D., & Rhee, M. H., 2022. Comparative antiplatelet and antithrombotic effects of red ginseng and fermented red ginseng extracts. Journal of Ginseng Research, 46(3), 387-395.
[36]. Singla, N., Gupta, G., Kulshrestha, R., Sharma, K., Bhat, A. A., Mishra, R., Gupta, S., 2024. Daidzein in Traditional Chinese Medicine: A Deep Dive into Its Ethnomedicinal and Therapeutic Applications. Pharmacological Research-Modern Chinese Medicine, 12 (01) 100460.
[37]. Wang, J., Behl, T., Rana, T., Sehgal, A., Wal, P., Saxena, B., ... & Singla, R. K., 2024. Exploring the Pathophysiological Influence of Heme Oxygenase-1 on Neuroinflammation and Depression: A Study of Phytotherapeutic-Based Modulation. Phytomedicine,; 127 (07)155466.
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Anaesthetic Management of A Patient with Pan Facial Trauma with Restricted Mouth Opening Posted for Open Reduction and Internal Fixation of Facial Bone FracturesAuthor: Mahalakshmi RDOI: 10.21522/TIJPH.2013.SE.24.05.Art031
Anaesthetic Management of A Patient with Pan Facial Trauma with Restricted Mouth Opening Posted for Open Reduction and Internal Fixation of Facial Bone Fractures
Abstract:
Airway management of patients with maxillofacial trauma remains a challenging task for an anaesthesiologist in emergency and perioperative settings due to anatomical distortion. Appropriate planning and a team based approach is mandatory for establishing the airway during elective surgical procedures and in postoperative period. Here we report a 24 year old male with alleged history of road traffic accident who sustained injury to face. Patient had restricted mouth opening of 1 finger breadth due to pain and multiple facial bone fractures. Patient was posted for Open reduction and Internal fixation of facial bone fractures. In view of anticipated difficult intubation airway management was discussed as team and planned. In OR, before induction, USG guided bilateral maxillary and mandibular block was given, which improved patient’s mouth opening. This approach facilitated easy intubation and thereby avoiding airway related complication. The tube was fixed submentally so as to allow good intraoral work space for the surgeons. This case report suggests that use of USG guided maxillary and mandibular blocks facilitated in airway management in this patient with restricted mouth opening. Proper preemptive planning for difficult airway cases and multimodal analgesia helps in managing facial trauma cases successfully without complications.
Anaesthetic Management of A Patient with Pan Facial Trauma with Restricted Mouth Opening Posted for Open Reduction and Internal Fixation of Facial Bone Fractures
References:
[1]. Kovacs, G., & Sowers, N. 2018, Airway management in trauma. Emergency Medicine Clinics of North America, 36(1), 61–84.
[2]. Saini, S., Singhal, S., & Prakash, S. 2021, Airway management in maxillofacial trauma. Journal of Anaesthesiology, Clinical Pharmacology, 37(3), 319–327.
[3]. Nordquist, D., & Halaszynski, T. M. 2014, Perioperative multimodal anesthesia using regional techniques in the aging surgical patient. Pain Research and Treatment, 2014, 902174.
[4]. Barak, M., Bahouth, H., Leiser, Y., & Abu El-Naaj, I. 2015, Airway management of the patient with maxillofacial trauma: Review of the literature and suggested clinical approach. BioMed Research International, 2015, 724032.
[5]. Dhanrajani, P. J., & Jonaidel, O. 2002, Trismus: aetiology, differential diagnosis and treatment. Dental Update, 29(2), 88–92, 94.
[6]. Kassam, K., & Messiha, A. 2014, Fractured zygomatic arch: a traumatic cause for trismus. BMJ Case Reports, 2014(apr03 1), bcr2013202633.
[7]. Kojima, Y., Sendo, R., Ohno, S., & Sugimura, M. 2020, Ultrasound-guided inferior alveolar nerve block for trismus during dental treatment: a case report. JA Clinical Reports, 6(1), 94.
[8]. Heard, A. M. B., Green, R. J., Lacquiere, D. A., & Sillifant, P. 2009, The use of mandibular nerve block to predict safe anaesthetic induction in patients with acute trismus. Anaesthesia, 64(11), 1196–1198.
[9]. Jain, G., Yadav, G., Singh, A. P., Singh, Y., & Singh, D. K. 2016, Efficacy of ultrasound-guided mandibular block in predicting safer anesthetic induction. Anesthesia, Essays and Researches, 10(2), 184–188.
[10]. Shetty, P. M., Yadav, S. K., & Upadya, M. 2011, Submental intubation in patients with panfacial fractures: A prospective study. Indian Journal of Anaesthesia, 55(3), 299–304.
[11]. Borba, A. M., Porto, A. N., Santini, A., Santos, T. I. dos, Miloro, M., Borges, A. H., & Pedro, F. L. M. 2018, The effect of facial fractures on mouth opening range: a case series. RSBO, 1(3), 142.
[12]. Kumita, S., Murouchi, T., & Arakawa, J. 2017, Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty. Asian Journal of Anesthesiology, 55(4), 89–90.
[13]. Sola, C., Raux, O., Savath, L., Macq, C., Capdevila, X., & Dadure, C. 2012, Ultrasound guidance characteristics and efficiency of suprazygomatic maxillary nerve blocks in infants: a descriptive prospective study: Ultrasound-guided suprazygomatic maxillary nerve block. Paediatric Anaesthesia, 22(9), 841–846.
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Distinguishing between Emergence Delirium and Pain in Early Post-Operative Period among Paediatric Patients: A Prospective Observational StudyAuthor: Anand SDOI: 10.21522/TIJPH.2013.SE.24.05.Art032
Distinguishing between Emergence Delirium and Pain in Early Post-Operative Period among Paediatric Patients: A Prospective Observational Study
Abstract:
Emergence delirium (ED) and postoperative pain are common and significant concerns in paediatric anaesthesia. Both conditions can occur early in the postoperative period and are challenging to distinguish due to overlapping clinical presentations. ED is characterized by confusion, agitation, and disorientation after anaesthesia, often leading to distress in the child and anxiety among caregivers. Postoperative pain can similarly present with agitation and crying, making differentiation critical for effective management. This study aimed to prospectively observe paediatric patients to identify distinguishing characteristics between ED and pain, thereby improving postoperative care and reducing misdiagnosis. This prospective observational study included 100 paediatric patients aged 2 to 6 years. All participants were ASA physical status 1 or 2 and underwent elective surgeries requiring general anaesthesia. Postoperative behaviour was assessed using the PAED score for ED and the FLACC scale for pain. Two trained observers, blinded to the study hypothesis, evaluated the children at multiple time points during and after surgery. The primary outcomes were the incidence of ED and pain, and the relationship between sevoflurane exposure time and these outcomes. The majority of patients (89.375%) exhibited normal postoperative behaviour, while 10.5% experienced ED, and 3.75% experienced pain without ED. A smaller subset (3.5%) experienced both ED and pain. Patients with sevoflurane exposure greater than 100 minutes had a significantly higher risk of ED, with a risk ratio of 4.5 compared to those with less exposure. ED was most prevalent at awakening and rapidly decreased, while pain became more prominent later in the recovery period. While most paediatric patients recover from anaesthesia without issues, a notable group remains at risk for ED, especially with longer sevoflurane exposure.
Distinguishing between Emergence Delirium and Pain in Early Post-Operative Period among Paediatric Patients: A Prospective Observational Study
References:
[1]. Bai, Y., Jin, Q., Cai, W., Li, J., Zhou, Y., 2024., Effects of the timing of satisfactory sedation with preoperative oral midazolam on anesthesia induction and recovery in children undergoing adenotonsillectomy., Chinese Journal of Clinical Medicine., 29(3):296.
[2]. Maaly AM, Mahgoub A, Osman Y, et al. 2024, Comparison between nalbuphine versus dexmedetomidine for prevention of emergence agitation in pediatrics during sevoflurane anesthesia: prospective study. Alexandria Journal of Medicine. 60(3):237-244.
[3]. Hassan MAI, Tawfik MS, El Desouky MI, et al. 2024, Effects of Preoperative Ketamine or Midazolam or Ketamine versus Oral Dextromethorphan for Reducing Sevoflurane Emergence Agitation among Preschool Children. Zagazig University Medical Journal.
[4]. Davies L, Qi TS, Ng A. 2024, Emergence delirium: an overview with an emphasis on the use of electroencephalography in its management. Anesthesia and Pain Medicine.
[5]. Sawicki, CM., Janal, MN., Wade, SD., 2024., Preoperative Multisensory Room Use in Pediatric Patients with Autism: A Randomized Clinical Trial. Pediatric Dentistry.,46(2):123-130.
[6]. Hajdini H, Guelbert C, Sanofky B, Spencer J. 2024, Implementation of Pediatric Emergence Delirium (PAED) Scale. Journal of PeriAnesthesia Nursing.
[7]. Zenghui, Liang., Yanle, Xie., Shuhan, Chen., Haibo, Liu., Lv, H., Bertrand-Geoffrey, Muhoza., Fei, Xing., Jingjing, Yuan., Wei, Xin., Na, Xing., Jianjun, Yang., Z, Wang., Jingjing, Yuan. 2024, Predicting postoperative pain in children: an observational study using the pain threshold Index. Frontiers in Pediatrics, doi: 10.3389/fped.2024.1398182.
[8]. Jian-Ming, Yue., Qi, Wang., Bin, Liu., Leng, Zhou. 2024, Postoperative accurate pain assessment of children and artificial intelligence: A medical hypothesis and planned study. World Journal of Clinical Cases, (2024). doi: 10.12998/wjcc.v12.i4.681.
[9]. Sugandhini, Boda., Rajeshwari, K. 2024, Association between anesthetic type and perioperative outcomes in pediatric patients undergoing elective surgery: An observational study. Asian journal of medical sciences, doi: 10.3126/ajms.v15i2.59580.
[10]. Lijing, Li., Jianmin, Zhang., Jiayi, Li., Yi, Ren., Zheng, Gao., Jia, Gao., Fuzhou, Zhang., Fang, Wang., Tiehua, Zheng. 2023, Development of a nomogram to predict negative postoperative behavioral changes based on a prospective cohort. BMC Anesthesiology, doi: 10.1186/s12871-023-02228-4.
[11]. Semkovych, Ya.V. 2023, Clinical and laboratory changes in postsurgical pain markers in children. Neonatology surgery and perinatal medicine 8(4(50)):92-98, (2023), doi: 10.24061/2413-4260.xiii.4.50.2023.13.
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[13]. Sikich, N., & Lerman, J. 2004, Development and psychometric evaluation of the Pediatric Anesthesia Emergence Delirium Scale. Anesthesiology, 100(5), 1138-1145.
[14]. Chandler, J. R., Myers, D., Mehta, D., et al. 2008, Emergence delirium in children: A randomized trial to compare total intravenous anesthesia with sevoflurane anesthesia. Pediatric Anesthesia, 18(4), 332-340.
[15]. Dahmani, S., Delivet, H., & Hilly, J. 2010, Emergence delirium in children: An update. Current Opinion in Anaesthesiology, 23(4), 494-499.
[16]. Moore, A. D., Anghelescu, D. L., Christensen, R., et al. 2010. Emergence delirium in pediatric patients: Risk factors and associated behaviors. Journal of Pediatric Surgery, 45(4), 714-718.
[17]. Sarah, R, Martin., Theodore, W., Heyming., Michelle, A., Fortier., Zeev, N., Kain. (1) Paediatric laceration repair in the emergency department: post-discharge pain and maladaptive behavioural changes. Emergency Medicine Journal, (2024). doi: 10.1136/emermed-2023-213858.
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Association of Microalbuminuria in Patient with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in A Tertiary Care CentreAuthor: Maghimaa MDOI: 10.21522/TIJPH.2013.SE.24.05.Art033
Association of Microalbuminuria in Patient with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in A Tertiary Care Centre
Abstract:
NAFLD (Nonalcoholic Fatty Liver Disease) is a prevalent chronic liver disorder characterized by metabolic abnormalities. Microalbuminuria have been linked to cardiovascular and renal diseases, but its association with NAFLD remains underexplored. This cross-sectional study assessed urine microalbumin levels in patients diagnosed with NAFLD. Demographic data, NAFLD grading, and microalbuminuria status were analyzed in non-NAFLD and NAFLD groups. Statistical analysis has been performed to evaluate the associations. Males were more common than females among NAFLD patients (n=100), particularly in the age range of 41 to 60. Compared to non-NAFLD controls (0%), NAFLD patients (76%) had a considerably higher prevalence of microalbuminuria. BMI showed no significant association with NAFLD prevalence. NAFLD grading revealed Grade 1 as the most prevalent (52%), followed by Grade 2 (32%) and Grade 3 (16%). Our findings demonstrate a strong association between microalbuminuria and NAFLD, suggesting a potential link with adverse cardiovascular and renal outcomes. Monitoring microalbuminuria in NAFLD patients may aid in risk stratification and management. There is a need to conduct larger population-based-randomized studies.
Association of Microalbuminuria in Patient with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in A Tertiary Care Centre
References:
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The Complexity of Diabetes Mellitus: Pathophysiology, Prevalence, and Innovative Management StrategiesAuthor: Prabhudas NelaturiDOI: 10.21522/TIJPH.2013.SE.24.05.Art034
The Complexity of Diabetes Mellitus: Pathophysiology, Prevalence, and Innovative Management Strategies
Abstract:
In recent years, the global use of nutraceuticals, nutritional supplements, and natural therapies for therapeutic purposes has grown significantly. Traditional synthetic drugs often fall short in addressing the therapeutic needs of managing diabetes. In contrast, herbal medicines offer a promising alternative with fewer side effects. Nutraceuticals include a wide range of biological interventions such as amino acids, fatty acids, botanicals, antioxidants, vitamins, and minerals designed to enhance overall well-being, manage symptoms, and prevent diseases. These agents offer diverse therapeutic benefits and show potential in disease management, prevention, and health promotion. Numerous nutraceuticals in clinical practice address the root causes of diabetes mellitus, metabolic syndrome, and their related complications, thereby positively influencing various biochemical and clinical outcomes. Hypoglycemic agents are commonly used in traditional medicine systems to mitigate the risk of diabetes mellitus. In this review, we highlight the risk factors and regional approaches to utilizing nutraceuticals for diabetes management.
The Complexity of Diabetes Mellitus: Pathophysiology, Prevalence, and Innovative Management Strategies
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Charting the Monthly Waves: An Observational Study on the Dynamics of Premenstrual SyndromeAuthor: Akshaya RadhakrishnanDOI: 10.21522/TIJPH.2013.SE.24.05.Art035
Charting the Monthly Waves: An Observational Study on the Dynamics of Premenstrual Syndrome
Abstract:
Premenstrual syndrome (PMS) is an assortment of painful symptoms that occur around the period of menstruation and they are related to hormonal changes that have been known by physicians for millennia, potentially leading to difficulties in daily functioning and a poor quality of living. The Moos Menstrual Distress Questionnaire (MDQ) was used to gather data in this cross-sectional research with 200 participants in Chennai. ANOVA and T-tests were used to examine the data using SPSS software. Participants were provided with PMS reporting diaries to document symptoms for two consecutive menstrual cycles. The 168 total sample sizes were calculated using the equation of power analysis. There were no irregular menstrual periods among the girls. The average age of the participants was 20.3 years and their average menarche age was 13.5 years. Notably, 124 (73.8%) of individuals reported having considerable blood flow during their menstrual cycle, with 142 (84.5%) of the individuals reported having menstrual cramps. There was no discernible correlation found between the prevalence of PMS and the use concerning junk food, physical activity, sugar, salt, or citrus fruits. Although menstruation is a natural physiological process, many individuals experience menstrual abnormalities and PMS, which require treatment. It is recognized that a significant portion of people have irregular periods and PMS highlights the need for efficient treatment approaches, even though menstruation is a normal physiological function.
Charting the Monthly Waves: An Observational Study on the Dynamics of Premenstrual Syndrome
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Control of Multidrug-Resistant Hospitalized Pathogenic Bacteria Using the Secondary Metabolites of Calotropis procera and In-silico Analysis of Bacterial Virulent ProteinsAuthor: Thangaswamy SelvankumarDOI: 10.21522/TIJPH.2013.SE.24.05.Art036
Control of Multidrug-Resistant Hospitalized Pathogenic Bacteria Using the Secondary Metabolites of Calotropis procera and In-silico Analysis of Bacterial Virulent Proteins
Abstract:
This study explores the multidrug-resistant pattern of hospitalized pathogens and their pharmacological impact against the secondary metabolites isolated from Calotropis procera, for its medicinal properties. Moreover, this study implies that comprehensive analysis, including isolation of multidrug-resistant hospitalized bacterial species and extraction and characterization of secondary metabolites by GC-MS from Calotropis procera, molecular docking, ADMET profiling, and, was conducted to evaluate the therapeutic potential of these compounds. The multidrug-resistant Klebsiella pneumonia, Salmonella typhi, and Pseudomonas aeruginosa were isolated and they also showed sensitivity against C. procera leaf extract. GC-MS reveals the key volatile compounds, including oleic acid, and the molecular docking with the proteasome (PDB ID: 5JXG) identified 5-Methyl-2-phenylindolizine as the most promising compound due to its high binding affinity (-6.7 kcal/mol), with 2,6-Dimethylphenol, 3,5-Dimethylaniline, and Ethyl Heptanoate showing progressively lower affinities. Interaction analysis highlighted the importance of PRO266, TRP531, GLU271, and ARG490 residues. ADMET profiling revealed that 2,6-dimethylphenol and 3,5-Dimethylaniline have favorable absorption and minimal CYP interactions, while 5-methyl-2-phenylindolizine demonstrated excellent absorption and BBB permeability. Additionally, the study found that C. procera metabolites could target furin, a proprotein convertase involved in bacterial virulence, offering a novel approach to combat multidrug-resistant bacterial infections. These findings underscore the potential of Calotropis procera metabolites as effective therapeutic agents and active against multidrug-resistant bacterial species.
Control of Multidrug-Resistant Hospitalized Pathogenic Bacteria Using the Secondary Metabolites of Calotropis procera and In-silico Analysis of Bacterial Virulent Proteins
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Green Synthesis of Silver Nanoparticles Using Coriandrum sativum Extract and Their Antioxidant, Anti-inflammatory and Antibacterial Activities Against UTI PathogensAuthor: Lakshmi ThangaveluDOI: 10.21522/TIJPH.2013.SE.24.05.Art037
Green Synthesis of Silver Nanoparticles Using Coriandrum sativum Extract and Their Antioxidant, Anti-inflammatory and Antibacterial Activities Against UTI Pathogens
Abstract:
This study explored the green synthesis of silver nanoparticles (AgNPs) utilizing Coriandrum sativum extract and investigated their potential applications in terms of antibacterial and antioxidant activities. UV‒visible absorption spectra revealed a distinctive absorption peak at 450 nm, indicating successful AgNPs synthesis and stabilization with Coriandrum sativum extract and the TEM analysis revealed the shape to be spherical and size was found to range between 5-25 nm. Antibacterial assays revealed concentration-dependent zones of inhibition against Staphylococcus aureus, Escherichia coli, Pseudomonas sp., and Klebsiella sp., confirming the efficacy of Coriandrum sativum-mediated AgNPs as antibacterial agents. The AgNPs exhibited significant antioxidant properties, with concentration-dependent scavenging activities observed in the DPPH, hydrogen peroxide, and FRAP assays. Protein denaturation assays revealed concentration-dependent effects, suggesting potential applications in biological and medicinal contexts. Additionally, membrane stabilization assays revealed the robust concentration-dependent impact of Coriandrum sativum-mediated AgNPs, underscoring their promising role in diverse applications, from antibacterial treatments to antioxidant therapies and protein stability studies.
Green Synthesis of Silver Nanoparticles Using Coriandrum sativum Extract and Their Antioxidant, Anti-inflammatory and Antibacterial Activities Against UTI Pathogens
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Promising Health Benefits of FucoxanthinAuthor: Palukuri Yashwanth KumarDOI: 10.21522/TIJPH.2013.SE.24.05.Art038
Promising Health Benefits of Fucoxanthin
Abstract:
Fucoxanthin, a unique carotenoid found in brown seaweed, contains an allenic bond in its structure along with a cyclic core, conjugated double bonds, and functional groups. It plays a crucial role in photosynthesis by absorbing and transferring light energy to chlorophyll a. It also exhibits health benefits, such as improving immunity and gut health and protective activities, including hepatic, neuro, and nephroprotective against various diseases, which makes it a promising pharmaceutical and dietary component for combating infectious disorders. Recent research focuses on the health-promoting properties of fucoxanthin, highlighting its various health promoting mechanisms, aiming to guide future biochemical studies toward developing new supplements utilizing fucoxanthin and its metabolites. This review provides a foundation for future health-promoting investigations focused on developing novel pharmaceutical and dietary supplements targeting fucoxanthin and its various metabolites
Promising Health Benefits of Fucoxanthin
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Post-surgical Functional Assessment Following Three Different Types of Surgical Repair in Type III to VI Acromioclavicular Joint DisruptionAuthor: Akshay J KumarDOI: 10.21522/TIJPH.2013.SE.24.05.Art039
Post-surgical Functional Assessment Following Three Different Types of Surgical Repair in Type III to VI Acromioclavicular Joint Disruption
Abstract:
This study assesses the functional outcomes and associated risks of various surgical procedures for types III to VI acromioclavicular (AC) joint injuries, including Endo button flipping, hamstring grafting, and the suture anchor & eight plate method. Conducted at Saveetha Medical College Hospitals from June 2021 to June 2022, the study involved 21 patients aged 25 to 60 with AC joint injuries, excluding types I and II injuries and those with medical ineligibility. Surgical correction included reconstructing the coracoclavicular ligaments using various techniques, followed by at least one year of follow-up. Functional outcomes were measured using the Constant Murley Score, and radiographic evaluations were performed at set intervals. The mean Constant scores were 92.54, 90.85, and 91.42 for the suture anchor, Endo button flip, and hamstring graft methods, respectively. Although the suture anchor technique had a slightly higher score, the difference was not statistically significant. All methods maintained coracoclavicular distance and provided a good range of motion. Patients treated with suture anchors showed notably fewer complications during the one-year follow-up. In conclusion, all surgical methods resulted in successful outcomes for AC joint injuries of types III to VI, with the suture anchor technique showing a trend toward better functional scores, though without significant differences. Further long-term monitoring is recommended to determine the optimal treatment approach.
Post-surgical Functional Assessment Following Three Different Types of Surgical Repair in Type III to VI Acromioclavicular Joint Disruption
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Polydatin: A Promising Natural Agent with Anti-Hepatocellular Carcinoma PropertiesAuthor: Nallusamy DuraisamyDOI: 10.21522/TIJPH.2013.SE.24.05.Art040
Polydatin: A Promising Natural Agent with Anti-Hepatocellular Carcinoma Properties
Abstract:
The review extensively examines the multifaceted anti-cancer properties of polydatin (PD), a stilbenoid compound sourced from fruits and vegetables. PD is known for its antioxidant capabilities, anti-inflammatory effects, and anti-cancer properties. The analysis delves into PD's impact on cancer characteristics such as cellular proliferation, metastasis, and apoptosis. It highlights PD's potential as a targeted therapeutic agent and its synergistic interactions with existing anti-cancer medications, aiming to enhance understanding and innovative strategies in cancer therapy. Ultimately, this review aims to provide a comprehensive analysis of PD's diverse anti-cancer attributes and intrinsic value in advancing novel paradigms in cancer treatment and prevention, instilling hope for the future of cancer therapy.
Polydatin: A Promising Natural Agent with Anti-Hepatocellular Carcinoma Properties
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Insight on the Health Benefits of Functional Food: Dark ChocolateAuthor: Nallusamy DuraisamyDOI: 10.21522/TIJPH.2013.SE.24.05.Art041
Insight on the Health Benefits of Functional Food: Dark Chocolate
Abstract:
Dark chocolate is known for its rich content of bioactive compounds such as polyphenols and flavonoids, which possess potent antioxidant properties that counteract oxidative stress and lower the risk of chronic diseases like cardiovascular diseases and certain cancers. Studies have shown that dark chocolate consumption can improve cardiovascular health by enhancing endothelial function and reducing blood pressure. Mendelian randomization studies have further indicated a potential decrease in the risk of essential hypertension and venous thromboembolism. Additionally, dark chocolate may favour lipid metabolism, weight management, and inflammation in individuals with chronic kidney disease. There is also emerging evidence suggesting that dark chocolate could positively influence cognitive function and mood and offer protection against neurodegenerative diseases like Alzheimer's and Parkinson's. Researchers are exploring innovative fortification methods to enhance the nutritional profile of dark chocolate and maximize its health benefits. In this review, we have summarized the investigation of the association between dark chocolate consumption and its health-promoting effects.
Insight on the Health Benefits of Functional Food: Dark Chocolate
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