Is mercury in Tibetan Medicine toxic? Clinical, neurocognitive and biochemical results of an initial cross-sectional study

Mercury an important therapeutic substance in Tibetan Medicine undergoes complex “detoxification” prior to inclusion in multi-ingredient formulas. In an initial cross-sectional study, patients taking Tibetan Medicine for various conditions were evaluated for mercury toxicity. Two groups were identified: Group 1, patients taking “ Tsothel” the most important detoxified mercury preparation and Group 2, patients taking other mercury preparations or mercury free Tibetan Medicine. Atomic fluorescence spectrometry of Tibetan Medicine showed mercury consumption 130 µg/kg/day (Group 1) and 30 µg/kg/day (Group 2) ( P ≤ 0.001), levels above EPA (RfDs) suggested threshold (0.3 µg/kg /day) for oral chronic exposure. Mean duration of Tibetan Medicine treatment was 9 ± 17 months (range 3–116) (Group 1) and 5 ± 1.96 months (range 1–114) (Group 2) (NS) with cumulative days of mercury containing Tibetan Medicine, 764 days ± 1214 (range 135–7330) vs. 103 days ± 111 (range 0–426), respectively ( P ≤ 0.001). Comparison of treatment groups with healthy referents (Group 3) not taking Tibetan Medicine showed no significant differences in prevalence of 23 non-specific symptoms of mercury toxicity, abnormal neurological, cardiovascular and dental findings and no correlation with mercury exposure variables; consumption, cumulative treatment days, blood/ urine Hg. Liver and renal function tests in treatment groups were not significantly increased compared to referents, with mean urine Beta2 Microglobulin within the normal range and not significantly associated with Hg exposure variables after correcting for confounding variables. Neurocognitive testing showed no significant intergroup differences for Wechsler Memory Scale, Grooved Pegboard, Visual Retention, but Group1 scores were better for Mini-Mental, Brief Word Learning, Verbal Fluency after correcting for confounding variables. These results suggest mercury containing Tibetan Medicine does not have appreciable adverse effects and may exert a possible beneficial effect on neurocognitive function. Since evidence of mercury as a toxic heavy metal, however, is well known, further analysis of literature on mercury use in other Asian traditional systems is highly suggested prior to further studies.

Download Full-text

Role of feasibility and pilot studies in randomised controlled trials: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-022233 ◽

2018 ◽

Vol 8 (9) ◽

pp. e022233 ◽

Cited By ~ 27

Author(s):

Amanda Jane Blatch-Jones ◽

Wei Pek ◽

Emma Kirkpatrick ◽

Martin Ashton-Key

Keyword(s):

Feasibility Study ◽

Randomised Controlled Trials ◽

Feasibility Studies ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Group 2 ◽

Randomised Controlled ◽

Pilot Feasibility Study ◽

Group 1

ObjectivesTo assess the value of pilot and feasibility studies to randomised controlled trials (RCTs) funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. To explore the methodological components of pilot/feasibility studies and how they inform full RCTs.Study designCross-sectional study.SettingBoth groups included NIHR HTA programme funded studies in the period 1 January 2010–31 December 2014 (decision date). Group 1: stand-alone pilot/feasibility studies published in the HTA Journal or accepted for publication. Group 2: all funded RCT applications funded by the HTA programme, including reference to an internal and/or external pilot/feasibility study. The methodological components were assessed using an adapted framework from a previous study.Main outcome measuresThe proportion of stand-alone pilot and feasibility studies which recommended proceeding to full trial and what study elements were assessed. The proportion of ‘HTA funded’ trials which used internal and external pilot and feasibility studies to inform the design of the trial.ResultsGroup 1 identified 15 stand-alone pilot/feasibility studies. Study elements most commonly assessed weretesting recruitment(100% in both groups),feasibility(83%, 100%) andsuggestions for further study/investigation(83%, 100%). Group 2 identified 161 ‘HTA funded’ applications: 59 cited an external pilot/feasibility study wheretesting recruitment(50%, 73%) andfeasibility(42%, 73%) were the most commonly reported study elements: 92 reported an internal pilot/feasibility study wheretesting recruitment(93%, 100%) andfeasibility(44%, 92%) were the most common study elements reported.Conclusions‘HTA funded’ research which includes pilot and feasibility studies assesses a variety of study elements. Pilot and feasibility studies serve an important role when determining the most appropriate trial design. However, how they are reported and in what context requires caution when interpreting the findings and delivering a definitive trial.

Download Full-text

Soluble Inter-Cellular Adhesion Molecule-1 in Urban Asian North Indians: Relationships with Anthropometric and Metabolic Covariates

Disease Markers ◽

10.1155/2002/843537 ◽

2002 ◽

Vol 18 (3) ◽

pp. 111-120 ◽

Cited By ~ 8

Author(s):

Astha Sethi ◽

Anoop Misra ◽

Ravindra Mohan Pandey ◽

Kalpana Luthra ◽

J. Rama Devi ◽

...

Keyword(s):

Risk Factor ◽

Adhesion Molecule ◽

Cross Sectional Study ◽

Urban Slums ◽

Slum Area ◽

Sectional Study ◽

Cross Sectional ◽

Cellular Adhesion Molecule ◽

Group 2 ◽

Group 1

Background:High prevalence of diabetes, obesity, and dyslipidemias in people belonging to poor socio-economic strata in urban slums of northern India has been recorded recently. To assess whether this population has high levels of soluble intercellular adhesion molecule-1 (sICAM-1), a cytokine involved in the pathogenesis of atherosclerosis, we investigated subjects belonging to poor socio-economic strata in urban slums and compared them to healthy control subjects from non-slum urban areas of New Delhi.Design:Cross-sectional study.Methods:Subjects from a previously carried out cross-sectional study, Delhi Urban Slum Project (DUSP) were divided into two groups: Group-1 (n= 56) included subjects dwelling in slum area, having at least one risk factor (hypertension, hyperglycemia, hypertriglyceridemia and hypercholesterolemia), while group-2 (n= 60) consisted of subjects without any risk factor dwelling in the slum area. A third group (n= 29) of non-obese subjects without any risk factor living in non-slum urban area was included for comparison. Measurements included; body mass index (BMI), waist-hip ratio (W-HR), four skinfolds, percentage body fat, fasting plasma glucose (FPG), serum lipids, and serum levels of sICAM-1.Results:Though statistically not significant, mean level of sICAM-1 was higher in group-1 (718.5 ± 232.8 ng/ml) as compared to the other groups. Of note, 35% of subjects in group-1 (p< 0.05 as compared to other two groups), and 25.3% of all subjects had levels of sICAM-1 in uppermost quartile (>850 ng/ml). Partial correlation coefficients (R) of sICAM-1 levels with various parameters adjusted for age were statistically significant for BMI (R= 0.27,p< 0.05) in group-1; W-HR (R= 0.26,p< 0.05) and BMI (R= 0.19,p< 0.05) for group-2; and FPG (R= 0.17,p< 0.05) for all the subjects considered together. For females, the levels of sICAM-1 were significantly higher in the following: BMI ≥ 25 kg/m2(p= 0.04) and FPG >7 mmol/l (p< 0.05). Multiple linear regression analysis suggests that an increment in BMI by one kg/m2would correspond to an increase in the levels of sICAM-1 by 8.5 units controlling for the influence of age and W-HR in the pooled data of all subjects.Conclusions:High percentage of subjects had levels of sICAM-1 in the upper quartile in the study, particularly those dwelling in the slum area and having coronary risk factor (s). The levels of sICAM-1 strongly correlated to the anthropometric and metabolic parameters, particularly in females. These observations are of potential importance for the pathogenesis of atherosclerosis in this population, though further studies are needed to predict those prone to the complications of atherosclerosis, based on sICAM-1 levels, as has been observed in other ethnic groups.

Download Full-text

Assessment of Anti-SARS-CoV-2 Antibodies Post-Coronavac Vaccination in the Amazon Region of Brazil

Vaccines ◽

10.3390/vaccines9101169 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1169

Author(s):

Carlos David Araújo Bichara ◽

Maria Alice Freitas Queiroz ◽

Ednelza da Silva Graça Amoras ◽

Gergiane Lopes Vaz ◽

Izaura Maria Vieira Cayres Vallinoto ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Cross Sectional Study ◽

Age Group ◽

Receptor Binding Domain ◽

Sectional Study ◽

Cross Sectional ◽

Humoral Immune ◽

High Prevalence ◽

Group 2 ◽

Group 1

The present study evaluated the frequency of seropositivity for anti-SARS-CoV-2 (S1 and S2) total antibodies and anti-SARS-CoV-2 (receptor binding domain-RBD-S1) neutralizing antibodies in individuals vaccinated with the immunizing agent Coronavac. This was a cross-sectional study involving 358 individuals divided into two groups. Group 1 consisted of 205 volunteers who were tested for anti-SARS-CoV-2 total antibodies; group 2 consisted of 153 individuals tested for the presence of anti-SARS-CoV-2 neutralizing antibodies. Seropositivity was greater than 70% in both groups, although 17.6% and 20.9% of individuals showed no neutralizing or total antibody reactivity, respectively. The frequency of anti-SARS-CoV-2 total antibodies displayed a significantly different distribution between the sexes but not according to age. The frequency of anti-SARS-CoV-2 neutralizing antibodies was 93.3% (95% CI 68.1–99.8) in the age group from 21 to 40 years but significantly decreased with advancing age, and was 76.2% (95% CI 52.8–91.8) for 41 to 60 years, 72.5% (95% CI 62.8–80.9) for 61 to 80 years, and 46.7% (95% CI 21.3–73.4) for >80 years. Our results reveal a high prevalence of anti-SARS-CoV-2 total antibodies and anti-SARS-CoV-2 neutralizing antibodies in individuals who received both doses of the Coronavac vaccine, suggesting a lower effectiveness of the humoral immune response among those older than 60 years of age, which might be associated with senescence of the immune system.

Download Full-text

Adverse pathophysiological influence of early testosterone therapy on the testes of boys with higher grade sex chromosome aneuploidies (HGAs): a retrospective, cross-sectional study

Journal of Endocrinological Investigation ◽

10.1007/s40618-020-01452-w ◽

2020 ◽

Author(s):

M. Spaziani ◽

C. Tarantino ◽

C. Pozza ◽

A. Anzuini ◽

F. Panimolle ◽

...

Keyword(s):

Sex Chromosome ◽

Cross Sectional Study ◽

Testicular Volume ◽

Sectional Study ◽

Testosterone Therapy ◽

Cross Sectional ◽

Hormone Profile ◽

Group 2 ◽

The Impact ◽

Group 1

Abstract Purpose Higher grade aneuploidies (HGAs) of the male sex chromosomes are a rare genetic group of pathologies caused by nondisjunction meiotic events. The aim of this study was to evaluate the impact of early androgenic therapy on the testicular secretory hormone profile, and the pathophysiological implications. Patients and methods In this cross-sectional study, 18 HGA subjects aged 6–8 years were recruited. They were divided into two groups, based on whether or not they had previously undergone testosterone therapy (group 1: 11 untreated subjects; group 2: 7 treated subjects). Serum FSH, LH, testosterone (T), inhibin B (INHB) and anti-Müllerian hormone (AMH) were determined, and auxological parameters were assessed. Five group 1 patients and four group 2 patients were treated with hCG (human chorionic gonadotropin) for inguinal cryptorchidism; their hormone profile and auxological parameters were assessed both pre- and post-hCG treatment. Results Group 1 subjects showed significantly higher testicular volume and higher levels of AMH and INHB (p < 0.0001). Subjects who had undergone hCG therapy showed a significantly higher testicular volume, penis length (respectively, p = 0.008 and p = 0.0005 for group 1 and p = 0.04 and p = 0.001 for group 2) and T (p = 0.005 for group 1 and p = 0.004 for group 2). Conclusions HGA patients undergoing early testosterone therapy show an earlier and persistent suppression of testicular secretory function. At this age, the testes are still responsive to stimulation with hCG. The selection of patients to be treated must be accompanied by a thorough clinical and hormonal evaluation.

Download Full-text

Evaluation of prescription pattern and quality of life in postmenopausal osteoporosis: a cross sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20193191 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1861

Author(s):

Siddharth Pravin Agrawal ◽

Suhani V. Patel ◽

Supriya Malhotra ◽

Pankaj R. Patel

Keyword(s):

Quality Of Life ◽

Drug Utilization ◽

Cross Sectional Study ◽

Minor Trauma ◽

Sectional Study ◽

Utilization Pattern ◽

Cross Sectional ◽

Group 2 ◽

Group 1

Background: Osteoporosis (OP) is a silently progressing metabolic bone disease that results in loss of mineralized bone and subsequent fractures with minor trauma. Fracture related pain and physical inability to perform activities of daily living can lead to psychological consequences that impair Quality of Life (QoF). However, much less is known about Indian scenario. Hence, our study becomes imperative. Aim of this study to the drug utilization pattern and to analyze Quality of life of postmenopausal women suffering from osteoporosis.Methods: An analytical cross-sectional study was done on 91 post-menopausal osteoporotic women. Drug utilization pattern was evaluated. Pre-validated QUALEFFO-31 questionnaire was administered to each patient to record patient’s perceived QoL. Scores were calculated according to the algorithm. Higher scores indicated poor QoL. The collected data was analyzed with SPSS software (version 23)and p value ≤0.05 was considered as statistically significant.Results: The mean age group of presenting patients was 56.2±6.6 years. All the patients received Calcium and vitamin D supplements and non-steroidal anti-inflammatory drugs for pain relief. But only 33% of the patients received any one of the bisphosphonates (BP). For analysis, patients were grouped into Group-1(n=60) who did not and Group-2 (n=31) who did receive a BP. QOL analysis showed that pain domain was affected the most. Also, patients in Group 2 reported worse score in all the domains in comparison to Group 1 (P<0.05). It is likely that BP might need more time to show considerable effect or because it was added only to those patients who already had more complaints and could afford the high cost.Conclusion: BP in spite of being the drug of choice for OP is used less commonly in India. OP causes pain and physical debilitation with detrimental effect on mental health. Longer duration prospective studies are needed to study the association of QoL and use of BP in OP patients.

Download Full-text

Triggering Factors for Breakthrough Seizures among Epileptic Patients. Cross Sectional Study in Epileptic Patients Attending Epilepsy Clinic Mansoura University Hospital, Egypt

International Neuropsychiatric Disease Journal ◽

10.9734/indj/2019/v13i130103 ◽

2019 ◽

pp. 1-10

Author(s):

Mohammed Gomaa ◽

Ahmed Esmael ◽

Mohammed Saad

Keyword(s):

Cross Sectional Study ◽

Idiopathic Epilepsy ◽

Sectional Study ◽

Precipitating Factors ◽

Cross Sectional ◽

Epileptiform Discharges ◽

Significant Difference ◽

Epileptic Patients ◽

Group 2 ◽

Group 1

Background: The prevalence of breakthrough seizures in persons with epilepsy is very high in developing countries. Consequently, patients and physicians should be aware of the possible factors that may cause breakthrough seizures. Objective: The aim of our study is to determine the possible factors that may be a precipitating cause for breakthrough seizures in patients with epilepsy. Methods: This cross-sectional study included 100 persons with epilepsy with idiopathic epilepsy receiving antiepileptic drugs (AEDs). They were divided into two groups. Group 1 included 50 persons with epilepsy with a history of recent breakthrough seizures. Group 2 included 50 persons with epilepsy who had not experienced any recent breakthrough seizures. Patients were subjected to a thorough questionnaire addressing precipitating factors. All participants were subjected to an electroencephalogram (EEG) and the Morisky Medication Adherence Scale (MMAS). Results: There was no significant differences between group 1 and group 2 regarding age, sex, age of onset of epilepsy, occupation and marital status (P value range 0.5 – 0.2). The patients in group 1 were found to have longer durations of epilepsy, lower adherence to AEDs (P = 0.001), more missed doses of AEDs (P = 0.0001), more side effects of AEDs (P = 0.0005), more sleep deprivation, lower level of AEDs (P = 0.0006), more frequently on AED polytherapy (P = 0.0002), and more flickering lights (P = 0.04) than the participants in group 2. In terms of the EEG, group 1 showed a higher percentage of abnormal EEGs and more frequent focal epileptiform discharges (P = 0.003). Also, pathological findings in MRI brain were associated with higher breakthrough seizures (P = 0.005). No significant difference was found in both group1 and group 2 regarding emotional stress (P = 0.55), substitution of brand AEDs by generic one (P = 0.83), concurrent illness (P = 1), or the use of non AEDs (P = 0.79). Conclusion: The precipitating factors of breakthrough seizures are multifactorial and it is very important to educate patients about these precipitating factors to achieve better control of epilepsy.

Download Full-text

A CROSS SECTIONAL STUDY TO EVALUATE SELFMEDICATION PRACTICE AMONG MEDICAL STUDENTS

Pakistan Journal of Public Health ◽

10.32413/pjph.v9i2.385 ◽

2019 ◽

Vol 9 (2) ◽

pp. 82-85

Author(s):

Shamaila Khalid ◽

Ateeba Ayesha Khan ◽

Musarrat Sultana

Keyword(s):

Medical Students ◽

Adverse Effects ◽

Cross Sectional Study ◽

Sectional Study ◽

Self Medication ◽

Cross Sectional ◽

Presenting Symptoms ◽

Life Threatening ◽

Group 2 ◽

Group 1

Background: Self-medication is unsupervised use of medication commonly practiced for minor or acute presenting symptoms. Inappropriate self-medication can lead to drug resistance, life-threatening adverse effects, drug dependence or aggravation of disease. This practice is becoming common among medical students due to their pharmacological knowledge and clinical posting despite the fact that they are aware of its harmful effects. Methods: A cross-sectional study was conducted on a sample of medical students of all academic years from a public sector medical university. Data was collected using semi-structured questionnaire after verbal consent. Data was analyzed using SPSS-16. Results: Sample consisted of 324 students divided in two groups. Group 1 consisted of students of pre-clinical academic years whereas Group 2 consisted of students of clinical years. 79.48% of Group 1 and 81.54% of Group 2 practiced self-medication. Antipyretics and analgesics were the most common self-medicated medicines in Group 1. Group 2 showed greater self-use of antibiotics and anxiolytics compared to pre-clinical year students. The preference of drug selection was different for both groups. Whereas pre-clinical students preferred anti-diarrheal, clinical academic students preferred antibiotics for diarrhea treatment. Conclusions: Self-medication among medical students in highly prevalent despite awareness of adverse effects.

Download Full-text

CORRELATION OF LIPID PROFILE & BODY MASS INDEX (BMI) OF PATIENTS AT A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.508 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Shorya Taliyan ◽

Sandeep Kumar Yadav ◽

Bharat Kumar Gupta

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Lipid Profile ◽

Body Mass ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Group 2 ◽

Group 1

Background: Sedentary daily life have an impact on the prevalence and incidence of metabolic syndrome disorder and results in development of type 2 diabetes mellitus, Dyslipidemia and metabolic disorders that aggravate the risk in the development of cardiovascular diseases (CVD). Methods: In our study Data of 92 males and 112 females, from the age group of 25 to 55 years were selected from December 2018 to July 2019 in a cross sectional manner. Blood sample (3 ml) was collected from each subject. Serum was separated by centrifuging blood at 3000 rpm for 10 min and analyzed for lipid profile by Siemens Dimension RXL max, wet chemistry analyzer. Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters. Results: In our hospital based study we estimated the lipid profile in individuals categorized into two groups. (Group 1 BMI <25) and (Group 2 BMI ≥25), we found the values of Triglycerides, LDL and VLDL in Group 1 are lower as compared to Group 2 values for same analytes. Conclusion: Our study found positive correlation between lipid profile and obesity. Results of this cross sectional study again prove that, Obesity predisposes individuals to metabolic syndrome associated ailments. Keywords: BMI, Lipid Profile, Metabolic Syndrome, Obesity, Dyslipidemia

Download Full-text

Nosologic independence of pediatric protracted bacterial bronchitis in real clinical practice: single-stage continuous cross-sectional study

Perm Medical Journal ◽

10.17816/pmj36619-26 ◽

2020 ◽

Vol 36 (6) ◽

pp. 19-26

Author(s):

E. S. Mazunina ◽

E. G. Furman ◽

T. G. Evseenkova ◽

I. M. Valiulov

Keyword(s):

Respiratory Diseases ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Protracted Bacterial Bronchitis ◽

Group 2 ◽

Definition Of ◽

Wet Cough ◽

Real Clinical Practice ◽

Group 1

Aim. To study the clinical and paraclinical features of protracted bacterial bronchitis (PBB), stated according to clinical definition of disease in children with relapsing course of respiratory diseases and a symptom of wet cough for more than 4 weeks. Materials and methods. The study included 68 children with relapsing course of respiratory diseases, who have a symptom of wet cough for more than 4 weeks. Group 1 enclosed 30 (44 %) children, who corresponded to clinical definition of PBB. Group 2 38 (56 %) children without PBB manifestations. Results. Bronchial asthma (46.6%, p 0.05), degree 2-3 tracheobronchomalacia (30 %, p 0.05) were more common in the group of children with clinical PBB. No any allergic pathology was observed in 13 (44.8 %) children with PBB. Among the main clinical features of PBB there were observed the following: the presence of night cough (73.3 %, p 0.05), fine moist rales in the lungs (76.6 %), bronchoscopically the presence of diffuse catarrhal-purulent endobronchitis (86.6 %). Conclusions. Physicians should bear in mind one of the most frequent causes of protracted wet cough (more than 4 weeks), namely, PBB. When suspecting PBB, a patient should be sent to pulmonologist, undergo bronchoscopy and BAL by indications so as to assess microbial landscape in children with protracted productive cough and rales for a timely diagnosis of PBB and administration of antibacterial therapy.

Download Full-text

Assessment of tooth loss in chronic periodontitis patients with and without diabetes mellitus: A cross-sectional study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl3.3649 ◽

2020 ◽

Vol 11 (SPL3) ◽

pp. 1927-1931

Author(s):

Thanish Ahamed S ◽

Arvina Rajasekar ◽

Mebin George Mathew

Keyword(s):

Chronic Periodontitis ◽

Tooth Loss ◽

Soft Tissues ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Missing Teeth ◽

Cross Sectional ◽

Group 2 ◽

Group 1

Periodontitis refers to infectious disease affecting both hard and soft tissues of the oral cavity. The disease is modified by a variety of risk factors such as tobacco smoking, poor oral hygiene, systemic diseases, hereditary, malnutrition. The relation between diabetes and periodontitis is bidirectional. Diabetes increases the risk of periodontal disease progression resulting in early tooth loss. The aim of this study was to assess tooth loss in chronic periodontitis patients with and without diabetes. This cross-sectional study was conducted among 400 chronic periodontitis patients (200 in each group; Group 1: Diabetes; Group 2: Non-diabetes) reported to Saveetha Dental College and Hospitals, Chennai. Based on the clinical examination data, all missing teeth except third molars were recorded in both groups. In group 1; among 200 diabetic patients, 1002 missing teeth were observed and in group 2; among 200 non-diabetic individuals, 638 missing teeth were observed. Also, the correlation between the systemic health status of the patients and the number of missing teeth was assessed. It was found to be statistically significant with the p-value of 0.00. The present study suggests that the prevalence of tooth loss was high among chronic periodontitis patients with diabetes (1002 missing teeth) compared to chronic periodontitis patients without diabetes (638 missing teeth)

Download Full-text