Study of Effect of Vitamin D Supplementation on Selected Hepatic and Renal Parameters in T2DM with Vitamin D Deficiency

Introduction:- Vitamin D has been studied as modifiable risk factor in DM. Apart from its role in glucose homeostasis, the anti-inflammatory effect of vitamin D is claimed to have important effect on beta cell survival and on hepatic cells. Vitamin D is said to have anti-inflammatory, anti-proliferative and anti-fibrotic actions in liver. VDD is more prevalent in T2DM, obese and NAFLD even when these conditions occur separately. Literature states the protective effective of vitamin D on kidney. Association of VDD with albuminuria and chronic kidney disease in diabetics has also been reported. Material and Methods:- This is a type of comparative and interventional study. 63 T2DM patients aged 30 – 60 years with VDD were included. Baseline investigations determined blood levels of vitamin D, calcium, phosphate, liver enzymes (AST, ALT, ALP) and serum creatitine. Patients received vitamin D intervention orally in the dose of 2000 IU daily for 12 weeks. After 12 weeks blood levels of vitamin D, calcium, phosphate, liver enzymes (AST, ALT, ALP) and serum creatitine were determined. Results:- There was no correlation of vitamin D with urea, creatinine, calcium, phosphate, AST, ALT and ALP. There was extremely significant rise in vitamin D, significant fall in phosphate level, non-significant fall in creatinine, AST, ALT, ALP and non-significant rise in calcium, urea after 12 weeks of vitamin D supplementation. Conclusion:- There was no correlation of vitamin D with hepatic and renal parameters. Also 12 weeks of vitamin D supplementation had no significant improvement in these parameters in T2DM.

Some structural characteristics of pre-monsoon depression in the Bay of Bengal

During the period 6 to 16 May. 1995. three deep depressions formed one after another over west Bay of Bengal and moved from south to north. In this paper, structural characteristics of these systems are investigated from the distribution of thermal and thermodynamical field observed around the depression center utilising daily Rs/Rw and other available coastal observations during the period, Major findings of the study are: (i) The depressions have low level cold core and middle and upper tropospheric warm core. (ii) Thermal and moisture fields tilt north ward with height but vertical tilt of contour height is .not uniform at all levels, (iii) During intensification of the system significant increase in temperature and moisutre occurs above 700 hPa and significant fall of contour height occurs below 300 hPa.

EP.TH.30Effect of One Anastomosis Gastric Bypass on Haematinics, Vitamin D, and Parathyroid Hormone Levels: A comparison between 150 cm and 200 cm Bilio-Pancreatic Limb

Introduction There is little data on the effect of One Anastomosis Gastric Bypass (OAGB) on Haematinics, Vitamins D, and Parathyroid Hormone levels. It is further unclear if an OAGB with a Bilio-Pancreatic Limb (BPL) of 150 cm (OAGB-150) would deliver better outcomes than that with a BPL of 200 cm (OAGB-200). Methods We investigated our records to obtain information on patients who underwent an OAGB-200 or OAGB-150 until 31st July 2018 in our unit. Results A total of 405 patients underwent either an OAGB-200 (n = 234) or OAGB-150 (n = 171). The mean age was 46±10.98 years and 276 (67.3%) were females. The mean preoperative weight and the Body Mass Index (BMI) were 139±29.96 kg and 49±8.14 kg/m2 respectively. With OAGB-200 there was a significant increase in anaemia rates at 1 and 2-years compared to preoperative levels with a significant fall in haemoglobin levels. After OAGB-150 there was a significant fall in haemoglobin levels at 1 and 2-years but the increase in anaemia rate was only significant at 2-years. There was a significant increase in PTH levels and the number of abnormal values at 1 and 2-years with OAGB-200. With OAGB-150, PTH changes were significant at 2 years only. Conclusion Both OAGB-200 and OAGB-150 are associated with a significant increase in anaemia and secondary hyperparathyroidism. Our findings should prompt the evaluation of supplementation protocols with higher dosages than we recommend for iron, folate, and calcium. Consideration should also be given to evaluating shorter BPL lengths than 150 cm with OAGB.

Comparison of Cardiovascular Response during Induction of General Anaesthesia Using Etomidate Versus Using Propofol under Bispectral Index Guidance in a Tertiary Care Medical College, Dibrugarh

BACKGROUND The present study was done to compare the cardiovascular responses of etomidate and propofol as induction agents of general anaesthesia under Bispectral index (BIS) guidance and evaluate the effect of intravenous induction agent etomidate and propofol on the variation in heart rate and blood pressure during induction of general anaesthesia. METHODS This is a prospective randomized and double blinded comparative study done in Assam Medical College and Hospital on patients scheduled for elective surgeries under general anaesthesia from June 2019 to May 2020. 80 patients were randomly allocated to group E (etomidate group) and group P (propofol group) of 40 each. All patients were pre-medicated with fentanyl 2 microgram / kg intravenously. Group E received etomidate infusion at 0.05 mg / kg / min and group P received propofol infusion at 0.5 mg / kg / min until Bispectral index value dropped to 60. Patients were intubated with vecuronium 0.1 mg / kg and maintenance of anaesthesia was continued according to institutional protocol. At the end of anaesthetic period, extubation was done after acceptable recovery. Haemodynamic parameters were recorded in both the groups until 10 minutes of induction. RESULTS Statistically significant fall in heart rate was seen in group P than that of group E starting from 3 minutes of induction up to 10 minutes with P value < 0.05 and statistically significant fall in systolic, diastolic, and mean arterial pressure (MAP) was seen in propofol group from that of etomidate group starting from 1 minute of induction up to 10 minutes was seen. CONCLUSIONS We conclude that etomidate is haemodynamically more stable than propofol during the time of induction of anaesthesia. KEY WORDS Etomidate, Propofol, Bispectral Index

Beryllium Induced Biochemical Alterations in Rodent Model and its Treatment with Calcium Salt of Diethylene Triamine Penta Acetic Acid with α -tocopherol

To evaluate therapeutic efficacy of chelating agents tiron (Sodium-4,5- dihydroxy-1,3-benzene di-sulphonate) and CaNa3DTPA (Calcium tri-sodium di-ethylene tri-amine penta acetic acid) in presence of α-tocopherol against beryllium induced toxicity, adult female albino rats were exposed to beryllium nitrate for 28 days followed by therapy with tiron (471 mg/kg, ip) and CaNa3DTPA (35 mg/kg, ip) alone and in combination with α-tocopherol (25 mg/kg, po). Results revealed non-significant fall in hemoglobin and total serum protein content while significant fall in blood sugar level and activity of serum alkaline phosphatase. On the other hand, significant rise in the activity of serum transaminases and LDH was noticed after beryllium administration. Significant increase in total and esterified cholesterol was found in liver and kidney after toxicity. Significant increase in lipid peroxidation and decreased level of reduced glutathione in both the organs showed oxidative stress due to beryllium exposure. CaNa3DTPA showed moderate therapeutic efficacy; however, its effectiveness was enhanced with α-tocopherol to some extent. Tiron in combination with α-tocopherol exerted statistically more beneficial effects in reversal of beryllium induced biochemical alterations.

Contractionary Devaluation Risk: Evidence from the Free Silver Movement, 1878–1900

I identify significant effects of devaluation risk on interest rates and output using US silver coinage policy news between 1878 and 1900 as clean shocks to exchange rate expectations. The Free Silver movement heightened fears the United States would abandon the gold standard and depreciate the dollar. Because Congress, rather than a central bank, set silver coinage policy, silver policy news was likely uncorrelated with economic shocks. Corporate bonds exposed to dollar devaluation returned an additional 1 percent relative to safer bonds when silver risk decreased. Additionally, increased silver coinage risk is associated with an economically significant fall in industrial production.

Urinary C3d is elevated in patients with active Lupus nephritis and a fall in its level after 3 months predicts response at 6 months on follow up

Introduction Complement activation is central to the pathogenesis of lupus nephritis (LN). Low serum complement C3 and C4, are traditionally used as markers of lupus disease activity in general and LN in particular. In this study we prospectively measured plasma and urine C3d and C4d, degradation products of C3 and C4 corrected to creatinine in a cohort of biopsy proven LN in a longitudinal fashion for its correlation with disease activity. Methods Twenty eight biopsy proven active lupus nephritis (AN) were recruited along with four inactive nephritis (IN) and 10 healthy controls (HC). Plasma and urine were collected at baseline, prior to induction treatment and 3 months later. Clinical measures of disease activity, Systemic lupus erythematosus disease activity index 2000 (SLEDAI 2K), renal SLEDAI, serum C3, C4 and antibodies to ds DNA, urine protein and creatinine excretion (UP/UC) were collected. Plasma and urine C3d and C4d were measured using ELISA and normalized to spot urine creatinine value. Results Twenty eight AN of median age of 26.5 (20–31.50) years and disease duration of 3 (0.7–5) years were enrolled. The median urinary C3d/creatinine before treatment was 388.20 (48.98–1296) ng/mg which fell significantly to 62.69 (28.04–502.4) ng/mg at 3 months followup (p-0.01). The baseline values for the active renal disease was significantly different from IN group (9.9 (4.5–46.53 ng/mg) p-0.00). Treatment responders (partial and complete) at 6 months showed a significant fall in urinary C3d at 3 months whereas non responders had a non significant change in value. There was a significant correlation of urine C3d/creatinine with SLEDAI2K (r-0.433, p-0.00), renal SLEDAI (r-0.356, p-0.00), UP/UC ratio (r-0.489, p-<0.0001) but no significant correlation with C3 or C4. There was a significant fall in the median values of plasma C3d from 791.1 (516.0.00–1550.43) µg/ml to 338.52 (211.35–525.82) (p-0.00) µg/ml at the end of 3 months. The values showed a significant correlation with SLEDAI 2K, renal SLEDAI, UP/UC along with a significant negative correlation with C3 and C4. Conclusion Urinary C3d/creatinine levels and plasma C3d levels can be used as biomarker of disease activity and treatment response.

Effect of Covid-19 lockdown in trauma cases of Rural India

Covid-19 has shocked the world and forced almost all the countries to a dumbfounded state. This virus has minimised the movement of humans, showing changes like never seen before. Positive effects have already been seen in nature and wildlife in the form of pollution control. The adverse effects of lockdown are seen as economic collapse. In this study, all the trauma patients coming to Acharya Vinobha Bhave Rural Hospital, Wardha were included irrespective of their age and mode of trauma. Period of two weeks before and two weeks after the initiation of lockdown in India from 23rd march 2020 have been taken into consideration. Both the outpatient and emergency patients were included in our study. We have observed a significant fall on overall trauma cases as expected due to the lockdown. There was a fall in the total number of cases by around three times. Our study showed that the demography of geriatric trauma, which remained almost the same and nearly all of them were old age females. Low-velocity trauma has shown an increase after lockdown from 42% to 64%, while the total numbers of cases are still less as compared to before the lockdown. High-velocity trauma cases have been reduced from 52% to 31% after lockdown, which indicates less road traffic-related injuries. During the lockdown, however, we have seen a significant fall in head neck and face trauma when compared to the upper limb and lower limb trauma.