Longitudinal genome-wide DNA methylation changes in response to kidney failure replacement therapy

Chronic kidney disease (CKD) is an emerging public health priority associated with high mortality rates and demanding treatment regimens, including life-style changes, medications or even dialysis or renal transplantation. Unavoidably, the uremic milieu disturbs homeostatic processes such as DNA methylation and other vital gene regulatory mechanisms. Here, we aimed to investigate how dialysis or kidney transplantation modifies the epigenome-wide methylation signature over 12 months of treatment. We used the Infinium HumanMethylation450 BeadChip on whole blood samples from CKD-patients undergoing either dialysis (n = 11) or kidney transplantation (n = 12) and 24 age- and sex-matched population-based controls. At baseline, comparison between patients and controls identified several significant (PFDR < 0.01) CpG methylation differences in genes with functions relevant to inflammation, cellular ageing and vascular calcification. Following 12 months, the global DNA methylation pattern of patients approached that seen in the control group. Notably, 413 CpG sites remained differentially methylated at follow-up in both treatment groups compared to controls. Together, these data indicate that the uremic milieu drives genome-wide methylation changes that are partially reversed with kidney failure replacement therapy. Differentially methylated CpG sites unaffected by treatment may be of particular interest as they could highlight candidate genes for kidney disease per se.

Dietary Modification and Life Style Changes due to COVID-19 Pandemic Homestay among Nursing Students of Pokhara: Descriptive Cross-Sectional Study

INTRODUCTION: In December 2019, new coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) emerged in Wuhan, China causing pandemic all over the world which results in homestay order. Homestay lead to changes in lifestyle like sedentary life, sleeping habits and eating behavior. So, the objective is to assess dietary and life style modification among nursing students of Manipal College of Medical Sciences, Pokhara, Nepal. MATERIAL AND METHODS: A descriptive cross-sectional online survey was conducted from August 1 to October 15, 2020. The setting of study (Manipal) was selected purposively in which enumerative sampling technique was used constituting total sample size of 216 nursing students. Data was collected through self-administer semi-structure questionnaire via online mode which was further analyzed using descriptive statistics SPSS 20.0 version. RESULTS: There was slight modification in intake of food items like fruits, vegetable, protein, fats, commercialized items, carbonated/sweetened beverages and non-vegetarian diets (chicken and fish). During COVID-19, less than one-fifth (15%) wake up before 7 AM and 78.2% sleep duration is 7-9 hours. About 64.1% pass their leisure time watching TV/ facebook/ messenger/ youtube/ whatsapp/ instagram. Nearly 99.1% engaged in household activities during home stay. More than three-fourth (77.8%) of respondents were doing physical activity. But still 69.9% had weight gain. CONCLUSION: Despite physical and household activities, some unhealthy practices like waking up late, increased sleep duration and use of screen was observed. There was less modification in dietary pattern. So it is recommended to follow healthy diet like Mediterranean diet having several health benefits like weight reduction, prevention from non-communicable diseases and boost immune system in period of pandemic.

Epidemiological characteristics of patients Hypertension attended 48Hospithal in 2019

Introduction: Hypertensive is one of the most health problems in the world. People who have hypertension become high risk for other diseases . This study was conducted to identify distribution of hypertensive among patients attended 48 Hospital during 2019. Method : A cross-sectional study was conducted and collected the data of all patients diagnosed with hypertension during the year 2019 as registered by 48 medical compound. The study area has electronic information system which is data collected and filled by physician or specialist in different medical departments and outpatient clinics. The data in excel sheet contain information's about the disease including: name, age, sex and marital status, complications and laboratory tests lipid profile for each patient. Results and conclusion: Hospital registration system indicated the admission of total number of patients with hypertensive was 2225 during that year. Chi square and fisher test analysis showed that the most patients with hypertensive were with age group above 60 year (50%) , married (97.8%) , residence in Sana'a 88.4% . Females under age 60 years (62%), males above age 60 years (56.9%) and hypertension was significant with age with p-value 0.001. Hypertensive heart diseases patients without heart failure (82.7%) most them : (83%) above age 40 years , females (84.7%) and married (82.7%).The most complication of hypertension were heart disease (82%), renal disease (5.9%) , heart failure (5.1%) and stroke (3.2%). In future the researchers need study more about hypertensive risk factors such as life style changes .

Comparative case control study on risk factors of Coronary Artery Disease among Sedentary and Heavy Workers

Introduction: Coronary artery disease is most common heart disease among people in this world. It is a preventable lifestyle disease. Certain life style changes will influence the risk factors of developing coronary artery disease in sedentary workers and heavy workers. Objectives: the primary objective of the study was to compare the risk factors of coronary artery disease among sedentary and heavy workers. Methodology: A quantitative approach and non-experimental comparative case control was adopted for the study. Total 120 samples (60 sedentary workers and 60 heavy workers) selected by convenient sampling technique. Data were collected by interview method using structured questionnaire method. The collected data were analyzed by frequency and percentage distribution. Results: The results showed that there was a significant association between the risk factors of CAD among sedentary workers such as BMI (χ2=8.58, p=0.014), types of work (χ2=45.50, p=0.001), age (χ2=18.99, p=0.001) and exercise (χ2=0.00, p=0.001). And there was a significant association between the risk factors of CAD in case among sedentary and heavy workers such as monthly family income (χ2=6.74, p=0.034), alcohol (χ2=12.43, p=0.006), coffee (χ2=19.47, p=0.001) and mode of transportation (χ2=34.35, p=0.001) and there was a significant association between the risk factors of CAD in control among sedentary and heavy workers such as BMI (χ2=19.36, p=0.001), alcohol (χ2=20.26, p=0.001), smoking (χ2=8.11, p=0.044), coffee (χ2=30.97, p=0.001), and mode of transportation (χ2=30.00, p=0.001). Conclusion: The study concluded that the risk factors of coronary artery disease is more common in sedentary workers than heavy workers. Being aware of the risk factors will help the peoples become aware of their chances of developing coronary artery disease and therefore will encourage them to adopt healthy lifestyle.

Gastric Bypass versus Sleeve Gastrectomy in Morbid Obesity Management

Background Obesity is caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications, or psychiatric illness. The main aim of obesity therapy is weight loss and maintenance by dietary interventions and increased physical activity. Aim of the Work to review two of the most commonly performed modalities of weight loss namely Sleeve Gastrectomy, Gastric Bypass, and to study their early post-operative complications, outcomes, effects regarding excess body weight loss (EBWL), life style changes and sustainability. Patients and Methods This is a prospective comparative randomize study included 40 patients presented with morbid obesity with BMI range between (40 to 60 kg/m2) were treated 20 cases by laparoscopic sleeve Gastrectomy and 20 cases by laparoscopic Gastric Bypass (15 cases one anastomosis gastric bypass – 5 cases Roux-en-Y bypass) in Ain Shams Hospital during the period from October 2017 till May 2018. Cases were followed up monthly for 6 months and after 1 year. Results Laparoscopic sleeve gastrectomy has higher incidence of complications (15%) than the incidence of complications of Laparoscopic Gastric Bypass (5%). Conclusion Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Bypass are both safe and effective procedures for the surgical management of morbid obesity. Laparoscopic Gastric Bypass has slightly higher mean of (EBWL%) than Laparoscopic sleeve gastrectomy at 6 months, and a higher mean of (EBWL%) than Laparoscopic sleeve gastrectomy at 1 year follow up.

Life style changes in above 50 years old patients presenting in Urology Department during COVID 19 pandemic - a multicenter survey.

Objective: In the current pandemic of COVID-19 the health care workers are working with social scientist to assist the government policy makers to slow the spread of this disease. These studies are focusing on different social aspects of the disease. A few studies are conducted on the behavior changes in community in response to this pandemic. Study Design: Cross Sectional Survey. Setting: Urology Outpatients Department of Four Hospitals. Period: May 2020. Material & Methods: YouGov behavior change Performa was used for the survey with a 4 points scale from "Not at all" to "Drastic Change". Results: Total 285 patients were included in this study. Among these 191 patients were male while 94 were female. The age range was 50-68 years. Among 285 patients 159 an education level above primary. Among these 285 patients 234 patients (82.1%) belong to urban area while 51 patients (17.9%) belongs to rural area. Regarding change in behavior, 168 patients responded that there is no change, 56 showed a little change, 32 showed significant change and 28 showed drastic change in the habit of hand washing. In change in travel habit 128 mentioned not at all, 84 said a little change, 53 showed significant change and 20 said drastic change. In work from home 120 mentioned not at all, 88 said a little change, 57 showed significant change and 20 said drastic change. In piling of food and medicine 164 mentioned not at all, 96 said a little change and 25 showed significant change while there was no drastic change. In elderly and child care160 mentioned not at all, 68 said a little change and 57 showed significant change while there was no drastic change. In social distancing 160 mentioned not at all, 72 said a little change, 24 showed significant change and 29 said drastic change. In use of face mask 124 mentioned not at all, 132 said a little change, 24 showed significant change and 05 said drastic change. Conclusion: As there is no vaccine for this disease and treatment plans are also under trial so the role of preventive measures increases. The most important preventive measures are wearing of face masks, social distancing and avoidance of unnecessary traveling. As, at present, we can only decrease the spread of disease by adopting preventive measures.

Expression of Urocortin 3 mRNA in the Central Nervous System of the Sea Lamprey Petromyzon marinus

In this study, we analyzed the organization of urocortin 3 (Ucn3)-expressing neuronal populations in the brain of the adult sea lamprey by means of in situ hybridization. We also studied the brain of larval sea lampreys to establish whether this prosocial neuropeptide is expressed differentially in two widely different phases of the sea lamprey life cycle. In adult sea lampreys, Ucn3 transcript expression was observed in neurons of the striatum, prethalamus, nucleus of the medial longitudinal fascicle, torus semicircularis, isthmic reticular formation, interpeduncular nucleus, posterior rhombencephalic reticular formation and nucleus of the solitary tract. Interestingly, in larval sea lampreys, only three regions showed Ucn3 expression, namely the prethalamus, the nucleus of the medial longitudinal fascicle and the posterior rhombencephalic reticular formation. A comparison with distributions of Ucn3 in other vertebrates revealed poor conservation of Ucn3 expression during vertebrate evolution. The large qualitative differences in Ucn3 expression observed between larval and adult phases suggest that the maturation of neuroregulatory circuits in the striatum, torus semicircularis and hindbrain chemosensory systems is closely related to profound life-style changes occurring after the transformation from larval to adult life.

Ayurvedic Management of Parikarthika (Acute Fissure in Ano) – A Case Study

Among anorectal diseases, Parikarthika (Fissure in ano) is considered one of the most painful diseases. Now a days the incidence rate of this disease became more due to the irregular food habits as well as unproper modern life style changes. Due to this its recent occurrence in all types of age groups irrespective of gender. This case study described the effective management of acute fissure in ano which was managed with ayurvedic treatment modalities. A 23-year male patient came with symptoms of pain and burning during and after defecation and also having the presence of blood streak while passing of stool. The patient was diagnosed as acute fissure due to the presence of a cut longitudinal ulcer in lower part of anal canal at the 6 o’clock position. Ayurvedic treatment approach both internally and externally were followed. Jatyadi Ghritham Pichu application followed by a lukewarm water sitz bath was advised as external treatment. The complete improvement was found in this within 12 days of treatment. No reoccurrence was noted even after 3rd month of follow up.

The efficacy of the boric acid-based maintenance therapy in preventing recurrent vulvovaginal candidiasis

Current gold-standard treatment of recurrent vulvovaginal candidiasis (RVVC) is mainly based on maintenance with fluconazole. Moderate to high recurrence rates at long-term use and secondary fluconazole resistance emerge as reasons to seek for new topical maintenance regimens. In this study, it is aimed to assess the efficacy and safety of boric acid-based treatment approach to treat clinical RVVC. In this retrospective study, patients who were diagnosed with RVVC received a treatment package for six months that consist of induction with boric acid vaginal suppositories 600 mg daily for 14 nights followed by maintenance for five nights starting with every fifth day of the menstrual cycles; a vaginal estriol-lactobacilli combination; and several rigorous life-style changes. The success was defined as the absence of symptomatic recurrence during the follow-up. Success rate at the first year was found to be 94.8% in a total of 173 patients. Mild, reversible side effects were observed in five patients (2.9%). Boric acid, along with a vaginal estriol-lactobacilli combination and lifestyle changes can be a safe and effective alternative in lieu of potent systemic antifungal drugs as a first-line treatment for the patients referred with RVVC.

STUDY OF SERUM URIC ACID LEVEL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

BACKGROUND:Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. AIM:To evaluate the serum uric acid level in patients with type 2 Diabetes mellitus. MATERIALS AND METHODS:It was a prospective observational study conducted on 100 patients attending Medicine Department of Jhalawar Medical College, Jhalawar, Rajasthan. The study was done to assess the uric acid status in patients with diabetes mellitus and to find out its association with Age, Gender, Body Mass Index (BMI), Waist Hip Ratio (WHR), Dyslipidemia and Hypertension. Relevant history, vitals, clinical examination and laboratory investigations were done and recorded. RESULTS:This study evaluated the level of serum uric acid in Type 2 diabetes mellitus patients and confirmed there significantly high prevalence of hyperuricemia among type 2 diabetes subjects and increased association with increasing age, BMI, WHR, Dyslipidemia, Hypertension and female sex. CONCLUSION: Patients with Poor metabolic control and longer duration of diabetes were more susceptible to develop various complications including hyperuricemia. Early diagnosis and control of Diabetes Mellitus and its complications is indicated and potential therapeutic approaches (therapeutic life style changes and pharmacotherapy) should be initiated.