Gujarat Population Research Articles

Correlative study of diameter of carotid canals with cranial index in Gujarat population

Correlative study of diameter of carotid canals with cranial index in Gujarat population

Efficacy of an exercise program on balance and lower limb functional level among elderly population of Gujarat, India: A randomized controlled trial to prevent falls

Background: Altered balance and lower limb muscle weakness are the common risk factors associated with falls in elderly. Objectives: The purpose of this study was to assess the efficacy of an exercise program on balance and lower limb functional level in elderly population with moderate risk of fall. Materials and Methods: An exercise program, including warm-up exercises, balancing exercises, strengthening exercises, flexibility, and cool-down exercises, was designed for this interventional study. A total of 50 participants were selected by simple random sampling method from the physiotherapy department of the hospital, Ahmedabad, and they were randomly allocated into an interventional group of 25 and a control group of 25 participants. The inclusion criteria included, age: 60–80 years, both men and women, and Berg balance scale (BBS) score of ≤45. The intervention group received the exercise program for 4 times/week for up to 6 weeks and the control group was kept in waiting period. Pre- and post-exercise programs, a comparison of all measures was done with focus on BBS and lower extremity functional scale as primary outcome measures to find out the efficacy of the treatment protocol. The general linear model: Repeated measures analysis of variance and the independent t-test was used for analysis and values of P < 0.05 were considered statistically significant. Results: A total of 50 participants including 28 females and 22 males aged 60–80 years with an average age of 69.2 ± 6.6 years were included in the study. The balance and lower limb functional level of the intervention group were significantly higher than the baseline values with large effect size. Furthermore, the intervention group showed statistically significant improvement in balance and lower limb function when compared with the control group. Conclusion: The randomized controlled trial indicated that the designed exercise program for elderly was effective, and there was a significant improvement in balance and lower limb functional level in participants who received the exercise program. This study suggested that elderly people with moderate risk of fall can minimize falls and related fractures by better balance and strength with exercises.

Prevalence of oral squamous cell carcinoma in South Gujarat population

Background: The purpose of the study was to determine the prevalence of oral squamous cell carcinoma (OSCC) at specific anatomic sites or within specific age or gender groups and the correlation between various forms of tobacco usage in South Gujarat population. Methodology: The study covers the period from January 2016 to January 2018. OSCC cases who reported to the Bharat Cancer Hospital and Research Centre, Saroli, Surat, Gujarat, were analyzed for age, sex, site, and habits. The findings were formulated to chart the prevalence in South Gujarat population. Results: The study revealed that males represented a higher proportion than females, i.e., 79% of males and 21% of females, with the highest incidence of OSCC developing in the fourth and fifth decades of life, whereas recently a shift was also observed in terms of age group as 23 patients were falling into younger age group (20–30 years), which is an alarming factor. Overall, the most common site was buccal mucosa followed by tongue and lower alveolus. Smokeless tobacco habit was more prevalent than smoking tobacco habit. Conclusion: Close follow-up and education about the harmful and carcinogenic effects of tobacco and alcohol should be provided on a larger scale and broader population.

Sexual dimorphism of maxillary sinus in Gujarat population CT - A retrospective study

Sexual dimorphism of maxillary sinus in Gujarat population CT - A retrospective study

Phenotyping of Rh, Kell, Duffy and Kidd Blood Group Antigens among Non-Tribal and Tribal Population of South Gujarat and its Implication in Preventing Alloimmunization in Multitransfused Patients.

Background:Sickle cell anaemia is common amongst Tribal population of south Gujrat. Alloimmunisation in multitransfused sickle cell anaemia patient is 10 times commoner in these patients than beta Thalassemia major patients from regular blood donor communities.&#x0D; Study design &amp; methodology: Red cell antigen typing of Rh (D,C,E,c,e ), Kell (K, k), Duffy (Fya, Fyb) and Kidd (Jka, Jkb) were carried out in 222 regular voluntary blood donors who belonged to non-tribal population and in 113 samples of tribal population using conventional antisera.&#x0D; Results: Rh D antigen frequency was 96.6% in non-tribal and 96.5% in tribal population. 2.4% of K antigen was found in non-tribal population whereas the antigen was absent in tribal population .Amongst Rh antigens, e was the most common (100%) followed by D, C (91.0%, 85.8%), c (50.5%, 44.2%) and E (16.5%, 17.0%) with DCe/DCe (R1R1, 48.0%, 55.8%) being the most common phenotype in both the groups. In Kell antigens k antigen was 100% ,Kidd and Duffy antigens Jk (a+b-) (39.2%, 46.9%) and Fy (a+b-) (64.2%, 52.2%) were the most common phenotypes in non-tribal and tribal population respectively.&#x0D; Conclusion: There is significant difference in Duffy , Kidd and Kell (k) antigen distribution between non tribal and tribal population . Total absence of Kell antigen in tribalsalong with. E antigen in a significant portion of blood donors and its absence in large number of tribals also increase the risk of alloimmunisation. &#x0D;

Insertion-deletion polymorphism of angiotensin converting enzyme and susceptibility to rheumatoid arthritis in South Gujarat population

Rheumatoid Arthritis (RA) is a chronic inflammatory disease of synovial joints. High levels of angiotensin-converting enzyme (ACE) have been documented in RA synovial fluid (SF) and pleural effusions. The ACE gene insertion-deletion (INDEL or I/D; Intron 16; AF118569) polymorphism has been associated with the variability of serum ACE activity in which DD and II genotypes possess the highest and lowest ACE activity, respectively.The study investigated the association of ACE gene I/D polymorphism with RA in South Gujarat Population. Total 174 RA patients and 261 healthy controls were genotyped for ACE I/D polymorphism by polymerase chain reaction (PCR) method. The plasma ACE levels in 34 RA patients and 42 healthy controls were estimated by ELISA. The genotype and allele frequencies of the polymorphism were significantly differed between patients and control population (p = 0.0013; p < 0.0001 respectively), suggesting that ACE I/D polymorphism is associated with RA susceptibility in South Gujarat population. The susceptible ‘D’ allele was prevalent in RA group as compared to the control group (67.00% vs 54.00%). Though, there was no significant difference in the levels of ACE between patient and control groups (p = 0.827), the genotype-phenotype analysis revealed that individuals with DD and ID genotypes exhibit increased ACE levels as compared to the II genotypes (p = 0.0174; p = 0.0062 respectively). In addition, ‘DD’ genotype being prevalent in early age of onset group and severe RA group of patients proposes a crucial role of ACE I/D polymorphism in RA development and disease activity.Overall, our study suggests that ACE I/D polymorphism may be associated with RA susceptibility in South Gujarat Population.

Role of TNF −308 G/A, TNFβ +252 A/G and IL10 −592 C/A and −1082 G/A SNPs in pathogenesis of Immune Thrombocytopenia Purpura in population of Gujarat, India

Immune Thrombocytopenic Purpura (ITP) is an autoimmune disease, also known as Idiopathic Thrombocytopenia Purpura is characterized by the presence of antibodies against self-platelets. The etiology of ITP remains unclear, but it is generally accepted that both environmental and genetic factors and probably also a synergistic relationship between these factors, play important roles in the development of the disease. The etiological data for Indian population is insufficient. Several reports have suggested an association of cytokine polymorphisms with ITP, especially in occurrence and progression of acute ITP to chronic ITP disease. We therefore investigated association of candidate gene viz. TNFA (−308G/A), TNFB (+252A/G) and IL10 (−592C/A; −1082G/A) polymorphisms with Immune Thrombocytopenia Purpura in Population from Gujarat state of India.To investigate this, total 154 subjects (103 control and 51 ITP patients) were selected irrespective of sex. DNA was extracted and PCR-RFLP analysis was performed to assess the association of the above mentioned SNPs in patients 51 with respect to 103 controls.Results revealed that SNP of TNFA (−308) GA genotype was significantly higher in ITP patients (p < 0.0001, OR 7.8887 and 95% CI = 3.857–16.13) as well as elevated frequencies of recessive genotype AA (p < 0.001, OR = 11.40, 95% CI = 5.176–25.11) were present. Similarly, IL10 (−1082G/A) showed significant association with ITP patients with increased GA genotype frequency (p = 0.398, OR = 2.057, 95% CI = 1.030–4.109). The homozygous recessive genotype AA was also found to be significantly high (p < 0.0013, OR = 3.088, 95% CI = 1.541–6.190). However, we did not observe any association between TNFB(+252A/G) and IL10 (−592C/A) SNPs with ITP patients.Overall, our study suggests that the GA/AA genotype of the TNFA −308G/A and IL-10 −1082 polymorphism may be a significant genetic risk factor for the pathogenesis of ITP. Moreover, TNFA and IL-10 single nucleotide polymorphisms (SNPs) are known to be associated with altered expression of these proteins which may lead to dysregulation in downstream pathways of inflammation, thereby further strengthening the possibility, of role of inflammatory pathway's components in the development of ITP.

Genetic variants of tumor necrosis factor-α and its levels: A correlation with dyslipidemia and type 2 diabetes susceptibility

Tumor necrosis factor-α (TNF-α) and its genetic variants are implicated in the development of type 2 diabetes (T2D) as a result of systemic inflammation, dyslipidemia, and insulin resistance. The aim of the present study was to investigate i) single nucleotide polymorphisms (SNPs) of TNF-α and its association with altered TNF-α transcript levels and plasma concentrations ii) free fatty acid (FFA) concentrations as a marker for dyslipidemia and its association with TNF-α and iii) genotype-phenotype correlation analysis in T2D patients. Plasma and PBMCs were separated from venous blood of 478 diabetic patients and 502 age-matched non-diabetic individuals. Genomic DNA was isolated from PBMCs and RNA was isolated from PBMCs and adipose tissue samples. PCR-RFLP was used for genotyping and qPCR to estimate TNF-α levels. TNF-α and FFA concentrations were estimated from plasma samples by ELISA. Our study suggests: i) involvement of TNF-α-857C/T in T2D patients (p<0.0001), ii) 2.072 and 6.7 fold elevation in TNF-α transcript levels in patients' PBMCs and adipose tissues respectively, increased plasma TNF-α (p=0.0122) particularly in obese patients (p=0.0405), increased plasma FFA (p=0.0215) and, iii) association of TNF-α-238G/A with body mass index (BMI) (p=0.0270) and,-857C/T with fasting blood glucose (FBG) (p=0.0122) and triglycerides (TG) (p=0.0015). Correlation analysis suggests that TNF-α concentrations are positively correlated with BMI (r=0.3, p=0.04) and negatively correlated with HDL (r=-0.39, p=0.001) while the FFA concentrations are positively correlated with BMI (r=0.35, p=0.0004). It can be concluded that the genetic variant of TNF-α along with elevated TNF-α and FFA concentrations play a role in the development of dyslipidemia which could be a potent risk factor towards T2D in Gujarat population.

Association of melatonin &MTNR1B variants with type 2 diabetes in Gujarat population

Aim/hypothesisMelatonin is a circadian rhythm regulator and any imbalance in its levels can be related to various metabolic disorders. Melatonin and the genetic variants of Melatonin Receptor 1B (MTNR1B) are reported to be associated with Type 2 Diabetes (T2D) susceptibility. The aim of the present study was to investigate i) plasma melatonin levels ii) Single Nucleotide Polymorphisms (SNPs) of MTNR1B and iii) Genotype-phenotype correlation analysis in T2D patients. MethodsPlasma and PBMCs were separated from venous blood of 478 diabetes patients and 502 controls. Genomic DNA was isolated from PBMCs. PCR-RFLP was used for genotyping. Melatonin was estimated from plasma samples by ELISA. ResultsOur study suggests: i) decreased plasma melatonin levels in T2D patients and, ii) association of MTNR1B rs10830963 GG genotype with increased Fasting Blood Glucose (FBG). ConclusionIt can be concluded that reduced titer of melatonin along with altered FBG due to MTNR1B genetic variant could act as a potent risk factor towards T2D in Gujarat population.

Association of elevated homocysteine levels and Methylenetetrahydrofolate reductase (MTHFR) 1298 A > C polymorphism with Vitiligo susceptibility in Gujarat

BackgroundSeveral studies have reported hyperhomocysteinemia in vitiligo patients, suggesting the potential role of elevated homocysteine levels in precipitating vitiligo. ObjectivesWe aimed to estimate homocysteine and vitamin B12 levels, and to investigate the role of MTHFR 677 C > T and 1298 A > C polymorphisms in vitiligo susceptibility in Gujarat population. MethodsHomocysteine and vitamin B12 levels were estimated in plasma of 55 vitiligo patients and 60 controls by Electrochemiluminescence immunoassay (ECLIA). Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) techniques were used to genotype MTHFR 677 C > T and 1298 A > C polymorphisms in 520 vitiligo patients and 558 controls. ResultsOur results showed significantly elevated homocysteine levels (p = 0.0003) as well as significant decrease in vitamin B12 levels (p = 0.0102) in vitiligo patients, as compared to controls. No significant difference in genotype and allele frequencies of MTHFR 677 C > T polymorphism was observed among patients and controls, however, the frequency of ‘CC’ genotype of MTHFR 1298 A > Cpolymorphism was significantly increased in patients as compared to controls (p = 0.0151). Analysis based on the type of vitiligo revealed a significant increase in ‘C’ allele of MTHFR 1298 A > C polymorphism in patients with generalized (p = 0.003) and active (p = 0.007) vitiligo as compared to controls. Both the polymorphisms of MTHFR were in low linkage disequilibrium (LD) and susceptible ‘TC’ haplotype was more frequently observed (p = 0.008) in vitiligo patients. Interestingly, elevated homocysteine levels were also positively correlated with MTHFR 1298 A > C polymorphism in vitiligo patients. Structure based in silico prediction revealed structural perturbations in MTHFR protein due to Ala222Val and Glu429Ala amino acid substitution. ConclusionsThe present findings suggest that MTHFR 1298 A > C polymorphism and, altered homocysteine and vitamin B12 levels might play a vital role in the precipitation of vitiligo.

Sero-Epidemiology of Camel (Camelus dromedarius) brucellosis

Brucellosis is an emerging zoonotic bacterial disease of ruminants and also reported in camels. Camels are one of the most important sources of livelihood for the poor nomadic population in Gujarat. The present study was aimed to determine the brucella specific antibodies in camel using RBPT and i-ELISA. On screening of 658 serum samples, 131(19.90%) and 78 (11.85%) samples found to be positive by RBPT and i-ELISA, respectively. Prevalence rate of brucellosis in different categories viz. herd size, physiological status, sex, district, region and breed were calculated. Susceptibility of brucellosis in different categories was also compared by using chi-square test.

Genotyping and clinical characteristics screening of children with intellectual disability in Western India

Background: The RhoGTPases (ARHGEF6, OPHN1 and PAK3) are key signaling proteins, and can inter-relate extracellular and intracellular signals to sort out changes in the actin cytoskeleton of neuronal network connectivity. IL1RAPL2 is a member of Interleukin 1 receptor family that is expressed at high level in post-natal brain structures involved in the hippocampal memory system. The mutations of these genes have been reported to cause intellectual disability (ID). Therefore, this study is conducted to scrutinize distinctive distributions of genomic variations on West Indian population. Subjects and Methods: The genotyping for determination of SNPs associated with X-linked genes (rs35747426 in ARHGEF6, rs121434612 in PAK3, rs199985543 in OPHN1 and rs9887672 in IL1RAPL2) was performed in phenotypically screened 116 intellectually disabled and 100 healthy children by PCRRFLP method. Results: It has identified that allelic frequencies for rs199985543 and rs9887672 are seen progressively present in the disease group, indicating a significant level of association with ID in Gujarat population. The multifactor dimensionality reduction (MDR), SNP-SNP genotype models are resulted with a relationship of ID if there should be an occurrence of the OPHN1 and IL1RAPL2 gene variants. Additionally, rs199985543 was analyzed for OPHN1 protein structure and stability prediction, which results damaging effect to the protein. Surprisingly, no variation was found for rs35747426 ARHGEF6 and rs121434612 PAK3 polymorphisms in the present study population. Conclusion: This phenotype-genotype relationship has a solid and measurable connection according to the carrier genotypes of the variations and different types of ID, that confirm the mutation in OPHN1 and IL1RAPL2 genes permit serious attention for disease risk.

Association of interleukin 1 receptor antagonist intron 2 variable number of tandem repeats polymorphism with vitiligo susceptibility in Gujarat population.

Vitiligo is a multifactorial, polygenic, autoimmune skin disorder caused by selective destruction of melanocytes. Interleukin 1 receptor antagonist intron 2 polymorphism was found to be associated with various autoimmune disorders. We aimed to investigate the association of interleukin 1 receptor antagonist intron 2 variable number of tandem repeats polymorphism (rs2234663) with vitiligo to assess interleukin 1 receptor antagonist transcript levels and to perform possible genotype-phenotype correlation. Three hundred and seven vitiligo patients and 316 controls were enrolled in the study, genotyping of interleukin 1 receptor antagonist rs2234663 was performed by polymerase chain reaction, and relative gene expression of interleukin 1 receptor antagonist was carried out in peripheral blood mononuclear cells from patients (n = 36) and controls (n = 36) by real-time-PCR. A significant difference was observed in the frequency of interleukin 1 receptor antagonist *A (1/2) genotype among patients with active and stable vitiligo (P = 0.0172). Interleukin 1 receptor antagonist*A (2/2) genotype and allele frequencies were significantly different between SV patients and controls (P = 0.0246 and P = 0.0046, respectively). Significant difference was also observed for interleukin 1 receptor antagonist*A2 (allele) in active and stable vitiligo patients (P = 0.0060). However, other comparisons did not show any significant difference in genotype and allele frequencies. Moreover, interleukin 1 receptor antagonist*A (3/2) genotype was observed only in patients whereas interleukin 1 receptor antagonist*A (5/2) was observed only in controls. Gene expression analysis showed no significant difference in interleukin 1 receptor antagonist transcript levels in patients compared to controls (P = 0.5962). Interestingly, genotype-phenotype correlation analysis revealed that individuals with IL1RN*A (2/2) exhibited higher interleukin 1 receptor antagonist expression compared to other major genotypes interleukin 1 receptor antagonist*A (1/2) (P = 0.01) and interleukin 1 receptor antagonist*A (1/1) (P = 0.03). More case-control studies on interleukin 1 receptor antagonist rs2234663 polymorphism and gene expression from different ethnic populations are required to explore the impact of interleukin 1 receptor antagonist in vitiligo susceptibility. Interleukin 1 receptor antagonist*A2 might be a risk factor for progressive vitiligo.

Prevalence of commissural lip pits in population of central Gujarat: A hospital-based study.

Background:Commissural lip pits (CLPs) fall among the rare congenital deformities recorded. CLP usually follows dominant hereditary pattern and may be associated with other congenital defects. CLP can appear as unilateral depression or bilateral depression.Objective:To assess the prevalence, age distribution, site and gender predilection of CLP in a central Gujarat population.Materials and Methods:Outdoor patients over a period of 6 months were examined for clinical evidence of CLPs.Results:A total of 14,403 patients were examined for the presence of CLP. CLP was identified in 381 patients with a prevalence of 2.65%. The occurrence of CLP was more in male patients. The maximum number of patients was in the age groups of 20–29 years. No significant statistical difference was observed in the distribution of CLP. Unilaterally distributed CLP was more common on the left side.Conclusion:Our study showed 2.65% prevalence of isolated CLPs with a male predilection. There was almost equal distribution of unilateral and bilateral CLP. In unilateral cases, the left side was affected the most. Although literature says lip pits can be an associated feature of certain syndromes, there were no syndromic patients in our study.

Meningo-Orbital Foramen in South Gujarat population

Abstract Background &amp; Aims: Meningo-orbital foramen is provides a route for an anastomosis between the meningo-orbital branch of the middle meningeal artery and recurrent meningeal branch of ophthalmic artery. Practical importance is emphasized when the middle meningeal artery has abnormal origin, in the cases of subtemporal epidural hematoma, tumors, vascular malformations and in the cases when the foramen spinosum is absent. Present study was undertaken in order to explore the frequency and positional anatomy of this foramen in ninety dry adult human skulls of south Gujarat population. Material &amp; Method: This study was conducted on 90 dry skulls of human origin. Different parameters were noted. Result: Meningo-orbital foramen was absent bilaterally in 35[38.88%] of the skulls studied .The presence of the Meningo-orbital foramen was detected in the 55[61.11%] cases. It was present unilaterally in 30[33.33%] cases [10 on the right and 20 on the left side], and bilaterally in 25[27.77%] cases. Triple MOF were in 2 skulls on right orbit only. Largest variability was noted for distance from the lateral end of the superior orbital fissure. Conclusion: Knowledge of presence and variation in meningo-orbital foramen's anatomical parameter can be crucial for ophthalmologists and neurosurgeons.

Determination of root canal configuration and the prevalence of “C-shaped” canals in mandibular second molar in central and South Gujarat population: An in vitro study

Aims: The aim of the present study was to determine the canal configuration and the prevalence of “C-shaped” canals in mandibular second molar in Central and South Gujarat population. Materials and Methods: A total of 122 mandibular second molar teeth were collected and stored in 10% formalin. Identification of these teeth as mandibular second molar was confirmed by two independent observers. An endodontic access cavity was then prepared in each tooth. Then, they were injected with India ink and demineralized, they were made clear and transparent with methyl salicylate. Then, anatomy of their canals was studied. Results: Out of 122 mandibular second molars, prevalence of “C-shaped” canals was 10.65% (13 teeth). These configurations were seen mostly in single-rooted mandibular second molars. Out of five categories of “C-shape,” predominantly found category was (C1) – 46.15%. Conclusion: Hard tissue of mandibular second molar contains dental pulp which can take a variety of configurations and shapes. The great differences reported among studies with regards to anatomy of the mandibular second molars and prevalence of “C-shaped” canals may be attributable to study methods and racial differences.

Association of Neuropeptide-Y (NPY) and Interleukin-1beta (IL1B), Genotype-Phenotype Correlation and Plasma Lipids with Type-II Diabetes.

BackgroundNeuropeptide Y (NPY) is known to play a role in the regulation of satiety, energy balance, body weight, and insulin release. Interleukin-1beta (IL1B) has been associated with loss of beta-cell mass in type-II diabetes (TIID).ObjectivesThe present study attempts to investigate the association of NPY exon2 +1128 T/C (Leu7Pro; rs16139), NPY promoter -399 T/C (rs16147) and IL1B -511 C/T (rs16944) polymorphisms with TIID and their correlation with plasma lipid levels, BMI, and IL1B transcript levels.MethodsPCR-RFLP was used for genotyping these polymorphisms in a case-control study involving 558 TIID patients and 1085 healthy age-matched controls from Gujarat. Linkage disequilibrium and haplotype analysis of the NPY polymorphic sites were performed to assess their association with TIID. IL1B transcript levels in PBMCs were also assessed in 108 controls and 101 patients using real-time PCR.ResultsOur results show significant association of both structural and promoter polymorphisms of NPY (p<0.0001 and p<0.0001 respectively) in patients with TIID. However, the IL1B C/T polymorphism did not show any association (p = 0.3797) with TIID patients. Haplotype analysis revealed more frequent association of CC and CT haplotypes (p = 3.34 x 10−5, p = 6.04 x 10−9) in diabetics compared to controls and increased the risk of diabetes by 3.02 and 2.088 respectively. Transcript levels of IL1B were significantly higher (p<0.0001) in patients as compared to controls. Genotype-phenotype correlation of IL1B polymorphism did not show any association with its higher transcript levels. In addition, NPY +1128 T/C polymorphism was found to be associated with increased plasma LDL levels (p = 0.01).ConclusionThe present study provides an evidence for a strong correlation between structural and promoter polymorphisms of NPY gene and upregulation of IL1B transcript levels with susceptibility to TIID and altering the lipid metabolism in Gujarat population.

A study of morphometric variations of celiac trunk using computed tomographic angiography

Aims and Objectives: Evaluate the normal anatomy of celiac trunk and prevalence of ana­tomical variations of celiac trunk in the South Gujarat population. Materials and Methods: Total 50 subjects irrespective of age and sex, who underwent CT angiography of abdominal aorta for medical or surgical indications, were selected for the study. Subjects allergic to contrast medium or having history of malignancy or previous abdominal surgery or aorto-arteritis were excluded from the study. The angiography images were obtained using spiral CT scanner from department of radio-diagnosis of Surat Municipal Institute of Medical Education and Research (SMIMER) and reformatted as 3D images to evaluate celiac arterial anatomy and its variations with respect to level of origin, length, diameter and branching pattern. Results: Variation in the vertebral level of origin of celiac trunk was observed in about 60 % cases. The length and dimensions of the trunk also displayed a wide range of variation. Variant branching patterns are found in 32 % of subjects with bifurcation of celiac trunk into splenic and common hepatic arteries and left gastric arises from some different sources. Conclusion: The knowledge of morphometric variations of celiac trunk is indispensable for diagnostic and operative procedures of abdomen. Without a thorough understanding of the arterial architecture and the knowledge of variations, surgery may carry a considerable risk leading to lethal complications. A high celiac trunk may lead to its compression. Variation in branching pattern is considerably important in hepato-biliary surgery and chemo-embolization for malignancy. Key words: Angiography, celiac trunk, computerized tomography, variation

Investigating the Role of Plasma Glucose Concentration as a Phenotypic Marker for CYP2C9 Genetic Variants, in the Diabetic Population of Gujarat.

The present study was aimed to investigate the role of plasma glucose concentration as a phenotypic marker and to study the frequency distribution of CYP2C9 genetic variants in Gujarat state diabetic population. One hundred and nine unrelated diabetes mellitus patients treated with sulfonylureas were genotyped for CYP2C9*2 and CYP2C9*3 alleles. Their pre- and posttreatment postprandial blood glucose levels were recorded and mean glucose drop per milligram of drug values were calculated and further used as an index for phenotypic correlation. The frequencies of CYP2C9*1, CYP2C9*2 and CYP2C9*3 alleles in the Gujarat state diabetic population were 0.84, 0.07 and 0.09, respectively. The distribution of CYP2C9*1/*1, CYP2C9*1/*2, CYP2C9*1/*3, CYP2C9*2/*2, CYP2C9*2/*3 and CYP2C9*3/*3 genotypes were 0.73, 0.08, 0.13, 0.0, 0.06 and 0.0, respectively. Patients with CYP2C9*1/*2 genotype did not show any significant difference in the mean glucose drop per milligram of drug values when compared with wild-type patients in glipizide-treatment group. Patients with CYP2C9*1/*3 genotype showed greater mean glucose drop per milligram of drug values than patients with CYP2C9*1/*1 wild-type genotype for both glipizide and glimepiride while patients with CYP2C9*2/*3 genotype showed greater drop than patients with CYP2C9*1/*1 genotype only in the glipizide-treatment group. The presence of CYP2C9*3 allele significantly affected plasma glucose drop per milligram of drug values in patients taking glipizide and glimepiride, while effects of CYP2C9*2 allele were insignificant. Further studies are needed to confirm the effects of CYP2C9*2 allele on plasma glucose drop per milligram of drug values. However, plasma glucose concentration is a complex physiological marker that cannot be used to establish perfect genotype-phenotype correlation. Hence studies exploring robust phenotypic markers must be initiated.

High prevalence of chronic kidney disease in a semi-urban population of Western India.

BackgroundGlobally there is an increase in incidence of chronic kidney diseases (CKDs). Diabetes mellitus (DM), hypertension and stone diseases are the major risk factors for CKD. We organized kidney disease screening camps in a semi-urban population of Gujarat, India on the occasion of World Kidney Day (WKD).MethodsVoluntary participants from six towns were screened. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease formula and CKD was defined as an eGFR <60 mL/min/1.73 m2 or albuminuria ≥1+. Urogenital ultrasonography was performed with emphasis on stone burden. Participants with known diabetes, stone diseases, hypertension, kidney/liver/cardiac disease, hepatitis, HIV, transplant recipients, pregnant women and those <18 years were excluded from the study.ResultsOf the 2350 participants (1438 men), CKD was found in 20.93% and eGFR <60 mL/min/1.73 m2 was noted in 8.29% of participants. The prevalence of CKD peaked after the seventh decade of life in both genders. There was no significant difference in the prevalence of CKD between coastal and non-coastal regions, however, obesity, hypertension and diabetes were more common in the coastal belt, whereas stone burden was greater in the non-coastal region.ConclusionsThe prevalence of CKD in a semi-urban apparently healthy Indian population was higher than the reported prevalence in developed countries. Significant differences between regions point to the need to evaluate and correctregion-specific risk factors.