Normal Healthy Control Subjects Research Articles

Biomechanical properties of the ascending aorta in patients with arterial hypertension by velocity vector imaging.

Aortic stiffness is an important risk factor for cardiovascular events and morbidity. Increased aortic stiffness is associated with an increase in cardiac and vascular hypertension-related organ damage.To evaluate the biomechanical properties of the ascending aorta (AA) in patients with arterial hypertension (AH) by velocity vector imaging (VVI).Ninety-five patients with AH and 53 normal healthy control participants were prospectively enrolled. AA biomechanical properties, i.e., ascending aortic global longitudinal strain (ALS), ascending aortic global circumferential strain (ACS), and fractional area change (FAC), were evaluated by VVI. Relative wall thickness (RWT) and left ventricular mass (LVM) were calculated. Pulsed Doppler early transmitral peak flow velocity (E), early diastolic mitral annular velocity (e'), left ventricular global longitudinal strain (GLS), distensibility (D) and stiffness index (SI) of AA were also obtained.The ALS, ACS and FAC were significantly lower in the AH patients, especially in those with ascending aorta dilatation (AAD), than in the normal healthy control subjects. The patients with AAD had a higher E/e' ratio, RWT, LVM and SI and a lower GLS and D than patients without AAD and normal healthy volunteers (p < 0.05). There were significant associations between biomechanical properties and D, SI, E/e' and GLS (ALS and D: r = 0.606, ALS and SI: r = - 0.645, ALS and E/e': r = - 0.489, ALS and GLS: r = 0.466, ACS and D: r = 0.564, ACS and SI: r = - 0.567, ACS and E/e': r = - 0.313, ACS and GLS: r = 0.320, FAC and D: r = 0.649, FAC and SI: r = - 0.601, FAC and E/e': r = - 0.504, FAC and GLS: r = 0.524, respectively, p < 0.05).The biomechanical properties of AA were impaired in patients with AH, especially patients with ascending aorta dilatation. Hypertension is associated with a high prevalence of diastolic and systolic dysfunction and increased arterial stiffness. Further study is needed to evaluate the clinical application of AA biomechanical properties by VVI.

Adiponectin: A novel prognostic marker for rheumatoid arthritis: A case control study in a tertiary care hospital in central India

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by symmetrical synovitis, progressive damage to the articular cartilage and the subchondral bone, pain, fatigue, and disabilityRecognition of RA as early as possible is important, because a significant proportion of the patients develop irreversible joint damage shortly after disease onset &amp; risks associated with its treatment. The adiponectin is an active participant in the regulation of physiological and pathological processes, inflammatory process as mediator. This study was done to compare the progression of rheumatoid arthritis in conjunction with changes in levels of adiponectin and to evaluate its role as a prognostic marker. Analyse serum adiponectin level to evaluate its potential role to assess disease severity in patients of rheumatoid arthritis &amp; compare its level in normal healthy control subjects. This study was conducted in MY Hospital, Indore. We enrolled 50 cases of confirmed rheumatoid arthritis patients of 20-70 years age group and 50 age and sex matched apparently healthy controls. Both cases (n=50) and controls (n=50) were assessed for haematological tests and biochemical tests, lipid profile, uric acid, CRP &amp; adiponectin. The data were expressed as mean ± SD and analysed by using SPSS version 20. P-value of &amp;#60; 0.05 was accepted as statistically significant. The mean age of the cases was 44.74 ± 13.10 and that of controls was 42.26 ± 8.09. Maximum number of study patients were in the age group of 31-40 years &amp; women. The rheumatoid arthritis group was divided into subgroup according to DAS28 Score. Out of 50 cases, 2 patients (4.0%) had remission, 2 patients (4.0%) had low disease activity, 30 patients (60.0%) had moderate disease activity and 16 patients(32.0%) had high disease activity. The mean CRP in the rheumatoid arthritis group was 21.56 ± 25.46 mg/dL while in the control group was 11.09 ± 7.95 mg/L. The difference was found to be statistically significant (p&amp;#60;0.05).The mean ESR in the rheumatoid arthritis group was 21.26 ± 8.88 mm/hour while in the control group was 15.70 ± 5.40 mm/hour. The difference was found to be statistically significant (p&amp;#60;0.05).The mean adiponectin level in the rheumatoid arthritis group was 30.13 ± 13.04 µg/ml while in the control group was 17.08 ± 8.69 µg/ml. The difference was found to be statistically significant (p&amp;#60;0.05).The mean adiponectin level was highest in the high disease activity subgroup and lowest in the low disease activity subgroup.In our study we concluded that patients of rheumatoid arthritis have raised level of adiponectin &amp; CRP as compared to normal healthy control group. Adiponectin might be better marker for RA compare to CRP &amp; ESR. Also higher levels of adiponectin were observed in patients with severe disease. Therefore, adiponectin might be used for screening which will help in predicting disease progression.

Evidence of chromosomal damage in scleroderma

Evidence of chromosomal damage in scleroderma

Cytokine gene variants and socio-demographic characteristics as predictors of cervical cancer: A machine learning approach

Cervical cancer is still one of the most prevalent cancers in women and a significant cause of mortality. Cytokine gene variants and socio-demographic characteristics have been reported as biomarkers for determining the cervical cancer risk in the Indian population. This study was designed to apply a machine learning-based model using these risk factors for better prognosis and prediction of cervical cancer. This study includes the dataset of cytokine gene variants, clinical and socio-demographic characteristics of normal healthy control subjects, and cervical cancer cases. Different risk factors, including demographic details and cytokine gene variants, were analysed using different machine learning approaches. Various statistical parameters were used for evaluating the proposed method. After multi-step data processing and random splitting of the dataset, machine learning methods were applied and evaluated with 5-fold cross-validation and also tested on the unseen data records of a collected dataset for proper evaluation and analysis. The proposed approaches were verified after analysing various performance metrics. The logistic regression technique achieved the highest average accuracy of 82.25% and the highest average F1-score of 82.58% among all the methods. Ridge classifiers and the Gaussian Naïve Bayes classifier achieved the highest sensitivity—85%. The ridge classifier surpasses most of the machine learning classifiers with 84.78% accuracy and 97.83% sensitivity. The risk factors analysed in this study can be taken as biomarkers in developing a cervical cancer diagnosis system. The outcomes demonstrate that the machine learning assisted analysis of cytokine gene variants and socio-demographic characteristics can be utilised effectively for predicting the risk of developing cervical cancer.

SERUM IRON LEVELS IN PSORATIC PATIENTS IN PAKISTAN

Objective: &#x0D; The persuasive evidence shows that proper iron (Fe) nutrition has a chief role in human health. Hence a study was designed to estimate the serum iron in psoriatic patients in Pakistan.&#x0D; Materials and Methods:&#x0D; 500 patients (males &amp; females) with different ages and different types of psoriasis were randomly chosen for this study. Similarly 100 non–psoriatic volunteers, sex and age matched were included who served as controls were evaluated for serum iron level. Serum iron level was measured with atomic absorption spectrophotometer (AAS).&#x0D; Results:&#x0D; The serum iron level was found to be low in 80% patients. Mean ± SD of serum iron was 850.40 ± 2.30 µg/dL in disease group and 898.10 ± 1.50 µg/dL in control subjects. In patients serum iron level was notably lower than normal healthy control subjects (p&lt;0.001)&#x0D; Conclusion:&#x0D; It was concluded that deficiency of iron may play a role in the pathogenesis of psoriasis and routine serum iron estimation in patient with psoriasis will be helpful in evaluating and describing the severity of psoriasis.

Resting-State Static and Dynamic Functional Abnormalities in Active Professional Fighters With Repetitive Head Trauma and With Neuropsychological Impairments.

Previous neuroimaging studies have identified structural brain abnormalities in active professional fighters with repetitive head trauma and correlated these changes with fighters' neuropsychological impairments. However, functional brain changes in these fighters derived using neuroimaging techniques remain unclear. In this study, both static and dynamic functional connectivity alterations were investigated (1) between healthy normal control subjects (NC) and fighters and (2) between non-impaired and impaired fighters. Resting-state fMRI data were collected on 35 NC and 133 active professional fighters, including 68 impaired fighters and 65 non-impaired fighters, from the Professional Fighters Brain Health Study at our center. Impaired fighters performed worse on processing speed (PSS) tasks with visual-attention and working-memory demands. The static functional connectivity (sFC) matrix was estimated for every pair of regions of interest (ROI) using a subject-specific parcellation. The dynamic functional connectivity (dFC) was estimated using a sliding-window method, where the variability of each ROI pair across all windows represented the temporal dynamics. A linear regression model was fitted for all 168 subjects, and different t-contrast vectors were used for between-group comparisons. An association analysis was further conducted to evaluate FC changes associated with PSS task performances without creating artificial impairment group-divisions in fighters. Following corrections for multiple comparisons using network-based statistics, our study identified significantly reduced long-range frontal-temporal, frontal-occipital, temporal-occipital, and parietal-occipital sFC strengths in fighters than in NCs, corroborating with previously observed structural damages in corresponding white matter tracts in subjects experiencing repetitive head trauma. In impaired fighters, significantly decreased sFC strengths were found among key regions involved in visual-attention, executive and cognitive process, as compared to non-impaired fighters. Association analysis further reveals similar sFC deficits to worse PSS task performances in all 133 fighters. With our choice of dFC indices, we were not able to observe any significant dFC changes beyond a trend-level increased temporal variability among similar regions with weaker sFC strengths in impaired fighters. Collectively, our functional brain findings supplement previously reported structural brain abnormalities in fighters and are important to comprehensively understand brain changes in fighters with repetitive head trauma.

Hypoadiponectinemia as a marker of increased cardiovascular risk in patients with non-alcoholic fatty liver disease: correlation with albumin/creatinine ratio.

We assessed plasma adiponectin and its correlation with carotid intima-media-thickness (CIMT), as a marker of atherosclerosis, and urine albumin/creatinine ratio (ACR) in patients with non-alcoholic fatty liver disease (NAFLD). The study included 100 Egyptian subjects (50 patients with NAFLD with no history of diabetes or hypertension and 50 age and sex-matched normal healthy control subjects). Urine albumin/creatinine ratio (ACR) was assessed in all participants and fasting plasma adiponectin was measured using ELISA technique. Ultrasonography was used to diagnose NAFLD. CIMT was assessed using high-resolution Doppler ultrasonography. Mild albuminuria was detected in patients with NAFLD (mean urine ACR = 42 ± 30 mg/g). Plasma adiponectin was significantly lower and urine ACR and CIMT significantly higher in patients with NAFLD as compared with the control group (P < 0.001 for all). A significant negative correlation was found between plasma adiponectin and both urine ACR and CIMT in patients with NAFLD (P < 0.001 and < 0.05 respectively). A significant positive correlation was also found between CIMT and urine ACR in those patients (P < 0.05). Plasma adiponectin and urine ACR were independent determinants of CIMT in patients with NAFLD (P < 0.01 and < 0.05 respectively). Patients with NAFLD, without diabetes, have an increased risk of atherosclerosis and cardiovascular disease. Hypoadiponectinemia and low-grade albuminuria are important markers of that risk.

Diagnostic utility of corneal confocal microscopy in type2 diabetic peripheral neuropathy.

Aims/IntroductionThe early pathological changes of diabetic peripheral neuropathy (DPN) are mainly small nerve fiber injuries. Corneal confocal microscopy (CCM) is an easy, rapid, non‐invasive and repeatable technique to detect the damage of small nerve fibers. The purpose of this study was to explore the application of CCM in DPN and other chronic complications of type 2 diabetes mellitus.Materials and MethodsA total of 220 individuals (48 normal healthy control participants and 172 patients with type 2 diabetes mellitus) were included in the study. All participants were assessed and scored for neurological symptoms and neurological deficits, quantitative sensory test, neuroelectrophysiological test, and CCM.ResultsCorneal nerve fiber density, corneal nerve fiber length and corneal nerve branch density were significantly reduced in patients with type 2 diabetes mellitus compared with normal healthy control subjects (P < 0.001, P < 0.001 and P < 0.001, respectively). In the DPN group, corneal nerve fiber density, corneal nerve branch density and corneal nerve fiber length were significantly lower than for patients without DPN (P < 0.001, P < 0.001 and P < 0.001, respectively). Receiver operating characteristic analysis showed that the optimal cut‐off values were 24.68, 39 and 15.315, respectively, in which corneal nerve fiber density and corneal nerve fiber length had moderate sensitivity and specificity.ConclusionThis study provides more support for the clinical use of CCM to diagnose type 2 diabetes mellitus‐related complications, especially DPN.

Evaluation of Subclinical Nail changes in Patients with Chronic Plaque Psoriasis using Dermoscopy

Abstract Background Dermoscopy is a non-invasive technique that allows the visualization of subtle clinical features of the skin surface and appendages details not visible to the naked eye, allowing magnifications of up to 200x. It is widely used for evaluating and diagnosing all nail diseases, as it provides important information. As any other examination, nail dermoscopy (onychoscopy) requires a good knowledge of nail anatomy &amp; physiology and the pathogenesis of the nail diseases, and it is helpful for the diagnosis of numerous nail diseases and tumors. Nail disorders are defined according to their appearance and the part of the nail affected (from distal to proximal): hyponychium, onychodermal band (ODB), nail bed, nail plate, lateral nail folds (perionychium), lunula (distal part of the matrix), cuticle, nail matrix and proximal nail fold. Objective To study the dermoscopic findings of subtle nail changes in patients with chronic plaque psoriasis and compare it with that nail changes in healthy controls by both polarized and non polarized mode of dermoscope, aiming to assist clinicians in correctly evaluating and diagnosing nail changes with the help of dermoscopy. Methods We conducted a comparative descriptive study on 50 patients having chronic plaque psoriasis, 26 were males (52.0%) and 24 were females (48.0%), as well as 50 normal healthy control subjects, 31 were males (62.0%) and 19 were females (38.0%). Patients and controls were randomly recruited from the outpatient clinic of dermatology department at Ain Shams University Hospitals, during the period from February 2018 till September 2018. And the age of both groups ranged from 14 to 70 years. Results Our study revealed that the most common fingernail changes found in psoriatic patients were nail plate thickening and crumbling followed by Dilated nailbed capillaries at the onychodermal band, Oncholysis, Subungual hyperkeratosis, Pitting, Longitudinal ridges, Scales, Salmon patch, Leukonychia, Splinter hemorrhage, Lunula red spot and Trachyonychia. And the most common toenail changes found in psoriatic patients were Subungual hyperkeratosis followed by Nail Plate Thickening &amp;Crumbling, Oncholysis, Pitting, Longitudinal ridges, Scales, Salmon patch, Trachyonychia, Dilated nailbed capillaries at the onychodermal band, Splinter hemorrhage, Leukonychia and Lunula red spot. We found there was no difference between polarized and non polarized mode of dermoscope in examination of fingernails and toenails except that the non polarized mode showed the changes of the Dilated capillaries at the onychodermal band more obviously. And also, there was no difference between wet and dry method of polarized mode of dermoscope. Conclusion This study confirms that a handheld dermoscope is a very efficient and simple tool for detection of any nail abnormality.

Proteomic sift through serum and endometrium profiles unraveled signature proteins associated with subdued fertility and dampened endometrial receptivity in women with polycystic ovary syndrome.

The objective of this study is to discern the proteomic differences responsible for hampering the receptivity of endometrium and subduing the fertility of females with polycystic ovary syndrome in analogy to healthy fertile females. This study was designed in collaboration with Hakeem Abdul Hameed Centenary Hospital affiliated to Jamia Hamdard, New Delhi, India. Serum samples were taken from infertile PCOS subjects (n = 6) and fertile control subjects (n = 6) whereas endometrial tissue samples were recruited from ovulatory PCOS (n = 4), anovulatory PCOS (n = 4) and normal healthy fertile control subjects (n = 4) for proteomic studies. Additionally, endometrial biopsies from healthy fertile control (n = 8), PCOS with infertility (n = 6), unexplained infertility (n = 3) and endometrial hyperplasia (n = 3) were taken for validation studies. Anthropometric, biochemical and hormonal evaluation was done for all the subjects enrolled in this study. Protein profiles were generated through 2D-PAGE and differential proteins analyzed with PD-QUEST software followed by identification with MALDI-TOF MS protein mass fingerprinting. Validation of identified proteins was done through RT-PCR relative expression analysis. Protein profiling of serum revealed differential expression of proteins involved in transcriptional regulation, embryogenesis, DNA repair, decidual cell ploidy, immunomodulation, intracellular trafficking and degradation processes. Proteins involved in cell cycle regulation, cellular transport and signaling, DNA repair, apoptotic processes and mitochondrial metabolism were found to be differentially expressed in endometrium. The findings of this study revealed proteins that hold strong candidature as potential drug targets to regulate the cellular processes implicating infertility and reduced receptivity of endometrium in women with polycystic ovary syndrome.

Topography of cortical thinning in the Lewy body diseases.

ObjectiveRegional cortical thinning in dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) may underlie some aspect of their clinical impairments; cortical atrophy likely reflects extensive Lewy body pathology with alpha-synuclein deposits, as well as associated Alzheimer's disease co-pathologies, when present. Here we investigated the topographic distribution of cortical thinning in these Lewy body diseases compared to cognitively normal PD and healthy non-PD control subjects, explored the association of regional thinning with clinical features and evaluated the impact of amyloid deposition.MethodsTwenty-one participants with dementia with Lewy bodies (DLB), 16 with Parkinson disease (PD) - associated cognitive impairment (PD-MCI and PDD), and 24 cognitively normal participants with PD underwent MRI, PiB PET, and clinical evaluation. Cortical thickness across the brain and in regions of interest (ROIs) was compared across diagnostic groups and across subgroups stratified by amyloid status, and was related to clinical and cognitive measures.ResultsDLB and PD-impaired groups shared a similar distribution of cortical thinning that included regions characteristic of AD, as well as the fusiform, precentral, and paracentral gyri. Elevated PiB retention in DLB and PD-impaired but not in PD-normal participants was associated with more extensive and severe cortical thinning, in an overlapping topography that selectively affected the medial temporal lobe in DLB participants. In DLB, greater thinning in AD signature and fusiform regions was associated with greater cognitive impairment.ConclusionsThe pattern of cortical thinning is similar in DLB and PD-associated cognitive impairment, overlapping with and extending beyond AD signature regions to involve fusiform, precentral, and paracentral regions. Cortical thinning in AD signature and fusiform regions in these diseases reflects cognitive impairment and is markedly accentuated by amyloid co-pathology. Further work will be required to determine whether the distinct topography of cortical thinning in DLB and PD-associated cognitive impairment might have value as a diagnostic and/ or outcome biomarker in clinical trials.

Inverse correlation of Serum Lactate Dehydrogenase and Haemoglobin Levels in patients with Oral Submucous Fibrosis

Serum lactate dehydrogenase (LDH) is a marker of cellular necrosis and is elevated in oral potentially malignant disorders, Oral Submucous Fibrosis (OSMF). Serum LDH levels have been used as a valuable biochemical marker in diagnosis of OSMF. To evaluate and compare the levels of serum LDH and haemoglobin in OSMF with normal healthy individuals. Two mL of venous blood was collected by under aseptic conditions and serum was separated from the normal healthy control subjects (Group 1, n= 22) and the OSMF (clinically and histopathologically confirmed cases) patients (Group 2, n= 22). Quantitative estimation of serum LDH and haemoglobin was performed. Significant rise was observed in the serum LDH levels (518.14 ± 48.62 IU/L) while the mean Hb levels (11.3 ± 1.14) were decreased in patients with OSMF in comparison with normal healthy individuals (LDH: 189.77 ± 28.30 IU/L, Hb: 12.94± 0.98 gm%) (P value &lt; 0.0001, &lt; 0.0001). Serum LDH and Hb estimation would serve as a valuable biochemical marker in the diagnosis of OSMF

3D-CNN based discrimination of schizophrenia using resting-state fMRI.

This study reports a framework to discriminate patients with schizophrenia and normal healthy control subjects, based on magnetic resonance imaging (MRI) of the brain. Resting-state functional MRI data from a total of 144 subjects (72 patients with schizophrenia and 72 healthy controls) was obtained from a publicly available dataset using a three-dimensional convolution neural network 3D-CNN based deep learning classification framework and ICA based features. We achieved 98.09 ± 1.01% ten-fold cross-validated classification accuracy with a p-value < 0.001 and an area under the curve (AUC) of 0.9982 ± 0.015. In addition, differences in functional connectivity between the two groups were statistically analyzed across multiple resting-state networks. The disconnection between the visual and frontal network was prominent in patients, while they showed higher connectivity between the default mode network and other task-positive/ cerebellar networks. These ICA functional network maps served as highly discriminative three-dimensional imaging features for the discrimination of schizophrenia in this study. Due to the very high AUC, this research with more validation on the cross diagnosis and publicly available dataset, may be translated in future as an adjunct tool to assist clinicians in the initial screening of schizophrenia.

440-P: The Effects of DPP-4 Inhibitors on Plasma Catecholamines and Their Metabolites in Patients with Type 2 Diabetes

Previous preclinical and clinical studies have raised a concern that dipeptidyl peptidase 4 inhibitors (DPP-4i) increased sympathetic activity, which may be related with increased risk of heart failure in DPP-4i-treated type 2 diabetics. In this study, we aimed to evaluate the relationship between DPP-4 activity and catecholamine secretion in patients with type 2 diabetes. Patients with type 2 diabetes (n=119) and normal healthy control subjects (n=25) participated in this cross-sectional study which included the measurement of serum DPP-4 activity and plasma levels of epinephrine (Epi), norepinephrine (NE), metanephrine (MET) and normetanephrine (NMET), other blood and urine biochemical tests, and the collection of demographic and clinical data. The median ages of patients with type 2 diabetes and healthy control subjects were 61 and 56 years, respectively. Compared with the control group, patients with type 2 diabetes were associated with lower plasma levels of catecholamines and their metabolites. In DPP-4i-treated diabetic patients (n=86) had lower plasma NMET level compared with other antidiabetic treatment group (n=36) [0.31 (IQR: 0.21, 0.43)] nmol/L vs. 0.41 (0.29, 0.46) nmol/L, p&amp;lt;0.05], while the plasma concentrations of the two catecholamines and MET were comparable. The difference in plasma NMET level between the two treatment groups was not affected by beta-blocker and angiotensin II receptor blocker therapy, respectively. Additionally, in DPP-4i-treated type 2 diabetics, DPP-4 activity showed inverse correlations with plasma levels of NE (r=-0.312, p&amp;lt;0.01) and NMET (r=-0.275, p&amp;lt;0.05). However, those inverse correlations were not observed in the healthy control group and type 2 diabetics treated with non-DPP-4i antidiabetic agents. Our results suggest that DPP-4i treatment in type 2 diabetics affects NE release from sympathetic nerve in a DPP-4 inhibitory action-dependent manner. Disclosure I. Park: None. D. Lee: None. K. Lee: None.

Cardiac, diabetic and normal subjects classification using decision tree and result confirmation through orthostatic stress index

Abstract Cardiac and diabetic diseases are common and troublesome complications, leading to increased morbidity and mortality rates that cause a large economic burden. Researchers have explored cardiac or diabetic diseases for analysis separately; however, combined study of both diseases is missing. A retrospective Heart Rate Variability (HRV) analysis on ECG data was performed, analyzing the data of 78 subjects, which includes 26 cardiac (suffering from congestive heart failure), 17 diabetic and 35 normal (healthy subject or control) subjects. These subjects were labeled as cardiac, diabetic and normal based on HRV parameters. A classification and regression tree (CART) was employed to develop an automatic classifier to infer implications of disease in the early stages. Furthermore, to cross verify the above results, an orthostatic stress index was calculated from HRV parameters of ECG data recorded in the sitting and supine position. Cardiac subjects have the lowest HRV values among the three classes, whereas healthy subjects have the highest. The results are consistent with OSI values. The results are consistent with the consensus shown by previous studies, namely that depressed HRV is a useful tool for risk assessment in patients, and implying that cardiac subjects are at highest risk. The proposed classification model has achieved an accuracy of 93.58%, and a precision and recall of 94%.

DIABETIC PATIENTS

Objectives: Inflammation is the one of the major causes for development of type 2diabetes mellitus and its complications. In this study, association between inflammation and type2 diabetes mellitus was studied by measuring various inflammatory markers (soluble vascularcell adhesion molecules type – 1, Interleukin – 6 and C- reactive protein) between healthy anddiabetic patients. Study Design: A cross sectional comparative study. Place and Duration ofStudy: The study was conducted at Department of Biochemistry &amp; Molecular Biology, ArmyMedical College, Rawalpindi in collaboration with Combined Military Hospital, Rawalpindi andCentre for Research in Experimental and Applied Medicine (CREAM), Army Medical College,Rawalpindi for blood sampling and biochemical assays respectively. Material and Methods:The study was performed in 40 human subjects divided into two groups containing 20 subjectseach. One group was designated as control while the other was diseased (diabetic) group.Glycemic status was measured to confirm their normal and diabetic state. Inflammatory markerswere measured by Enzyme Linked Immunosorbent Assay (ELISA). Results: Levels of allinflammatory markers (soluble vascular cell adhesion molecules type – 1, Interleukin – 6 and Creactiveprotein) were found to be raised in the experimental diabetic groups; 1991.5 ± 201.97ng/ml, 24.99 ± 1.366 pg/ml and 2931 ± 168.319 respectively compared to the control group;570.2 ± 16.526 ng/ml, 6.64 ± 0.3516 pg/ml and 1806.6 ± 183.32 respectively. Conclusions:Inflammatory markers were significantly elevated in patients with diabetes mellitus as comparedto normal healthy control subjects.

Evaluation of UHRF1 and P16INK4A expression levels in newly diagnosed AML patients

Introduction: Gene mutation is an infrequent cause of tumor suppressor gene (TSG) defect in de novo AML patients. Instead, it seems that leukemic cells employ epigenetic tricks to attenuate the negative impacts of intact TSGs. Ordinarily, critical TSGs, such as p16INK4A, is hyper-methylated in AML blasts under the impact of master epigenetic regulators, such as UHRF1. In this study, we investigated the correlation between UHRF1 and p16INK4A gene expression levels in newly diagnosed AML patients.&#x0D; Methods: Bone marrow and peripheral blood samples were obtained from 50 newly diagnosed AML patients and 18 healthy normal control subjects. Gene expression levels of UHRF1 and P16INK4A were surveyed using SYBR Green Quantitative Real-time PCR. Statistical analyses were done using SPSS statistical software 21.0.&#x0D; Results: P16INK4A gene expression showed reduced levels in 80.64% of patients above 45 years of age, while only 32% of patients below 45 years had reduced expression levels. The Spearman correlation test also demonstrated a significant negative correlation between UHRF1 and p16INK4A gene expression levels in AML patients, which was not observed in the control group (r=0.343 and P= 0.015).&#x0D; Conclusion: Regarding the age-related patterns of UHRF1 and p16INK4A gene expression, and also the presence of negative correlation between them, we conclude that UHRF1 may potentially be involved in p16INK4A down-regulation in elderly AML patients, which may subsequently facilitate the progression of AML in older ages.&#x0D;

Relationship between Atherogenic Indices and Carotid Intima-Media Thickness in Prediabetes: A Cross-Sectional Study from Central India

Prediabetes is the precursor stage of diabetes mellitus and is also considered to be a risk factor for the development of cardiovascular disease. Atherogenic indices have been used for assessment of risk for cardiovascular disease development. To date, there is no data on evaluating the relationship between atherogenic indices (cardiac risk ratio (CRR), atherogenic coefficient (AC), and atherogenic index of plasma (AIP)) and carotid intima-media thickness (CIMT) in prediabetes. Hence, we aimed to determine atherogenic indices (CRR, AC, and AIP) and CIMT in prediabetic subjects and then sought to evaluate the relationship between them. A total of 400 human subjects were included in the present study, out of which 200 were prediabetic subjects and 200 were normal healthy control subjects. For each subject, CRR, AC, and AIP were calculated from routine lipid parameters and carotid intima-media thickness was measured as well. Atherogenic indices, that is, CRR, AC, and AIP, were significantly increased in prediabetic subjects as compared to the controls (5.87 ± 0.87 vs. 4.23 ± 0.50, p < 0.001; 4.87 ± 0.87 vs. 3.23 ± 0.50, p < 0.001; and 0.29 ± 0.07 vs. 0.09 ± 0.09, p < 0.001, respectively). Moreover, a significant and positive correlation was observed between CIMT and AIP (r = 0.529, p < 0.01), CRR (r = 0.495, p < 0.01), and AC (r = 0.495, p < 0.01). Prediabetic subjects present abnormalities in atherogenic indices and CIMT, which indicate a greater propensity of prediabetes for the development of cardiovascular disease. Hence, atherogenic indices can be used in addition to routine lipid parameters for the better assessment of subclinical atherosclerosis in prediabetic subjects.

A Voxel-Based Magnetic Resonance Imaging Morphometric Study of Cerebral and Cerebellar Gray Matter in Patients Under 65 Years with Essential Tremor.

BackgroundThe aim of this study was to compare the morphological changes in cerebral and cerebellar gray matter in patients with essential tremor under 60-years-of-age, with age-matched and gender-matched normal healthy volunteer control subjects, using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM) analysis.Material/MethodsA retrospective, controlled, comparative clinical study included 17 patients with essential tremor, <60 years-of-age, and 17 age-matched and gender-matched healthy volunteer control subjects, recruited between June 2010–July 2012. MRI and VBM analysis were used to compare cerebral and cerebellar gray matter density between groups. The Washington Heights–Inwood Genetic Study of Essential Tremor (WHIGET) rating scale was used to assess tremor severity in the patient group. Clinical and demographic characteristics were recorded for all study participants.ResultsMRI and VBM analysis showed significant bilateral expansion of the cerebellum, occipital fusiform cortices, right inferior temporal gyrus, and precentral lobes in patients with essential tremor (P<0.005); reduction in gray matter was found in the left parietal lobe. The region of interest (ROI) analysis showed volume enlargement in the thalamus, midbrain, and the precuneus (P<0.005). No significant correlation between changes in gray matter and changes in clinical variables, including age, gender, tremor duration, the activity of daily living (ADL) scale, the mini-mental state examination (MMSE) scale, family history, and tremor severity were found.ConclusionsPredominantly cerebellar gray matter expansion in patients less than 60 years-of-age with essential tremor might be the result of compensation for the decline in cerebellar function.

Study of Serum N-Terminal-Pro C-Type Natriuretic Peptide and its Relation to the Risk of Variceal Bleeding in Cirrhotic Hepatitis-C Virus Patients

The current guidelines recommend that all cirrhotic patients should undergo screening endoscopy at diagnosis to identify patients with risky varices who will benefit from primary prophylaxis. This leads to a heavy burden on endoscopy units and affects patient compliance. Noninvasive identification of risky patients would limit performing endoscopy to those most likely to benefit. Upper GIT endoscopy is the gold standard against which other tests are compared, but is not without its limitations. Some tests are clearly preferable to patients but are not as accurate as upper GIT endoscopy in the diagnosis of esophageal varices. The aim of this work is to study the relation of serum NT pro-CNP to severity of cirrhosis and the presence of esophageal varices and the risk of their bleeding. The study was carried-out on 80 subjects divided into 4 groups: 20 cirrhotic patients with esophageal varices which have previously bled, 20 cirrhotic patients with esophageal varices which have not yet bled, 20 cirrhotic patients without esophageal varices and 20 normal healthy control subjects. Serum NT pro-CNP level was significantly elevated in cirrhotic patients with esophageal varices compared to cirrhotic patients without esophageal varices, but not significantly elevated in bleeders than in nonbleeders. Also spleen and portal vein diameters, Child’s score, Fib-4 score, serum bilirubin and AST levels and prothrombin activity were significantly elevated in the same group. Therefore, serum NT pro-CNP is a promising noninvasive marker for predicting severity of cirrhosis and presence of esophageal varices and not the risk of variceal bleeding in HCV-related liver cirrhosis patients.