Moderate exercise attenuates caspase-3 activity, oxidative stress, and inhibits progression of diabetic renal disease in db/db mice

Diabetic nephropathy, the leading cause of end-stage renal disease, is characterized by a proapoptotic and prooxidative environment. The mechanisms by which lifestyle interventions, such as exercise, benefit diabetic nephropathy are unknown. We hypothesized that exercise inhibits early diabetic nephropathy via attenuation of the mitochondrial apoptotic pathway and oxidative damage. Type 2 diabetic db/db and normoglycemic wild-type mice were exercised for an hour everyday at a moderate intensity for 7 wk, following which renal function, morphology, apoptotic signaling, and oxidative stress were evaluated. Exercise reduced body weight, albuminuria, and pathological glomerular expansion in db/db mice independent of hyperglycemic status. Changes in renal morphology were also related to reduced caspase-3 (main effector caspase in renal apoptosis), caspase-8 (main initiator caspase of the "extrinsic" pathway) activities, and TNF-alpha expression. A role for the mitochondrial apoptotic pathway was unlikely as both caspase-9 activity (initiator caspase of this pathway) and expression of regulatory proteins such as Bax and Bcl-2 were unchanged. Kidneys from db/db mice also produced higher levels of superoxides and had greater oxidative damage concurrent with downregulation of superoxide dismutase (SOD) 1 and 3. Interestingly, although exercise also increased superoxides, there was also upregulation of multiple SODs that likely inhibited lipid (hydroperoxides) and protein (carbonyls and nitrotyrosine) oxidation in db/db kidneys. In conclusion, exercise can inhibit progression of early diabetic nephropathy independent of hyperglycemia. Reductions in caspase-3 and caspase-8 activities, with parallel improvements in SOD expression and reduced oxidative damage, could underlie the beneficial effects of exercise in diabetic kidney disease.

Comparative digestibility of amino acids of maize, sorghum, finger millet and pearl millet in cockerels and Japanese quails

1. The objective of the present study was to determine the apparent digestibilities of amino acids of maize, low tannin sorghum, pearl millet and finger millet in adult cockerels and Japanese quails. 2. Adult White Leghorn cockerels (25 weeks of age) and adult Japanese quails (15 weeks of age) were used to determine the apparent digestibilities of amino acids in cereal grains. 3. The digestibilities of amino acids in sorghum determined with quails were similar to cockerels, with the exception of histidine, which was significantly lower in quails. 4. In finger millet, the digestibilities of methionine and leucine were significantly higher, while that of histidine and cystine were significantly lower in adult quails than in adult cockerels. 5. The digestibilities of pearl millet amino acids were similar in quails and cockerels, except for that of histidine, which was significantly lower in quails. 6. Almost all the amino acids in maize, except histidine, had significantly higher digestibility values in quails than in cockerels. Histidine digestibility of all the 4 cereal grains was significantly lower in quails than in cockerels. 7. The amino acid digestibility values for certain cereal grains determined with cockerels do not support their use in formulating practical quail diets. The amino acid digestibility values of maize were underestimated by using cockerels while that of finger millet was overestimated.

Metastatic ovarian tumour in patient of carcinoma stomach

Krukenberg tumour (KT) is a metastatic ovarian tumour with primary usually seen in the gastrointestinal tract. Here we report the case of a 50-year old menopausal patient with gastric tumour presenting with solitary metastasis to the ovary within 5 months of primary gastric surgery, for which total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. This case stresses the urgent need for early detection and surveillance of treatable tumours metastasising to the ovary.

Recombinant human epidermal growth factor inclusion body solubilization and refolding at large scale using expanded-bed adsorption chromatography from Escherichia coli

Amongst the various endogenous growth factors, epidermal growth factor (EGF) plays an important role in normal wound healing of tissue such as skin, cornea and gastrointestinal tract. Various studies have proved that supplementing recombinant human EGF (rhEGF) results in significant augmentation of wound healing. In the present work, a high level expression system with poly-arginine sequences was used for the production of recombinant human EGF (rhEGF) as inclusion bodies. The inclusion bodies were solubilized and the protein was refolded by using expanded-bed adsorption chromatography. The renatured protein was digested with appropriate concentration of trypsin and subsequently the digested rhEGF is purified by passing through ion-exchange chromatography (Toyopearl-SP) to obtain a biologically active protein. This process is the shortest process with reduced number of steps of purification, eliminates the usage of preparative reversed phase HPLC (RP-HPLC) for final purification, which is an expensive technique. The purified protein was analyzed by RP-HPLC, showing a purity > 99% and size exclusion chromatography profile shows that there are minimal aggregates, with 99% renatured active protein. The purified rhEGF showed a specific activity of 5 x 10(5) IU/mg protein, in comparison with NIBSC standard (1st International Standard of rDNA-derived EGF, Code 91/530). The process has been successfully adopted at 100 L fermentation scale and the rhEGF based formulation has been commercialized with brand name REGEN D, with excellent clinical results.

Evaluation of bismuth subgallate and adrenaline paste as haemostat in tonsillectomy bleeding

Haemorrhage is a frequent and often feared complication of tonsillectomy. This has prompted the use of a variety of topical haemostatics such as bismuth subgallate to achieve haemostasis and reduce the risk of postoperative haemorrhage. In this study effect of bismuth subgallate and adrenaline paste was investigated. A total of twenty five subjects undergoing tonsillectomy were randomly recruited. The distinctive feature of study was that each patient constituted a matched pair, with left tonsillar fossa acting as control and right tonsillar fossa as trial side. Bismuth subgallate adrenaline paste was made by mixing 13 gm of Bismuth subgallate powder with 10 ml of normal saline and 0.35 ml of 1: 1000 adrenaline. The application of twin reagent paste resulted in reduced blood loss in trial fosse (60.8 ± 19.3 ml) as compared to control fossa (91.2 ± 20.27) (p < 0.0001). Similarly the average number of ligatures applied to control bleeding was also less in trial fosse. Only one patient reported reactionary haemorrhage while there was no report of secondary haemorrhage from amongst tonsillar fosse on trial side. However, two patients presented with secondary haemorrhage from control side fosse.

BK viral infections in patients treated with alemtuzumab

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Background: Alemtuzumab is a humanized monoclonal antibody against CD52 resulting in profound, prolonged T-cell depletion that may be associated with opportunistic infections and reactivation of latent viruses (e.g., CMV). BK virus is a polyomavirus that infects most humans during childhood and remains latent in the urinary tract. Reactivation of BK virus is an important cause of tubular nephropathy following renal transplantation and hemorrhagic cystitis after allogeneic stem cell transplant. Methods: A single institution pilot trial of alemtuzumab and Dose-Adjusted (D-A) Etoposide, Prednisone, Doxorubicin, Vincristine, and Cyclophosphamide (EPOCH) investigating efficacy and toxicity in chemotherapy naïve aggressive T- and NK-cell lymphomas was undertaken. BK virus was detected in urine by polymerase chain reaction (PCR) methods to quantify genomic copies in pts with dysuria and hemorrhagic cystitis. Results: Four of 20 pts treated with alemtuzumab and DA-EPOCH developed five episodes of hemorrhagic cystitis. One had grade 1 and 2 cystitis, two had grade 2 cystitis and one had grade 3 cystitis. In contrast, only one of over 200 pts treated with EPOCH alone or in combination with rituximab developed hemorrhagic cystitis. Hemorrhagic cystitis occurred at a median of 88 days after initiation of therapy and lasted a median of 22 days. Even if considered an unlikely cause, steps to minimize cyclophosphamide toxicity were taken; in one, mesna was given during the fifth cycle and cyclophosphamide was withheld from the final cycle of therapy. Another received a reduced dose of cyclophosphamide during the final cycle of therapy and the third did not receive the final cycle of therapy altogether. The fourth pt developed hemorrhagic cystitis after completion of therapy. PCR for BK virus showed a median of 8.87 x 108 (range 2.3 x 105-8.7 x 109) genomic copies per ml. Conclusions: Hemorrhagic cystitis secondary to BK virus reactivation may occur following Alemtuzumab therapy. Symptoms tend to abate after 1 to 7 weeks with conservative measures alone.

[Table: see text]

No significant financial relationships to disclose.

Growth pattern and prevalence of obesity in affluent schoolchildren of Delhi

OBJECTIVE

To investigate the prevalence of obesity in affluent schoolchildren of Delhi.

DESIGN

This was a cross-sectional study covering over 4000 students. Anthropometric measurements and birth weights of all the students were recorded.

SETTING AND SUBJECTS

The study was carried out in a school catering to the affluent section of Indian society and included both boys and girls in the age range 4 to 17 years.

RESULTS

The heights and weights of the children were almost similar to those of the National Center for Health Statistics standards, and were much above the values reported by the Indian National Nutrition Monitoring Bureau, which largely captures rural children belonging to lower socio-economic strata in India. Of the subjects studied, 22% were overweight and 6% were obese. Only 6% of these children had low birth weight.

CONCLUSION

The prevalence of obesity is rising among children because of their change in lifestyle. Children born with a birth weight of > or = 3 kg tended to have higher body mass index in their adolescent years and maybe consequently in their adult years. Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications.

Spectrum of radiological changes in hypertensive children with reversible posterior leucoencephalopathy

We prospectively studied 19 children with severe hypertension to evaluate the spectrum of radiological changes, severity and reversibility of this entity. All of them were subjected to clinical and biochemical evaluation, followed by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). Headache was seen in 17 children, 13 had confusion and drowsiness, 12 had nausea and vomiting, 10 patients had visual disturbances, seizure and dyspnoea. Only two had focal neurological deficit (one with right facial palsy and another with right lateral rectus palsy). Of these 19 children, 15 patients had hypertensive retinopathy and four had normal fundi. The positive MRI findings in 17/19 patients were: bilateral leukoencephalopathic changes in occipitoparietal region (9/17), diffuse white/grey matter lesion (3/17) patients, brain stem hyperintensity (2/17) and haemorrhagic lesions (3/17). On MRA, 12/19 patients had attenuation of cerebral arteries of different degree. On follow up, MRI findings resolved in all except three patients. All patients had normal MRA on follow up, except one with persistent minimal attenuation of middle cerebral artery and another had spasm in anterior, middle and posterior cerebral arteries. The intracranial abnormalities in these patients with severe hypertension were reversible in many of the cases after control of blood pressure was achieved. We therefore conclude that severe hypertension may lead to leuoencephalopathy, which had a wide radiological spectrum. A better understanding of this complex syndrome may obviate unnecessary investigations and allow management of associated problems in prompt and appropriate ways.

Chronic exposure to estrogen and tamoxifen regulates synaptophysin and phosphorylated cAMP response element-binding (CREB) protein expression in CA1 of ovariectomized rat hippocampus

We report here the in vivo effects of estrogen (E2) on modulation of synaptic plasticity and the agonistic (estrogen-like) role of selective estrogen receptor modulator (SERM), tamoxifen (TAM) in the CA1 of the rat hippocampus. Effects on synaptophysin (SYP), a presynaptic vesicular protein, and phosphorylated cyclic AMP responsive element-binding (p-CREB) protein, a signal transduction pathway molecule, were studied using the ovariectomized (OVX) experimental rat model. Bilateral ovariectomy was performed on 40 rats and these were divided into 4 groups based on the treatment they received (at 2 weeks post-ovariectomy, a subcutaneous injection daily for 4 weeks) viz., OVX+E2 (0.1 mg/kg body weight), OVX+TAM (0.05 mg/kg body weight), OVX+vehicle and one group served as OVX control. An additional 10 animals served as the ovary intact control group. At the end of the treatment schedule, five animals/group were used for immunohistochemical staining of SYP and p-CREB using specific antibodies with peroxidase anti-peroxidase technique on paraformaldehyde-fixed cryostat sections. Protein estimation and Western blot analysis coupled with densitometric analysis (using gel-documentation system and image analysis software) were performed on unfixed hippocampus collected from rest of the five animals/group. Serum estradiol levels were estimated with radioimmunoassay prior to sacrifice. The results revealed that ovariectomy reduced SYP and p-CREB expression whereas E2 or TAM administration resulted in their upregulation. Serum estradiol levels of E2 administered animals were comparable with the ovary intact group whereas those of TAM administered group persisted in the range of OVX controls. To conclude, long-term estrogen therapy modulates the synaptic plasticity of hippocampal neurons and presumably, the agonist biocharacter of TAM as observed in the present investigations, may in the long run have a potential in the treatment and prevention of various estrogen-related disorders.

Prevalence of anaemia in pregnant & lactating women in India

BACKGROUND & OBJECTIVES

The prevalence of anaemia during pregnancy and lactation was significantly lower in the National Family Health Survey 1998-1999 (NFHS-2), using the hemocue method for haemoglobin estimation compared to earlier surveys. The present study selected seven States and used the same districts and villages studied in the NFHS-2, to see if the reported reduction in prevalence of anaemia was due to health and nutrition inputs and/or due to a different method for haemoglobin estimation.

METHODS

A total of 1,751 women (1,148 pregnant and 603 lactating- exclusively breastfeeding up to 3 months of age), from seven States- Himachal Pradesh and Haryana in north; Assam and Orissa in east; Kerala and Tamil Nadu in south and Madhya Pradesh in central India, were selected. Haemoglobin was estimated by the cyanmethaemoglobin method, so that comparison was possible with earlier studies. Data on socio-demographic characteristics, pregnancy, nutritional status and dietary intakes were collected.

RESULTS

Prevalence as well as severity of anaemia was significantly higher in the present study as compared to the NFHS-2 study data. The difference could be due to haemocue method, which gives higher haemoglobin values. The contributing factors found on multiple regression analysis for anaemia in pregnancy and lactation were: literacy, occupation and standard living index of the study women; their awareness about anaemia, its prevention by regular consumption of ironfolate tablets and increase in food intake. Maternal height, age of marriage, parity and foetal loss also contributed to haemoglobin level. There were interstate differences; lower fertility, higher literacy and better diet was observed in Himachal Pradesh as compared to Haryana. The literacy and nutritional status of women in Tamil Nadu was lower than Kerala. The remaining 3 states had poor fertility, lower social living index and nutritional status with >90 per cent women being anaemic in pregnancy and lactation. Low prevalence of severe anaemia in Orissa as compared to Assam was due to availability and consumption of iron folate tablets. The antenatal services in the first trimester and checkup by a doctor, along with availability and consumption of iron folate tablets over 3 months in all the States influenced haemoglobin levels.

INTERPRETATION & CONCLUSION

Despite the measures taken to control anaemia in pregnancy and lactation in the last two decades, the severity of nutritional anaemia continues to remain a public health issue of great magnitude, suggesting that these measures have been largely ineffective. The present findings also showed interstate differences particularly in fertility, women education, nutrition status and occupation; availability of antenatal services and iron folate tablets as possible factors responsible for differences in prevalence of anaemia.