Notes

Study from the Molecular Components associated with De-oxidizing Destruction as well as Immune Reply Downregulation in Liver associated with Coilia nasus Under Starvation Strain.
Real-world data on the effectiveness of antihypertensive drugs (AHDs) in India is limited. The present study aims to provide updated evidence regarding the effectiveness of olmesartan as monotherapy or in combination with other AHDs in Indian patients with essential hypertension.

Electronic medical record data of adult patients who were diagnosed with essential hypertension (≥140/90 mmHg) and were prescribed olmesartan as mono- or add-on therapy were retrospectively analyzed. Patients were classified based on the number of AHD classes prescribed on initiation of olmesartan. Change in systolic and diastolic blood pressure (SBP and DBP) from baseline was the primary endpoint. Secondary endpoint was evaluation of proportion of patients who achieved treatment goals as per 2018 European Society of Cardiology/European Society of Hypertension guidelines. Readings were obtained before initiating olmesartan and after at least a month of therapy with olmesartan.

Among the 459 included patients, majority were on oduced blood pressure in Indian patients with essential hypertension as well as in patients with comorbid diabetes.
Olmesartan prescribed as mono- or add-on therapy during routine clinical practice significantly reduced blood pressure in Indian patients with essential hypertension as well as in patients with comorbid diabetes.
Stormy course has been reported among hospitalized adults with COVID-19 in high- and middle-income countries. To assess clinical outcomes in consecutively hospitalized patients with mild covid-19 in India we performed a study.

We developed a case registry of successive patients admitted with suspected covid-19 infection to our hospital (n=501). Covid-19 was diagnosed using reverse transcriptase polymerase chain reaction (RT-PCR). Demographic, clinical, investigations details and outcomes were recorded. Descriptive statistics are presented.

Covid-19 was diagnosed in 234 (46.7%) and data compared with 267 (53.3%) negative controls. GLPG0187 antagonist Mean age of covid-19 patients was 35.1±16.6y, 59.4% were <40y and 64% men. Symptoms were in less than 10% and comorbidities were in 4-8%. History of BCG vaccination was in 49% cases vs 10% controls. Cases compared to controls had significantly greater white cell (6.96+1.89 vs 6.12+1.69x109 cells/L) and lower lymphocyte count (1.98+0.79 vs 2.32+0.91x109 cells/L). No radiological and electrocardiographic abnormality was observed. All these were isolated or quarantined in the hospital and observed. Covid-19 patients received hydroxychloroquine and azithromycin according to prevalent guidelines. One patient needed oxygen support while hospital course was uncomplicated in the rest. All were discharged alive. Conversion to virus negative status was in 10.2±6.4 days and was significantly lower in age >40y (9.1±5.2) compared to 40-59y (11.3±6.1) and ≥60y (16.4±13.3) (p=0.001).

This hospital-based registry shows that mildly symptomatic or asymptomatic young covid-19 patients have excellent prognosis.
This hospital-based registry shows that mildly symptomatic or asymptomatic young covid-19 patients have excellent prognosis.
Nonalcoholic fatty liver disease (NAFLD) is conventionally considered to be a disease of obese subjects. Recent data suggests increasing incidence of NAFLD among lean subjects also. The aim of this study was to evaluate the metabolic profile of lean subjects with NAFLD and compare it with obese subjects with NAFLD. We also aimed to compare the same with lean subjects without NAFLD.

This study included 250 subjects with NAFLD and 500 non-NAFLD controls. Clinical, anthropological and biochemical data were collected. Subjects with body mass index (BMI) >= 25 kg/m2 were taken as obese and subjects with BMI <25 kg/m2 were taken as lean. Study population was divided into four groups i.e. lean subjects with NAFLD (LN), obese subjects with NAFLD (ON), lean subjects without NAFLD (LNN) and obese subjects without NAFLD (ONN).

Out of 250 NAFLD subjects, 69 (27.6%) were lean. Out of 69 lean subjects with NAFLD, 54 (78.3%) were having diabetes mellitus. Metabolic profile (including lipid profile, diabetic profubjects appeared to have less severe transaminasemia.
Lean NAFLD has significantly higher WC in comparison to non-NAFLD counterparts suggesting possible association with central adiposity. Lean and obese NAFLD share common set of metabolic abnormalities, albeit with varying intensity. Lean NAFLD has more severe insulin resistance in comparison to obese NAFLD. Lean NAFLD subjects appeared to have less severe transaminasemia.The central nervous system is believed to be a safe sanctuary site which is established very early in the course of HIV infection where the virus can escape antiretroviral therapy. HIV associated neurocognitive disorder (HAND) is seen to occur even in patients on successful systemic ART. HIV RNA can be at higher levels in CSF than plasma termed as CSF / plasma discordance or CSF escape. We aimed to study the prevalence, risk factors and outcomes in HIV patients who develop neurocognitive dysfunction on otherwise successful (suppressive) ART. We reported 6 cases of HAND in patients on regular successful ART over a 3 year period. Neurological examination , CSF analysis , plasma CD4 T cell count and neuroimaging were done.. Plasma HIV RNA and CSF HIV RNA was also estimated. Most of the patients' (5/6) were male, median age was 38.5 years and median time since HIV diagnosis was 3 years. All patients' were on Tenofovir plus Boosted Protease inhibitors when neurocognitive symptoms were manifest. 4/6 patients had an acute onset of clinical presentation. CSF showed elevated protein and mild pleocytosis in all patients. Median nadir CD4 T cell count was 222 cells / μl and at presentation of HAND with CSF escape was 374 cells / μl. CSF / Plasma HIV RNA discordance was present in all patients' at time of diagnosis. Outcome is good if diagnosed and treated early.
The aim of the present study was to assess the glycemic status measured as Fasting Plasma Glucose (FPG) and glycosylated haemoglobin (A1C); prevalence of Insulin Resistance (IR), hypogonadism and to study their correlation with CD4 (CD4 lymphocyte) counts in HIV infected patients receiving ART. Correlation between percentage android fat and IR was also studied.

84 HIV male patients as diagnosed by ELISA test aged 18 to 70 years were included in this case control study. Software IBM SPSS 20.1 and Microsoft Excel 2013 was used for analysis of data. The numerical data was compared using two tailed student t-test. Log transformation was used for the conversion of qualitative data (% android fat) to quantitative data so that it can be correlated to HOMA-IR. The level of significance was considered 0.05.

Out of total 84 patients, 19 had FPG ≥ 100. 11(13%) had Impaired Fasting Glucose (IFG) and 8 (9.5%) had Diabetes Mellitus (DM). 20 patients had A1C > 5.6. Nine (10.7%) patients had Impaired Glucose Tolerance (IGT) and 11 (13.
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