UK and US guidelines for TB imply out-patient management as the norm. Our study shows a very high rate of in-patient care, largely a consequence of the emergency admission of acutely ill, previously undiagnosed cases. There are public health implications in terms of spread of infection from individuals with advanced disease. The high utilization of expensive in-patient resources has significant implications for purchasers and providers of care for TB in socio-economically deprived areas. Further, the cost-effectiveness of public health interventions aimed at limiting the spread of TB should be assessed by reference to this true, high cost of managing TB, not a low cost based on false assumptions about rates of out-patient versus in-patient care.
Background: Alzheimer’s disease is a progressive neurological disorder that develops with aging. Objective: In this research, we have examined the anti - Alzheimer’s effect of ethanolic extract from roots of Cassia occidentalis L. on colchicine induced Alzheimer’s in Wistar rats. Methods: Ethanolic extract was obtained and spectroscopic, chromatography analysis was performed. Acute toxicity studies using OECD Guidelines 423 were performed to examine and make sure that there were no signs of toxic effects. The induction of AD was done using colchicine which leads to symptoms like neurotoxicity, neuroinflammation, and neurodegeneration. Body weight, behavioral parameters, locomotor activity, biochemical evaluation was performed. Results: Pharmacognostic analysis showed the presence of vascular bundles, starch grains, fibers, calcium oxalate crystals, elongated parenchyma, and collenchyma mucilage. Presence of phytoconstituens as flavonoids, alkaloids, tannins and phenols was detected. Locomotor activity, Escape latency time, Conditioned avoidance response, Transfer latency were improved with treatment. Interleukin- 6 levels were reduced significantly in treatment Group V (739.2±0.37) than in Group - II (850.6±0.40). Tumor necrosis factor (TNF-α) was decreased in Group - V (1030.93±0.00) than in Group - II (1455.06±1.25). A significant decrease in beta-amyloid protein level was observed in Group- II (2.52± 0.10), (3.33±0.90) as compared to Group- V (5.27±0.09), (5.01±0.10) respectively, in the Hippocampus and Entorhinal cortex. Histopathology of the Hippocampus and Entorhinal cortex showed reduced neuroinflammation, diminished amyloid plaques, and neurodegeneration in the treatment groups. Conclusions: The ethanolic extract from roots of Cassia occidentalis L. improved memory damage, was neuroprotective in Alzheimer’s induced rats. It restored neuronal degeneration in the Hippocampus, and Entorhinal cortex and reduced oxidative stress.
Adolescent period is marked by bone modeling and remodeling and leads to accrual of peak bone mass. Ideal peak bone mass depends on diet, hormones, genetic influence and environment and has consequences on bone health in adulthood. We measured biochemical indicators of bone health in rural adolescent girls. Methods: Five hundred fifty adolescent girls from longitudinal DERVAN cohort study from Indian state of Maharashtra underwent anthropometry. Biochemical parameters (intact parathyroid hormone, vitamin D, calcium, phosphorus and alkaline phosphatase) were measured. Results: Prevalence of underweight & stunting was 28.8%, 30.7% respectively. More than 56% were thin & only 5% were obese. Median body fat% & bone mass measured by bio-impedance were 23.3 and 1.6 Kg respectively. More than 80% were vitamin D deficient and 12.0% were calcium deficient. Median dietary calcium intake was 158.5mg/day which was far below recommended 850 mg/day. Median parathyroid hormone concentration was 8.49pmol/L and 66.7% had elevated concentrations (> 6.89pmol/L). Elevated phosphorus and alkaline phosphatase were observed in 23.3% and 23.0%. Parathyroid hormone was inversely associated with age (p<0.001) and vitamin D (p<0.001) and directly with phosphorus and alkaline phosphatase (p<0.05) for both. On multivariate analysis elevated parathyroid hormone was associated with low vitamin D (p<0.001). Conclusion: The adolescent girls of KONKAN are undernourished and vitamin D deficient. Despite poor dietary calcium intake the serum calcium levels were maintained at the cost of elevated parathyroid hormone. Thus parathyroid hormone may be used as a marker of bone health. This could be useful in planning early interventions to improve bone health.
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