Objective: Stroke has become the second most common cause of death. Several biomarkers have been detected in the peripheral blood from stroke patients, but none has found a place in clinical practice. Cell-free DNA (cf-DNA) liberated into the blood soon after the onset of stroke might be useful for assessing disease severity and prognosis. Study Design and Methods: A total of 54 patients presenting with ischemic stroke were recruited consecutively with the exclusion of patients having trauma, tumor, infections, and organ failure. The cf-DNA was extracted by circulating nucleic acid kit from Qiagen and measured by real-time quantitative polymerase chain reaction assay for β-globin gene. The primary outcome measure was poststroke modified Rankin scale Score at 3 months after the onset of symptoms. Results: Higher cf-DNA levels were associated with severity at the time of admission measured by National Institutes of Health Stroke Scale (P=0.003) and poor outcome as measured by modified Rankin scale 3-month scores (P=0.001). Therapeutic intervention in the form of a mechanical thrombectomy or IV thrombolysis was associated with improved outcome in patients with cf-DNA<10,000 kilogenome-equivalents/L (P≤0.01). Conclusions: cf-DNA level correlates well with the severity of stroke at admission and long-term prognosis. It can be used as an additional marker to predict the outcome of therapeutic intervention.
PurposeSeveral blood markers have been evaluated in stroke patients, but their role remains limited in clinical practice. This study was designed to evaluate the utility of cell free DNA (cf DNA) in stroke patients undergoing therapeutic intervention in the form of mechanical thrombectomy in acute ischemic stroke patients.Materials and MethodsTwenty-six patients with ischemic stroke who were managed with interventions like intravenous thrombolysis (IVT) and mechanical thrombectomy were recruited consecutively in this study. The cf DNA was extracted by using circulating nucleic acid kit and measured by real-time quantitative PCR assay for β-globin gene. The neurological outcome was measured by modified Rankin scale (mRS) score at three months after the onset of symptoms.ResultsCf DNA levels correlated with severity of stroke at the time of admission (r=0.421, P=0.032) and poor outcome at three months (r=0.606, P=0.001). Therapeutic intervention in the form of mechanical thrombectomy or IVT was associated with improved outcome in patients with cf DNA <10,000 kilogenome-equivalents/L (P=<0.05).ConclusionCf DNA level correlated well with the 3 month outcome in acute ischemic stroke patients. It can be a potential supplementary marker to predict neurological outcome after therapeutic intervention.
Background: During COVID 19 pandemic many countries implied nationwide lockdown which affected academic and educational activities of medical students. We evaluated the level of depression, anxiety and stress among first MBBS students of Government Medical College, Himachal Pradesh. Aims and Objective: To estimate the level of depression, anxiety and stress among first MBBS students during COVID-19 pandemic and study its relationship with gender. Materials and Methods: A standard questionnaire DASS 21 (Depression Anxiety and Stress Scale) was administered to 110 first MBBS of Government Medical College, Himachal Pradesh. The responses were collected via Google form and scores evaluated. Results: The overall score for depression was 10.44±5.1, 10.94±5 for anxiety and 12.29±5.3 for stress. About 58 % participants had depression, 74% had anxiety & 32 % had stress in various grades of severity. Depression, anxiety & stress was more among females as compared to males (p<0.05). There was strong correlation among the scores of Depression, Anxiety & Stress among the participants (r >0.8). Conclusion: During this COVID-19 pandemic higher scores of depression, anxiety & stress were recorded among the first year MBBS students; females having more scores than male students. This study highlights the importance of and need for routine screening of depression, anxiety and stress among medical students.
Background: With digitization the e-learning modalities are being increasingly used by medical students. These often help the first MBBS students to overcome limitations of conventional teaching methods like didactic lectures. However, e-learning is not official part of medical education in India and the awareness about its use among medical students need to be evaluated. Aim and objective of the study was to assess the extent to which MBBS first year students use e-resources for learning as well as to assess knowledge, attitude, skills and habits of first MBBS students towards e-learning.Methods: A questionnaire of twenty five questions on various aspects of e-learning was administered to the first MBBS students at two medical colleges. The data generated from responses was compiled and analyzed on SPSS to get insight on various aspects of e-learning.Results: Out of 236 students surveyed 77.97% were aware about the academic websites related to first MBBS subjects. 90.68 % accepted that e-learning helped in understanding topics, 84.32% recommended conventional teaching to be supplemented with e-learning. However there was no statistically significant difference between responses from two groups i.e. female and male students (p>0.05).Conclusions: The majority of first MBBS students use e-resources for learning various topics in anatomy, physiology and biochemistry. The e-resources have made a positive impact on overall learning especially anatomy. e-learning can supplement conventional teaching in the first year of medical training.
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by ectopic bone formation involving the connective tissues leading to severe skeletal manifestations. The genetic defect in this disorder has not been characterized in Indian patients till date. The authors report three cases of FOP along with the molecular defects identified in them. Exon 4 of the ACVR1 gene was amplified and analysed by sequencing. All three cases revealed common heterozygous mutation i.e., c.617(G>A). Identification of this mutation would lead to decrease in misdiagnosis and subsequent iatrogenic harm caused to these children by unnecessary surgical procedures. Also, mutation detection would provide an opportunity for prenatal diagnosis.
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