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Lupine Publishers |Subjection between Breast Cancer and Body Mass Index, the Role of L-Carnitine in Prediction and Outcomes of the Disease

Open Access Journal of Oncology and Medicine

Abstract

Increasing the effectiveness of antitumor therapy in breast cancer patients who take L-carnitine during preoperative systemic antitumor therapy compared with patients receiving standard neoadjuvant systemic antitumor therapy served as a prerequisite for studying possible antitumor mechanisms of L-carnitine. The positive effect of L-carnitine is due to the transfer of palm-n-LC through the inner membrane into the mitochondrial matrix, which promotes the formation of a significant number of ATP molecules. It has also been shown that L-carnitine can have a double protective effect, enhancing the energy dynamics of the cell and inhibiting the hyperexcitability of the cell membrane, that making it an ideal nutrient for the prevention and treatment of cancer. This article summarizes the results of epidemiological and clinical studies of the use of L-carnitine in the treatment of breast cancer

Keywords: Body mass index (BMI); Breast cancer (BC); Obesity; Overall survival; L carnitine

Introduction

The incidence of breast cancer in the world in general and in Ukraine in particular is growing. In 2017, in Ukraine the incidence reached 16 percent of female population, for which, the breast cancer ranked first in structure of oncological incidence among women. In analyzing the data of the National Cancer Registry of Ukraine, it should be noted, that in comparison with 2014 year, the prevalence rate of breast cancer in 2016has increased by 5,1%, that indicates importance of improvement diagnostic procedures and methods of treatment it [1]. Studying the scientific literature on this subject, we noticed that there is a strong biological relationship between obesity and a poor outcome of breast cancer. And having analysed the date of Ministry of Health in Ukraine it can be concluded, that about 26% of women in 2017 year had overweight or obesity.

Obesity has a chronic metabolic character, which is the result of the interaction of the endogenous factors, environmental conditions and lifestyle. Endogenous factors could be considered a violation of the genetic and hormonal balance. The external conditions and type of lifestyle include irregular rhythm nutrition, use of substandard products and sedentary lifestyle. Obesity is the first risk factor for metabolic syndrome, diabetes type II, cardiovascular disease and some forms of cancer, including breast cancer. Since overweight is a risk factor for breast cancer, there is reason to believe that among patients with breast cancer the percentage of obese women is higher than in the population. The risk of breast cancer in postmenopausal women by 30%, it is more than in premenopausal, women with obesity-50%. Furthermore it was proven that obesity is associated with poor prognosis in patients with breast cancer, regardless of menopausal status, and effectiveness of systemic medication breast cancer in patients that have over weight is lower than in patients with normal BMI.

Although obesity is associated with a poor outcome in women with breast cancer, it is unclear how weight loss after diagnosis will change its course and results. Recently, complementary and alternative medicine (CAM) is widely accepted among patients with breast cancer, which may provide several beneficial effects including reduction of therapy-associated toxicity, improvement of cancer-related symptoms, fostering of the immune system, and even direct anticancer effects [2]. L-carnitine is a metabolite of C4 oil LC, which is involved in the transfer of palm-n-LC through the inner membrane into the mitochondrial matrix and is a substrate for the formation of ATP molecules. Carnitine is a trim ethylated amino acid naturally synthesized in the liver, brain and kidneys from protein lysine and methionine. Several factors, such as sex hormones and glucagon, can influence the distribution and level of carnitine in tissues [3,4].

In the absence of L-carnitine, the inner membrane of the mitochondria becomes impermeable to fatty acids, which entails a chain of various metabolic disorders in the human body. Carnitine has a modulating effect on the function of acetylcholine excitatory neurotransmitter, glutamate excitatory amino acid, insulin growth factor-1 (IGF-1) and nitric oxide (NO)[3]. Also proved, that L-carnitine may have a dual protective effect by enhancing the energy dynamics of the cell and inhibiting cell membrane hyper excitability, which make it an ideal nutrient for cancer prevention and treatment [5]. In view of the foregoing, the study of the influence of the body mass index on the effectiveness of systemic treatment of breast cancer is an urgent scientific problem and a promising field of research. This article presents the information of epidemiological and clinical studies of the influence of the body mass index on the effectiveness of breast cancer treatment by individualizing therapeutic measures taking into account the characteristics of patient's metabolism.

Studies on the Effects of BMI on The Course and Outcome of Breast Cancer and the Role of L-Carnitine in the Treatment of Cancer: The effectiveness of the prescribing of L-carnitine for breast cancers' treatment, as well as the effect of BMI on the outcome of the disease is proven in epidemiological and clinical studies.

Epidemiological and Clinical Studies

DSM Chan and co-authors [6] reported that women who have BMI> 30 course and outcomes of breast cancer are significantly worse than women with BMI <30. They proved, that women with BMI> 30 have the overall relative risk of total mortality 1.41, women with BMI of 25> 30 - 1.07. At the same time, for every 5 kg / m2 of the increase BMI, the risk of both total mortality and mortality from breast cancer increased, namely by 18% and 14%, respectively M. Protani and co-authors [7] have shown that women with breast cancer, who are suffering in obesity, have lower survival rate than women with breast cancer without obesity. Recently published data of randomized clinical researches by ML Neuhouser and coauthors [8] demonstrated, that for women> 50 years old, with 2 and 3 stages of obesity (BMI> 35) is typically the development of GR+ breast cancer.

Similarly, B. Pajares et al. [9] who found significantly worse results for patients with BMI >35 compared with patients with BMI <25, stated that the magnitude of the effect depended on the cancer subtype (estrogen receptor (ER) / progesterone (PR) positive and HER2 negative, HER2 positive, triple negative). An analysis of the pooled data of the three adjuvant studies of the Eastern Cooperative Cancer Group showed significantly worse results for patients with obesity (BMI > 30) than for patients with normal BMI with a hormonal receptor-positive disease. And it was noted absence of negative effect of obesity on survival in patients with other breast cancer subtypes. C Fontanella et al. [10] studied the effect of BMI on different molecular subtypes of breast cancer and concluded that in women with ER / PR-positive and HER2-negative breast cancer, as well as with TNBC, the risk of death is significantly higher than in other subtypes of cancer.

It is proved that even the highest BMI figures are not a risk factor for death for patients with luminal A-like subtype of breast cancer. The reason for this is that fatty tissue produces an excessive amount of estrogen, a high level of which is associated with an increased risk of developing breast, endometrial, ovarian and some other cancers. It has also been proven that the level of adipokine, that promotes cell proliferation, increases in the blood with increasing of level of fat in organism. And adiponectin, which people with obesity have less than people with normal BMI, can have anti proliferative effects. Such data can serve as evidence of the effect of BMI on the course and outcome of breast cancer. Yet another proof of influence developing metabolic syndrome on the course and outcome of breast cancer was proposed by R. Bhandari et al. [11]. They proved that that the presence of metabolic disorders (that is, the metabolic syndrome) is associated with an increased risk of breast cancer in adult women.

The above data led to the need to investigate medicines that contribute to fat burning, such as L-carnitine. Based on the data provided by Rania M. Khalil and co-authors [12], we can prove the positive effect of this medicine on the course and outcome of breast cancer. The study showed that patients who received Tamoxifen with L-carnitine had significant decrease of Her-2 / neu and IGF-1 level (P <0.05) in the serum compared with patients who received only Tamoxifen. Using of L-carnitine led to significant decrease Her- 2 / neu level in the serum (P <0.05) compared to each of the control patients, namely, 59.5%. The effect of tamoxifen on IGF-1 (P <0.05) -decrease its level by 5.4% [13].However, it has been proved that using of L-carnitine in the treatment of ER+ breast cancer does not significantly reduce the level of estradiol, but leads to decrease both tumor markers CEA and CA15.3 (P <0.05,% decrease by 80.9% and 67, 8%, respectively) [13].

Using of L-carnitine in patients with breast cancer and obesity improves the metabolism of fatty acids in mitochondria, restores normal mitochondrial function and, thus, improves the general condition and quality of patients’ life [14]. Carnitine may alsomimic some of the biological activities of glucocorticoids, particularly immunomodulation, via suppressing TNF-a and IL-12 release from monocytes (5). L-carnitine as adjuvant therapy in cisplatin-treated cancer patients proved a beneficial effect in reducing the cisplatin- induced organ toxicity [15]. It is possible that, the extremely lipophilic nature of carnitine may be responsible for the decrease in EGFbinding [16]. Carnitine may insert in the cell membrane and/or interact with one of the many cellular enzymes having lipid substrates or cofactors. In addition, carnitine may interact directly with the EGFR [17].

Experimental evidence is available showing that ROS may induce the light and independent phosphorylation of the EGFR activating Her-2/neu. Moreover, the expression of the receptor is induced in conditions of oxidative stress [18]. L-carnitine, via its free radical scavenging and antioxidant properties, may inhibit ROS-mediated EGFR phosphorylation. It has been found that palmitoyl-carnitine can inhibit the activity of heart and brain protein kinase C in a competitive manner and subsequent phosphorylation of the EGFR [19]. Although the tumor markers and IGF-1 showed no significant difference in TAM-treated patients before and after administration of L-CAR, there was a tendency to decline after L-CAR supplementation [13]. The results of the above studies became a prerequisite for conducting clinical studies aimed at establishing the role of L-carnitine in the treatment of breast cancer.

To date, the search in the online clinical research registration system ClinicalTrials.gov using key words L-carnitine + breast cancer has revealed several studies evaluating the efficacy and safety of L-carnitine in the treatment of breast cancer patients. Analyzing the obtained results, we can conclude that L-carnitine was the drug of choice for neuropathies, as a consequence of chemotherapy, in patients with breast cancer.

Conclusion

L-carnitine is widely used in clinical practice. However, recently this medicine causes growing interest among oncologists. In a number of studies, L-carnitine has proven itself as a medicine that capable, during the preoperative systemic antitumor therapy, to increase its effectiveness compared with standard neoadjuvant systemic antitumor therapy. And also, taking L-carnitine with neoadjuvant systemic antitumor therapy helps to increase the number of cases of complete morphological regression (V degree of therapeutic pathomorphosis). To date, there are several clinical studies that are researching using L-carnitine in various malignant tumors, the results of which are the basis for further in-depth study of the effect of the medicine in the treatment of malignant neoplasms.

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Lupine Publishers | Inclusive Educational Environment as a Condition for Successful Socialization of Students with Disabilities Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Annotation

Education and socialization of students with disabilities will be more effective if you design and create a model of an inclusive educational environment that implements certain social; psychological and pedagogical conditions and reflects this very complex and multilateral process. The article analyzes the practical experience of universities in creating an inclusive educational environment for students with disabilities. In this connection; leading characteristics; structural components; and some problems of designing this environment at the university are discussed.

Keywords: Higher education; Students with disabilities; Disabled people; Inclusive educational environment; Inclusive education; Accessible environment; Educational needs.

Introduction

Today; many indifferent people concerned about the issue: how in the twentieth century I century feels Russian invalid; the extent to which it met the specific needs of what is; by and large; his philosophy of life in society. The answer to this question depends on the degree of maturity of an inclusive society; public policy with respect to persons with disabilities. And on the other hand; the question can and should be raised; but what can ablebodied; educated disabled person give to society? This is a topical issue; primarily because in our country there has been a tendency to reduce labor resources. The working-age population in Russia will be reduced by more than 2 million by 2020. Therefore; the employment of able-bodied people with disabilities is precisely that reserve that will fill up the shortage of labor resources. We must admit the fact that; despite the efforts made to integrate people with disabilities into society; they still remain a special group; very poorly included in social processes and very limited in rights; not only because of their psychophysical characteristics; but also due to a number of barriers to the realization of basic human needs. So; the employment rate among disabled people of working age; according to the Ministry of Labor; is 25%; which is 2.5 times lower than the same indicator for Russians without restrictions on health. “Chronic” unemployment among people with disabilities of different nosologies reaches 77%. By 2020; the employment rate among people with disabilities should double and reach 50%. Now only every second student with a disability is subsequently employed-by 2020 this provider must grow to 90% [1-9] However; to achieve such indicators; it is necessary; first of all; to increase the effectiveness of career guidance for children with disabilities; the accessibility and quality of general professional and higher education. H ADO to take into account the fact that the number of children with disabilities up to 18 years in Russia from year to year - this year compared to last increased by almost 19 thousand. With oday general education system rapidly changing; increasingly adapting to training for children with disabilities. These changes; creating new opportunities for learning and socialization for children with disabilities; will in the future lead to an increase in their level of need for higher education. Therefore; universities should be prepared in advance for an increase in the number of applicants and students with disabilities. International experience offers models of vocational training for people with disabilities; both in an inclusive (or integrated) form; and in specialized centers equipped with special equipment; training technologies and conditions for people with disabilities to stay. Today; inclusion as a way of organizing the education of children with disabilities is recognized by the whole world community as the most humane. Inclusion has become one of the leading strategies in Russian educational policy. The importance of creating an inclusive educational environment is recognized by socio- pedagogical practice; reinforced by the domestic regulatory framework; and becoming the norm. It is educational inclusion that meets the ideology as much as possible; which eliminates any form of discrimination against the disabled and creates the necessary conditions for their successful socialization. In modern psychological and pedagogical science and practice; the concept of “inclusive educational environment” is widely used when discussing the educational conditions of children with disabilities. Inclusive educational environment (hereinafter - IOS) is a special type of educational environment that involves solving the problem of education of children with disabilities by adapting the educational space to the needs of each child; including reforming the educational process; methodological flexibility and variability; a favorable psychological climate; and providing students with disabilities supporting services [1]. This releases some levels inclusive air azovatelnoy environment [10].

The first level is also an inclusive general educational environment. E the level of implementation of inclusive general education purposes in a particular school with its terms; the objective factors of the regional environment of its location; as well as subjective factors; the characteristics of real subjects’ education. In the studies of [1-6] presents the leading characteristics of IOS in mass educational institutions. The second level is the inclusive environment of the educational organization of secondary vocational and higher education. E is a specially organized space that promotes the most comfortable receiving professional formation I ; taking into account the special educational needs and psycho- physical characteristics of students with disabilities . Moreover; this concept is interpreted widely. It includes not only the situation of the educational institution; but also “... the inner circle; the circle of communication of the disabled person: this is the family and those who surround him; who are next to him in the process of learning; during leisure hours” [3]. And finally; the third level is the inclusive educational environment of a particular person (a student with a disability; his typical peer; teacher) as a subject of inclusive higher education. It is necessary; because the development of this environment is aimed at achieving educational goals and results. Naturally; the personal environment of each participant in the inclusive educational process should be self-organizing at the level of this person; but methodologically managed by the university. Therefore; the level of the educational environment of a university is a combination of specific conditions and individuality of students. The holistic educational environment of a university under inclusive education appears as a supersystem for many unique; personality-adapted; personally significant social and educational developmental environments of each and everyone [1]. In recent years; experts have increasingly begun to pay attention to the design features of an inclusive educational environment [ 3,7-9]. The purpose of designing is to create a conceptual model of the educational environment; reflecting its essential properties and requirements for it in accordance with the educational specialization; the principles of the pedagogical system; the specifics of its implementation and subject teaching.

Each educational institution of higher education (university; academy; institute) creates its own IOS and; therefore; creates its own abstract and universal image (model of this university) for this environment. So; the purpose of the IOS project of the Moscow State University of Economics and Economics is to develop and test the current IOS model; which ensures the accessibility and improvement of the quality of higher education for people with disabilities with social security ; their socialization and integration into society through systemic state support for the learning process for people with disabilities. One of the main goals of the IOS formation is the development and adaptation of educational and informational educational resources for higher education programs to the needs of users (students with disabilities); the creation of a system of programmatic; normative and informational support for the processes of university education; compensation and rehabilitation ( habilitation ) of students disabled people; the development of various forms of alternative education; effective psychological and pedagogical support of the educational process ; providing spy the physiological health of all participants in the inclusive educational process [4].

Implementation of the project will make it possible to justify and design a model of training teachers in additional professional education for work in the conditions of IOS of the university; to develop and test diagnostic tools to determine the level of formation of teachers’ professional readiness for the formation of IOS in the university. In addition; the implementation of the university’s IOS project will be important to ensure the coherence of the actions of participants in the inclusive educational process; social partners; and the development of a system of psychological ; medical; pedagogical; informational; scientific; methodological and sociocultural support for students; teachers and staff involved in the formation of an adequate IOS ; increase the level of tolerance towards people with disabilities; their social adaptation and integration in ordinary groups of students. And the inclusive educational environment of a university is a pedagogical system that has a specific structure that includes a number of system components.

Spatial Subject Component

It characterizes the material capabilities of the university; such as: affordable (barrier-free ) architectural and spatial organization; provision of modern technical means and systems that meet the educational needs of students with disabilities and disabilities of various nosological groups. By law; a student with a disability has the right to apply for an adapted educational environment. By accepting such a student; the university takes responsibility; and the conditions must comply with its health restrictions. Implementation of the relevant regulatory standards for space accessibility; technical equipment and the arrangement of a “ barrier-free environment” for those universities that plan to accept disabled people for training is required. Building on our university’s territory an environment accessible for educating people with NODA was one of the first tasks that were solved when creating special educational conditions. On the instructions of the Ministry of Education and Science of Russia in 2012; our university; together with the Moscow State University of Civil Engineering; developed guidelines for ensuring the accessibility of buildings and structures of educational institutions of secondary prof. and higher education for persons with disabilities of various nosological groups.

Monitoring of the status of inclusive higher education conducted by the RMTC shows that the vast majority of universities are not ready for the inclusion of disabled people either morally; methodologically; or technically [2,3]. Moreover; the lack of infrastructure for the needs of people with disabilities is one of the most acute problems limiting the access of people with disabilities to higher education. Universities with effective technologies for teaching students with disabilities and staff with relevant professional competencies are concentrated mainly in 10-12 subjects of the Central; Volga and North-West federal districts. This encourages some applicants with disabilities to apply to such universities. However; admission to them for people from remote regions is associated with a number of difficulties that not every potential student with disabilities is able to overcome.

Of course; ensuring the physical accessibility of the educational environment requires effort- organizational; financial. And not every university is seriously engaged in this. Moreover; if in former times; when there were no official strict requirements for the accessible environment of an educational institution; children with disabilities studied at a comprehensive school; they were accepted to universities; now disabled students are simply denied admission to the admission campaign; allegedly due to the lack of special conditions. So; according to the monitoring of the Ministry of Education and Science ; within the framework of the admission campaign of the last three years; people with disabilities submit approximately 10 to 12 thousand applications for admission to higher education programs ; and only every second applicant with disabilities receives it.

Content Methodological Component

Includes curriculum and teaching and methodical the activities of students and teachers in the conditions of inclusive education ( goal ; differentiation; individualization and variation in the organization and content of the educational process ; teaching style and character control; flexible educational methods and technologies the ) [4]. There is a widespread belief that most students with disabilities are not able to fully master the content of academic disciplines and receive a quality professional education. Indeed; they experience difficulties in mastering the educational program at the same pace; on the same educational material and in the same sequence as other students. And these circumstances must be considered when organizing an inclusive educational process [5]. However; university practice shows that even with a technically equipped audience; teachers who do not have the skills to work with students with disabilities prefer to give the material the old fashioned way; ignoring the special educational needs of students with disabilities . Often; the teacher is satisfied with the empty “ sitting out “ of a disabled student at lectures; instead of an adequate presentation of the material; he tries to pay off with positive grades in the set-off. Or; on the contrary; it is not uncommon for a student with disabilities to impose unrealistic requirements for completing control tasks by misunderstanding . It is therefore important is finding teachers competences in methods of work in terms of inclusive higher education.

To create an adapted educational environment; according to [6,7] it is necessary: to apply experimental; stimulating interest and activity methods of development of students; apply more practical teaching methods; including business games; case technologies; apply methods of phased assimilation of new material; make students understand that they are responsible for completing assignments; provide them with greater freedom of choice; pay more attention to the emotional needs and interests of everyone; use unifying types of productive activities that contribute to the unity of students in an inclusive educational environment [2] . At the same time; it is necessary to proceed from the individual needs of each; using individualized types of activities; involve parents of students with disabilities in collaboration ; coordinate an individual educational route with them; rely only on the positive achievements of the learning outcomes . One of the productive mechanisms for ensuring accessibility and quality of education for people with disabilities and disabilities is distance learning; the possibilities of which are systematically increasing: the number of universities is increasing, and the quality of distance learning technologies is improving. According to the results of expert evaluations; no less than 80% of universities have access to educational portals for students; where they can master the training material needed to prepare for classes. Training using distance learning technologies is carried out in the implementation of full-time; part-time and part time forms of training.

This training offers a range of educational services provided to persons with disabilities and disability with the help of specialized information - educational environment; based on the medium of exchange of educational information at a distance. The choice of interactive teaching aids that provide operational interaction with the teacher; with other students; as well as with teaching material; helps to increase the effectiveness and quality of distance learning for students with disabilities and disabilities. The content-methodological component of the IOS of the university is interconnected with the means of information and communication technologies (ICT) and contains a system of information and educational resources (IOR) ; including a system of electronic educational resources (ESM). In 2016 designed and in March 2017 launched in test mode; the Internet portal of information support of inclusive higher education (https: // inklyuzivnoeobrazovanie born in f) ; a maximum of adapting the first for use by persons with disabilities when using the PC and various mobile devices. The portal contains and annually updates information on the state of ensuring the availability of conditions for the education of disabled people in universities. Currently; information is provided on 716 universities and 408 branches. It is possible to search for a university by given parameters (region; desired specialty; type of nosology of the applicant; and so on). Having specified a specific nosology; a disabled person can see a list of universities where the most favorable conditions for students with this disease are created; and also see the Atlas of the most popular professions. For students with disabilities; it is possible to take an online career guidance test and get advice on choosing the direction of preparation and admission to universities. In addition; there is access to a library of teaching materials and open courses tailored to nosology; and graduates are provided with information on employment opportunities.

The modern educational process at the university is high-tech in terms of using technical and informational teaching aids; which for a student with health restrictions can act both as a barrier and as a resource. On the one hand; complex laboratory work; including the use of technical devices; mandatory for many specialties and areas of training; can be difficult or dangerous for a student with visual; hearing; and motor impairments. On the other hand; modern computer and information technologies make it possible to provide information in a form accessible to students with sensory impairments (electronic magnifiers for the visually impaired and voice programs for the blind; sound amplifying equipment and multimedia for hearing impairments). Computer simulators allow students with motor disabilities in a simulation mode to perform experimental procedures inaccessible to them. A variety of ESM cannot and should not fully replace live communication with the teacher and other students during various forms of classroom activities; but can significantly help a student with disabilities. In this regard; providing an inclusive educational process with technical means of receiving and transmitting information in forms that meet the special educational needs of students with disorders of various nosology; as well as the development and application of appropriate pedagogical technologies; is an effective way to increase the accessibility of higher education for people with disabilities [8,4] .

The content-methodical component of the IOS of the university accumulates methodological resources; classified according to the subject and subjects of study; including those having electronic presentation. However; it is possible; for reasons of specific expediency; the allocation of a specialized resource component of the IOS that integrates all the methodological and educational information resources. The need for such a component is also caused by the fact that not all universities have experience in teaching and organizational and pedagogical support of disabled people of various nosological groups. In order to increase the effectiveness of the system of supporting the activities of universities for the education of persons with disabilities; 3 resource educational and methodological centers were created in 2016; and in October 2017; the RMTC network was expanded by creating another 13 RMCs based on educational institutions under the jurisdiction of the Russian Ministry of Education and Science ; including Moscow State University of Economics and Economics. In the higher education system; ROMCs act as a resource that other universities can use to increase the accessibility and quality of education for people with disabilities. The program for introducing inclusive education through the RMTC network is planned until 2020. For the most part; the centers are based in universities with departments of defect logical education; as well as in universities that have approved AEHE . In RUMTS launched retraining courses for the teaching staff of universities. On the one hand; the picture is rather optimistic the university community has moved in the right direction; on the other; the specialists of the RMTC believe; some of the universities undergo retraining to close the gap before accreditation.

Communicative and organizational component

Is a space of interpersonal interaction in a direct or subjectmediated form and ways of interaction between subjects of an inclusive educational process; a favorable psychological climate in inclusive groups; management of team activities of specialists providing inclusive practice at a university. Higher education; in fact; ensures that students enter a wide variety of social interactions into the special sociocultural environment of the university; which creates and expands the basis for adaptation. Developing social skills; collectivism; organizational skills; the ability to establish contacts and collaborate with different people. A worldview and civic position are being formed. The practical experience of MSGEU shows that the introduction of an inclusive approach to teaching people with disabilities today faces not only difficulties in organizing an accessible environment (physical accessibility to university facilities; special teaching aids; and special equipment). The most difficult to solve are problems of a socio-psychological nature; including the prevailing stereotypes of education; the lack of readiness of participants in the educational process (teachers; students; parents) to accept new principles of education; the lack of comprehensive psychological and pedagogical knowledge and technology; special monitoring studies regarding the experience of inclusive higher education [10].

The socio-psychological situation in the educational institution is an important aspect of an inclusive educational environment. Here we are talking about the nature of the relationship that a student with a disability develops with teachers; other students; supervisors; all staff of the educational organization. In fact ; there are good reasons for relational barriers with an inclusive approach in modern conditions. So; when presenting the same requirements to all students; students with disabilities often need to spend more time to master the material they have gone through; make more effort than a “healthy” student. During the lecture; students with disabilities ask more clarifying questions; and the pace of writing material is much lower. As a result; “healthy” students have to expect a continuation of the lecture; which causes irritation in individuals; a conflict may arise in the group. Moreover; facts are known when people with disabilities that are not externally expressed acted on the side of discrimination against persons with disabilities [9]. As psychologists note; this attitude is usually associated with one’s own disagreement with one’s real state of health It is also worth noting that the conflict can also occur between the “disabled” - “disabled” groups; and “healthy” students can support one or the other. According to our observations; conflicting parties are formed on issues of active and passive relations. So; students who study continuously in an inclusive approach within the walls of the university; more easily adapt to new conditions; establish contact with their peers. In addition to educational activities; they are engaged in scientific and social life; and show their leadership qualities. Students with disabilities who previously studied at a specialized educational institution or received a general education at home; the socialization process is difficult; time-consuming; there are communication barriers. A negative attitude arises between groups: students with an active position consider others unsure of themselves; students with a passive position consider the other group as “upstarts”; directly showing this with their behavior. In our opinion; despite such a negative attitude in groups; conflict can be considered as a way to resolve contradictions. The identification and resolution of conflicts as a whole is useful both for these social groups; and for society as a whole. Paying attention to conflict resolution; an individual; group or society as a whole achieve more effective results; of course; if they follow certain rules aimed at the civilized regulation of conflicts and management of their development [5].

Conclusion

The most important aspect of the communicative and organizational component of the IOS is the management of inclusive practice at the university. It is well known that the education and socialization of a person with disabilities is a complex problem even in a special educational institution. Inclusion of the educational process makes even greater demands on the interprofessional and interagency interaction of specialists. The managers in the field of vocational education; combining the knowledge of a wide range of pedagogical technologies of higher education with special defect logical training; are practically absent. To create a truly inclusive university; it is necessary to cultivate such professionals of a new formation. It is obvious that the country’s universities will inevitably have to solve a wide variety of tasks in the formation of an adapted educational environment - methodological; technical; regulatory and accreditation. But; first of all; participants in the educational process need to learn inclusive interaction-full-scale entry into equal relations. By this distribution of roles or di students or ordinary students or teachers are often not prepared. It is such a conscious “inclusion” that needs to be learned first.

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Lupine Publishers | Lupine Publishers | The Possibility of Complex Treatment of Optic Nerve Atrophy based on Etiopathogenetic Approach using the New Classification of this Ophthalmopathology

Open Access Journal of Biomedical Engineering and Biosciences

Lupine Publishers | Open Access Journal of Biomedical Engineering and Biosciences

Abstract

Application of treatment, differentiated based on the degree of functional changes and stages of atrophy, type of atrophy and nature of the lesion, significantly alters the effectiveness of treatment when compared to the isolated electropharmocological stimulation and even more so compared to the traditional medication method of treatment.

Keywords: New clinical classification and treatment of optic nerve atrophy

Abbrevations: ONA: Optic Nerve Atrophy; PONA: Partial Optic Nerve Atrophy

Introduction

Optic nerve atrophy (ONA) is the end result of disease, intoxication, genetically determined abnormality or injury of retinal ganglion cells and/or their axons situated between the retina and the lateral geniculate bodies of the brain. The prevalence percentage of various optic nerve diseases in the eye disease hospital is approximately 1-1.5%, 19 to 26% of those cases resulting in complete atrophy of the optic nerve and incurable blindness. Causes of ONA are: diseases of retina and optic nerve (inflammation, dystrophy, including glaucomatic and involutional, poor circulation due to hypertension, atherosclerosis, diabetes, etc., swelling, profuse bleeding, compression and damage of the optic nerve), diseases and injuries of the orbit, Central nervous system diseases (optic-chiasm leptomeningitis, abscesses and brain tumors with increased intracranial pressure, neurosyphilis, demyelinating disease, traumatic brain injury), intoxication with methyl alcohol, antibiotics (streptomycin, gentamicin), anti- malarial drugs (quinine, hingamin). ONA may be a component or sole manifestation of a number of hereditary diseases (congenital amaurosis, hereditary optic nerve atrophy, etc.) [1,2].

Table 1:Clinical Classification of the Partial Optic Nerve Atrophy.

Treatment of optic nerve atrophy is a very complex and difficult problem because of the extremely limited regenerative ability of the neural tissue. All depends on how widespread the degenerative process in the nerve fibers is and whether their viability is preserved. Some progress in the treatment of optic nerve atrophy has been achieved with the help of pathogenetically directed influences aimed to improve the viability of nervous tissue. The development of new methods of treatment of partial optic nerve atrophy (PONA) has greatly enhanced the possibility of rehabilitation of patients with this pathology. However, the abundance of methods in the absence of clear indications complicates the choice of a treatment plan in each individual case. [1,3,4,5,6,7] The analysis of literature on diagnosis and treatment of PONA showed lack of clear classification and the existence of various approaches to the assessment of the severity of the disease[2,8,9,10]. The following classification presented in Table 1 was used to determine the treatment plan [7,9]. The purpose of work. To create a method of optic nerve atrophy treatment differentiated depending on severity and other individual characteristics of the patient and to analyze the effect of the application of this technique.

Material and Methods

To treat the patients with partial atrophy of the optic nerve, we use the following methods. Infita-a low-frequency pulse physiotherapy device designed to expose the central nervous system (CNS) to low-frequency pulse electromagnetic field (without direct contact with the patient), which results in an improved central blood flow, saturation of blood with oxygen, and increased redox processes in the nervous tissue. It has as the following characteristics: no output signal - a triangular voltage pulse with negative polarity, pulse frequency 20 - 80 Hz (most frequently used 40 - 60 Hz), pulse duration of 3 ± 2 V, recommended number of procedures 12 - 15, starting with 5 minutes, increasing to 10 and then 12 minutes beginning with the fifth procedure and so on up to 12 treatments. Treatment method, hereinafter called the direct electropharmacological stimulation (EPS), includes installation of a soft PVC catheter into the retrobulbar space and a repeated inoculation of various medications through it into the retrobulbar space selected based on the etiopathogenesis of the atrophy. All patients were infused with a 10% solution of piracetam and exposed to electrical stimulation through a needle electrode inserted into the retrobulbar space through the catheter with the device "AMPLIPULS" 40 minutes later [11,12].

Also the following surgical methods can be used -ligation of the superficial temporal artery, implantation of a collagen sponge into the subtenon space, decompression of the optic nerve. In connection with the specifics of performing of surgical procedures in our clinic the technique of their execution is given below. Ligation of the superficial temporal artery. Local anesthesia - lidocaine 2.0 % subcutaneously. A 3 cm long skin incision is made 1 cm in front of the tragus. The tissue is bluntly separated. The superficial temporal artery is ligated with two stitches and overlaps between them. Albucidum powder is infused into the wound. The soft tissue is sutured with catgut suture. Silk sutures are placed on the skin. The wound is treated with a solution of brilliant green dye, aseptic sticker is placed. Implantation of a collagen sponge into the subtenon space. Local anesthesia - lidocaine 2,0 % subcutaneously and dicain 0,5 epibulbarly. A 5-6 mm long skin incision is made in the upper nasal quadrant 5-6 mm away from the limbus, parallel to the limbus. A tunnel is formed between the sclera and the capsule of tenon to the posterior pole using a spatula. An implant of a collagen sponge 10 - 8 mm long and 5 - 6 mm wide, pre-soaked with the solution of emoxipine (cortexin, retinalamin and other drugs or their combinations) is implanted into the tunnel closer to the optic nerve. The suture is placed on the conjunctiva and under the conjunctiva, followed by antibiotics and dexamethasone. After the implantation, antibiotics and a solution of diclofenac is applied locally for 5 - 7 days [13,14].

Decompression of the optic nerve is performed under general anesthesia. Blepharostat is used. An incision is made on the inner side of the conjunctiva. The internal straight muscle is sutured up in front the tendon and is clipped off. Three incisions of the scleral ring around the optic nerve are made. The solution of albucid is applied, and the muscle is locked in place. The suture is placed on the conjunctiva. Dixon and antibiotics are placed under the conjunctiva. The following scheme of treatment was suggested for the peripheral section of the optic nerve:

i. Degree: Emoksipin + dexamethasone subcutaneously in the region of the mastoid process, mildronat + emoxipin subcutaneously in the temple region, vitamin B1 1,0, alternate vitamin B6 1.0 V/m with piracetam 5.0 V/m, low-frequency electromagnetic stimulation.

ii. Degree: Catheterization of the retrobulbar space, direct EPS + long-term melioration: dexamethasone + emoksipin 2 times, piracetam (or other schemes depending on etiology), implantation of a collagen sponge with emoxipin into the subtenon space (ICS), piracetam 20,0 intravenously with physiological saline 200,0.

iii. Degree: Catheterization of the retrobulbar space, direct EFS + piracetam, dexamethasone, emoksipin 2 times a day. Implantation of a collagen sponge with emoxipin into the subtenon space, ligation of the superficial temporal artery, piracetam 20,0 intravenously with physiological saline 200,0.

iv. Degree: Step 1 - decompression of the optic nerve, step 2 or in case step 1 is not possible (severe somatic pathology) - catheterization + direct EFS, piracetam, dexamethasone, emoksipin 2 times retrobulbarly into the catheter. Ligation of the superficial temporal artery (if not done earlier). Implantation of a collagen sponge with emoxipin into the subtenon space, fenotropil tablets according to the treatment scheme, piracetam 20,0 intravenously with physiological saline 200,0.

Treatment scheme for the lesion of the central part of the visual pathway.

a. Stage I: Glycine 1 tablet 3 times a day sublingually for one month, cavinton according to the treatment scheme, then phenotropil (tablets) according to the treatment scheme. "Infita” - percutaneous low-frequency electrical stimulation.

b. Stage II: Cortexin intramuscularly No. 10. Trental intravenously in a physiological saline No. 5 (or aminophylline). Cerebrolysin intravenously No. 5. Glycine 1 tablet 3 times a day for one month. "Infita” low-frequency electrical stimulation.

c. Stage III: Cortexin intramuscularly No. 10. Glycine sublingually 1 tablet 3 times a day for one month. Trental intravenously in a physiological saline No. 5 (or aminophylline). Cerebrolysin or actovegin intravenously No. 5. Piracetam 5,0 intramuscularly No. 10. Antiplatelet agents (aspirin, clopidogrel) if necessary.”Infita” - percutaneous low-frequency electrical stimulation.

d. Stage IV: Cortexin intramuscularly No. 10.Emoxipin intramuscularly No. 10. Trental intravenously No. 5. Cerebrolysin or actovegin or solkoseril No. 10 Piracetam 5,0 intramuscularly No. 10. Antiplatelet agents (aspirin, clopidogrel) if necessary. Catheterization with direct EPS, dexamethasone, piracetam, emoksipin retrobulbarly into the catheter.

In case of total lesion of the visual pathway the elements of both treatment schemes of the corresponding stages are combined. To compare the effectiveness of different PONA treatment schemes three groups of patients were formed. The first group consisted of 358 patients (508 eyes) with optic atrophy of various etiology and pathogenesis, getting treatment, differentiated based on the stage, localization and duration of existence of atrophy. The second group consisted of patients who, regardless of the stage of atrophy, were subjected to a course of electropharmacological stimulation: 107 patients (152 eyes). The control group consisted of 77 patients (126 eyes) who received only medication treatment. The percentage composition of the main types of dystrophy in all three groups was similar.

The main study group consisted of 136 glaucoma patients (183 eyes), 81 patients (122 eyes) with the atrophy of vascular origin, post-inflammatory atrophy was observed in 51 (76 eyes), cerebral in 25 patients (50 eyes), traumatic 52 patients (52 eyes), toxic in 13 patients (25 eyes). The second group included 36 patients with glaucoma (46 eyes), 14 patients (38 eyes) with the atrophy of vascular origin, post-inflammatory atrophy was observed in 16 (24 eyes), cerebral in 5 patients (10 eyes), traumatic in 18 patients (18 eyes), toxic in 8 patients (16 eyes). The control group consisted of 24 patients with glaucoma (42 eyes), 21 patients (32 eyes) with the atrophy ofvascular origin, post-inflammatory atrophy was observed in 14 people (22 eyes), cerebral in 3 patients (6 eyes), traumatic in 8 patients (10 eyes), and toxic in 7 patients (14 eyes). Patients of this group were treated in a conservative manner: emoxipin with mildronate subcutaneously in the temple region, emoksipin with dexamethasone subcutaneously in the area of the mastoid process, taufon under the conjunctiva, piracetam intramuscularly. The result of the treatment of patients with partial atrophy of the optic nerve depending on the type of treatment can be seen in Tables 2 & 3.

Table 2:Results of treating patients with partial atrophy of the optic nerve.

Table 3:Results of treating patients with partial atrophy of the optic nerve.

Note: p<0.01, compared to the values before treatment.

No cases of deterioration were recorded.

Conclusion

Medication therapy combining medications which have various effects on the nervous tissue is effective only for the initial stages of atrophy of the optic nerve. Also, the use of non-invasive physiotherapeutic methods is effective in early stages. The use of direct electropharmacological stimulation is more reasonable for advanced stages, and surgical methods - for severe cases. The use of treatment, differentiated based on the degree of functional changes, the type of atrophy and the nature of the lesion, significantly increases the effectiveness of treatment compared to the isolated use of EPS and even more so compared to medical treatment.

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Lupine Publishers| Ictal Asystole after Meningioma Resection: Case Report

Lupine Publishers|Open Access Journal of Neurology & Neurosurgery

Abstract

We report the first-ever case of left fronto temporal-onset seizures causing ictal a systole, within 24 hours of a left sphenoid wing meningioma resection. It reinforces the importance of close monitoring of neurosurgical patients with continuous EEG.

Keywords: Seizure; A systole; Meningioma; Case report

Introduction

Autonomic dysfunction in various forms, affecting the cardiovascular, respiratory, gastrointestinal and other systems, is commonly associated with seizures. Seizures frequently affect the heart rate and rhythm, often in a transient manner. An increase in heart rate is very common with various kinds of seizures, but ictal bradycardia and a systole are much less common [1]. Symptomatic ictal Brady arrhythmias occur in less than 0.5% of epilepsy patients, and the overwhelming majority have been reported in association with temporal lobe epilepsy. The common presentation is a patient who has complex partial seizures with or without secondary generalizations, who develops ictal a systole and syncope. It has been suggested that this is a seizure self-termination mechanism [2].

We report here a case of a woman with new onset seizures caused by a meningioma, who had episodes of ictal a systole following tumor resection. To our knowledge, this is the first-ever report of ictal a systole that began after tumor resection - most cases in the literature noted this in the setting of long-standing temporal lobe epilepsy. While illustrating the importance of the central autonomic network in cardiac function, it also emphasizes the need for neurosurgical patients to be closely monitored following their procedure.

Case Report

A 69-year old female with diabetes mellitus with a newly- diagnosed left sphenoid wing meningioma was admitted to our hospital for resection. The meningioma had been diagnosed after she had developed new-onset seizures a month prior to admission. She had been started on levetiracetam for seizure prophylaxis. Her admission labs were significant for elevated glucose, and mild hyponatremia of 128mill moles per liter, that corrected to 135mmol/L when adjusted for elevated glucose level.

After an uneventful left craniotomy and mass removal, she remained in the intensive care unit for monitoring. Late in the evening on the day of her surgery, she had an episode of bradycardia progressing to loss of pulse, for which cardiopulmonary resuscitation with chest compressions was initiated. However, she regained spontaneous circulation quickly. She was showing some confusion and altered speech, and therefore had a long-term EEG placed to rule out seizure. The EEG was significantly asymmetric, with attenuation, slowing, and rare trains of epileptiform activity over the left hemisphere. She had another episode of loss of pulse, requiring cardiopulmonary resuscitation through chest compressions, with the spontaneous return of circulation within 1 minute. EEG revealed subtle left frontal seizure preceding the asystole that quickly spread to the contra lateral hemisphere. Subtle left arm and head jerking were the only other clinical correlate. Diffuse EEG suppression followed the a systole.

She was started on a dopamine infusion, but the next morning she had two more episodes of asystole lasting 15 and 10 seconds in rapid succession. There was EEG evidence of left fronto temporal onset seizures with rapid progression to involve the contra lateral side preceding this asystolic event. There was also evidence for fontal rhythmic intermittent delta activity (FIRDA) on the left, a nonspecific finding that might indicate increased intracranial pressure or other frontal dysfunction. A temporary transvenous pacemaker was implanted. She had an episode of supra ventricular tachycardia, but remained otherwise stable.

Figure 1: (A) Standard scalp EEG sampled at 500 Hz, time compressed at 2mm/sec and viewed with filter 1-70 Hz. The red circle denotes onset of a partial seizure in the left temporal region. The blue circle highlights asystole lasting 56 seconds. (B) Single lead EKG demonstrating bradyarrythmia leading to asystole. (C) left temporal chain electrodes demoinstarting seizure onset. (D) Time compressed FFT (1-40Hz) - left hemisphere over right hemisphere. The black circle highlights the abrupt flattening of EEG following asystole.

Increasing the daily levetiracetam dose and correction of hyponatremia with hypertonic saline led to the cessation of epileptiform discharges on the EEG. However, her affect remained flat, and the decision was made to taper the levetiracetam and start oxcarbazepine. Her seizures remained under control, and no further brad arrhythmias were noted, leading to the removal of the temporary pacemaker five days after it was inserted. The patient was discharged to a rehabilitation facility and remained stable at follow-up (Figure 1).

Discussion

The cause of ictal Brady arrhythmias is debated. There does not seem to be any evidence for primary cardiac conduction defects. It has been suggested that the fact that there are delays between seizure onset and a systole that the pathology involves activation of certain brain regions [2]. It is known that there is a central autonomic network in the brain, of which the insula is a part, and stimulation of areas within it can trigger parasympathetic outflow changes. Catenoix et al. [3] stimulated the insula in human subjects, causing high-frequency discharges there, which were followed by a systole after 2 seconds. A direct postganglionic effect on the heart is possible, which may tend to synchronize autonomic input to the heart with epileptic activity [4].

The insula is a deep structure, and scalp correlate to an insular seizure is likely to be a frontal or a temporal ictal discharge. In our case, subtle but unequivocal left frontotemporal rhythmicity preceded the a systole in both events. It was otherwise absent from the record. It is feasible to postulate that left frontal seizures originating from a known lesion reached the insula, and caused cardiac pause and/or a systolic arrest.

There are some studies which suggest that autonomic control, especially as mediated by the insula, shows hemispheric lateralization, with the right hemisphere predominantly modulating sympathetic tone, and the left hemisphere parasympathetic tone [5]. However, studies on ictal arrhythmias have not been consistent in their findings concerning lateralization [2]. Therefore, the question of what makes certain epilepsy patients prone to Brady arrhythmias and a systole, as opposed to tachy arrhythmias, remains open.

Conclusion

This first report of ictal a systole following meningioma resection reinforces the need for close monitoring of neurosurgical patients, especially with EEG, and being alert to the possibility of a systole and syncope in those with fronto temporal seizures. The brain-heart connection as represented by the central autonomic network's influence on cardiac function needs to be further investigated.

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Lupine Publishers| Integration of Novel Emerging Technologies for the Management of Type-2 Diabetes

Lupine Publishers | Journal of Diabetes and Obesity

Introduction

The incidence of twin epidemics, obesity and type-2 diabetes are increasing rapidly worldwide in the past two decades [1-7]. By azand large, clinicians manage diabetes by meticulous management of blood glucose levels to meet the guidelines established by professional societies and regulatory agencies (8, 9). The American College of Physicians (ACP) published the most recent guideline in April of this year (8). Major guidance statements include:

a) Clinicians should personalize goals for glycemic control in patients with type-2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients’ preferences, patients’ general health and life expectancy, treatment burden, and costs of care.

b) Clinicians should aim to achieve an HBA1c level between 7% and 8% in most patients with type-2 diabetes.

c) Clinicians should consider de-intensifying pharmacologic therapy in patients with type-2 diabetes who achieve HBA1c levels less than 6.5%.

d) Clinicians should treat patients with type-2 diabetes to minimize symptoms related to hyperglycemia and avoid targeting an HBA1c level in patients with a life expectancy less than 10 years due to advance age (80 years or older), residence in a nursing home, or chronic conditions (such as dementia, cancer, heart failure) because the harms outweigh the benefits in this population [8]. Recently three major professional bodies have issued guidelines on this topic. They are, American Association of Clinical Endocrinologists, American College of Endocrinology, and the American Diabetes Association [9]. In this overview (point of view), we will briefly discus some of the recent emerging technologies that may help empower and encourage patients to monitor their glucose levels and better manage their post-meal glycemic load.

According to Rebecca Voelker’s report in the recent issue of JAMA Network (May 2018), the.com Food and Drug Administration (FDA) has approved a continuous glucose monitor (CGM) that can work in tandem with mobile medical apps and automated insulin pumps to help people with diabetes manage their interstitial sugar more easily. The Dexcom G6 is the first CGM approved as both a stand-alone device and one that can be integrated into automated insulin dosing systems. According to the manufacturer, Dexcom Inc. of San Diego, California, its newly approved CGM has an easyto- use auto applicator that inserts a small sensor just beneath the skin. The sensor measures glucose levels and a transmitter inside of it sends readings wirelessly every 5 minutes to a receiver or a compatible smartphone or smartwatch. With a mobile app, users can share readings with up to 5 people. No finger sticks are needed for calibration or diabetes treatment decisions. In 2 trials, 324 adults and children aged 2 years or older with diabetes used the Dexcom G6 for 10 days. During multiple clinic visits, their readings were compared with laboratory test results that measured their blood glucose levels. An FDA statement indicated that no adverse events were reported during the studies. We would be glad to validate these sensors if the manufacturers provide them for our clinical evaluation in India.

We in India are validating another CGM (Ambulatory Glucose Monitor, AGM) that is developed by Abbott Diabetes Care, Free Style Libre Pro (www.freestylelibre.com). The sensor comes with an easyto- use auto applicator. Manufacturers claim that the sensor is 48% less bulky than the Dexcom G5 transmitter and sensor. One has to use the reader that is provided by Abbott Diabetes Care. Abbott as well as iPhone do not have any apps to monitor the data from these sensors. However, android phones (with Near Frequency Communication capabilities) can read the data from these sensors. According to my collaborator Dr. Santosh, parents of type-1 diabetes patients love this system as they can keep an eye on the sugar levels of their children. To be competitive, iPhones and Abbott also should develop smart phone Apps. Abbott sensor measures glucose levels every 15 minutes for two weeks. Risk level is assessed for five time periods (there are 2 periods between bedtime and breakfast). A typical graph of median glucose is shown below. Abbott claims a strong correlation between median glucose and HBA1c (Figure 1).

Figure 1: Abbott Diabetes Care

We are validating the usefulness or otherwise of this new glucose sensor in two independent sites in India (All India Institute of Medical Sciences, Patna, and Karnataka Institute of Endocrinology and Research, Bengaluru). The author has done some preliminary study using this sensor and a typical summary of the results are shown below. Since this study was done by an authorized endocrinologist of Karnataka Institute of Endocrinology and Research (KIER) using me as the test subject, I will refer the subject as the patient. He is (a resident of USA) over 80 years of age with well characterized type-2 diabetes for over 20 years. He is under medications (Metform in 500mg two tablets, twice daily, DPP-4 inhibitor Januvia 50mg/twice daily, Glipizide 10Mg/twice daily) and the graph shown below shows the results of a wellmanaged glucose profile. Author thanks Dr. Santosh Olety(KIER) and MS. Smitha Raja (Noesys software, Bengaluru) for these studies and analysis of the data.

Figure 2 shows a composite data for the duration of the study (12 days). According to this data estimated HBA1c was 7.2 fairly close to the estimated clinical values. Figure 3 gives the mean glucose values for each day (variation in the mean values are not very significant). Currently, we are conducting studies to determine the correlation between the blood glucose measured by the finger prick method and the interstitial glucose measured by these emerging technologies. We also are evaluating the usefulness or otherwise of this method of glucose monitoring for the management of postmeal glucose as well as for screening of indigenous anti-diabetic drugs and their combinations.

Figure 2: Abbott Diabetes Care

Figure 3: Abbott Diabetes Care

As the manufacturers of glucose sensors (Dexcom and Abbott) claim, the new glucose sensors that can work in tandem with mobile medical apps and automated insulin pumps help people with diabetes manage their interstitial sugar more easily. As discussed in this overview, these sensors will serve as useful tools to manage post-meal glucose levels as well as for screening anti-diabetic drugs, dietary supplements and herbal products. Emerging technologies in device development, availability of mobile apps, improved analytics will play a very important role in the development of better affordable healthcare.

Acknowledgementment

Author thanks the following collaborators: Dr. M. A Shekar, The Director, Karnataka Institute of Endocrinology and Research (KIER), Dr. Santosh Olety, Pediatric Endocrinologist, KIER, Ms. Smitha (Raja) Bopanna, Co-Founder, Director, Noesys Software, Pvt, Ltd, Bengaluru. Dr. Sadhana Sharma, Professor, Head, Department of Biochemistry, All India Institute of Medical Sciences, Patna. Abbott Diabetes Care, Regional Representatives: Dr. Navneeth Selvan (Southern Region), Dr. Silpi Bardhan (Eastern Region).

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The Elemental Composition of Soils of Saline Agrolandscapes and Sanitary-Hygienic Conditions of the Southern Part of the Prichanovskaya Depression

Lupine Publishers- Environmental and Soil Science Journal

Annotation

Studying the macro- and microelement composition of the soils of the saline agrolandscape of the southern part of the Prichanovskaya depression, it was established that meadow-chernozem poorly saline sandy soil was formed in the eluvial position, and low-saline solonchikovy clayey soil in the bottom. Of macronutrients in them is dominated by silicon. Calcium is more than magnesium, especially in the soil horizons of the lower position. The content of trace elements in the soil of the lower position is 2-3 times higher than at the top due to their movement with surface and groundwater. The content of arsenic, barium, boron and strontium is several times higher than the MPC, which creates a difficult situation in the area, which must be considered in the production of agricultural products.

Keywords: Saline agrolandscape; Catena; Macro and microelements; Sanitary and hygienic conditions

Introduction

Currently, agricultural production is undergoing great changes. The main direction of use becomes its greening on a landscape basis. The founder of this direction is BB Polynov [1]. The landscape is a large and complex dynamic system of the earth’s surface, within which interaction and interpenetration of the elements of litho, hydro, and atmosphere occur [2]. In connection with the agricultural use of the territory, a variety of landscape began to stand out-an agroland landscape, which takes into account all its peculiarities of development and existence-climatic, biological, lithological, soil, etc. Such major scientists - soil scientists as VA Kovda [3], Kiryushin VI [4], who were forced to look at this problem differently than in the previous research period. Earlier, in the development of zonal farming systems for the rational use of soil cover, zonal features of the territory were mainly taken into account. It turned out that with soils and living organisms in it and on it, scientific substantiation, accuracy and thoroughness of agrotechnical and ameliorative treatment is necessary. Underreporting and lack of knowledge of natural conditions, especially of the soil cover, is one of the reasons for low yields. With the scientifically based and effective management of soil fertility, two difficult tasks are solved: obtaining high and stable yields and increasing soil fertility. At the same time, it is important to know the chemical composition of soils belonging to a particular landscape and the direction of geochemical processes within it. The purpose of these studies is to study the chemical elemental composition of the soil and the sanitary and hygienic situation in the saline agrolandscape of the southern part of the Prichanovskaya depression, which is part of the Barabinskaya plain.

Research Tasks

a) To study the macronutrient composition of catena soils: meadow-chernozem ordinary low-power low-rich sandy loam-eluvial (high) part of the agrolandscape and meadow-marsh saline heavy clay-accumulative (low).

b) To determine the microelement composition of these soils and to identify the sanitary and hygienic environment of the studied saline agrolandscape. In fulfilling their goals and objectives, they used modern approaches to study selected agrolandscapes [4-6]. In 1990, an agromeliorative grouping of sone-almonds and recommended measures for their improvement were developed for sodic and saline soils in 1990 [7]. Currently, this group is outdated. It does not match the approaches to the development of adaptive-landscape farming systems. Therefore, an agroecological typology of lands of the Barabinskaya lowland was proposed, which underlies the present work [6].

Objects and Methods of Research

The studies were conducted in the southern part of the Prichanovskaya depression of the Barabinskaya lowland, which covers 65.5% of the territory of the Novosibirsk region or 11.7 million hectares. Here, in the immediate vicinity of Lake Chany, we laid two soil cuts in a saline agrolandscape in the form of catena. The incision (P40)-on the elevated mesorelief (eluvial position) and the incision (P21)-in the lower part (accumulative position).

The Location of the P40 Soil Section is as Follows

Chistyozerny region of the Novosibirsk region, dry meadow, eastern apical part of the margin of the mane (76° 45ʹ 09.08ʺ N). Height above sea level-120 m. The soil is a meadow-chernozem ordinary medium-power poorly mature sandy sand, and the P21 cut (54° 46ʹ 52.1ʺ.N., 76° 50ʹ 22.3ʺ E), height above sea level-103 m; grass-wormwood meadow, boils from HCL from the surface. Groundwater-from 60cm. Soil: meadow-marsh saline, heavy clay (Table 1) (Figure 1).

Figure 1: The location of the cuts on the saline agrolandscape (satellite image).

Table 1: Physico-chemical properties of catena soils in the saline natural landscape of the southern part of the Prichanovskaya depression.

Discussion of the Results

The gross content of 7 macroelements-Si, Fe, Al, Ca, Mg, Na, P (Table 2) was determined. From the data of (Table 2) it can be seen that the macro element Si dominates in the soils. On the eluvial position, its catena is twice as large as in the accumulative position, which is associated with weak leaching and movement of silicon by surface flows. Somewhat different There were results on the content of Ca and Mg. In both soils, the Ca content prevailed over the Mg content. With depth along the profile, the amount of calcium increased dramatically, especially in meadow-marsh saline soil, since the latter is located in a modern lakeside belt, where conditions are created for its enrichment in a biogenic way (during spill, die-off mollusks, etc.) and due to soluble salts. The magnesium content in both soils is distributed more or less evenly. With depth, its amount gradually increases, and in the accumulative zone it is almost 3 times more than in the eluvial one. The sodium content in the upper horizons of the meadow-chernozem soil (eluvial positions) exceeds the contents of Ca and Mg and is slightly less than in the hell and Al horizons of the marsh, which indicates a periodic enhanced leaching of these horizons during floods. Phosphorus is slightly more contained in the salt marsh in the accumulation zone, where natural conditions are created for its accumulation in anaerobic conditions.

Table 2: The profile distribution of the gross content of macroelements in the saline natural landscape of the southern part of the Prichanovskaya depression.

Summarizing the content of macronutrients in catena soils, it can be noted that the eluvial positions in the natural saline landscape in the hemihydromorphic soil profile contain less macronutrients than the soil profile in the accumulative positions by about 2-3 times. The issue of distribution of trace elements in the soil scientists pay great attention. In particular, a number of monographs on the Novosibirsk region and the city of Novosibirsk were published [8-10], where the authors highlight the problem of the great importance of trace elements in the life of plants, animals and humans. A brief description of the biological role of individual chemical elements, even those whose significance for living organisms is not enough or little is known [8]. The authors of this monograph conducted biogeochemical zoning of the territory of the Novosibirsk region. Thus, within the region, two biogeochemical provinces have been identified, which include 8 biogeochemical regions (BR). They are significantly different in environmental stress.

Object of Study

According to this regionalization, is located in the Barabinskaya Plain in the extensive biogeochemical province 1 (BGHP-1). It is characterized by a wide distribution of saline rocks and soils, mineralized groundwater, groundwater and surface water, a lack of Co and Cu, an unfavorable ratio in Ca: Mg plants. Here the most complicated biogeochemical situation has developed. This report provides an analysis of 14 microelements and examined their content depending on the position of the sections along the catenaupper (eluvial) and lower (accumulative) positions.

Pb is lead. In medicine and in biology, interest in this element is associated exclusively with its toxicity for all living things. However, it has now been established that lead in small amounts (for plants from 2 to 6mg/kg of dry matter and animals from 0.05 to 0.5mg/kg) is necessary for their normal life activity [11,12]. Plant resistance to excess lead is different-legumes are more resistant, and less so are grains. Signs of toxicity to an excess of lead in plants for this reason can occur when its total content in the soil varies from 100 to 500mg/kg [13,14]. The data we obtained (Table 3) indicate that for catena in eluvial and accumulative positions, the total lead content ranges from 10.5 to 26.0mg/kg of soil. This amount is significantly less than the MPC-100mg/kg [15]. In the upper humus horizons its content is found more, and in the lower-somewhat less. In the eluvial zone in the profile of the meadow-chernozem soil slightly less than the accumulative. Our data indicate that there is no significant change in the Pb content in the profile of both soils. Only in the hell horizon of the meadow-marsh saline soil, the amount of Pb increases to 26mg / kg of soil, which indicates its transformation from the upper eluvial positions to the lower accumulative ones.

Table 3: The profile distribution of the gross content of trace elements in the soils of the saline agrolandscape of the southern part of the Prichanovskaya depression.

As is arsenic. Arsenic has long been used both as a deadly poison and as a medicine, since it has healing and tonic properties. He, like other trace elements, in small quantities is necessary for living organisms and extremely dangerous in high concentrations. The biological role of arsenic is related to the fact that it is chemically close to phosphorus and can replace it in separate biochemical reactions. The phytotoxic threshold of arsenic in soils depends on the particle size distribution and properties-on light, low-humus soils with low absorptive capacity, it is 10-20mg/kg, and on heavy, high-humus with high absorptivity, it can exceed 100mg/kg [12]. MPC of arsenic in sandy and sandy sour soils does not exceed 2; in loamy and clay neutrals-10mg/kg. The arsenic data obtained by us (Table 3) indicates that in the top positions in the meadowchernozem soil along the profile it is distributed more or less evenly and ranges within 18mg/kg in the B2 carbonate horizon and slightly higher 21.6, which exceeds the MPC. More than 34.5mg/kg is found in the accumulative zone in the horizon of arsenic hell. In the lower horizons it is significantly less-13.0–15.5mg/kg. This is due to the heavier particle size distribution of the soil and the alkaline reaction of the environment. According to Russian regulations, these soils have a high arsenic content.

Cd is cadmium. Cadmium is known as a toxic chemical element, but recently it has been established that it stimulates the growth of animals and humans in small quantities. The need for cadmium for plants has not yet been established. Cadmium easily enters the plants through the root system, and from the atmosphere into the leaves. The main cause of cadmium toxicity for plants is that it disrupts the activity of enzymes, inhibits photosynthesis and makes it difficult for plants to enter a number of nutrients. MAC of cadmium in soil in different countries ranges from 2 to 5mg/kg, in water (mg/l) 0.05; in feed-1mg/kg of dry matter. According to Il’ina VB and Syso AI [8] in the Novosibirsk Region there is no dangerous entry of cadmium into plants from the soil, which is also confirmed by our data (Table 3). The number of Cd in the soil profile of the studied landscape is small. In the upper soil horizons of the eluvial positions, its content is 0.8, and in the lower horizons it is 0.9 mg/ kg, then some decrease occurs. In soil-forming rocks, the amount of cadmium increases in comparison with the middle horizons. There is an increase in cadmium in accumulative positions.

Ba is barium. Despite the presence of barium in many plants and animals, its physiological significance has not been established. Due to chemical similarity and antagonism with calcium and strontium, barium is able to displace them from plants. Plants easily absorb Ba, especially from acidic soils, and are able to tolerate its high concentrations. The MPC of barium in soils, food and feed has not been developed, and in drinking water it is 0.1mg/l [16]. As Ilyin VI and Syso AI noted [8] in the Novosibirsk region there may be an excess amount of barium in plants and in living organisms due to its high content in soils and waters. The data we obtained (Table 3) suggests that the Ba content in eluvial positions is high and varies along the profile of the meadow-chernozem soil from 543 in the parent rock to 676mg/kg in the humus horizon A. Significantly higher is its quantity respectively 1040 and 829mg/ kg, which indicates leaching and movement of Ba down the catena and accumulation in vegetation and living organisms.

B-bor. The biological functions of boron in plants are associated with the metabolism of carbohydrates, the transfer of sugars through membranes, the synthesis of nucleic acids and phytohormones. However, the mechanism of its action is not fully understood. In the south of Western Siberia there is practically no shortage of plant boron. Soils are rich in this trace element, and an excess of boron is a frequent occurrence here, especially in saline soils [17]. MPC boron in drinking water-0.5mg/l. An excess of boron in the soils of the Barabinskaya Plain is a serious environmental problem, both for plants and for animals and humans. A high concentration of boron in saline soils not only reduces the yield, but also causes boric enteritis, an endemic disease of the gastrointestinal tract in animals and humans. In the studied agrolandscape (Table 3), the boron content in the eluvial position is 38–57.8mg/kg of soil, and in the accumulative position, it is 2 times higher in the profile of the meadow-marsh saline soil, which creates serious sanitary and epidemic problems for this area of residence [18].

Mn is manganese. Manganese provides redox processes in plants, since it is able to change valence easily and reversibly transfer from Mn2+ to Mn7+. With a shortage or an excess of Mn, these functions are violated [12,19,20]. In plants, manganese is involved in the respiratory process, nitrogen metabolism, promotes the formation of chlorophyll and the synthesis of nucleic acids. In living organisms, manganese performs the same functions as in plants, but at the same time new, specific ones appear. It is needed for the body to produce insulin, the formation of the skeleton, the work of the central nervous system. According to Ilyin VB and Syso AI [8], in the Novosibirsk Region there are areas with both low manganese content and high, and anthropogenic impact on agricultural landscapes can increase both the deficit and excess of this element. Our studies have shown that in the eluvial positions of saline agrolandscape in the profile of meadow-chernozem soils, the gross Mn content does not exceed 855mg/kg, which is lower than the regulated sanitary and hygienic standards adopted in the soils of Russia (1500-3000mg/kg). In accumulative positions in the profile of meadow-marsh saline soil, the manganese content is somewhat higher-up to 1090 mg/kg in horizon A1. However, the ratio Fe/Mn is high and significantly exceeds the standard (1.5-2). This gives reason to consider this area unfavorable for the cultivation of cultivated plants (Table 4), because manganese deficiency is added to other adverse conditions.

Table 4: Fe/Mn ratio in the studied soils.

Cu-copper. Copper is involved in many physiological processes occurring in living organisms. In plants, these include photosynthesis, hemoglobin synthesis, respiration, redistribution of carbohydrates, etc. Such wide participation of copper in plant life is associated with its ability, as well as Fe, Mn, Co and Mo to change valence. Copper, like zinc, is responsible for reproductive functions. Its lack leads to a decrease in grain and its quality.

In Russia, MPC of copper for soils is set depending on its particle size distribution and pH value. In sandy and sandy soils, the MPC of gross copper content is 33; in loamy and clay sour-66; loamy and clay neutral and alkaline-132mg/kg. As can be seen from (Table 3), the gross copper content in the eluvial position in the profile of meadow-chernozem solodized soil ranges from 18.5 in horizon AB to 28.5mg/kg in horizon A. and more times more, which indicates the spatial movement of this element from the top to the bottom where it accumulates. Copper content below MPC is typical for all horizons of the studied soils.

Cr-chrome. Chromium, as a chemical element, is vital for living organisms, since in the processes of carbohydrate metabolism, it interacts with insulin, participates in the structure and function of nucleic acids and, possibly, the thyroid gland. The chromium content in plants ranges from 0.02-1.0mg/kg of dry matter. As a rule, plants under normal conditions do not lack it. MPC for chromium in Russia has not yet been developed. According to Kloke A [15], the MPC in animal feed should not exceed 20mg/kg. In drinking water in Russia, the MPC is 0.05mg/l. Researches by Ilyin VB and Syso AI found that no high and dangerous concentrations of chromium were found for the health of animals and humans in the soils of the Novosibirsk Region [8]. Our studies have shown that in eluvial positions, the gross chromium content in the meadow-chernozem soil is below the MPC. According to the profile, its quantity changes insignificantly and only in the horizon of AV it decreases sharply, which, apparently, is connected with the processes of podzolization and lassival. In accumulative positions in the profile of a meadowswamp soil, the chromium content increases and is on the verge of the MPC or slightly above it, especially in the A1 horizon-121mg/ kg, which may be due, on the one hand, to the movement of this chemical element with surface and underground waters, and on the other-with its accumulation due to the periodic flood of Lake Chany during the flood season.

Mo-molybdenum. As an element with variable valence, molybdenum in living organisms performs the function of electron carrier. In plants, molybdenum takes part in nitrogen exchange. It is a catalyst in the conversion of nitrites to nitrates, ensures the fixation of atmospheric nitrogen by nodule bacteria of legumes. The optimal ratio of Cu/Mo=4: 1. With a higher ratio, grazing diarrhea syndrome appears in cattle. As evidenced by the results of the research of Il’in VB and Syso AI, in the soils and plants of the Novosibirsk Region both a deficiency and an excess of molybdenum are possible. Its content in feed and plants below 0.2-2.5mg/kg of dry matter is considered critical, and non-dangerous-10mg/ kg. The MPC in soils is 5mg / kg [15]. Our research suggests that the molybdenum content in both the top and bottom positions is low and well below the MPC-from 3.6 to 2.05mg/kg (Table 3). It is about the same and its accumulation in the accumulative positions does not occur. However, there is a high ratio between Cu/Mo-up to 20 (Table 5). Consequently, in this natural landscape, the balance between copper and molybdenum is disturbed, which can cause diseases in animals and people.

Table 5: Cu/Mo ratio in catena soils of the saline natural landscape.

(Table 5) Cu/Mo ratio in catena soils of saline natural-Vvanadium. Vanadium is a necessary chemical element for living organisms, and for plants its significance remains unexplained. In plants, vanadium contains a little-up to 2mg/kg of dry matter, whereas in soils it is quite a lot. Vanadium was found to be involved in plant photosynthesis. With its lack of plants, the amount of chlorophyll is reduced. Like molybdenum, vanadium is a catalyst in the processes of nitrogen fixation from the air by nodule bacteria of legumes of the plant landscape In the Novosibirsk region in the diets of animals neither vanadium deficiency nor phytotoxicity is observed. According to Kloke A [15], the MPC of vanadium in soils is 100mg/kg; in Russia-150mg/kg, for food-5mg/kg and for drinking water-0.1mg/l. Our data indicate that the content of vanadium in the upper positions of catena in the profile of meadow-black earth soils varies from 55.0 to 70.1mg/kg. The profile distribution of vanadium is more or less evenly, except for the horizon AB, where a decrease in its content is observed. In accumulative positions there is its accumulation, but in quantities much smaller MAC. The maximum content of vanadium falls on the A1 horizon of the meadow-marsh saline soil and is 130mg/kg (Table 3).

Zn is zinc. Zinc is involved in many functions of living organisms. It is part of various enzymes involved in the metabolism of carbohydrates, proteins and phosphates and in the reproduction process. In higher plants, Zn, as a rule, accumulates in the seeds, where it is concentrated in the germ. The MPC of zinc in soils according to Kloke A [15] is 300mg/kg. In Russia, depending on the granulometric composition of the APC (gross) zinc in sandy and sandy soils-65; in loamy and clay (acidic)-110; in loamy and clay (neutral)-220mg/kg. In the studied agrolandscape, the total zinc content in eluvial positions ranges from 30 to 50mg/kg, which is significantly lower than the MPC. In the upper horizons it contains up to 50mg/kg (Table 3). In the horizon AB its quantity decreases and in the parent rock it increases again to 42mg/kg. In accumulative positions, the zinc content increases almost 2 times. Its maximum amount is typical for the upper horizon A. The bottom of the Ziz content is Zn, but the decline is weak.

Co-cobalt. It is established that cobalt has a positive effect on the growth and development of plants and ensures the ability of leguminous crops to capture molecular nitrogen from atmospheric air. In addition, cobalt is part of provitamin B12, which is formed in plants and is necessary for animals and humans. It is established that if the cobalt concentration is reduced to 0.1mg/kg of dry matter and lower, the use of cobalt fertilizers gives a positive result. Co deficiency in soils can cause carbonate, alkalinity, including podzolization and solubility, as well as a high content of humus, iron oxides and manganese. MPC of this element in soils-50mg/ kg, in drinking water-0.1mg/l, in feed-10mg kg of dry matter. In the studied saline agrolandscape (Table 3), no excess of cobalt was found in the soils. In the eluvial positions in the profile of the meadow-chernozem soil, its maximum amount falls on the upper humus horizons A1 and A1-8.5-7.8mg/kg, in the horizon ABdecreases to 5.8, and then its content again slightly increases. On alluvial positions in the profile of meadow-marsh saline soil, the amount of gross Co is almost 2mg/kg falls on the upper horizon of Hell, which can be explained by the movement of Co from upper positions to lower ones with surface and subsurface waters. The cobalt content in the studied soils is significantly lower than the MPC.

Sr-Strontium. Gross strontium is a toxic chemical element for plants and animals. In addition, it can cause a negative effect. For example, iodine in the presence of strontium becomes inaccessible to living organisms in which iodine deficiency begins to develop, with all the negative consequences that follow [21]. Currently, MPCs for strontium have been developed for drinking water up to 2mg/l [16]. For soils, MPCs of strontium have not been established, but according to the studies of Kovalsky VV [21], 600mg/kg should be considered a critical level of strontium content in the soil. The strontium - calcium balance expressed by the Ca/Sr ratio in the most prosperous areas, for example, in the Kursk Region is 200, and in the endemic areas of the Amur Region it decreases to 3.5. According to the data of researchers [8,22,23], the saline soils of the Barabinskaya plain contain high amounts of Sr, which is an antagonist of Ca. The results of our early studies convincingly indicate that the distribution of the total strontium content is characterized by its accumulation in accumulative positions and a decrease in eluvial concentrations [24]. Our data are consistent with the results of previous researchers. From (Table 3) it can be seen that on the eluvial position, the content of strontium in the upper horizon is 233mg/kg. In the AB horizon, it decreases to 131, and in the parent rock again increases to 328 mg/kg. In the accumulative position, its amount increases many times. Maximum-4640mg/kg-accounted for the parent rock. Such amount of Sr indicates its high content in the territory of the saline natural landscape. It was established that the average Ca/Sr ratio in the soils of the Barabinskaya Plain is 26-52. In the area under study, it also fluctuates within the same limits (Table 6). This ratio between Ca/Sr indicates a significant imbalance of their content in the soil and in plants. An increase in strontium concentration in soils is one of the main factors increasing them in plants and then in animals and humans. The optimal balanced ratio of Ca/Sr in feed and food is considered to be 80 [24].

Table 6: Ca/Sr ratio in soils of a saline agrolandscape of the southern part of the Prichanovskaya depression.

Ni-Nickel. The need for this chemical element for the life of living organisms has been recently established [8]. It is indispensable in the composition of urease and is consumed by bacteria of legumes, stimulates the processes of nitrification and mineralization of nitrogen compounds, positively affects the activity of nitrate reductase, which contributes to the recovery of nitrates and nitrogen fixation. In living organisms, nickel is involved in the structural organization of DNA, RNA and proteins [25-26]. In the Novosibirsk region, there is no natural shortage or excess of this chemical element for plants and animals.

The Regulated Nickel Content in the Soils of Russia is as Follows

APC in sandy and sandy soils-20; in loamy and clayey (sour-40); in loamy and clay (neutral)-80mg/kg. MPC for plant products in feed grain-1, in coarse and succulent feeds-3 mg/kg of dry matter. MAC in drinking water in many countries of the world is 0.1mg/l. In the studied saline natural landscape, the nickel content in the soils of the catena under consideration is significantly lower than the established JDC. At the eluvial position in the meadow-chernozem soil, the nickel content is more or less evenly distributed over the genetic horizons, while at the accumulative position its content increases almost twice, especially in the upper horizon of the hell meadow-marsh saline soil up to 70mg/kg, gradually decreasing with depth, reaching 49mg/kg in the C horizon. The obtained data convincingly indicate that nickel is easily washed away by surface waters from the soil profile of the upper landscape positions to the lower ones and accumulates in the upper soil horizons.

Conclusion

a) A profile study of the macro-and microelement chemical composition of soils was carried out in one of the EPA of a saline agrolandscape in the southern part of the Prichanovskaya depression by catena, in which eluvial (upper) and accumulative (lower) positions were distinguished. At the top position, the soil is represented by a meadow - chernozem plain poorly malignant, and at the bottom - by a meadow – marsh salt marsh.

b) The study of the content of Si, Fe, Al, Ca, Mg, Na, and P macronutrients showed that silicon prevails in both eluvial and accumulative positions, but its eluvial positions are 2 times higher than in accumulative ones. In both soils, the Ca content predominates over the Mg content, especially in the carbonate horizons of the lower position, where conditions are created for its accumulation in a biogenic way. The Na content in the upper horizons of the meadow-chernozem soil exceeds the Ca content.

c) Mg and slightly less than in the hell and A horizons of the meadow-marsh soil due to the periodic flushing of these horizons.

d) In the lower positions of the salted agrolandscape, more microelements accumulate (2-3 times or more) than in the upper positions due to their movement with surface and groundwater. Basically, their content is below the established MPC, which indicates the absence of natural pollution by them. The exceptions are trace elements-arsenic, barium, bromine, and strontium, whose content is several times higher than the MPC. Especially dangerous for animals and humans is the low Ca/Sr ratio in the soils of this region, both in eluvial (23-103) and accumulative (21-39) positions at a rate of 200. Therefore, it is necessary to take measures to increase the Ca content or decrease Sr in soils.

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lupine-publishers-lojpcr · 3 years

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Lupine Publishers | Inhibition of Aortic Medial Calcification: miPEP-200b and miRNA-200b as Potential Mediators

Lupine Publishers | LOJ Pharmacology & Clinical Research

Introduction

In molecular biology, the established central dogma is the widely accepted framework of genetic information flow. This process begins with the DNA transcription from the nucleus of the cell into linear, single-stranded messenger RNA (mRNA). Ribosomes then read the mRNA strand following transportation to the cytoplasm, and translation of the code into single amino acids, which are added sequentially to the growing peptide. Once the peptide is fully synthesized, both the mRNA strand and the peptide are released from the ribosome [1]. Although this pathway has been established universally as the only way for protein synthesis, only 1.5% - 2.5% of the human genome codes for proteins [2]. The remainder of the genome produces noncoding RNAs (ncRNAs). These ncRNAs can be further classified into various subtypes; of note are miRNAs, small nucleolar RNAs (snoRNAs), long noncoding RNA (lncRNA), and circular RNA (circRNA) [3]. Although ncRNAs have always been thought to have no role in protein synthesis, many previously unknown indirect functions of ncRNA have been elucidated within the past five years. They have been shown to be involved in many settings such as macrophage activation during an immune response, abnormal expression in diabetic wounds, retinal diseases, and even endometrial physiology and disease states such as endometriosis [4-7]. Perhaps the most groundbreaking findings in the realm of ncRNAs have been their association with various human cancers [8]. Most research has been focused on exploring the epigenetics and post-transcriptional activity of ncRNA, which allows these molecules to exert regulatory effects on the expression of the genome [9]. By directly binding to mRNA strands, miRNAs are able to regulate their ability to eventually lead to protein synthesis [10]. It has been demonstrated that this process is extremely precise, allowing targeting of mRNA with high specificity. Interestingly, the miRNA family has identical 5’ regions with the 3’ region differentiating these molecules and their specificities [11]. Although protein translation and miRNAs have conventionally been thought to have such an indirect relationship, our recent discoveries suggest a much more direct engagement between the two. We have shown that the sequences in certain pri-miRNAs, more specifically pri-miR-200a and pri-miR-200b, contain ORFs that are able to be recognized by ribosomes and subsequently translated directly into protein products, miPEP-200a and miPEP-200b. Even more intriguing is the potential role of these pri-miRNA-derived peptides (miPEPs) in cancer repression [12-15].

Figure 1: Expression of miPEP-200b in prostate cells (PNT1A) and breast cells (MCF-7). MCF-7 and PNT1A cells were harvested and prepared for western blot. Total extracts were subjected to western blot analysis using miPEP-200b (antibody raised against mi-PEP-200b). 8 Kda band represents expected band for miPEP-200b.

Figure 2: Proposed mechanism of aortic medial calcification pathogenesis (dashed red line: causing decreased activity of the target, dashed green line: causing increased activity of target).

Recently we have studied the expression of miPEP-200b in mammalian cells by raising polyclonal antibodies to miPEP-200b. Our results demonstrate that miPEP-200b is expressed in both breast and prostate cells (Figure 1). These results establish the presence of pri-miRNA-encoded proteins in mammalian cells. Many studies have been conducted on the implications of the miR- 200 family in cancer development and repression; however, its association with cardiovascular pathology has not been a central area of focus. Because the miR-200 family has been shown to affect specific cellular pathways in various conditions, it would not be farfetched to speculate on its implications in cardiovascular diseases known to have abnormalities in the same cellular pathways. It was found that a single gene variant for the miR-200 family could cause increased protein kinase A (PKA) activity, with subsequent thrombocyte activation and ensuing atherosclerosis [16]. In addition, PKA has been shown to act as a promoter of human smooth muscle cell (HSMC) calcification [17]. These processes are known to be the initial steps to the eventual development of vascular calcification [18]. Previously, we have shown that pri-miRNAs of 200a and 200b code for miPEP-200a and miPEP-200b respectively and these miPEPs function like miR-200a and miR-200b suggesting that Nature preserved this duplication of functions in case of a failure in any one of their functions. As such, we hypothesize that in the same way that miR-200b plays a role in decreasing PKA activity in atherosclerotic processes, the peptide miPEP-200b (encoded by pri-miR-200b) may also act as an inhibitor of PKA-induced HSMC calcification (Figure 2). Furthermore, targeted miPEP-200b, miRNA-200b, and PKA inhibitor therapy may lead to a substantial decrease in ISH development in older patients, with an ensuing decrease in the incidence and prevalence of diastolic heart failure secondary to longstanding hypertension. In this article, we will discuss the various components that provide evidence for these potential relationships and their sequelae.

Mirna and Mipep Interaction

Although there is a significant amount of information to be discovered regarding the functions of miPEPs, certain recent important findings allow us to predict potential activities of miPEPs in relation to miRNA. Of note is the study by Lauressergues et al. which showed that in plant cells, miPEPs behave as positive feedback on miRNA production [19]. It is possible that this relationship will also be shown in human physiology under controlled experiments in the future. This relationship is quite interesting, given the scarcity of positive feedback mechanisms observed in nature. In addition, various experiments in previous years involving miRNAs that attributed their observed findings to the effects of miRNAs alone may need to be revisited. As an example, it has been demonstrated that miRNA-200a and miRNA-200b are involved in the suppression of the epithelial-to-mesenchymal transition (ETM) in certain cancer types [20]. Although miRNA itself was originally thought to be the mediator of this observation, our recent findings demonstrate that the observed ETM suppression may be a result of miRNA alone, miPEP alone or a combination of both miRNA and miPEP activity [12]. Allowing this scenario to serve as a framework (Figure 3) in many other cellular pathways, one can imagine the vast number of cellular processes that may, in fact, have a different mechanism than what was previously proposed [21,22].

Figure 3: Proposed miRNA and miPEP relationship (dashed red line: causing decreased activity of the target, dashed green line: causing increased activity of target).

PKA and Aortic Calcification

The vasculature anatomy consists of 3 main layers: tunica intima, tunica media, and tunica adventitia. In the setting of aortic wall calcification, the media layer is involved. The main component of this layer is HSMC, which aids in constriction and dilation of vessels by contracting and relaxing, respectively (Figure 4). However, during the pathological process of medial aortic calcification, these cells begin to behave as osteoblasts, evident by upregulation of several markers associated with bone synthesis, including greater alkaline phosphatase activity [23]. Although there may be several mechanisms involved in this process, one explanation is the over-activity of PKA. PKA is an enzyme found in a multitude of cell types and tissues in the body. The enzyme is activated via cyclic AMP, and following activation, it is able to phosphorylate its substrates [24]. Abnormal PKA activity, therefore, causes various downstream effects. In particular, increased PKA activity may have important pathological implications in vascular calcification. There seems to be a potential mechanism involving PKA-induced elevation of parathyroid hormone (PTH). This may then induce medial aortic calcification [25]. with one experiment involving an in vivo model of rats with elevated PTH levels causing substantial calcification of the aorta [26]. In another study, it was shown that inorganic phosphate (Pi), which acts as a stimulator of PKA, led to HMSC calcification. In this experiment, HSMC were treated with Pi, calcium levels were measured, and subsequently, PKA inhibitors were added, then calcium levels were remeasured. It was demonstrated that inhibition of PKA activity by utilizing siRNA led to a greater than 50% decrease in HSMC calcium levels [27]. Although this study utilized siRNA as the inhibitor of PKA, Magenta et al. suggest that an increased PKA activity may be observed due to a single nucleotide polymorphism (SNP) where a thymidine nucleotide was substituted by cytosine in genes coding for the miR- 200family [16]. This may suggest that the miR-200family plays a significant role in moderating PKA activity.

Figure 4: Various layers of arterial vasculature.

Aortic Calcification, Hypertension, and Heart Failure

A major sequela of vascular, specifically arterial, calcification is the development of hypertensive disease. As a result of the calcific process involving the media, the arterial system (including the aorta) becomes stiffened and loses its ability to dilate and decrease systemic vascular resistance. The resulting hemodynamic state is such that an isolated elevation in systolic blood pressure is observed, leading to both ISH and concomitant increased pulse pressure (difference between systolic and diastolic blood pressure). Although ISH has a strong association with medial calcification, its relationship with intimal atherosclerosis has not been elucidated to a significant degree [28]. With sustained, chronic hypertension, cardiac ventricular muscle cells undergo hypertrophy as a means to compensate for this increased afterload. Although this mechanism is compensatory, it is not without pathological consequence, with severe left ventricular hypertrophy (LVH) eventually leading to diastolic heart failure [29].

Discussion

Among the numerous functionalities that miRNA-200b has been shown to have [30], its suggested role in downregulating PKA activity may be an important player in preventing medial aortic calcification. This can be inferred as increased PKA activity has been associated with the deposition of bone-like material in the aortic medial layer. Although many cellular pathways may potentially be involved, one proposed mechanism is the PKA-induced increase in PTH levels. Interestingly, PTH is generally thought to be involved in bone resorption. However, it appears to have the opposite effect leading to calcification in the vasculature. Following calcification of the aorta and other arteries, the stiffening of these vessels leads to ISH. With longstanding ISH, the myocardium becomes hypertrophied as a compensatory mechanism with the eventual development of diastolic heart failure. This proposed sequence is presented in Figure 1. Furthermore, miPEP may prove to be paramount in maintaining high miRNA activity, given the positive feedback that miPEP exerts on miRNA; although this observation has only been made in plant cells, the existence of both miPEP and miRNA in humans could provide the same relationship. No such studies have been published on the potential regulatory role of miPEP on miRNA in human physiology due to the relatively recent discovery of miPEP in our previous study [12]. A very recent study showed that miRNA-8 and miPEP-8 act to produce the same end result, regardless of their exact mechanisms of action, in Drosophila [31]. These findings are quite interesting, simulating many other protective mechanisms seen in nature, such as genetic redundancy [32]. By providing two mechanisms of accomplishing the same end goal, one mechanism serves as the main actor, and the other serves as the back-up in case of an event that renders one of them nonfunctional. As such, even in the case of a knock-out polymorphism of miRNA-200b, miPEP-200b can independently regulate the function of PKA by interfering with its regulatory subunit [16] and decreasing vascular calcification.

Conclusion

If our proposed mechanism of disease progression in medial aortic calcification in the context of miRNA-200b and miPEP- 200b is shown to hold true, it will provide targets for therapeutic interventions. PKA antagonists, miRNA-200b, and miPEP-200b could be utilized with the end goal of decreasing PKA activity and decreasing vascular calcification with a subsequent decrease in the incidence and prevalence of both ISH as well as diastolic heart failure. Furthermore, there is potential for miRNA-200b and miPEP-200b levels to serve as prognostic factors for these diseases. There is reason to suggest this, as multiple studies have shown the promising potential of using miR-200 family levels as a strong prognostic marker for disease severity; low levels of the miR200 family have shown to be accurate predictors of a worse prognosis in pancreatic, lung, gastric, and bladder [33-36]. Although there is much to be discovered in this new arena involving miPEP, these findings provide an excellent starting point for future experimental designs, arming scientists with a new outlook on cellular pathways that were previously thought to behave differently.

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lupine-publishers-ctbm · 3 years

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Lupine Publishers | Hidden Tale of Pollution: Need of Solution

Lupine Publishers | Current Trends on Biotechnology & Microbiology

Editorial

Environment and human beings are too interlinked with each other as we are part and parcel of it. As human beings are shaping into super beings with help of science and technology in this process new pollutants are invited into environment on regular basis. We are just postponing and changing the dumping areas which eventually occupying environment making more complicated to clear. This means we are at high risk from those pollutants as they are occupying in all levels as we are unable to sustain far with all these dumping of pollutants. Environment is not advancing as fast as pollutants to degrade them through natural process and retain to normal condition. Products obtained from living organisms, have simple mechanisms to dispose and degrade them into useful forms. The dumping of nature as carbon deposits from millions of years stored in earth, are now released again into atmosphere by us. If we go on in this process, we will pay the price to our own acts. We know this from the eve of origin of life i.e., 3.5 billion years ago with many new combinations of chemicals and their fluctuations, kept many organisms at bay. Cyanobacteria released oxygen approximately 2.5 billion years ago, as oxygen, which increased slightly become a pollutant took its toll by killing many organisms. If we go through five mass extinctions occurred in past, we can clearly see pollutants are playing major role in creating disasters for living organisms. In Ordovician-Silurian mass extinction, carbon dioxide was sucked into rocks which caused glaciations causing many organisms death. In late Devonian mass extinction, Sulphur dioxide occurred as acid rains causing many organisms to perish. In Permian-Triassic mass extinction also called great dying may be caused by release of carbon dioxide, greenhouse gasses as methane which lead to global warming which indirectly lowered oxygen levels leading to mass extinction. In Triassic-Jurassic mass extinction, carbon dioxide levels were quadrupled making the mighty dinosaurs to death. In Cretaceous-Paleogene mass extinction, most of the species wiped out due to increase of components like Sulphur. From the above we can figure out if pollutants not treated, they will take their price wiping out organisms how mater big they are without showing mercy or forgiving. Now it’s necessary to think and analyze how vulnerable we are to fight with pollutants. It is need of hour to find new solutions to clear pollutants with help of our co-organisms like plants and microorganisms to battle with pollutants. It is well known truth that microorganisms are used from dawn of humans, for our own benefits in food and spread it to medical applications, now we are extending them to degrade the pollutants. Microorganisms are living biotechnology laboratories which are boon for human race to modify and use them. These little soldiers can be genetically modified and use them for just to degradation of pollutants at all levels. They had lived through very harsh environment from their origin and have a great deal in using some of the pollutants as their substrates. Already there are so many microorganisms involved in bioremediation and biodegradation process, in these lines microorganisms should be used within control to protect us from the pollutants. We need to prepare not only for to clean up our pollutants but also be ready to clear any type of pollutants when occurred abruptly. There should be many discussions and debates on the environment issues through which innovations and new findings will come out, without discussions and also without proper guidelines there will be more harassment to health of environment which ultimately takes it wrath on humans. We should now build up for living in this world with sustainable development and the scientists should focus on the environment pollutants to dispose them fast without much suffering of the environment. The advancements of Science and technology can’t be sopped as that’s what makes the humans to survive with less energy and happily comfortably but with this, we should also make new discoveries for the pollutant disposal.

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lupine-publishers-sjfn · 4 years

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Lupine Publishers | Reduction of Immune Related Disease with Diet Rich in Antioxidants

Lupine Publishers | Scholarly Journal of Food and Nutrition

Abstract

Immune system is an intricate mechanism, the functioning of which maintains a balance between various diseases. The proper functioning of Immune system is dependent upon the healthy, nutritional diet which thereby helps in combating many diseases and pathogen attack.

Introduction

The nutritional value of the food that we consume plays a very important role in combating many diseases. Industrialization, urbanization, economic and social development has brought to prompt changes in diets and life style. Consequently people have become more prone to cancer, hypertension, strokes etc due to inappropriate diet. One of the major causes of many of these diseases is oxidative stress caused by disturbance in the balance between antioxidants and prooxidants. Prooxidants or free radicals are the species capable of independent existence that contain one/more unpaired electrons [1]. Free radicals not only contribute to the elimination of infected cells, but when present in higher concentrations react with cellular DNA, proteins, lipids and other macromolecules. The disease such as brain dysfunction, cancer, autoimmune pathologies, gastrointestinal inflammation and ulcers [2], heart diseases and immune decline could be due to these free radicals [3]. In physiological condition, the human body can compensate for a mild degree of oxidant stress and remove oxidatively damaged molecules by activating antioxidant enzymes like superoxide dismutase, catalase, glutathione peroxidase, etc. Thus, owing to their ability to reduce oxidative damage.

The deleterious impacts of these free radicals can be reduced down by adding natural antioxidant rich diet in our daily routine. It is tempting to speculate that the restorative and rejuvenating power of these antioxidants be due to their action on the immune system which is responsible for the protection of the organism from extraneous substances and maintaining homeostasis. Nutritional Immunology arose largely during the early 20th century. The recognition of various vitamins and advancement in the field of Immunology made it possible to study the impact of free radicals on Immune system and thereby generation various diseases and disorders.

Free Radicals and Antioxidants in the Immune System

The immune cell functions such as those involved in the inflammatory response, cytotoxic activity and particularly in phagocytes as regards their microbicidal activity, are specially linked to reactive oxygen species (ROS) generation. However, it is very well known fact that excessive amounts of ROS which are not counteracted by the antioxidant defenses of the cell, can become a source of tissue damage, since free radicals can attack cellular components and lead to death because of the molecular damage resulting from oxidative stress.

Thus, the immune cell functions are strongly influenced by the antioxidant=oxidant balance and, As the Immune cells have high percent of polyunsaturated fatty acids in their plasma membranes and a higher production of reactive oxygen species (ROS), which makes them more sensitive towards the oxidative stress. Additionally, the oxidative stress damages the membrane which in turn affects the defense function and binding of antigen by the immune cells. Antioxidant levels in these cells play a pivotal role in maintaining immune cells in a reduced environment and in protecting them from oxidative stress and preserving their adequate function [4]. The studies have shown that many pathogenic attack, and other diseases are more sever in immunocompromised host. Further the studies has shown that Immune system is very well affected by the deficiencies of other elements also (Table 1) showing the impact of these elements on Immune system.

The data suggests that that antioxidant nutrients commonly includes vitamin E, vitamin C, β-carotene, selenium, copper, iron and zinc improve different immune function exhibiting an important protective role in infections caused by bacteria, viruses or parasites. Fruits and vegetable are the rich source of natural antioxidants. Foods with darker, richer colors like orange, yellow, blue, and red tend to be higher in antioxidants. In addition to these fruits and vegetables, nuts and spices are also a good source of antioxidants. The intake of these antioxidants by many immunocompromised persons or with weakened immune system also showed tremendous results against infections and other pathophysiological conditions.

The results of recent studies emphasized that functional role of antioxidants as depends upon their concentration. Higher levels may leads to adverse effects where as low levels may lead to many diseases. All these antioxidants have been shown to improve the immune functions in vitro and in vivo [5-7]. Furthermore, the inhibition of activation of the nuclear transcription factor NF-kB produced by oxidative stress, which could result in a decrease of free radicals and pro-inflammatory cytokine production hence, showing antinflammatory action of these antioxidants. The imbalance in immune homeostasis leads to many diseases.

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lupine-publishers-tooaj · 4 years

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Lupine Publishers | The Caspian Littoral Strip in Azerbaijan is Concerned with the State of Ecology of Heavily Exposed Metals

Trends in Ophthalmology Open Access Journal

Lupine Publishers | Trends in Ophthalmology Open Access Journal

Abstract

The presented article considers the natural-geographic location of Absheron, analyzes the presence of heavy metals such as zinc, mercury, arsen, copper in soils and plants remoteness from sources of pollution. Also, the presence of microorganisms was revealed, depending on the degree of soil contamination with heavy metals.

Keywords: Heavy metals; Microorganisms; Bacteria; Critical level

Introduction

Pollution of the environment has become one of the most important tasks of our time; a special role belongs to heavy metals, which have the ability to accumulate in soils and through them to enter food products, while contributing to soil degradation. Absheron Peninsula is an anthropogenic load; it is the most tense in Azerbaijan. The peninsula is located on the western shore of the Caspian Sea and is the southeastern tip of the Greater Caucasus Range, occupying a total area of 200 thousand hectares. In the middle part its width is 28 km, and the length from east to west is 62 km. Absolute marks of hypsometric level of the surface from 25 to 300-350 m above sea level. The relief is characterized by soft, smoothed and weakly dissected, representing a slightly wavy plain, with a progress toward the west, where it gradually elevates, which is explained, first of all, by the young age in geological terms of the relief and the insignificant height of the peninsula above the basis of erosion.

Aridity of the climate in the presence of sandy transformations and crowding of soil-forming rocks on the Absheron Peninsula contributed to the wide development of arid-denudation, solonchakdeflation and eolian relief forms. Peninsula corresponds Periclinal immersion southeast Grand continuation megaantiklinoriya Caucasian and folded complex sedimentary formations Mesozoic (Upper Cretaceous) paleogene, Quaternary systems, power to 8000-9000m. The most widespread productive stratum deposits (average Pliocene), expressed sands lithological, sandstones, silts and clays and constitutes almost half of power (up to 3400m) the cut-Paleogenic neogene complex which assembled into a complex folds system [1]. The Absheron peninsula is characterized by a climate of moderately warm semi-deserts and dry steppes with dry summers. The greatest share of sunshine, about 30-35% (1900- 2500 hours per year) falls on summer. The total solar radiation throughout the territory varies from 120 to 135 kcal/cm2. The radiation balance is rather high 50-52 kcal/cm2. The average annual air temperature is 13.5-13.7°C in the northern and lowers central parts, 14.2-14.6°C in the extreme south of the peninsula [2].

The average annual precipitation is 130-150 mm per year. The greatest amount of precipitation up to 200 mm is observed in the Sumgait region. The soil cover of the Absheron peninsula was first investigated by VP Smirnov-Loginov [3]. Then Gasanov VG [4] composed of a large-scale soil map Absheron peninsula (1: 50,000), where the gray-highlighted brown swamped primitive gray-brown, gray-brown incompletely, gray-brown saline soils and sands. “We must clearly realize that the anthropogenic transformation of the biosphere in a sense has the nature of a global catastrophe and anthropogenic landscape-a landscape of the future. Apparently, in 100-200 years it will occupy the whole territory of the earth’s surface with the possible exception of eternal ice and mountain peaks. The reasons for this lie in an uncontrolled and progressive growth of the Earth’s population, non-stop building industry and agriculture, in the constant human need for energy sources other processes related “triumph of civilization” [2].

Measures to be taken by individuals, stakeholders and governments are important, complementary steps aimed at protecting the life support systems that not only ensure human well-being, but also the richness of the diversity of life on this planet [5]. The problems that arise in the design and operation of chemical enterprises have led to the fact that environmental problems have reached a critical level. The study of environmental problems occurring at the industrial site, the identification of the potential for environmental hazards in the industrial complex, is an urgent problem. Absheron was chosen as an array as a satellite to reduce the density of the industrial center of Baku. First, an industrial base of the petrochemical complex was created, on the basis of which other profiles also began to appear.

The basis of the chemical industrial complex of Sumgait consists of such enterprises as “Orgsyntez”, “Superphosphate”, “CAM”, and “Synthesis-rubber” (ethylene polyethylene), etc. The highest toxicity values are found in heavy metals such as mercury, lead, cadmium, arsenic, vanadium, zinc, copper, cobalt, molybdenum and nickel. They enter the active biological cycle of substances. The soil has a certain capacity for exchange and absorption capacity. In turn, these properties depend on the content of organic matter, particle size distribution, and the reaction of the soil environment, which means that the soil and even their different horizons capable of absorbing and retaining in its composition various amounts of manmade emissions [6]. Contamination of soils by heavy metals is due to air when watering wastewater in formulating oil, exhaust gases, when making organic (rich cadmium), phosphorus (impurities have uranium and lead) fertilizers. When using pesticides (preparations with mercury) [7,8].

Due to the fact that the soil is an object accumulating and supplying heavy metals to the biological chain, interest in studying its composition increases every year. At the same time, it is necessary to take into account that annually 350 kg/ha of harmful substances enter the soil with atmospheric emissions. It is noteworthy that in urban gardens, lead is concentrated in soil, zinc, copper is much larger than in arable soils. An increase in the concentration of heavy metals and aromatic hydrocarbons occurs in soils due to atmospheric precipitation from motorways [9]. Table 1 gives data on the content of heavy metals in the soil along the perimeter of industrial facilities.

According to the content of microelements, the investigated soils in the north-western and southern parts of the Absheron peninsula can be grouped according to the degree of concentration. Zinc, copper and cadmium are the most concentrated in comparison with others. Depending on the location of key areas of man-made emissions, the content of heavy metals varies. So in the Sumgait massif, 150 m northwest of the superphosphate plant, the concentration of zinc is 1.5 times, copper is 3-3.5 times higher than the allowable concentration in clarks. Retaining to the north by 500 m, their concentration decreases by an order of magnitude. Compounding, zinc 88 and cadmium 0.36 (mg/kg). In the northwest direction, the concentration of copper is markedly low; at the top of the soil is 5-9 mg / kg. To the south of the source of pollution, the values of the elements increase, amounting to: zinc- 84, cadmium-0.94 and copper-67 (mg/kg).

Probably, the excess of the concentration of elements in the soils located to the south in comparison with the northern part, despite the longer distance, is due to the prevalence of winds of the northern direction on the peninsula [10]. Many of the elements have a tendency to wash soil from the surface and accumulate in the lower layers, and cadmium inherent properties accumulate in the top layer of soil and poorly resist degradation in natural environment, which greatly complicates their purification. The next group includes lead, the indices of which are close to the Clark units. This element has fairly high values in sedimentary deposits, in some cases exceeding the geochemical background. Concentration of lead is close to clark units in the north-west, northeast and south directions (9 mg/kg), almost 2-3 times higher than the southern direction. Such an increased content of lead is probably due to the influence of the elevation of highly mineralized chloride waters to the surface.

The third group of metals-chromium, copper (Cu-only in certain directions), cobalt and nickel have a lower content of elements in soils - in tens, even hundreds of times, less than the permissible standards in all directions of the superphosphate plant. The lower content of these elements in soils is caused by their low mobility in the alkaline medium. Zinc exceeds the permissible concentration 100 m south of the plant by almost 2 times, amounting to 170 mg/ kg. Concentration of lead has approximate values for clarks, making 9 mg/kg to the south (100m from the enterprise) and exceeding them in 1, 5-2 times, closer to the highway (50 m from the road), making 16-21 mg/kg Concentration Copper in this part of the object exceeds the clark units in 4 times (85 mg/kg). The absorption of copper and zinc in the dissolved state differs from the damage of the applied elements in the form of a powder. Since this chemical element is absorbed 3 times more in the dissolved state than in the solid state. Mercury enters the lithosphere and the atmosphere in the form of waste. Mercury sludge belongs to the 1st category of hazardous substances.

When mercury sludge is in open space for a long time, it is a serious threat, as waste that occupies a huge area spreads through the open airspace and penetrates into water sources and the atmosphere of residential areas. Considering that mercury is an active substance and can quickly evaporate the waste can be considered a source of danger, which accumulates mainly on the surface of the soil. In addition to determining the presence of heavy metals in the soil around the perimeter of industrial plants, several kinds of fertilizers have been used in our studies for beet and coniferous trees. Of these, vermikompostnoe as an organic - mineral, manure of cattle - as an organic, and as a mineral-ammonium nitrate and potassium sulfate. The results of the analyzes showed that due to the use of fertilizers and vermicomposts, heavy metals were deactivated from the soil, which is the result of the primary stage.

Microorganisms present in the soil composition, influence the dissolution of heavy metals and their direct appropriation by plants. For example, as a strain called Pseudomonas Maltophili can turn a toxic Cr+6 into a harmless form of Cr+3, unevenly spreading in its various organs and tissues. Zn (zinc) mainly accumulates in the aerial part and especially in the old leaves. Heavy metals accumulate in the reproductive organs of plants less often than in vegetative organs. Absorption, transport, metabolism, distribution in tissues and organs of heavy metals, is related both to the species and to the variety of plants grown, Which are also affected by environmental and anthropogenic factors. Studies have shown that in the lower part of contaminated light gray-brown soils, depending on the type of contaminants, some changes in the color of the morphogenetic layers in gray-brown occur. These kinds of pollution cause serious negative damage not only to the morphology of the soil, but also to the biocenosis as a whole.

The absorption of heavy metals and atmospheric contaminants of plants can be considered as a complex chemical biological and physical process. In recent years, scientists strongly suggest planting trees and other plant species, where plants are regarded as a factor that purifies the air of the atmosphere. In a number of studies it was proved that the vegetation cover is an important factor contributing to the protection of the environment from contaminants. It should be noted that as a result of research, ecologists in recent years have identified such specific species of plant groups and endemic flora that adapt to soil contaminated with metals such as zinc, copper and nickel. Since adapting to the environment, plants are getting used to being resistant to soils contaminated with heavy metals. Metals are usually stored in plant leaves. But when the content of metal in the soil exceeds the permissible norm, the plants are able to synthesize them. In particular, from the degree of contamination, the number of bacteria and microbacteria in the soil changes drastically.

The amount of saprophytes of fungi of actinomycetes of Azotobacteria is considerably reduced. Oxidation-reduction reaction reduces the number of oxidizing bacteria and microbacteria. The presence of microorganisms in the soil, compared to heavy metals polluted with heavy metals, has an incomparable increase in the number of microorganisms in the variant with beet plantings, with the use of mineral and organomineral fertilizers up to 4400. Moreover, under coniferous plantations their number was 4200, and in variants without fertilizers Decreasing to 3,800 (beet) and 3600 (pine), while in areas contaminated with heavy metals their presence is practically not fixed.

Conclusion

A. It was established that in the soil cover of the Sumgait massif, the concentration of zinc around the perimeter of industrial enterprises varies with distance from the source of pollution, amounting to (Zn-48-84 mg/kg, Pb-5-9 mg/kg, Cd- 0.82-0.94 mg/kg.

B. It was revealed that the productivity of the dominant plant communities and the largest reserves of phytomass of the Sumgait massif falls on the eastern part of the superphosphate plant (15.7-17.2 c/ha)

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lupine-publishers-sjo · 2 years

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Audiometric Thresholds and Tinnitus Functional Index of Adult Patients with Tinnitus

Abstract

Introduction: Tinnitus is a common irritating symptom. Tinnitus functional index (TFI) and measurements of tinnitus match are useful tools for evaluating tinnitus impact. This study aimed at comparing the hearing thresholds to the Quality of life (QoL) of tinnitus patients.

Methodology: Clinical assessment, Pure tone audiometry (PTA), and QoL assessment were carried out. The data gathered from the study were evaluated and results were interpreted.

Results: The mean age of tinnitus subjects was 51.7 years. Male to female ratio was 1:1.4. Higher number of subjects experienced chronic tinnitus. High frequency and the tinnitus loudness above 15dB were the highest among them. The association between the QoL assessment and tinnitus loudness match (TLM) was statistically significant. Similarly, there was positive correlation between the TFI scores and pure tone average (PTAv), tinnitus pitch match and TLM.

Conclusion: Most patients described their experience of tinnitus as a big problem. There was a positive correlation between the pure tone average, TLM and the QoL measure. Routine measurement of tinnitus distress with TFI and psychoacoustic assessments were advocated.

Keywords: Tinnitus functional index; quality of life; pure tone average; psychoacoustic assessments

Abbreviations: TFI: Tinnitus Functional Index; QoL: Quality of Life; PTA: Pure Tone Audiometry; TLM: Tinnitus Loudness Match

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lupinepublishers · 5 years

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Lupine Publishers | Use of PROMIS and Functional Movement System (FMS) Testing to Evaluate the Effects of Athletic Performance and Injury Prevention Training in Female High School Athletes

Lupine Publishers | Orthopedics and Sports Medicine Open Access Journal

Abstract

Two major health concerns with female high school athletes are: 1) psychosocial wellness, and 2) sports-related injuries. It is also known that these health concerns are much greater for minority students who attend high school in economically depressed cities. While it has been well-established that exercise is an effective intervention for these health concerns, there are no established outcome measures to quantitatively assess athletic performance and injury prevention training interventions in this population. Previously, we have demonstrated the utility of Patient- Reported Outcomes Measurement Information System (PROMIS) as a robust outcome measure following ACL reconstruction. Functional movement screening (FMS) has been used as a tool to determine injury risk in female collegiate athletes. Since these tools are broadly available, we completed a pilot study of urban underrepresented minority and suburban female high school athletes, to assess the feasibility and utility of these tools to measure changes in this population during 10-weeks of athletic training. No adverse events of the training or study were reported.

A Kaplan-Meier assessment of the pilot revealed that there was high student retention throughout the 10 weeks. In addition, we found no difference in weekly attendance between the students that completed the pilot vs. the dropouts (while they were in the program), indicating that the students were highly motivated to attend when possible. While no significant differences were found for fatigue and physical function, the pilot significantly improved anxiety, peer relationships, pain interference, and trended towards significance for depression (p<0.05).In terms of physical performance, bench press, combined Pro Agility, and total FMS were all significantly improved (p<0.05). Surprisingly, there were 10 students (67%) in peril of sports- related injury (FM˂14) at the start of the program, and all but 1 (90%) eliminated this serious risk factor. Collectively, these pilot results demonstrate the feasibility of PROMIS and FMS outcomes to assess the efficacy of physical training interventions, in underrepresented minority female high school students, which warrants investigation in a formal prospective study.

Keywords: Underrepresented High School Students; Patient-Reported Outcomes Measurement Information System (PROMIS); Functional Movement Screening (FMS)

Introduction

Two major health concerns with female high school athletes are: 1) psychosocial wellness, and 2) sports-related injuries [1] It is also known that these health concerns are much greater for minority students who attend high school in economically depressed cities [2]. While it has been well-established that exercise is an effective intervention for these health concerns [3] there are no established outcome measures to quantitatively assess athletic performance and injury prevention training interventions in this population. Patient-Reported Outcomes Measurement Information System (PROMIS) instruments are a collection of short forms containing a fixed number of items from six PROMIS domains (Depressive Symptoms, Anxiety, Mobility, Pain Interference, Fatigue, and Peer Relationships) along with a single item on Pain Intensity. There are three PROMIS profile lengths, PROMIS-25 was used for this research study and it includes 4 items per domain. The profiles are universal rather than disease specific and assess all domains over the past seven days except for Physical Function which has no timeframe specified. Previously, we have demonstrated the utility of PROMIS as a high-throughput outcome measure following ACL reconstruction [4]. Functional movement screening (FMS) is a comprehensive exam that assesses quality of fundamental movement patterns to identify a person’s muscular imbalances and asymmetries. A fundamental movement pattern is a basic movement utilized to test range of motion, balance, and stability, concurrently [5]. To successfully complete seven fundamental movement patterns each individual must demonstrate muscular strength, flexibility, range of joint motion, coordination, balance, and proprioception. Each person is scored on a scale ranging from zero to 3 on each of the seven movement patterns and 3 is considered normal. Scores from the seven movements are compiled to obtain comprehensive score [5]. FMS has previously been used as a tool to determine injury risk in high school students [6] and female collegiate athletes [7]. We developed and conducted a pilot study of urban underrepresented minority and suburban female high school athletes, to assess the feasibility and utility of these tools to measure changes in this population during 10-weeks of athletic training.

Methods

All human subject research with children was performed following informed consent from a legal guardian and assent from the study subjects, on an IRB approved protocol. Female studentathletes from an urban minority high school (Rochester, NY, n=15) and suburban high schools (Webster, NY, n=15) were recruited into a 10-week athletic training study at the YMCA in Penfield, NY. Selfreported PROMIS data from the subjects were collected via iPad to a secure server at each session, and FMS baseline and final data were collected at the beginning and end of the 10-week study period, respectively. To obtain scores for FMS the female student-athletes were asked to perform seven movement patterns that included; 1) the deep squat which assesses bilateral, symmetrical, and functional mobility of the hips, knees and ankles, 2) the hurdle step which examines the body’s stride mechanics during the asymmetrical pattern of a stepping motion, 3) the in-line lunge which assesses hip and trunk mobility and stability, quadriceps flexibility, and ankle and knee stability, 4) shoulder mobility which assesses bilateral shoulder range of motion, scapular mobility, and thoracic spine extension, 5) the active straight leg raise which determines active hamstring and gastroc-soleus flexibility while maintaining a stable pelvis, 6) the trunk stability push-up which examines trunk stability while a symmetrical upper- extremity motion is performed, and 7) the rotary stability test which assesses multiplane trunk stability while the upper and lower extremities are in combined motion. The data acquisition and athletic training was performed by five certified athletic trainers from the University of Rochester Department of Orthopaedics. As a feasibility pilot study, the primary goals were to demonstrate our ability to: 1) recruit and retain the human subjects throughout the 10-week study period, 2) evaluate global health quantified by PROMIS (depression, anxiety, pain, peer relationships and physical function), and 3) assess risk of injury quantified by FMS testing. All performance data was obtained pre- and post-intervention. PROMIS scores were tabulated as t-scores using data taken from the first and last week of the intervention. To determine each individual’s maximal effort on the bench, press a weight was selected based on reps achieved during warm-up, each athlete lay in the supine position, un-racked the bar, and bench pressed the pre-selected weight five times.

The weight was either increased based on the athlete’s ability to obtain five repetitions. The test was stopped when the athlete was incapable of reaching five repetitions and the highest weight that they were able to achieve five reps without assistance was taken as their maximal effort. To deem a repetition, complete the individual’s hips must stay on the bench (i.e. you can’t lift the hips or “thrust” the weight up with your lower body), they must lock out the elbows at the top of the lift, and they are allowed to take a breath or pause at the top in between repetitions. Combined pro agility data was obtained by asking each athlete to start the test in a crouched position, in between two cones which are 10-yards apart. The test goes as follows: From the crouched position, the athlete explodes to the right and touches the line with their right hand, they then explode out of this cut and sprints 10 yards, touching the line with their left hand, and then explodes back through the middle cone. After a short break the test is the repeated but starts by going to the left first. Time starts on the athlete’s first move out of the crouched position and ends once they cross the middle line the second time. The average was taken from both right and left test. Statistical analyses to assess changes after the 10-weeks of athletic training were performed using paired t-test for pre/post differences and Kaplan-Meier curve were utilized to assess attendance.

Results & Discussion

Fifteen students completed the 10-week training, and no adverse events of the training or study were reported. A Kaplan- Meier assessment of the Pilot revealed that there was excellent student retention throughout the 10 weeks (Figure 1). We also tracked the attendance of each student, which showed that there was no difference in weekly attendance between the students that completed the Pilot vs. the dropouts (p=0.88), indicating that the students were highly motivated to attend during the time that they were in the program. The PROMIS data are presented in mean ± std (Figure 2). While no significant differences were found for fatigue and physical function, the pilot significantly improved anxiety (45.8 ± 7.4 vs.41.4 ± 7.0, p = 0.006), peer relationships (51.5 ± 6.8 vs.54.1 ± 6.5, p = 0.02), pain interference (47.0 ± 6.4 vs.44.1 ± 7.8, p = 0.02), and trended towards significance for depression (47.0 ± 7.9 vs.44.1 ± 6.8, p = 0.08). This is particularly encouraging since we were not expecting to observe these dramatic effects of the Pilot on such a challenging demographic with a very small cohort of students. The physical performance data are presented in mean ± std (Figure 3). Note that the Pilot significantly improved Bench Press (70.2 ± 10.7lbs vs. 82.0 ± 13.9lbs, p = 0.0009), Combined Pro Agility (5.8 ± 0.5sec vs. 5.4 ± 0.4sec, p = 0.005), and Total FMS (20.3 ± 4.6 vs. 30.4 ± 4.5, p <0.0001). Although the improvements in physical performance were predicted from the known effects of athletic training, surprisingly, there were 10 students (67%) in peril of sports-related injury (FMS<14) at the start of the program, and all but 1 (90%) eliminated this serious risk factor.

Figure 1: Excellent Retention and Regular Attendance of Students in the CHAMPP Pilot.

Figure 2: Effects of the CHAMPP Pilot on Students’ Anxiety, Depression, Peer Relationships and Pain by PROMIS.

Figure 3: Effects of the CHAMPP Pilot on Students’ Athletic Performance and Risk of Injury.

We enrolled 30 female high school students into the CHAMPP Pilot, and their (A) retention is piloted over the 10 weeks. Note that there were seven students who dropped out within 30 days, and the rest completed the program. To assess compliance, we quantified the (B) percentage of sessions that each student attended normalized to their drop-out or completion date. The percent attendance for each of the seven students that dropped out and the 23 students that completed the Pilot are graphed separately with the mean for each group. Circle represent data collected at baseline. Squares represent data collected after the intervention. PROMIS scores at baseline and after 10 weeks of the Pilot for each student for: (A) Anxiety, (B) Depression, (C) Peer Relationships and (D) Pain Interference. Significant changes from baseline were observed for all except Depression, which almost reached significance (*p<0.05). Note that negative (E) % change is the desirable outcome for all measures except Peer Relationships. Circle represent data collected at baseline. Squares represent data collected after the intervention. Student athletic performance data (n=15) were collected in Ortho Metrics TM at baseline and after 10 weeks of the Pilot for each student with the mean and % change is presented for Bench Press, Combined Pro Agility, and Total FMS. Significant changes from baseline are shown. Note that students with an FMS score below 14 are considered to be at risk for injury, and that the 25% increase in FMS score for the group was highly significant. Circle represent data collected at baseline. Squares represent data collected after the intervention.

Conclusion

Etiology and pathogenesis of PCLGC are unclear, however it is proposed that repetitive microtrauma of joint and soft tissue can promote expansion of mucin from ligament fibers and acting as a potential trigger [20]. Recognition of PCLGC as a clinical entity leading knee pain and impairment is increasing due to the sensitivity of MRI to identify intra-articular abnormalities. The typical finding is an ovoid fluid filled cystic lesion which can frequently be multilocular in the intercondylar notch of the knee [22,25]. In our case report MRI shows a cystic multilocular mass with fluid signal intensity within the synovial layer of the PCL. Although most knee cysts are asymptomatic, in some case they could be a relevant source of pain [20,21]. Clinical manifestations of a knee cyst are mostly dependent on the pathologic process involved, along with its location, size, mass effect, and relationship to surrounding structures [26]. The typical presentation of symptomatic PCLGC include posterior knee pain, restriction of ROM, stiffness and mild swelling [20,21].

Limited ROM is a typical finding with an intra-articular ganglion arising from the PCL, mainly with inability and pain to extreme flexion due to the compression of the cyst mass between the PCL and the posterior joint capsule. With this clinical picture in mind, athletes between 20 and 40 years old who present knee pain with restriction on hyperextension or full flexion, with no previous macrotraumatic report or knee instability, should raise a high level of suspicion for intra-articular ganglion cysts. Only symptomatic PCLGC need to undergo treatment. There a broad spectrum of treatments described for these lesions, from a rehabilitation program focused on ROM, strengthening and proprioception to avoid kinetic impairment, to ultrasound or CT-guided aspiration or infiltration, or even arthroscopic excision. Treatment choice must take into account several criteria such as level of activity, time for recovery, risk of joint damage and recurrence of the cyst. Arthroscopic treatment has demonstrated good outcomes with up to 95% of patients reporting good results and associated with the lowest recurrence rate, but it needs an hospitalization, anesthesia and a longer recovery period, which can become a major problem when we are dealing with competitive sports [23,24].

Athletes require quick return to play with minimal side effects, so we need to take into account less invasive treatments like US or CT-guided procedures, or even load management in addition to a rehabilitation program.

Conclusion

CCP is a rare and often asymptomatic condition. Its pathogenesis and prognosis are still unclear. In a young adult with posterior knee pain (popliteal aspect), no history of major event, limited ROM (hyperextension and extreme flexion), meniscus and ligament test negative and no confidence in demanding tasks it is important to think about this condition. The therapeutic option stems from the patient’s characteristics, but US or CT- guided puncture should be considered.

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lupine-publishers-sjpbs · 3 years

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Lupine Publishers | History, Historians and Anthropocene

Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Introduction

Man is a part of nature, and his war against nature is inevitably a war against himself- Rachel Carson. The Anthropocene is a generally accepted framework for describing the planet we now live in. The Anthropocene is a crucial paradigm for addressing environmental challenges in scientific, political, and ethical arguments. Its major contribution is a scientific, and hence non-normative, the hypothesis of man-made global warming. The assumed connection of man and environment provides a systemic perspective.

Holocene or Anthropocene?

The Holocene epoch relates to the fast proliferation, expansion, and global effect of humans, encompassing all its recorded history, technological revolutions, the emergence of major civilizations, and the overall considerable change to urban existence in the present. Sir Charles Lyell seems to have proposed the word Holocene in 1833, and it was adopted by the International Geology Congress in Bologna in 1885, referring to the post-glacial geological age of the past 10 to 12 thousand years of history. The Anthropocene has surpassed the Holocene as the most recent geological period. Since the year 2000, the notion of the Anthropocene has dominated discussion in practically every academic subject [1-4], including the humanities and social sciences, and has evolved into an inter-and transdisciplinary study area. It has also dissolved long-standing humanities divisions that have affected this discipline, such as those between ‘nature’ and ‘history,’ and ‘geological’ and ‘human.’ Furthermore, when previous ideas of human purpose, temporality, and collective memory- all of which are vital to historical inquirydeteriorate, historians must create new and crucial frameworks connecting the past and present to make sense of our future. At the very least, the term ‘Anthropocene’ sounded academic, combining Anthropos, the Greek word for ‘human,’ with ‘cene,’ the suffix used in geological period names [5]. The Anthropocene is a term from the Holocene Era that refers to the current evolutionary stage in which humans have become a significant factor in world activities.

Histories of the Anthropocene

The study of history is based on the concept that human history has a particular consistency that connects our past, present, and future. In our usual creative universe, we typically envisage the future using the same conceptual framework that allows us to comprehend the past. History of climate is the study of historical variations in climate and their impact on civilization from the advent of hominins to the present. This contrasts with palaeoclimatology, which studies climate change throughout Earth’s history. These historical effects of climate change may either improve human existence and lead society to thrive, or they can play a role in civilization’s eventual demise. Scholars have been hesitant to formally identify the Anthropocene as a new epoch, despite a huge increase in research over the last two decades. The difficulty in determining the beginning point is likely the most powerful argument, but issues about the human being, anthropocentrism and the validity of metaphors have also prompted many scientists to question the classification’s efficiency [6]. The Anthropocene’s projected ages, on the other hand, range from 50 to 10,000 years. The word “Anthropocene” was invented by Eugene Stoermer in the early 1980s, but it only acquired general acceptance in the scientific world until Dutch atmospheric scientist Paul Crutzen supported it in 2000. It occurs throughout the Holocene, a roughly 12,000-year period of growing natural stability during which varied human communities evolved.

The shift from the Holocene to the Anthropocene, unlike any previous geological shift, is driven by the purposeful behaviour of sentient creatures: ‘This is not merely an environmental disaster; it is a volcanic change induced by people.’ As a result, the notion of the Anthropocene implies that the history of human civilizations is inextricably linked to the history of the climate. History and geology are inextricably linked, posing a significant intellectual problem for the humanities. The Anthropocene hypothesis has become a solid, discussed phrase in the humanities and social sciences, bringing up new ways of thinking about humans, environmental communities, energy production, interactions with non-human life, confrontation, the social, and the presence of the past [7-9]. When academicians and other social scientists started studying globalization in the late 1980s and early 1990s, climate change became widely accepted in the public realm. While the Marxist critique of capital, subaltern studies, Indigenous science, and post-colonial criticism have all been enormously helpful in analysing globalization during the past twenty-five years, they have not fully equipped us to make sense of the ecological crisis in which humanity now finds itself. Joseph Needham, a physicist, and historian who had studied extensively in China, explored methods to break down boundaries and proposed a venture that highlighted all cultures’ reciprocal reliance.

The Anthropocene Controversy

We may make the case for the Anthropocene by stating that humans have depleted 40% of the world’s petroleum reserves during the previous few hundred years. This work has taken ages, if not millennia, to complete. Human activity has significantly altered approximately half of the Earth’s terrestrial area, generating biodiversity shifts [10,11], nutrient cycle, and soil, climatic, and environmental changes. Synthetic nitrogen fixation is currently fixing more nitrogen in terrestrial ecosystems than all-natural processes combined. People use half of all freshwaters, which is quickly dwindling in many areas. Some scientists think that the Anthropocene began in the late eighteenth century, when analyses of air trapped in polar ice indicated the beginning of increased global carbon dioxide and methane emissions. This day also happens to coincide with the creation of the steam engine. According to the WGA (Working Group on the Anthropocene), the Anthropocene Period began in 1950, because of nuclear testing, the discovery of plastics, and the exponential demographic rise of the human population. The Post-Anthropocene epoch is also known as the Plutocene epoch. Despite significant advances in the study over the previous century [5], we are still a long way from understanding nature. The Anthropocene debate is the peak of Nature/Society duality. And, though the Anthropocene is inadequate as a historical rather than geological assertion, it is always an argument worth considering. A sequence of early steps results in the emergence of new concepts. On the way to a new synthesis, there are various philosophical detours. Without a question, the Anthropocene definition is the most impactful of these compromises. No other theory based on historical transition has had such a broad influence throughout the Green Thought continuum; no other socioecological notion has piqued the public’s curiosity.

Anthropocene and Health

Go to

The fast expansion of the human population and human activities is producing a problem: the increasing pressure is disrupting important biophysical Earth systems and producing environmental changes that are detrimental and disastrous to human well-being. The Lancet Countdown on health and climate change report for 2019 shows how planetary health is evolving in the ecological, social, and human health realms.

Conclusion

If you assume that humans are the only species deserving of consideration, you have not comprehended Darwin’s revelation that we are but are no longer aware of our function in the environment. People’s ability to affect change at such a large scale and such a rapid pace were unparalleled. The rate at which these changes occur spans from decades to centuries, as opposed to hundreds to thousands of years for analogous transitions in Earth’s natural dynamics. The Anthropocene must be part of our lexicon if we acknowledge that not all men are equal contributors to our global ailments and that many are victims. We know who we are, what we do, and what our duties are as a community.

https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000210.pdf

https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/history-historians-and-anthropocene.ID.000210.php

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lupine-publishers-lojiid · 5 years

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For more Lupine Publishers Open Access Journals Please visit our website:https://lupinepublishersgroup.com/ For more open access journal of Immunology & Infectious Diseases articles Please Click Here:https://lupinepublishers.com/immunology-Infectious-disease-journal/ To Know More About Open Access Publishers Please Click on Lupine PublishersLupine Publishers | Does there is Relevancy between Falooda Ice Cream loving and Urine Nitrites?

Lupine Publishers | LOJ Immunology and Infectious Diseases

Abstract

Naturally source of nitrites are vegetables like cabbage, spinach and vegetables, it is form of nitrogen. High levels of nitrites in urine is sign of urinary tract infection. Some bacteria are responsible for urinary tract infection such as proteus and klebsiella, but doctor also prescribed some antibiotics against bacteria. Women are more suffering in urine tract infection than men. Positive test for nitrites is called nitrituria. For measuring the levels of nitrites in urine urinalysis is done. Falooda ice cream looking beautiful with different layers that make it healthy drink but a few of people try to avoid by eating it because it contains high levels of sugar.

Keywords: Nitrites; E. Coli; Antibiotics; Urethra; Diabetes; Urinary tract infection

Introduction

Nitrites is form of nitrogen, which contains two oxygen atoms. Nitrites is naturally found in vegetables like cabbage, celery, carrot and spinach. The presence of nitrites in urine may be harmful mean sign of urinary tract infection. The presence of nitrites in urine is due to bacterial infection in urinary tract. Urinary tract infection can occur in urethra, kidneys, ureters and bladder. Some bacteria have ability to convert the nitrates into nitrites due to presence of specific enzyme. The presence of nitrites in urine can be diagnosed with urinalysis test. The bacteria that are responsible for urinary tract infection, proteus, klebsiella, pseudomonas. But most common bacteria are E. coli in which urease enzyme is present that acidifies the urine. The symptoms of urinary tract infection include blood in urine, cloudy urine, strong smelling urine and burning with urination. Urinary tract infection is most common in pregnant women and may be dangerous. Urinary tract infection can cause premature delivery, headache, abdominal pain and high blood pressure in pregnant women if left untreated. If test for the nitrites in urine is positive it is called nitrituria. While negative nitrites test happens with dilute urine or low colony forming unit. A urinary tract infection is most common in women aged 20 to 50 years than man. There are many ways that one can prevents from nitrites in urine or urinary tract infection. Such as by drinking plenty of water bacteria can be flash out that is present in urinary system. Cranberry juice and apple cider vinegar also treat the urinary tract infection. Doctor also prescribed some medication for the treatment of nitrites in urine. Doctor prescribed antibiotics on the basis of what kind of bacteria cause infection. Patient should also take enough sleep and adopt personal hygiene. There are many drinks and foods that keep the body cool and fresh, similarly falooda ice cream is one of the most popular drink that sweet in taste and delicious. Falooda ice cream is a rich source of energy, one glass contains 218 calories. This is sweet dish that served to the people during hot days. This is made in tall glass which give beautiful appearance. The main ingredients of falooda ice cream sabja or basil seeds and semeia that is good for skin and hair have cooling properties. Other ingredients that are present in it like cream, milk, falooda, rooh afza and sugar. Sabja seeds help in weight loss and lowering the high blood pressure. Falooda ice cream has many health benefits, it provides energy to the body, keep body cool during hot days. There are many flavours of falooda ice cream like rabdi, rose syrup, royal, and kesar. People can make it at home easily. First, soaked basil seeds, dry them also soaked semeia seeds, boiled milk. Put them into blender and blend them. Then pour into tall glass add dry fruits, falooda, Almonds, ice cream and rooh afza and served it. If you want energy, then drink cold and sweet falooda ice cream because it contains vitamin and minerals due to presence of dairy products. People should drink or eat it 3 to 4 times per day. But patients of diabetes should avoid it because it contains too much glucose or sugar and cause heart disease and diabetes. The objective of present study was to correlate the falooda ice cream with urine nitrites [1,2].

Materials and Methods

For measuring the levels of nitrites in urine urinalysis is done. First of all, person will need an empty and clean plastic container so that filled it with fresh sample of urine. A strip and gloves are also required. By wearing the gloves dipped the new strip into container and stirred it into urine sample for 2 seconds. The colour of strip will change than before as it will dip into container. Draw out strip from the sample so that measured the levels of nitrites into urine. In the last discard the gloves, strip and container [3-6].

Project Design

There were 100 subjects who completed this survey, but main goal of this survey was asked to the students of Baha Uddin Zakariya university about falooda ice cream loving. Mostly students said that by eating falooda ice cream one can prevent from the hypertension and get too much energy. But the subjects who disagreed it said, that falooda ice cream lead to obesity and cardiovascular diseases (Table 1) [7].

Table 1: Relation between falooda ice cream and urine nitrites to the people that love falooda ice cream.

Table 2: Relation between falooda ice cream and urine nitrites to the people that do not love falooda ice cream.

This table shows males that have negative value of nitrites in their urine are 27% which are falooda ice cream loving and those who have positive value of nitrites are 13 % which are also falooda ice cream lover. Similarly, females having negative value are 22% and females with positive value are 8% which like the falooda ice cream. About the opinions of these males and female’s preparation of falooda ice cream is very easy and not cost expensive dish having many ingredients that prevent us from different diseases (Table 2).

This table shows that males with negative values are 17% and with positive values are only 4 % All of these males are not loving the falooda ice cream. Similarly, females having negative values are 6 %which are not like falooda ice cream. While females having positive value of nitrites in their urine are just 3% which are not loving falooda ice cream [8-10].

Conclusion

This was concluded that there is no relevancy between urine nitrites and falooda ice cream loving.

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Lupine Publishers|Seizure and Psychosis

Lupine Publishers | Journal of Neurology and Brain Disorders

Abstract

Go to

Seizures are due to abnormal excessive and synchronous neuronal activity in the brain [1]. Outward effects vary from uncontrolled shaking movements involving much of the body with loss of consciousness, to shaking movements involving only part of the body with variable levels of consciousness, to a subtle momentary loss of awareness. Up to 10% of people have at least one epileptic seizure in their lifetime out of which 50% have a recurrence [2].

Introduction

Go toAim

To differentiate between different types of psychosis following epilepsy.

Methods

A prospective study was conducted including 1000 consecutive patients with seizure disorder irrespective of the seizure type and cause and followed up between 2010 to 2017. The clinical profile of patients with seizures with respect to age, sex, aetiology of seizure, neurological status, seizure type, investigations, prescription pattern of Anti-Epileptic drugs and response to treatment was analysed.

Results

Out of a total of 1000 patients, 59% of the population had focal seizures and 41% had generalised seizures, 66% were found to have an idiopathic onset, followed by neurocysticercosis, tuberculosis, vascular, post infective, post traumatic and congenital having 16%, 8%, 3%,3% and 2% of the cases respectively. In the study 45.77% of patients with focal seizures remained uncontrolled while 46.35% and 20% of tonic clonic and myoclonic seizures remained uncontrolled. A total of 430 patients were prescribed monotherapy while 460 were on two and 110 on 3 or more drugs. Thirty-eight patients had associated psychosis, 20 patients having postictal psychosis, 12 having brief psychosis out which 3 were chronic (lasting more than 6 months) and 6 having inter-ictal psychosis.

Case Vignette

Go to

A 79-yr old male known to have diabetes and hypertension was admitted with complaints of progressively increasing irritability, alteration in behaviour, forgetfulness and intermittent episodes of disorientation since last 2 weeks. His blood investigations showed hyponatremia of 118meq/L, rest of the blood investigations were within normal limits. Gradual hyponatremia correction was done over 2 days but there was no clinical improvement in the patients’ clinical condition. Neuroimaging and CSF evaluation showed mild elevation in protein (58mg/dl) with normal csf glucose, viral markers and autoimmune antibody panels. Possibility of psychosis due to prolonged hospitalisation was also considered and was started on haloperidol and quitiapine but did not cause any clinical benefit. His EEG showed attenuation of alpha rhythm corresponding to age. He was started on Inj Lamotrigine 100 mg IV BD following which he showed improvement in the orientation and irritability over the next two days and was finally diagnosed as chronic ictal psychosis.

Case II

Go to

68-year-old lady admitted in an ICU at a hospital elsewhere 5 days back with accelerated hypertension, developed irritability, disorientation and loss of bowel and bladder control upon discharge the following day. Her blood investigations were normal including ammonia and liver function tests. Her MRI brain and CSF were within normal limits, EEG showed generalised slowing of theta- delta range. On day two an occasional jerky movement was noted over the face and started on Inj Lacosamide 100 mg IV BD, she showed dramatic improvement after 12 hours, being able to eat solid food herself and walk independently by the evening. She was diagnosed to have brief psychosis with seizures.

Discussion

Go to

The association between epilepsy and psychosis has attracted the interest of neurologists and psychiatrists alike for many years. While much of this interest has concerned the chronic psychosis. The categorization of these brief psychotic syndromes has traditionally been according to their temporal relationship to the seizures, as ictal, postictal, and inter-ictal.

Psychosis: A psychiatric disorder characterized by delusions, hallucinations, disorganized speech or thought, and/or grossly disorganized or catatonic behaviour.

Brief Psychosis: Psychosis that lasts more than a day but generally less than 1 month. Some epilepsy-related brief psychoses may last up to 2–3 months. Psychoses lasting more than 6 months are chronic, and those lasting more than 3 months are tending to chronicity.

Postictal Psychosis: Psychosis that follows immediately after 1 or generally multiple seizures, but certainly within 1 week of the last seizure.

Inter-Ictal Psychosis: Psychosis that develops when the patient with epilepsy has not had a seizure for more than 1 week or is unrelated to the any recent increase in seizure activity [3]. Psychosis may range from acute to subacute in presentation with clinical presentation ranging from mild disorientation to complete lack of awareness, being mute and unresponsive, frank catatonia, irritability and mania. Treatment would include primary biofeedback and behavioural therapy with pharmacotherapy mainly with atypical antipsychotics like quetiapine, olanzapine, aripiprazole. Initially to be started at a lower dosage of olanzapine 2.5 mg daily to 5 mg twice daily.

Conclusion

Go to

Though psychosis immediately following the episodes of seizures is most commonly encountered, chronic psychosis up to 6 months post the episode or those without any prior event are also present and should not be considered unrelated to the primary aetiology. Often it is encountered that a patient may present with psychosis and create a diagnostic dilemma due to long standing psychosis in a seizure disorder patient or psychosis presenting initially in a patient not having a prior history of evident seizures.

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