Ischemia modified albumin: A novel marker for acute coronary syndrome

Early identification of patients with acute myocardial infarction is of prime importance due to the associated very high mortality. Only 22% of the patients presenting at emergency cardiology care with chest pain have coronary disease. A number of biochemical tests like CKMB and Troponin-T/I have been introduced for early detection of the coronary syndrome (ACS). Ischemia modified albumin (IMA) has been recently introduced as a marker of myocardial ischemia. We estimated serum IMA in four sequential samples from 25 patients admitted to ICCU. Twenty five healthy volunteers formed the control group from which the normal range was derived. IMA was significantly raised in ischemia patients than in controls as well as compared to the patients who did not have cardiac ischemia. IMA demonstrated good discrimination between the ischemic and the non-ischemic patients with an Odds Ratio of 16.9 (6.29–46.87) than CKMB which showed an Odds Ratio of 2.07 (1.18–6.08). Sensitivity and specificity of IMA for the detection of ACS was 78.0% and 82.7% compared to 58.0% and 60.0%, respectively for the CK-MB assay. The area under the ROC curve of IMA for ischemic v/s non-ischemic patients was 0.834. IMA appears to be developing into a new and very potent marker, of cardiac ischemia.     

Developing a template for National Child Protection Index Reports

Objectives

What impact does the strengthening of child rights have on the experience and circumstances of children? CRC General Comment 13 emphasizes that defining measurable targets for improvements in child protection is a key element of efforts to strengthen child rights and well-being across the world. This paper describes an attempt to identify key domains relevant to such mapping of child protection indicators, and the feasibility of collecting data—from existing data sources or otherwise—to complete a “National Child Protection Index Report” summarizing achievements and concerns at a national level.

Methods

A process of inter-agency consultation was facilitated by the CPC Learning Network to establish a template for the Index Report. The template was modeled on that used for the “Countdown to 2015” maternal, neonatal and child health initiative, aiming to capture indices not only of key protection risks but also implementation and coverage of key protection measures. The work drew on indicator development and policy initiatives by a number of international child protection agencies. The template developed was used as a basis to pilot national data collection in Indonesia and, at a sub-national level, in northern Uganda.

Findings

The template provides a concise summary of protection issues of relevance to a broad range of constituencies, global and national. However, in the pilot settings, existing routine data collection was inadequate to effectively populate a large proportion of indicators. Mechanisms of collating findings from discrete assessments—another potential source of data for completion of the index report—were also generally underdeveloped.

Practice implications

In settings where state infrastructure allows the collection and analysis of routine data in such domains as health and economic activity, such efforts should be extended to the child protection sector. Discrete assessments by governmental or non-governmental agencies also provide significant potential for more effective sharing and collation of information. National Child Protection sub-clusters or equivalent structures can play an important role in facilitating both of these processes.     

Intravascular haemolysis during prolonged running on asphalt and natural grass in long and middle distance runners

Surface features such as uneven playing surfaces, low impact absorption capacity and inappropriate friction/traction characteristics are connected with injury prevalence whereas force impact during foot strike has been suggested to be an important mechanism of intravascular haemolysis during running. We aimed to evaluate intravascular haemolysis during running and compare the effect of running on two different types of surfaces on haemolysis. We selected two surfaces (asphalt and grass) on which these athletes usually run. Participants were randomly assigned to group A (asphalt) or group B (grass) with 10 athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjugated bilirubin (UBR) (mg · dl(-1)), lactate dehydrogenase (LDH) (μ · ml(-1)), haemoglobin (g · l(-1)) and serum ferritin (ng · ml(-1)) as indicators of haemolysis. Athletes who ran on grass demonstrated an increase in the haematological parameters (UBR: P < 0.01, LDH: P < 0.05) when compared to athletes who ran on asphalt (UBR: P < 0.05, LDH: P = 0.241). Our findings indicate that intravascular haemolysis occurs significantly after prolonged running. Furthermore, we conclude that uneven grass surface results in greater haemolysis compared to asphalt road.     

A science need: Designing tasks to engage students in modeling complex data

In this information age, the capacity to perceive structure in data, model that structure, and make decisions regarding its implications is rapidly becoming the most important of the quantitative literacy skills. We build on Kaput’s belief in a Science of Need to motivate and direct the development of tasks and tools for engaging students in reasoning about data. A Science of Need embodies the utility value of mathematics, and engages students in seeing the importance of mathematics in both their current and their future lives. An extended example of the design of tasks that require students to generate, test, and revise models of complex data is used to illustrate the ways in which attention to the contributions of students can aid in the development of both useful and theoretically coherent models of mathematical understanding by researchers. Tools such as Fathom are shown as democratizing agents in making data modeling more expressive and intimate, aiding in the development of deeper and more applicable mathematical understanding.

Role of Brain Biomarker in Predicting Clinical Outcome in Hypertensive Cerebrovascular Ischemic Stroke

This study was undertaken to evaluate the role of serum neuron specific enolase (NSE) in prediction of disability and neurological worsening in hypertensive ischemic cerebrovascular stroke. 80 hypertensive ischemic stroke patients diagnosed by a neurologist as per WHO definition along with radiological findings suggestive of cerebrovascular stroke and differentiating from hemorrhagic stroke and 60 controls having essential hypertension coming to hospital because of regular checkup or headache but with no neurological disease were included in the study. Neurological disability was assessed by NIHSS at the time of admission (within 72 h from the onset of stroke) and on 7th day after admission and cases were categorized into mild, moderate and severe disability. Venous blood samples were drawn within 72 h from the onset of symptoms. The samples were processed as per the laboratory protocol. The serum NSE samples were analyzed using an enzyme immunoassay based on the sandwich technique. We observed raised serum NSE in hypertensive ischemic stroke (17.4 ± 5.4 ng/ml) with significant association between different hypertensive groups than in hypertensive controls (9.1 ± 0.75 ng/ml). Greater degree of disability was observed in hypertensive stroke patients with raised serum NSE and hypertensive patients with mean serum NSE level of 22.9 ± 3.6 ng/ml and dyslipidemia had greater probability of neurological worsening as compared to those with mean serum NSE level of 12.7 ± 1.2 ng/ml. Serum NSE levels can serve as a peripheral indicator of neuronal damage and assist in the prediction of disability and clinical outcome in hypertensive cerebrovascular ischemic stroke patients.     

Governance of Indian Universities From decay to dynamism?

India with a current student population of around 4 million in its universities and colleges is the third largest system in the world after USA and USSR. The unprecedented expansion of higher education in India, which took place in the last four decades, has, however, been extremely uneven and resulted in the neglect of quality, research and managements aspects. The universities and colleges function much below their optimal levels and fail even to fulfil their minimum and basic tasks such as making admissions, completing teaching, conducting examinations, declaring results and awarding degrees on time. The very credibility of the university system stands eroded.Increasing government control, extra-constitutional pressures in their governance, appointment and dismissal of Vice-Chancellors on political considerations and drift of the academic community from serious academic pursuits have undermined the autonomy of the universities. The paper attempts to analyse from macro-micro angles the causes for the decay of the university system.The National Policy on Education-1986 aims at radical reorganisation of higher education to bring about dynamism in the system through multi-pronged strategies and programmes and structural reforms. Policy interventions have, however, failed to create much impact. The paper brings forth some of the important issues vital to the governance of the universities and highlights the need for a collective endeavour of teachers, students, educational administrators and government and rigorous system of performance audit to bring dynamism into the system.     

Antidyslipidemic Effect of Ocimum sanctum Leaf Extract in Streptozotocin Induced Diabetic Rats

The antidyslipidemic activity of Ocimum sanctum leaf extract was studied in streptozotocin induced diabetic rats. In this model, there was significant increase in plasma markers of diabetic-dyslipidemia following diminution of lipid metabolizing enzymes. Oral administration of leaf extract (500 mg/kg b.w.p.o.) for 15 days resulted in significant decrease in diabetogenic and dyslipidemia parameters; namely blood glucose, glycosylated hemoglobin, lipid peroxide, free fatty acids, small dense low density lipoprotein, lipid and protein components of plasma lipoproteins, adipose and liver. The regulation of lipids was accompanied by stimulation of postheparin lipolytic activity, reactivation of lecithin cholesterol acyl transferase and hepatic lipoprotein lipase enzymes. The results of the present study demonstrated antidyslipidemic and antioxidant activities in leaf extract of O. sanctum which could be used in prevention of diabetic-dyslipidemia and related complications.