Lack of Circadian Pattern of Serum TNF-α and IL-6 in Patients with Fibromyalgia Syndrome

The present study was designed to test the hypothesis of a circadian variation in circulating levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in women with fibromyalgia syndrome (FMS). Serum levels of IL-6 and TNF-α were measured at 4 h intervals of the day in 50 women with FMS satisfying American College of Rheumatology criteria for FMS (age 36.68 ± 9.89) as well as 50 healthy control women (age 32.82 ± 10.53). Serum TNF-α levels were substantially increased in patients with FMS but showed no circadian variation. In contrast, no difference in the levels of IL-6 was found. Moreover, there was also no circadian variation in both the groups of patients and controls. We conclude that no circadian pattern exists in the circulating levels of serum IL-6 and TNF-α in patients with FMS, although TNF-α levels are found raised in patients with FMS.     

Vanishing species: The planet in crisis

Rapid extinction of species is one of the most serious ecological problems faced by humanity today. Species are disappearing at a pace unprecedented in the history of the planet putting the very future of life at risk. The irony is that the root of the crisis is another species, Homo sapiens rather than some physical events that is poised to threaten its own survival. This article gives a brief introduction to the crisis, its consequences and possible mitigation strategies.     

A microfluidic platform for studying the effects of small temperature gradients in an incubator environment

Studies on the effects of variations in temperature and mild temperature gradients on cells, gels, and scaffolds are important from the viewpoint of biological function. Small differences in temperature are known to elicit significant variations in cell behavior and individual protein reactivity. For the study of thermal effects and gradients in vitro, it is important to develop microfluidic platforms which are capable of controlling temperature gradients in an environment which mimics the range of physiological conditions. In the present paper, such a microfluidic thermal gradient system (μTGS) system is proposed which can create and maintain a thermal gradient throughout a cell-seeded gel matrix using the hot and cold water supply integrated in the system in the form of a countercurrent heat exchanger. It is found that a uniform temperature gradient can be created and maintained in the device even inside a high temperature and high humidity environment of an incubator. With the help of a hot and cold circuit controlled from outside the incubator the temperature gradient can be regulated. A numerical simulation of the device demonstrates the thermal feature of the chip. Cell viability and activity under a thermal gradient are examined by placing human breast cancer cells in the device.     

Ochronosis of the Hip Joint: Differential Diagnosis of Inflammatory Arthropathy with Lytic Lesion

Alkaptonuria or ochronosis is a rare inborn disorder of metabolism which is characterized by deficiency of homogentisic acid oxidase. There is accumulation of homogentisic acid in the connective tissues causing brownish black pigmentation and skeletal damage. The most serious complication of this disease is crippling degenerative arthropathy which presents in late years of life. There is no definitive treatment for the condition. Symptomatic management is the main stay. Surgical management such as arthroplasty is done for severe cases of ochronosis. We report a case of ochronosis of the hip joint presenting with inflammation and lytic lesion which can create confusion and lead to error in diagnosis.     

Establishment of Trimester-Specific Reference Intervals of Serum TSH & fT4 in a Pregnant Indian Population at North Kolkata

Reference intervals (RIs) of serum thyroid stimulating hormone (TSH) and free thyroxine (fT₄) were determined in 402 healthy pregnant women by enzyme-linked immunosorbent assay (ELISA) technique after partitioning them into three trimesters. The reference population was chosen from a study population of 610 pregnant females by applying strict inclusion and exclusion criteria. The assays were done using proper quality control measures. RIs were calculated from the central 95 % of the distribution of TSH and fT₄ values located between the lower reference limit of 2.5 percentile and upper reference limit of 97.5 percentile value 0.90 confidence intervals for the upper and lower reference limits were also determined. The reference intervals for TSH were 0.25–3.35 μIU/ml for the first trimester; 0.78–4.96 μIU/ml for the second trimester and 0.89–4.6 μIU/ml for the third trimester. Similarly, the reference intervals for fT₄ for first, second and third trimesters were 0.64–2.0, 0.53–2.12 and 0.64–1.98 ng/dl respectively. The values thus obtained varied from those provided by the kit literature. In comparison to our derived reference intervals, the reference data from kit manufacturer under-diagnosed both subclinical hypo- and hyper-thyroidism within our pregnant reference population.     

A preliminary survey of professionalism teaching practices in anatomy education among Indian Medical Colleges

Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a “hidden curriculum” regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first‐year medical student. This opportunity may provide an early foundation for designing a professionalism‐integrated curriculum. Anat Sci Educ 10: 433–443. © 2017 American Association of Anatomists.     

Maternal mind-mindedness and attachment security as predictors of theory of mind understanding

This study investigated relations between social interaction during infancy and children's subsequent theory of mind (ToM). Infant-mother pairs (N = 57) were observed in a free-play context at 6 months. Interactions were coded for (a) mothers' use of mental state language that commented appropriately on the infants' mental states, and (b) mothers' use of mental state language that did not appropriately reflect their infants' minds. A third variable was (c) security of attachment, which was assessed using the Strange Situation procedure at 12 months. Performance on a battery of ToM tasks at 45 and 48 months was positively correlated with (a), but was not related to (b) or (c). A regression analysis showed that mothers' use of appropriate mental state comments independently predicted overall ToM performance, accounting for 11% of the variance. Children's verbal ability was the only other independent predictor of ToM performance, accounting for 16% of the variance. These findings represent the earliest known social predictor of individual differences in ToM.