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1.
Effectiveness of a school-based behavioural change intervention in reducing chronic disease risk factors in Chandigarh, India: a cluster-randomised controlled trial.
Kaur, S, Kumar, R, Lakshmi, PVM, Kaur, M
The Lancet regional health. Southeast Asia. 2024;:100353
Abstract
BACKGROUND Early behavioural risk factors such as unbalanced diets, physical inactivity and tobacco and alcohol consumption lead to chronic diseases in later life. We conducted a cluster-randomised controlled trial to measure the effect of a school-based health-promotion intervention in reducing the behavioural risk factors of chronic diseases. METHODS Twelve public schools in the Chandigarh, India were randomised to the intervention and control arm. Adolescents studying in eighth grade (n = 453), their parents (n = 395) and teachers (n = 94) were recruited for the current study. The Precede-Proceed Model was followed for intervention development. Intervention in each cluster comprised of one classroom session, four physical activity (PA) sessions every week for adolescents and four separate sessions for parents and teachers. Primary outcomes were eight binary or continuous measures of behavioural risk factors among adolescents (n = 359). Physical Activity Questionnaire-Adolescents (PAQ-A) scores were used to estimate physical activity. The ANCOVA based on cluster proportions or means was used to estimate the intervention effect accounting for baseline data. FINDINGS Among adolescents, the intervention reduced salt intake by 0.5 g/d (95% CI: -0.9, -0.1), proportion of current alcohol users by 5% (95% CI: -9, -0.007), and increased fruit consumption by 18 g/d (95% CI: 5, 30) and PA by 0.2 PAQ-A score (95% CI: 0.07, 0.3). However, the intervention had no effect on the sugar and vegetable intake and on smokers and tobacco chewers. Exploratory analysis revealed that among parents, PA increased by 205 metabolic equivalents task (MET) units (95% CI: 74.5, 336), fruits intake by 20 g/d (95% CI: 6, 34), and vegetable intake by 117 g/d (95% CI: 50.5, 183). Whereas salt consumption decreased by 0.5 g/d (95% CI: 0.15, 0.9) and the proportion of current alcohol users declined by 5% (95% CI: 9, -1) among parents. Vegetable consumption increased by 149 g/d (95% CI: 12, 286) among teachers. INTERPRETATION The intervention package implemented among adolescents by involving parents and teachers is an effective model for school-based behaviour-change interventions. FUNDING MK received partial funding from the George Institute for Global Health, Hyderabad, India for the salt-reduction component of the study.
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2.
Renal Adverse Effects of Tenofovir Containing Regimens in HIV-Infected Children and Adolescents in North India.
Kumar, R, Singh, MV, Shrivastava, A, Yadav, RK, Siddiqui, SA, Sachan, R, Maurya, M, Mishra, N, Shukla, SK, Sonkar, M
Indian pediatrics. 2024;(4):337-342
Abstract
OBJECTIVE To study the prevalence of abnormal renal functions among children living with HIV (CLHIV) receiving tenofovir disoproxil fumarate (TDF) containing antiretroviral therapy (ART). METHODS A prospective, observational study was conducted among CLHIV aged 10 years to 21 years attending the pediatric HIV clinic. We included CLHIV weighing ≥ 30 kg who had been receiving TDF-containing regimens for at least 6 months, with estimated glomerular filtration rate (eGFR) > 60 ml/min/m2 at enrolment and for whom baseline laboratory parameters were available before starting ART. Clinical and laboratory parameters like serum creatinine, serum phosphate, urinary protein and glucose estimation, CD4 count and viral load were noted from records. The mean change in serum creatinine, estimated glomerular filtration rate (eGFR), creatinine clearance, serum phosphate, and presence of urinary glucose and protein by dipstick were assessed at 3- and 12-months follow-up. RESULTS We enrolled 70 patients with mean (SD) age 14.99 (2.45) years who had been receiving TDF-based ART for a mean (SD) duration of 14.60 (12.80) months. At 3-months and 12-months follow-up, 32.85% and 41.42% patients, respectively, had eGFR below 90 mL/min/1.73m2, while 4.2% and 2.8% patients, respectively, had eGFR between 50-60 mL/min/1.73m2. One patient had creatinine clearance below 50 mL/min/1.73m2. Four patients had hypophosphatemia at the first and last follow-up respectively, and five patients had proteinuria. There was no statistically significant change in CD4 counts, serum potassium, or serum uric acid during study duration. CONCLUSION TDF-containing ART regimen is associated with decreased eGFR, creatinine clearance and proteinuria.
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3.
Nodular type but not vitamin D levels increases the risk of second primary cancers in melanoma patients: An observational study of 663 patients.
Massa, A, Isasi-Fuster, A, Requena, C, Manrique-Silva, E, Kumar, R, Nagore, E
Actas dermo-sifiliograficas. 2024;(2):143-149
Abstract
BACKGROUND Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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4.
Understanding CFTR Functionality: A Comprehensive Review of Tests and Modulator Therapy in Cystic Fibrosis.
Thakur, S, Ankita, , Dash, S, Verma, R, Kaur, C, Kumar, R, Mazumder, A, Singh, G
Cell biochemistry and biophysics. 2024;(1):15-34
Abstract
Cystic fibrosis is a genetic disorder inherited in an autosomal recessive manner. It is caused by a mutation in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene on chromosome 7, which leads to abnormal regulation of chloride and bicarbonate ions in cells that line organs like the lungs and pancreas. The CFTR protein plays a crucial role in regulating chloride ion flow, and its absence or malfunction causes the production of thick mucus that affects several organs. There are more than 2000 identified mutations that are classified into seven categories based on their dysfunction mechanisms. In this article, we have conducted a thorough examination and consolidation of the diverse array of tests essential for the quantification of CFTR functionality. Furthermore, we have engaged in a comprehensive discourse regarding the recent advancements in CFTR modulator therapy, a pivotal approach utilized for the management of cystic fibrosis, alongside its concomitant relevance in evaluating CFTR functionality.
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5.
Elevated temperature extraction of β-carotene from freeze-dried carrot powder into sunflower oil: Extraction kinetics and thermal stability.
Kumar, R, Oruna-Concha, MJ, Balagiannis, DP, Niranjan, K
Journal of food science. 2024;(3):1642-1657
Abstract
β-Carotene, a precursor of vitamin A, can alleviate the deficiency of this vitamin prevalent worldwide. Earlier research studies have addressed the extraction of β-carotene at relatively low temperatures (up to 70°C) due to its perceived instability at higher temperatures, as a result of which extraction rates recorded are relatively low. This study models the net rate of β-carotene extraction by considering both extraction and degradation kinetics. The model developed, which accounts for degradation occurring in solid and extract phases, has been experimentally validated for the extraction of β-carotene from freeze-dried carrot powder into sunflower oil over a range of temperatures 90-150°C. This study also gives insights into the application of sunflower oil as a carrier for β-carotene during cooking and food processing, by monitoring and modeling the thermal degradation and isomerization of β-carotene at temperatures up to 220°C. The modeling of extraction kinetics shows that it is possible to achieve viable extraction rates by employing temperatures in the range (90-150°C) for relatively short times (<5 min). The degradation kinetics shows that almost 75% of the β-carotene can survive heating at 180°C for 10 min-indicating the possibility of using β-carotene enriched edible oils for frying. This study also reports on the formation of three isomers of β-carotene identified using HPLC trans-, 9-cis, and 13-cis. The reaction network model developed in this study was able to account for the transient variation of the concentration of all three isomers. PRACTICAL APPLICATION β-Carotene is a precursor of vitamin A and its consumption can potentially alleviate the deficiency of this vitamin prevalent worldwide. This study validates a model for the extraction of β-carotene in sunflower oil, which takes into account extraction as well as degradation occurring during extraction, so that a rational method is available for the design of efficient extractors for this purpose. This paper also establishes the thermal stability of β-carotene under frying conditions by quantifying its thermal degradation as well as isomerization.
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6.
Improving Oral Bioavailability of Herbal Drugs: A Focused Review of Self-Emulsifying Drug Delivery System for Colon Cancer.
Bhardwaj, K, Sharma, A, Kumar, R, Tyagi, V, Kumar, R
Current drug delivery. 2024;(3):389-402
Abstract
One of the most frequent malignancies in the world is colon cancer. Both men and women are affected in the same way. The colon, which makes up the last part of the digestive system and is where water and minerals from food waste are absorbed, is vulnerable to cancer. The most suitable technique of drug administration is oral administration. Aqueous solubility is low in more than 40% of novel chemical entities, resulting in poor oral drug administration. In the formulation of oral medications, low inconsistent bioavailability is a major challenge. Increasing medication bioavailability is one of the most difficult aspects of pharmacological development. Self-nano-emulsifying drug delivery systems (SNEDDS) have been a potential platform for biopharmaceutical classification system class II and IV drugs for oral delivery. Enhanced bioavailability and solubility, control of toxicity, pharmacological effects, improved stability, improved tissue macrophage dispersion, prolonged delivery, and resistance to physical and chemical degradation are just a few benefits of SNEDDS for herbal drugs. To increase activity and address problems associated with herbal drugs, nanosized modern drug delivery technologies are expected to have a promising future. Improved patient compliance, fewer problems with liquid SNEDDS filled in capsules, and enhanced stability SNEDDS are all benefits of converting liquid SNEDDS to solid oral dosage forms or solid SNEDDS. SNEDDS differs from previous solubility augmentation methods due to its biodegradable components, simplicity of large-scale production, and range of drug-targeting possibilities.
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7.
Tolerance and adaptation mechanism of Solanaceous crops under salinity stress.
Altaf, MA, Behera, B, Mangal, V, Singhal, RK, Kumar, R, More, S, Naz, S, Mandal, S, Dey, A, Saqib, M, et al
Functional plant biology : FPB. 2024;(1):NULL
Abstract
Solanaceous crops act as a source of food, nutrition and medicine for humans. Soil salinity is a damaging environmental stress, causing significant reductions in cultivated land area, crop productivity and quality, especially under climate change. Solanaceous crops are extremely vulnerable to salinity stress due to high water requirements during the reproductive stage and the succulent nature of fruits and tubers. Salinity stress impedes morphological and anatomical development, which ultimately affect the production and productivity of the economic part of these crops. The morpho-physiological parameters such as root-to-shoot ratio, leaf area, biomass production, photosynthesis, hormonal balance, leaf water content are disturbed under salinity stress in Solanaceous crops. Moreover, the synthesis and signalling of reactive oxygen species, reactive nitrogen species, accumulation of compatible solutes, and osmoprotectant are significant under salinity stress which might be responsible for providing tolerance in these crops. The regulation at the molecular level is mediated by different genes, transcription factors, and proteins, which are vital in the tolerance mechanism. The present review aims to redraw the attention of the researchers to explore the mechanistic understanding and potential mitigation strategies against salinity stress in Solanaceous crops, which is an often-neglected commodity.
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8.
Viral hepatitis-induced acute liver failure.
Biswas, S, Kumar, R, Shalimar, , Acharya, SK
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 2024
Abstract
Viral hepatitis-induced acute liver failure (ALF) is a preventable cause for liver-related mortality worldwide. Viruses are the most common cause for ALF in developing nations in contrast to the west, where acetaminophen is largely responsible. Viruses may be hepatotropic or affect the liver secondary to a systemic infection. In tropical countries, infections such as leptospirosis, scrub typhus and malaria can mimic the symptoms of ALF. Differentiating these ALF mimics is crucial because they require etiology-specific therapy. Treatment of viral hepatitis-induced ALF is two-pronged and directed towards providing supportive care to prevent organ failures and antiviral drugs for some viruses. Liver transplantation (LT) is an effective modality for patients deteriorating despite adequate supportive care. Early referral and correct identification of patients who require a transplant are important. Liver support devices and plasma exchange have evolved into "bridging modalities" for LT. Preventive strategies such as hand hygiene, use of clean and potable water and inclusion of vaccines against viral hepatitis in the national program are simple yet very effective methods focusing on the preventive aspect of this disease.
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9.
A review on fluoride contamination in groundwater and human health implications and its remediation: A sustainable approaches.
Kumar, P, Kumar, M, Barnawi, AB, Maurya, P, Singh, S, Shah, D, Yadav, VK, Kumar, A, Kumar, R, Yadav, KK, et al
Environmental toxicology and pharmacology. 2024;:104356
Abstract
Contamination of drinking water due to fluoride (F-) is a major concern worldwide. Although fluoride is an essential trace element required for humans, it has severe human health implications if levels exceed 1.5 mg. L-1 in groundwater. Several treatment technologies have been adopted to remove fluoride and reduce the exposure risk. The present article highlights the source, geochemistry, spatial distribution, and health implications of high fluoride in groundwater. Also, it discusses the underlying mechanisms and controlling factors of fluoride contamination. The problem of fluoride-contaminated water is more severe in India's arid and semiarid regions than in other Asian countries. Treatment technologies like adsorption, ion exchange, precipitation, electrolysis, electrocoagulation, nanofiltration, coagulation-precipitation, and bioremediation have been summarized along with case studies to look for suitable technology for fluoride exposure reduction. Although present technologies are efficient enough to remove fluoride, they have specific limitations regarding cost, labour intensity, and regeneration requirements.
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10.
Honey infused with herbs: A boon to cure pathological diseases.
Kumar, S, Verma, M, Hajam, YA, Kumar, R
Heliyon. 2024;(1):e23302
Abstract
Healing with herbs has been a common practice for ages. Nowadays, various infectious diseases like malaria, flu, hepatitis B; COVID-19, etc. are commonly spreading around the world as a consequence of environmental pollution and related consequences. These diseases are not well controlled by the present drug treatment. Antibiotics are failing because of bacterial resistance. Although people believe that herbal medicines are more effective and safer. Therefore, traditional herbal remedies have been recommended for treatment purposes throughout the world. They are often used in combination, fused with honey, or alone for curing different types of ailments. Today, modern formulations of these medicines exist in the form of capsules, tablets, powders, and granules. In several traditional systems, 'Honey' is recommended as a natural medicine that improves several health conditions. In 'Ayurveda', honey is considered a most precious and miraculous product of nature and is used to treat various diseases either alone or after its infusion with herbs. It is a natural, antioxidant-rich, and highly nutritious food that is widely used as a natural sweetener without any side effects. It has antibacterial, antiviral, antifungal, and antioxidant properties. It also proves fruitful in managing/curing various disorders like colds, coughs, cancer, diabetes, wound healing, and cardiovascular disorders. Honey infused with herbs is also used to repair wounds, diabetes, lymphedema, and the prevention of chronic venomous diseases as a part of the folk medicinal system. The current article aims to analyse the medicinal efficiency of honey infused with herbs for curing/managing/treating various types of ailments.