Current Trends in Diagnosis and Treatment

Transcription

1 July-December 2017 Volume 1 Number 2 Editor-in-Chief AP Singh Current Trends in Diagnosis and Treatment An Official Journal of Academy of Medical Evaluators & Interpreters (A National Society)

2 Current Trends in Diagnosis and Treatment 1. Aims and Scope Current Trends in Diagnosis and Treatment (CTDT) is the official journal of Academy of Medical Evaluators and Interpreters. The journal is multi-disciplinary, peer-reviewed, open access at published bi-annually in January and June. The journal publishes original research articles, reviews including book review, case reports, invited editorials, latest informative medical news and scholarly articles on all scientific subjects of Medical sciences and education. This will include articles on all basic sciences and clinical research as well as medical education, legislation and health policy, medical manpower and organization development, medicine and society, ethics and humanities, research in nursing, physiotherapy and allied sciences. 2. Ethical Considerations Ethics and Plagiarism. Use of published or unpublished ideas or words of others without attrition or permission and presenting them as new and original rather than derived from an existing source, will be considered as plagiarism. Authors should make sure that their manuscripts are free from plagiarized material. If plagiarism is found it would lead to rejection of the article. The research work should be approved the relevant ethical committee. 3. Authorship Criteria It should be in accordance with the ICMJE guidelines. An author should be a person who has made substantial intellectual contribution to the research study. Authorship criteria require the fulfillment of following conditions: * Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data. * Drafting the article or revising it critically for important intellectual content. * Final approval of the version to be published. 3. Copyright Authors must agree in writing to transfer to the Journal the copyright for all material submitted, in case of its publication by the Journal. The published manuscript may not be reproduced elsewhere, wholly or in part, without the prior written permission of the Journal. Conflict of interest Conflict of interest exists when a financial or personal relationship of the author may inappropriately influence outcome of the study. Source of funding should be disclosed. For more information refer to For any clarification, contact at editor@jaypeebrohers.com 4. License Agreement We hereby declare that: 1. The article submitted has neither been published in any other peer-reviewed journal nor is under consideration for publication by any other journal. More so, the article does not contravene any existing copyright or any other third party rights. 2. The article contains no such material that may be unlawful, defamatory, or which would, if published, in any way whatsoever, violate the terms and conditions as laid down in the agreement. 3. We have taken due care that the scientific knowledge and all other statements contained in the article conform to true facts and authentic formulae and will not, if followed precisely, be detrimental to the user. 4. We permit the adaptation, preparation of derivative works, oral presentation or distribution, along with the commercial application of the work. 5. Each of us individually takes full responsibility for the design and conduct of the study, had full access to the data and controlled the decision to publish the study. 6. We agree to the order of authorship as stated on the title page of the manuscript. 7. Each of us has seen the final version of the manuscript submitted for publication and has approved of it. 8. All conflicts of interest are stated in writing. 9. Authors are solely responsible for the factual accuracy and originality of the content. 4. Subscription Information Subscription rates For information on subscription rates and the other journal-related enquiries, please contact: subscriptions@jaypeejournals.com Orders Journals Department Jaypee Brothers Medical Publishers (P) Ltd. 4838/24, Ansari Road, Daryaganj New Delhi , India Phone: Fax: subscriptions@jaypeejournals.com 5. Electronic Media An electronic edition of this journal is available at Manuscripts can be submitted online at 6. Advertisement For advertisement queries, please contact: Journals Department Jaypee Brothers Medical Publishers (P) Ltd. advertisements@jaypeejournals.com For any queries regarding online submission, please us at: help-desk@jaypeejournals.com For editorial queries, please contact: chetna.malhotra@jaypeebrothers.com The journal is printed on acid free paper. Copyright Jaypee Brothers Medical Publishers (P) Ltd. ii

3 CTDT July-December 2017 Vol. 1 No. 2 Current Trends in Diagnosis and Treatment Patron-in-Chief Bhai Gobind Singh Longowal President Shiromani Gurudwara Prabandhak Committee Chairman, SGRD Charitable Hospital Trust Chancellor, Sri Guru Ram Das University of Health Sciences, Amritsar, India Patrons Kulwant Singh Ded Vice Chancellor, Sri Guru Ram Das University of Health Sciences, Amritsar, India Manjit Singh Uppal Director Principal, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India EDITORIAL BOARD Editor-in-Chief AP Singh Deans Colleges Sri Guru Ram Das University of Health Sciences, Amritsar, India Additional Secretary Sri Guru Ram Das Charitable Hospital Trust, Amritsar, India Editor Richa Ghay Thaman Professor Department of Physiology, Sri Guru Ram Das Institute of Medical Sciences, Amritsar, India Joint Editors Manjula Bhargava Principal and Professor Department of Pharmacology, NIMS, Rajasthan, India Hemant Sharma Head and Professor Department of Medicine, Hindurao Hospital and NDMC Medical College, New Delhi, India Kulwinder Singh Associate Professor Department of Radiodiagnosis, BPS Government Medical College for Women, Haryana, India Publishing Center Publisher Jitendar P Vij Associate Director Chetna Malhotra Vohra Managing Editor Akash Mishra EDITORIAL ADVISORY BOARD Hardas Singh GS Wander Geeta Sharma Tejinder Singh Raju S Chhina Nalin Mehta Bhupesh Khajuria Baljit Khurana Dinesh Badyal National International Allan Vaag Denmark Pankaj Gupta Sandeep Bhattacharya Sahiba Kukreja Geeti Arora Puri Anterpreet Kaur Karaninder Singh Satendra Singh Baljit Singh Namrata Chhabra Mauritius Cheng Hwee Ming Malaysia Atul Kalhan UK Neeraj Singh USA Jaswinder Singh USA Mohammed Hassanien Saudi Arabia Soumendera Sahoo Malaysia Rashmi Prasad Sweden Editorial Office H.No. 4/312, New Roop Nagar Amritsar, Punjab. Phone: medicalevaluators2016@gmail.com Production Office PS Ghuman Journals Department Jaypee Brothers Medical Publishers (P) Ltd. 4838/24, Ansari Road, Daryaganj New Delhi , India Phone: , Fax: journals@jaypeebrothers.com Advertisements/Subscriptions/Reprints Ashwani Shukla Phone: advertisements@jaypeejournals.com subscriptions@jaypeejournals.com ashwani.shukla@jaypeebrothers.com For Website Queries Phone: contact@jaypeejournals.com iii

4 Academy of Medical Evaluators & Interpreters Chairman AP Singh Vice Chairman Geeta Sharma Gen. Secretary Richa Ghay Thaman Finance Secretary Taranjeet Singh Delhi, India Executive Members Baljeet Khurana Baljit Singh Bhupesh Khajuria J&K, India Hemant Sharma Delhi, India Karaninder Singh Himachal Pradesh, India Kulvinder Singh Haryana, India Manjula Bhargawa Rajasthan, India Pankaj Gupta Sahiba Kukreja Sandeep Bhatacharya Uttar Pradesh, India iv

5 Editorial Synchronize Your Biological Rhythm Rhythm is sound in motion. It is related to the pulse, the heartbeat, the way we breathe. It rises and falls. It takes us into ourselves; it takes us out of ourselves. Edward Hirsch We all have an internal biological clock that coordinates our circadian rhythm. It operates on a roughly 24 hrs cycle and is calibrated by the appearance and disappearance of natural light. Sunlight teaches the master clock in the brain to keep on track. The rotation of our planet around its central axis creates daily rhythm in environment factors, light intensity, temperature and availability of food. Organisms adapt to the changes present in their environment to enhance their survival. Most of the living organisms, including humans have evolved a biological clock that can anticipate and adapt these 24 hrs changes in the environment. This internal clock in humans resides in the suprachiasmatic nucleus (SCN) in the ventral hypothalamus. 1 Besides light, exercise, hormones and medications affect the SCN and setting of circadian rhythm. The SCN has around 20,000 neurons responsible for generating the rhythm. The neurons receive signals from the eye using light information projected via retinohypothalmic tract (RHT), which is then passed on to other areas of the brain. 2, 3 The nobel assembly at Karolinska Institute has awarded 2017 Nobel Prize in Physiology and Medicine jointly to Jeffrey C Hall, Michael Rosbach and Michael W Young for their discoveries of molecular mechanisms controlling the circadian rhythm. Hall and Rosbach both worked at Brandeis University in USA when they began their Nobelwinning work. Hall is presently associated with University of Maine. Michael Young is a faculty at Rockfeller University in USA. Their work explains how plants, animals and humans adapt their biological clock to synchronize with the Earth s revolutions. The Nobel laureates isolated a gene which controls the biological rhythm, using fruit flies (Drosophila) as their experimental organism. In 1984 Jeffery C Hall and Michael Rosbach together and also Michael Young almost at the same time succeeded in isolating the period gene, they later discovered that PER the protein coded by this gene accumulates at night and disintegrates during the day. 4, 5 The PER protein oscillate over a 24 hrs cycle in synchrony with the circadian rhythm. There is also an inhibitory feedback loop by which PER can regulate its own level throughout the day, therefore whenever PER levels increased in the cells its production decreased. 6 But the question remained as to how PER protein formed in the cytoplasm reaches the nucleus. In 1994 Michael Young discovered a second gene timeless, encoding the TIM protein required for circadian rhythm (Fig. 1). When TIM was bound to PER, the two proteins were able to enter the nucleus where they blocked period gene activity to close the inhibitory feedback loop. 7 These two proteins accumulate in the cytoplasm, but move into the nucleus of the cells if co-expressed. Regulation of cytoplasmic localization domains activity by assembly of PER/ TIM complex is seen to be a key determinant of period length. 8 Fig. 1: Later work by the Nobel Laureates uncovered a second clock gene that encodes for a protein called TIM, which binds to PER and allows the duo to enter the cell nucleus (Credit: The Nobel Committee for Physiology and Medicine. Illustrator: Mattias Karlen) 10 v

6 Editorial While these discoveries explained the phenomenon behind oscillations of cellular protein level, yet the unanswered question remained as to how the frequency of the oscillations is controlled. Yet another gene doubletime was identified by Michael Young which encoded the DBT protein that delayed the accumulation of the PER protein. 9 This helped in explaining the reason behind oscillations adjusted to match 24 hour cycle. They also identified other protein components which contribute in maintaining the biological rhythm. The press release from the Nobel Assembly at the Karolinska Institute, Stockholm, Sweden explains With exquisite precision, our inner clock adapts our physiology to the dramatically different phases of the day. The clock regulates critical functions such as behavior, hormone levels, sleep, body temperature and metabolism. Since the seminal discoveries by the three laureates, circadian biology has developed into a vast and highly dynamic research field, with implications on our health and well-being. 10 The most significant part of their work rests on the aspect as to what happens when the clock runs either too fast or too slow. Young said there is also growing research-mostly in animals that supports the idea that maintaining a more regular schedule, including eating and sleeping may contribute to longevity. 11 In fact modern world expectations are punishing for our bodies and brain we have misaligned body clocks. Nature has been created to nurture all organisms and being the most intellectual of all organisms on this Earth, we need to learn that our lifestyle choices should be aligned to the Mother Nature. Our well-being is affected when there is a temporary mismatch between the environment and our internal biological clock. Our lifestyle choices sometimes cause misalignment of our biological clock opening doors to insomnia, anxiety, depression, increased blood pressure, stress and so on. But it is easy to align with the environment cues getting a good night s sleep, maintaining disciplined lifestyle, eating rich nutritious food, getting sun exposure and living a simple life close to mother nature. The biggest circadian rhythm in our lives will always be the big yellow source of light, heat and energy which is at the center of our solar system. This justifies that even after millions of years of messing around with the sun s influence by lighting care fires; the human race remains prepensely diurnal from physiological, evolutionary and genetic point of view. 12 The modern human race however is in confrontation with the rhythms. People keep watching TV, working on computer and mobile phones late into the night. This mismatch is increasingly responsible for the increased incidences of headaches, lack of concentration and mood disorders. People keep sitting indoors to enjoy the modern amenities, missing the immense benefits of sunlight which is the pivot of circadian rhythm. Many of the health promoting benefits of sun s exposure are linked to Vitamin D synthesis. Many studies have also demonstrated a strong link between Vitamin D3 which we get from the sun and chronic diseases often associated changing including cognitive decline, osteoporosis, diabetes and cancer. 13, 14 Even small increases in sleep have shown to improve our concentration, memory and mood. In addition to well documented impact on age related diseases sunlight is associated with stronger immunity, reduced depression, and reduced stress even in small closes. 15 We must endeavor to strike a balance between modern lives and some real ancient wisdom fusion of reality and wisdom. In fact maintaining our body s biological rhythm on an even keel may be one of the best things to improve our overall health and reverse aging. This way we can better relish the time we have on this planet. REFERENCES 1. Abrahamson EE, Moore RY. Suprachiasmatic nucleus in the mouse: retinal innervation, intrinsic organization and efferent projections. Brain Res 2001; 916: Kalsbeek A, Palm IF, La Fleur SE, Scheer FA, Perreau-Lenz S, Ruiter M, et al. SCN outputs and the hypothalamic balance of life. J Biol Rhythms. 2006; 21: Morin LP, Allen CN. The circadian visual system, Brain Res Rev. 2006; 51(1): brainresrev Zehring, W.A., Wheeler, D.A., Reddy, P., Konopka, R.J., Kyriacou, C.P., Rosbash, M., and Hall, J.C. P-element transformation with period locus DNA restores rhythmicity to mutant, arrhythmic Drosophila melanogaster. Cell. 1984; 39, Bargiello, T. A., Jackson, F. R. & Young, M. W. Restoration of circadian behavioural rhythms by gene transfer in Drosophila. Nature. 1984; 312, Hardin, P. E., Hall, J. C. & Rosbash, M. Feedback of the Drosophilia Period gene product on circadian cycling of its messenger mrna. Nature 1990; 343, Vosshall, L.B., Price JL, Sehgal A, Saez L, Young MW. Block in nuclear localization of period protein by a second clock mutation, timeless. Science. 1994; 263: Lino S, Young M W, Regulation of Nuclear Entry of the Drosophila Clock Oroteins Period and Timeless. Neuron 1996; Vol. 17: vi

7 Editorial 9. Price JL, Blau J, Rothenfluh A, Abodeely M, Kloss B and Young MW. Doubletime is a novel Drosophila clock gene that regulates PERIOD protein accumulation. Cell 1998; 94: The Nobel Assembly. The 2017 Nobel Prize in Physiology and Medicine (press release). Karolinska Institute, Stockholm, Sweden; 2017 Oct Cha A E. Nobel in Physiology, Medicine awarded to three Americans for discovery of clock gene. The Washington Post Oct Day JD, Day JN. The Longevity Plan Seven life transforming lessons from Ancient China. New York. Harper Collins Meehan M and Penckofer S. The role of vitamin D in the aging adult. Journal of Aging and Gerontology. 2014; 2(2): Mead M. Benefits of sunlight: A bright spot for human health. Environment Health Perspective. 2008; 116(4): Moller Levet C, Archer Sn, Bucca G, Laing EE, Slak A, Kabiljo R et al. Effects of insufficient sleep on circadian rhythmicity and expression amplitude on the human blood transcriptome. Proceedings of the National Academy of Sciences of United States of America. 2013; 110(12): E1132-E1141; published feb 25, 2013 doi: /pnas Richa Ghay Thaman Editor Current Trends in Diagnosis and Treatment vii

8 Current Trends in Diagnosis and Treatment An Official Journal of Academy of Medical Evaluators & Interpreters July-December 2017 Volume 1 Number 2 Contents ORIGINAL RESEARCH A Comparative Study of Electrocardiographic and Echocardiographic Evidence of Left ventricular Hypertrophy Gurinder Mohan, Ranjeet Kaur, Ankur Kamra, Aakash Aggarwal An Insight into the Etiopathogenesis of Urinary Retention in Patients managed at a Tertiary Care Hospital in Amritsar, Darpan Bansal, Gurpreet S Bhangu, Ashish P Singh, Harpreet Singh, Noopur Bansal, Ritansh Bansal Anthropometric Determinants of Hand Grip Strength in Normal Healthy Punjabis Ravneet Sandhu, Parminder K Sandhu, Dimple Bajaj, Joginder P Singh A Quasi-experimental Study on Effectiveness of Cabbage Leaves Application for Breast Engorgement in Postnatal Mothers at Selected Hospitals, Amritsar, Rajbir Kaur, Parvesh Saini Knowledge about Safety Measures regarding Handling of Chemotherapeutic Agents among Staff Nurses in a Tertiary Care Teaching Hospital Rupinder Kaur REVIEW ARTICLE Cardiac Biomarkers in Acute Coronary Syndrome Gurinder Mohan, Ranjeet Kaur, Trimaan Singh CASE REPORTS Bilateral Superior Radioulnar Synostosis: A Rare Congenital Anomaly Seema Sehmi, Maninder S Sehmi Aeromonas hydrophila complicating Postpituitary Surgery for Microadenoma Manmeet K Gill, Sarabjeet Sharma Angioma Serpiginosum in Bilateral Distribution in a Male Child: A Rare Entity with Unusual Presentation Jasleen Kaur, Karuna Thapar, Simplepreet Kaur, Riya K Kalra MEDICAL EDUCATION Introduction of Case-based Learning as a Teaching/Learning Tool to enhance Students Knowledge in Biochemistry Sahiba Kukreja, Amandeep Kaur, Manmeet Gill, Namrata Chhabra viii

9 MEDICAL ETHICS, LAW AND SOCIETY Contents Recent Advancement in Human Reproduction Three-parent Babies: A Technique to Neutralize Mitochondrial Disease Load A Boon or a Bane for Society? Simranpreet Kaur, Madhu Nagpal Women s Reproductive Rights and Population Explosion Shyam S Deepti HEALTH MANPOWER AND MANAGEMENT Health care Leadership and Management The Changing Face, Making Difference Gaurav Thukral, Vishesh Madaan LETTER TO EDITOR Breast Abnormalities and Diseases in Adolescents Seema Dayal ix

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