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   Table of Contents - Current issue
Coverpage
July-September 2017
Volume 4 | Issue 3
Page Nos. 109-161

Online since Monday, October 16, 2017

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EDITORIAL  

Dietary cholesterol restriction is not good for health p. 109
Gopal Krushna Pal, Nivedita Nanda
DOI:10.4103/ijcep.ijcep_48_17  
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REVIEW ARTICLES Top

Potassium homeostasis, oxidative stress, and human disease p. 111
Udensi K Udensi, Paul B Tchounwou
DOI:10.4103/ijcep.ijcep_43_17  
Potassium is the most abundant cation in the intracellular fluid, and it plays a vital role in the maintenance of normal cell functions. Thus, potassium homeostasis across the cell membrane is very critical because a tilt in this balance can result in different diseases that could be life-threatening. Both oxidative stress (OS) and potassium imbalance can cause significant adverse health conditions. OS and abnormalities in potassium channel have been reported in neurodegenerative diseases. This review highlights the major factors involved in potassium homeostasis (dietary, hormonal, genetic, and physiologic influences), and discusses the major diseases and abnormalities associated with potassium imbalance including hypokalemia, hyperkalemia, hypertension, chronic kidney disease, and Gordon's syndrome, Bartter syndrome, and Gitelman syndrome.
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Placebo response in clinical trials: Taming the human brain p. 123
Payal Bhardwaj, Raj Kumar Yadav
DOI:10.4103/ijcep.ijcep_36_17  
The use of placebo in comparative clinical trials has exposed another lesser known side of the placebo, i.e., the placebo response. The placebo response is now being increasingly discussed, not only to adjust for the true clinical efficacy of a drug but also to understand the basis of psychological therapy, and benefits in therapeutic areas such as neurological disorders, especially pain. The mechanism of placebo action is multifaceted and works on the levels of brain and biochemical signaling, stimulated by priming and expectations. The imaging data show that certain areas of the brain are hyperactive while some are hypoactive during the placebo-mediated response, and trigger a biochemical pathway that relieves the symptoms. The data also suggest that the extent of benefit, i.e., the effect size of placebo response is directly proportional to positive expectations associated with the treatment, trust on the treating doctor, and certain beliefs associated with previous treatment. Although placebos incite a positive response, these might compromise or artifact the true efficacy of the drugs, thereby necessitating the need of addressing or minimizing the placebo response. Furthermore, it is important to identify the factors that modulate the placebo response, such as severity and natural burning out of the disease. Therefore, it is important to take a two-pronged approach- first, placebo as a treatment, for example, in neurological diseases, and second, adequately designed studies that minimize the placebo response. In this article, we discuss the placebo response, the mechanism behind it, its implications in clinical trials, and how to address the same.
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ORIGINAL ARTICLES Top

Sokolow-Lyon voltage and cornell voltage criteria in the diagnosis of left ventricular hypertrophy in obese individuals p. 129
Samata Padaki, Amrut Dambal
DOI:10.4103/ijcep.ijcep_29_17  
Background and Aim: Left ventricular hypertrophy (LVH) marks the ongoing disease process involving the heart. A precise diagnostic tool needs to be established to accurately determine LVH by electrocardiography (ECG), which itself is a predictor of future cardiovascular mortality and morbidity. Assessment of LVH electrocardiographically by Sokolow-Lyon voltage criteria and Cornell voltage criteria in obese individuals. Methods: Obese 50 individuals with LVH secondary to hypertension confirmed by echocardiogram were considered as study subjects. Standard 12-lead ECG was obtained and analyzed for Sokolow-Lyon voltage criteria and Cornell voltage criteria. Statistical analysis was done by unpaired t-test using SPSS package version 20. Results: According to Sokolow-Lyon voltage criteria, 42 cases (38.27 ± 2.96) and 41 controls (37.23 ± 2.01) had LVH which was statistically nonsignificant. According to Cornell voltage criteria, 36 male cases (35.42 ± 2.98) and 36 controls (32.3 ± 2.13) had LVH and it was statistically significant (P < 0.000 1). Ten female cases (26.87 ± 2.01) and 7 controls (22.9 ± 2.36) also had LVH and it was statistically significant (P < 0.002). About 84% of cases were assessed to have LVH by Sokolow-Lyon voltage criteria whereas 92% of cases were assessed to have LVH by Cornell voltage criteria. Conclusion: QRS duration is an independent ECG predictor of the presence of LVH. The Cornell voltage criteria significantly improve identification of LVH relative to Sokolow-Lyon voltage criteria in obese individuals.
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Efficacy of Selective Phenolic Compounds on the Activity of Voltage-gated K+ Current in Human Prostate Cancer Cell Line p. 133
Kiran George, Raman Malathi
DOI:10.4103/ijcep.ijcep_39_17  
Background and Aim: Phenolic compounds are reported to possess wide range of therapeutic properties against variety of diseases including cancer. Voltage-gated K+ channels (IK) are known to contribute many basic cellular functions in cancer cells. However, only few studies describe the IKcurrent blockade and inhibition of cancer cell growth in prostate cancer cells. To investigate the electrophysiological characteristics of IKchannels in prostate cancer cells. Methods: In the present study, whole-cell patch-clamp technique is used to study the modulatory effect of curcumin, rutin, troxerutin, and resveratrol on IKcurrent in human prostate cancer cell line PC-3. Results: The obtained results show that exposure of PC-3 cells to 200 μM of resveratrol inhibited IKcurrent more than half of the current when compared to control. However, this effect was reversible after application of external solution. Whereas curcumin, rutin, and troxerutin did not show any effect on IKcurrent in PC-3 cells. Conclusion: Our findings reveal that among the various tested compounds, only resveratrol effectively inhibited IK current in PC-3 cells and also this study concludes that not all the anticancer compounds have the ability to inhibit IK current in PC-3 cells.
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Relevancy of free online software and websites in detection of plagiarism Highly accessed article p. 139
Himel Mondal, Shaikat Mondal
DOI:10.4103/ijcep.ijcep_38_17  
Background and Aim: Plagiarism is disgraceful to authors and opposed in the scientific community. Before submitting articles to journals, authors should check whether the article is unintentionally plagiarized or not. However, online premium plagiarism checking service may not be accessible to many authors. For those authors, there are many websites which offer plagiarism detection service free of cost. The aim of the study was to assess the efficacy of those websites in the detection of plagiarism. Methods: A paragraph of text with 2 verbatim plagiarized sentences, 2 inadequately paraphrased sentences, and 2 perceived unique sentences was used as a tool. This paragraph was checked for plagiarism in 23 popular websites. Results showed by websites were recorded and analyzed. Chi-square test with α = 0.05 was used to compare the proportion of websites. Results: Among 23 websites, only 4 websites (17.39%) detected plagiarism above the expected level. Thirteen (56.52%) websites showed result of 0% plagiarism for the paragraph. Verbatim plagiarism was detected by 6 websites (26.09%) where only 1 website could detect inadequate paraphrasing. Conclusion: The majority of websites offering free plagiarism checking service failed to detect plagiarized content effectively. The level of detected plagiarism differs in the different website for same content. Hence, checking the manuscript in multiple websites would provide relatively better screening result for plagiarism.
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Increased cardiovascular risks in prehypertensives expressing angiotensin-converting enzyme gene polymorphism p. 142
Gopal Krushna Pal, Chandrasekaran Adithan, Pravati Pal, Nivedita Nanda, Allampalli Sirisha
DOI:10.4103/ijcep.ijcep_44_17  
Background and Aim: Although angiotensin-converting enzyme (ACE) gene polymorphism has been documented to play an important role in the genesis of hypertension, its role in the development of prehypertension has not been investigated. To study the association of ACE genotypes and their link to SVI and CV risks in young prehypertensives in Indian population. Methods: This cross-sectional study was conducted in 172 individuals divided into prehypertensives (n = 57) and normotensives (n = 115) based on their level of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Body mass index, cardiovascular (CV) parameters such as heart rate (HR), SBP, DBP, mean arterial pressure (MAP), rate pressure product, stroke volume, left ventricular ejection time, cardiac output, total peripheral resistance, and baroreflex sensitivity (BRS) were recorded by continuous BP variability (BPV) monitoring using finapres, and sympathovagal imbalance (SVI) was assessed by spectral analysis of HR variability (HRV). Biochemical parameters such as homeostatic model assessment of insulin resistance (HOMA-IR), lipid risk factors, inflammatory markers, renin and oxidative stress (OS) parameters were measured. Genotyping for ACE gene polymorphism (insertion [I]/deletion [D] or ID polymorphism) was done by polymerase chain reaction-restriction fragment length polymorphism methods. Multiple regression analysis was done to assess the association between SVI and metabolic markers, and logistic regression was done to determine the BRS prediction of prehypertension status and CV risks in ACE genotypes. The BPV, HRV, and biochemical parameters were significantly altered in prehypertensives. Results: The ID genotype of ACE was most commonly distributed among the population (33.3% prehypertensives and 50.4% in normotensives). LH-HF ratio, the marker of SVI, was significantly associated with MAP, HOMA-IR, interleukin-6, tumor necrosis factor-alpha, renin, and BRS in ID genotype of prehypertensive population. BRS, the marker of CV risk, had significant prediction of prehypertension status in ID genotypes population. Conclusion: The ACE ID gene polymorphism appears to be the candidate gene for prehypertension. ID contributes to SVI in young prehypertensives attributed by insulin resistance and inflammation. The CV risks are strongly associated with prehypertension status in ID genotypes in prehypertensives.
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A comparative study of glomerular filtration rate in normal healthy controls and type 2 diabetes mellitus patients in south India p. 148
Neelkanth Kote, MD Ranganath
DOI:10.4103/ijcep.ijcep_30_17  
Background and Aim: Diabetes mellitus (DM) is one of the most common metabolic diseases, which is characterized by increased blood glucose levels. DM is the leading cause for chronic kidney disease (CKD) and end-stage renal disease. To estimate the glomerular filtration rate (GFR) of normal healthy controls and type II DM (T2DM) patients using Cockcroft–Gault (CG) formula and to compare the GFR values of normal subjects and T2DM patients (with respect to glycated hemoglobin [HbA1c]). Methods: The total sample size of the study was 60, among which 30 were healthy individuals (controls) and 30 were T2DM patients (subjects with both controlled and uncontrolled HbA1c). A detailed history was taken from the subjects and controls followed by a thorough clinical examination. Blood and urine samples were collected from all the subjects for the estimation of serum creatinine, HbA1c, and urine routine analysis. The GFR is calculated for all the study participants using CG formula, and the results were expressed in the form of graphs and charts. Results: The overall GFR value was well within the normal limits in controls than the subjects. In the present study, the values of GFR were 106.87 + 8.29 and 100.03 + 12.42 in normal healthy controls (Group A) and diabetic subjects (Group B), respectively. In this study, value of HbA1c in healthy control males and females was 6.74 ± 0.39 and6.76 ± 1.04, respectively. Similarly, the value of HbA1c in diabetic subject males and females was 7.32 ± 0.69 and 7.06 ± 1.45, respectively. There was a significant positive correlation between GFR with the degree glycemic control in T2DM of the study population. Conclusion: The present study indicates that the degree of glycemic control in T2DM reflects the ongoing kidney damage by change in GFR of the kidney. The GFR of diabetic subjects is comparatively lower when compared with GFR of normal healthy controls. Our study also shows that there is a higher risk of developing CKD in diabetics with poor glycemic index than diabetics with good glycemic index.
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Neurophysiological and audiological assessment in at-risk infants by brainstem evoked response audiometry in Haryana p. 152
Divya P Wangoo
DOI:10.4103/ijcep.ijcep_40_17  
Background and Aim: Sensorineural hearing loss is a serious neurodevelopmental sequel among high-risk neonates and is one of the most common congenital disorders. To assess the neurophysiological and audiological impairment in at-risk infants in Haryana. Methods: This was a time-bound study of 12 months duration during which 101 at-risk infants visiting SGT Hospital, Haryana, were enrolled for the study. Brainstem evoked response audiometry (BERA) findings in these children were analyzed. Methodology standardized by IFCN Committee and instrument Neurostim NS-2 of Medicaid firm were employed. 10–20 International System of EEG Electrode Placement was used for scalp electrode placement. The data were analyzed using the Statistical Software Package for the Social Sciences version 20. Results: Highly significant prolongation of various latencies and interpeak latencies (IPLs) was observed in the cases. Conclusion: Risk factors known to cause hearing loss affect BERA parameters causing highly significant prolongation of latencies and IPLs, suggesting that at-risk infants are prone to sensorineural hearing loss. Universal newborn hearing screening by BERA can be carried out in children, especially when they come for routine immunization. BERA is the only test that gives precise information about hearing sensitivity in children, especially <1 year of age.
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CASE REPORT Top

Coexistence of epidermal growth factor receptor 19 deletion and 21 point mutation in nonsmall cell lung cancer: A report of 3 cases p. 157
Lu Yunyun
DOI:10.4103/ijcep.ijcep_32_17  
The coexistence of an epidermal growth factor receptor (EGFR) 19 deletion and 21 point mutation represents a rare event in patients with nonsmall cell lung cancer. We present three cases of female patients with lung adenocarcinoma who had the double genetic mutations. The patients were all treated with EGFR tyrosine kinase inhibitors (TKIs) because the tumors were judged inoperable. In all cases, tumor progression occurred after a few months. Further studies are needed to determine whether the EGFR-TKI resistance time in patients with double genetic mutations is longer than that in patients with a single mutation.
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NEWS AND VIEWS Top

News and Views p. 160
Pravati Pal
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