Title: Novel Strategies to Encounter Inflammation and ER Stress in Coronary Artery Disease

Abstract:

Atherosclerosis is the underlying cause of coronary artery disease (CAD) and a disease of multifactorial etiology. Recent investigations in atherosclerosis have been focused on inflammation and endoplasmic reticulum (ER) stress, providing new insights into the mechanism of the disease. Keeping in view the multifactorial aspects of this disease, novel strategies are urgently needed not only for identification of novel biomarkers, but also to search for remedies for prevention and treatment of this disease. C-reactive protein (CRP) is reported to be a biomarker of inflammation in CAD and is shown to actively contribute to the disease pathology. Our data from in vitro studies provided substantial evidence that MMP-TIMP and RAGE-EN-RAGE interactions significantly contribute to the pathophysiology of coronary artery disease.  CRP was found to play a potential role in the induction, amplification, and prolongation of inflammatory response in atherosclerosis via modulating these genes and atorvastatin showed the potential to curb the deleterious effects of CRP. However, it is evident that besides use of several drugs like statins, inflammation persists in CAD patients. Therefore, we conducted studies with Terminalia arjuna (TA), a medicinal plant with a wide variety of applications in traditional medicine and referred to as a cardiotonic in Ayurvedic system of medicine. Evidence in literature demonstrates that TA like atorvastatin possesses pleotropic properties. Studies carried out in our laboratory have clearly demonstrated its anti-inflammatory and antithrombotic properties both in vitro as well as in vivo and in experimental animals. Expression of inflammatory genes eg. was found to be significantly reduced in vitro in a dose and time-dependent manner by Terminalia arjuna. Using a Systems Biology approach, observations of the in vitro study were further validated in a randomized, placebo-controlled, double-blind clinical trial in subjects with stable CAD who received either placebo or T. arjuna (500 mg twice a day; Himalaya) and were followed up to 6 months. TA was shown to attenuate inflammation and played a pivotal role in modulation of both cellular and humoral immunity. Chronic ER stress is implicated in the pathophysiology of atherosclerosis and is found to be associated with apoptosis. Research work in our lab demonstrated that TA specifically targeted early foam cell apoptosis via activation of unfolded protein response pathway. The data from our studies suggests use of a multipronged approach using novel therapies in terms of combination/ adjuvant therapy in clinical studies utilizing indigenous resources of medicinal plants to prevent/treat complex disorders such as CAD.

Biography:

Veena Dhawan has completed her PhD from PGIMER and did post-doctoral research at minneapolis USA and post-graduate institute of medical education and research, chandigarh, India. At present, she is working as a professor in the department of experimental medicine and biotechnology at PGIMER a national institute of repute. She has published around 90 papers in reputed journals and written around seven book chapters.

Title: Iron deficiency anemia in children

Abstract:

Iron deficiency anemia in children

The purpose of the study: Was children with iron deficiency anemia and risk factors that may have affected children compared to non-anemic.

The Material & Methods: In this study are included 343 children; 244 children in the anemic study group and 99 children non-anemic in the control group.

Results: The result indicated that the children diagnosed with iron deficiency anemia consist more of male 57.4% compared to female 42.6% but they have no difference in the statistical significance. The age of these children consisted of approximately 19.2 months old (DS±13.7 months). Anemic children consisting of 62.2% were more often living in the city compared to those of controlling group by 52.5%; this difference had important statistical significance. The average mass of the child of birth body of the study group was 2973.5 gr while those of control group were 3405.7 gr. So, the average mass of the child of birth body of the study group (anemic) was significantly lower compared to children of the control group, which difference was statistically significant. Also, when involved in the study the average mass of the child of birth body of anemic children was much lower compared to the children of control group (difference was statistically significant.) Malnutrition was common in anemic children. Hypotrophy of the first instance was 36.5% and the second degree of hypotrophy was 6.6% of children of the study group. More than half (57.8%) of anemic children are fed with formula milk; 10.7% with commercial milk and 15.6% with natural milk or (cow milk). In 7.8% of cases they have mixed commercial with the formula milk or cow's milk and only one case was of commercial milk with cow's milk. Children of anemic group were less fed with meat, spinach, eggs; they were more fed with cereals compared with the children of control group; the difference consisted statistically significant. The average age of onset of artificial nutrition of children in the study group was 5.0 months; to children in the control group was 4.0 months without any statistically significance difference. Anemic children have started complementary food earlier than control group children with significant difference, which means that they are fed less exclusively breastfeeding and complementary feeding has started if not fed properly. Anemic children in the highest structure of anemic had their mothers anemic as well consisted of 47.1% compared with non-anemic children (27.3%) which difference was statistically significant. Bleeding during childbirth in similar structure of anemic children had mothers from (17.6%) and non-anemic from (18.2%) regardless statistically significant. Children of the study group were more often premature (14.3%) compared to those of control group (5.1%). They often resulted with lower body mass when in birth 29.1% versus 7.1%. More often twins 5.7% compared to those of control group 2.0%. To the anemic children we experienced a decrease in the number of erythrocytes, hemoglobin, MCV, hematocrit, and iron which was approximately 6.2 15.8 compared to the control group.

Conclusion: : From our data it is obvious that iron deficiency anemia is very often disease with many risk factors that can cause disease, as are the nutritional status and other diseases.

Biography:

The deficit of iron and anemia iron are considered as major problems of public health and lack of the most common nutritional worldwide due to their high prevalence, effective on growth and development, resistance to infections and linkage to mortality of less than two year babies. In Kosovo, we have no correct statistics on national level for the prevalence of iron deficiency anemia.