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Dysregulation of zinc (Zn) homeostasis causes a shift in the Th1/Th2 balance towards a Th2 response, which may lead to a heightened inflammatory response. Asthma is associated with an exaggerated Th2 response to antigens. This study attempts to find the association of serum Zn with the status of symptom control of asthma in children and adolescents with bronchial asthma. A total of 67 asthmatic children, diagnosed as per Global Initiative for Asthma (GINA) 2019 guidelines, were included in the study. Symptom control of asthma was assessed by Asthma Control Test (ACT) and Childhood Asthma Control Test (C-ACT) scores. Spirometry was performed on those participants who were able to perform satisfactorily. Serum Zn was analyzed using the photometric method. Participants were divided into two groups: controlled and uncontrolled groups according to ACT/C-ACT score. Mean age of the participants was 10.78 ± 3.67 years. The mean S. Zn (µg/dL) was 136.97 ± 48.37. This study found a higher mean S. Zn value in the controlled asthma group as compared to the uncontrolled group (158.06 vs 129.23, p = 0.006). At a cutoff of S. Zn (µg/dL) ≥ 126.84, it predicted controlled asthma with a sensitivity of 89% and a specificity of 55%. No significant difference was found between the mean serum Zn levels in terms of age, sex, severity, and CRP levels.A significant difference was observed between the mean value of Zn and symptom control of asthma (p = 0.006) with a weak positive correlation between the two which was statistically significant (rho = 0.26, p = 0.031). However, low levels of zinc were not significantly associated with symptom control of asthma. Thus, we conclude that maintaining an adequate zinc level could help in achieving better control of asthma in pediatric populations.• Zinc has a role in immunological response in the pathophysiology of immunological disorders such as bronchial asthma.• This study adds a significant association of serum zinc levels with symptom control of asthma in pediatric populations. • This study also gives a cut-off value of serum zinc level which predicts adequate symptom control of asthma.

Background: Globally, the number of diabetic patients has quadrupled in last 30 years and diabetes mellitus (DM) is among the major causes of death with rank 9 worldwide. Approximately there is 1 patient with DM in 11 people worldwide. Asia is among the major areas of where T2DM is rapidly emerging into global epidemic. In Asian countries China and India are top two epicenters for this rapidly emerging epidemic. Studies have shown that without immunosuppression in diabetic animal model, normoglycemia is maintained after implantation of encapsulation technique (macro/micro-encapsulation) containing islets at different sites in body. If this study could work well, it will be possible to implant a capsule in diabetic patient reducing dependency on insulin from outside using other methods like multi-layer-by-layer encapsulation. Purpose of this study will be to determine whether encapsulation of pancreatic β-cell in subcutaneous region could protect human islets from rejection and autoimmune destruction in diabetic patients, by overall decreasing insulin dependency in T2DM patients without immunosuppression. Methods and analysis: Protocol will be based on multi-layer-by-layer encapsulation procedure. Discussion: To our knowledge, there are no such studies which are performed in phases making this study to be a best example of evidence based protocol. Appropriate subgroup analysis has been planned while performing animal experimentation. Routine postoperative monitoring have been planned to ensure Ethics and dissemination. Analysis of encapsulation in different conditions i.e. in-vitro and in-vivo will provide diverse data on effects of encapsulated islet cells on different environmental conditions. In-vitro data will be compared with in-vivo data in order to find out detailed successful results. According to this protocol, if we will be able to develop encapsulated human islet cells that will produce insulin and decrease insulin dependency then this study will be a novel interventional research to decrease burden of insulin therapy in low income population such as of India.

Chronic cervical spondylitis (CCS), a degenerative disorder of the spine, is known for causing disability among old and young people. Single-nucleotide polymorphisms (SNPs) in various cytokine genes have demonstrated an impactful association with several inflammatory disorders. In the present study, we have investigated the SNPs and allelic distribution of the three most prevalent cytokines genes, IL-1β (-511C/T), TNF-α (-308G/A), and TGF-β (-509C/T), along with serum levels of these cytokines in 252 subjects. SNPs were analyzed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and digested fragments were separated and visualized using agarose gel electrophoresis and Native Polyacrylamide gel electrophoresis (PAGE). The serum cytokine levels were analyzed with a flow cytometer using a customized multiplex bead-based assay. It was observed that these SNPs did not reflect the susceptibility to CCS but were associated with susceptibility to CCS. We found a significant association between the C/C and G/G genotypes and the C and G alleles of IL-1β and TNF-α, respectively, suggesting a lower risk of CCS. The frequency distribution of risk alleles (-511T) and (-308A) were simultaneously higher in CCS compared to the control, reflecting the susceptibility to CCS. TGF-β showed a significant association with disease susceptibility, along with a significant correlation between age and the chronicity of CCS. The serum cytokine levels were significantly different in CCS and controls.

A bidirectional relationship is seen between periodontal disease and diabetes mellitus. Adipokines like resistin and chemerin act as a proinflammatory molecule. Their action is mediated by the generation of pro-inflammatory cytokines and the stimulation of inflammatory cell chemotaxis to the site of inflammation. This study aimed to compare the levels of resistin and chemerin in saliva in diabetes mellitus type 2 and chronic periodontitis after non-surgical periodontal therapy (NSPT). Forty-five subjects were recruited and divided into three groups – healthy controls (Group A), chronic periodontitis (Group B) and diabetes mellitus type 2 with chronic periodontitis (Group C). Group B and C received NSPT. The parameters included were gingival index, plaque index, clinical attachment loss and probing pocket depth which were evaluated at baseline and end of three months. Levels of resistin and chemerin in saliva were evaluated using resistin and chemerin enzyme linked immunosorbent assay (ELISA) kit.At 3 months, PI, GI, PPD and CAL was reduced statistically significant in B and C groups as compared PI and GI of group A. Salivary resistin and chemerin levels were also reduced significantly in all three groups except chemerin in group A. Mean salivary resistin and chemerin levels at baseline were highest in group C followed by group B and least in group A.Non-surgical periodontal therapy reduces all clinical variables, resistin and chemerin levels. Salivary resistin and chemerin levels can be used as a likely biomarker to assess the outcome following NSPT.

Ferritin is a known inflammatory biomarker in COVID-19. However, many factors and co-morbidities can confound the level of serum ferritin. This current metaanalysis evaluates serum ferritin level in different severity levels in COVID-19. Studies evaluating serum ferritin level in different clinical contexts (COVID-19 vs. control, mild to moderate vs. severe to critical, non-survivor vs. survivor, organ involvement, ICU and mechanical ventilation requirement) were included (total 9 literature databases searched). Metaanalysis and metaregression was carried out using metaphor “R” package. Compared to control (COVID-19 negative), higher ferritin levels were found among the COVID-19 patients [SMD −0.889 (95% C.I. −1.201, −0.577), I2 = 85%]. Severe to critical COVID-19 patients showed higher ferritin levels compared to mild to moderate COVID-19 patients [SMD 0.882 (0.738, 1.026), I2 = 85%]. In meta-regression, high heterogeneity was observed could be attributed to difference in “mean age”, and “percentage of population with concomitant co-morbidities”. Non-survivors had higher serum ferritin level compared to survivors [SMD 0.992 (0.672, 1.172), I2 = 92.33%]. In meta-regression, high heterogeneity observed could be attributed to difference in “mean age” and “percentage of male sex”. Patients requiring ICU [SMD 0.674 (0.515 to 0.833), I2 = 80%] and mechanical ventilation [SMD 0.430 (0.258, 0.602), I2 = 32%] had higher serum ferritin levels compared to those who didn't. To conclude, serum ferritin level may serve as an important biomarker which can aid in COVID-19 management. However, presence of other co-morbid conditions/confounders warrants cautious interpretation.

Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD), the two most significant physicochemical indicators, we find higher in water samples from plain regions than from hilly regions. Mean levels of As, Pb, Hg, Cd, Cr, Zn, and Ni were 5.48, 1.060, 4.4, 0.728, 3.5, 2.93, 26.56, and 7.68 (µg/L), respectively, in water samples, was within normal ranges, except Arsenic, which was found in higher at shukartal site > 10 µg/L. A marked correlation was observed between the physicochemical quality of water and bacterial density. The presence of specific bacterial strains, e.g. Enterococcus, Pseudomonas, Klebsiella, and Proteus spps., in higher concentrations suggests a significant level of faecal contamination in water. The Most Probable Number, Escherichia coli count, total coliform count, faecal streptococci count and faecal coliform count were discovered in the regions of Rishikesh, Roorkee, and Shukartaal, indicating that the total bacterial count was higher than the permitted range (GR1, GRR, and GS). The spatial distribution of the Hazardous index (H.I.) in the study area revealed a rising trend of environmental leaching from mountainous parts to plain regions. Children were at a higher carcinogenic risk compared to adults both males and females. The study recommends prevention and safeguarding against anthropometric variables.

Insulin resistance (IR) plays an important role as a major determinant of Metabolic syndrome (MetS). Various methods are available for measuring insulin resistance but they are laborious, time-consuming, and costly. Therefore various surrogate markers and indices have been devised to simplify and improve the determination of insulin resistance. Recently, a new index, single point insulin sensitivity estimator (SPISE) was proposed in the European population and was found comparable to the gold standard test (hyperinsulinemic euglycemic glucose clamp).This study was planned to evaluate whether SPISE could be a useful potential low-cost indicator for predicting MetS with IR patients in Indian population. Eighty-three participants from outpatient care of AIIMS Rishikesh were evaluated after informed consent. They were divided into Metabolic syndrome (n = 56) and Non Metabolic Syndrome(n = 27), using South Asian Modified National Cholesterol Education Program- ATP-III criteria for metabolic syndrome. SPISE index, HOMA-IR, Insulin Resistance Index, Triglycerides to high-density lipoproteins cholesterol ratio (TG/HDL-C) were calculated for all the subjects. Receiver operating characteristic (ROC) curve was plotted to assess discriminatory ability of SPISE, HOMA-IR, TG/HDL-C ratio, IRI and hs-CRP to differentiate between IR(Metabolic syndrome) and non-IR (Non-Metabolic syndrome) subjects. SPISE has greater area under curve with better sensitivity and specificity compared to HOMA-IR, IRI, TG/HDL-C ratio and hs CRP. So, SPISE has better predictive ability than HOMA-IR, IRI, TG/HDL-C ratio and hs CRP to discriminate IR from non-IR cases. SPISE could be a useful potential low-cost indicator with high sensitivity and specificity for predicting IR in MetS patients.

Hypertension is the most common chronic disease of older adults and an important modifiable cause of mortality and morbidity. In this cross-sectional study, we gathered information about the demographic profile and biochemical parameters associated with hypertension in 897 study subjects above 50 years by structured questionnaires and various laboratory investigations. Higher body mass index, sedentary lifestyle, male sex, living alone, diabetes mellitus, alcohol consumption, medication non-compliance, and a higher serum cholesterol level were associated significantly with uncontrolled hypertension in our study. Hence, weight reduction, adopting an active lifestyle, improving social support, and strict compliance with anti-hypertensives are the cornerstones of blood pressure control.

Control of diabetes is a constant challenge and natural remedies are being searched along with modern medicine. The effectiveness of cinnamon in managing it lacks consensus. Besides this, earlier trials had a variant in the type of product they used, quantity, duration, the form of molecules, etc. So, we aimed to measure the impact of cassia ground bark powder consumption, 1-2 gm/day for 90 days, in lowering plasma glucose and lipids among those with type 2 diabetes. The authors searched the PubMed, Medline, Embase, CINAHL, Clinical Key, Ovid, and Scopus databases and the Cochrane Central Register (last search December 30, 2020) with the MeSH terms and keywords of cinnamon, cassia cinnamon, Chinese cinnamon, and type 2 diabetes mellitus to conclude the effects of cassia cinnamon on diabetes based on the evidence of human clinical trials that reported at least one of the following: glycosylated hemoglobin (HbA1C), fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Weighted mean differences were calculated by using the random-effect model of RevMan software (The Cochrane Collaboration, London, UK), and the pooled analysis found an insignificant reduction of the outcome variable (p>0.05).

In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5–10% are symptomatic and only 1–2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria’s and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.

Background and aims Latent Autoimmune Diabetes of Adulthood (LADA) is different from type 2 diabetes. Present treatment protocols do not reflect that. DPP-4 and SGLT2 inhibitors have changed therapy. DPP-4 inhibitor use has shown delayed decline in beta-cell reserve in LADA. We studied patients with low c-peptide to assess relationship between c-peptide and anti-GAD65 antibody levels and compare DPP-4 inhibitors with SGLT2 inhibitors and sulphonylureas. Methods The study was an open-label trial conducted in 156 participants with low c-peptide ( 25 years, recently diagnosed diabetes with HBA1c ≥ 6.5%. Participants were enrolled into three arms: Group A received sulphonylureas + metformin, Group B received DPP-4 inhibitors + metformin, and Group C received SGLT-2 inhibitors + metformin. Serum anti-GAD-65 antibodies were assessed using sandwich ELISA. Participants were assessed on enrolment and after three months of dual pharmacotherapy. Results The three arms were comparable on enrolment. 52% of participants with low c-peptide had high anti-GAD65 antibody titers. Significant differences were observed after three months - DPP-4 inhibitors reduced HbA1c by 1.1 ± 0.3%, compared to SGLT2 inhibitors (0.8 ± 0.13%) and sulphonylureas (0.7 ± 0.3%) Conclusion DPP-4 inhibitors appear to provide better glycemic control than alternate therapeutic options in patients with low serum c-peptide.

Introduction: More than 70% of lung cancer comprises nonsmall-cell lung carcinoma and is associated with poor survival outcome owing to late diagnosis. Identification of lung cancer in early stages when no clinical signs or symptoms are evident, can drastically improve the prognosis. To this end, we aimed to evaluate the changes occurring at tissue level by assessing the expression of six microRNAs (miRNAs) in lung adenocarcinoma (AC) and squamous cell carcinoma (SCC). Materials and Methods: Peripheral blood of histopathologically proven cases of lung AC and SCC was collected and processed for the isolation of miRNAs using commercially available kit. Primers against mir-2114, mir-2115, mir-2116, mir-2117, mir-449c, and mir-548q with loading control Caenorhabditis elegans were used. Screening was carried out in thirty cases of both AC and SCC, whereas twenty healthy controls were included. Results:Real-time polymerase chain reaction data revealed that the expression of mir-2114 and mir-449c in AC and mir-2115 in SCC was significantly upregulated. The expression of these miRNAs was also confirmed in lung AC cell line. The differential pattern of expression of these miRNAs can be used for precise diagnosis of lung carcinoma Conclusions: We have used a noninvasive technique to identify the subtype of lung cancer based on molecular genetic signatures. The results suggest that through molecular profiling of miRNA, we can screen high-risk cases for cancer interception.

Background: Globally, high blood pressure (BP) is a main health problem among adult population. High BP is considered as a major risk factor which may lead to many cardiovascular diseases. Globally, it is also the leading cause of death. According to the American Heart Association, a BP of 120/80 mm of Hg is a normal range but when the systolic blood pressure ≥130 and diastolic blood pressure ≥80, it is always labeled as hypertension. Objectives: In the present study, the researchers wanted to identify the prevalence of undiagnosed elevated blood pressure in the adult population of Uttarakhand, India and also try to explore its lifestyle-related risk factors. Methods: This study was an exploratory survey with a cross-sectional design. Data were collected from 440 participants by using the cluster sampling technique. Results: The male:female ratio among participants was 1:4 and most of the participants were aged 25–30 years. The study found that the prevalence of high blood pressure was 26%, in which marginal elevated BP prevalence was 16%, hypertension stage I was 7%, and hypertension Stage II was 3% which is significantly higher in number at a young age. Lifestyle-related risk factors showed a significant association of hypertensive status with gender, consumption of balanced diet, and personal habits. This increases the chances of elevated blood pressure in young adults. Conclusion: All health professionals must be sensitized for elevated blood pressure problems among the young adult populations. Elevated blood pressure should be considered as a warning alarm at an early age when prescribing any medication and during any invasive procedure. Awareness should be created among public regarding elevated blood pressure issues at a younger age and motivate people to adopt a healthy and stress-free lifestyle.

Background: Hypertension is one of the leading causes of premature death worldwide and is a major risk factor for cardiovascular disease and all-of them cause mortality. Out of the estimated 1.13 billion people who have hypertension, less than 1 in 5 people have it under control. Aim and Objectives: To study the prevalence of hypertension and associated risk factors in the urban population of Rishikesh and the association of hypertension with other determinants. Methodology: A community based cross-sectional study was conducted in an urban area of Rishikesh. The World Health Organization (WHO) steps instrument and protocol was used for the assessment of risk factors and measurements. i.e. anthropometry and blood pressure. Sample size was calculated to be 478. Data was entered and analyzed using SPSS Version 20.0. Appropriate statistical tests were done. A P value of < 0.05 was considered significant. Results: The prevalence of hypertension in urban Rishikesh is 32.4%. The prevalence in male and female is 34.5% and 31.3% respectively. Among hypertensives 45.8% had hypertriglyceridemia, 32.2% had low high-density lipoproteins (HDL), 52.25% had fasting blood glucose more than 100, and 55.4% were obese individuals. Multivariate logistic regression analysis identified that age, waist circumference, body mass index, triglycerides level, and physical activity were independently associated with hypertension. Conclusions: As the prevalence of hypertension and cardiometabolic risk factors were higher, necessary health interventions were required to reduce the morbidity/mortality of the disease.

Background: Sleep disturbances and stress may intervene with the physiological processes in human body and act as a modulator of metabolic homeostasis. The aim and objectives of the study were to estimate the person’s average sleep propensity; to estimate the stress level in the study subjects; and to determine the association of sleep and stress with metabolic syndrome.Methods: A community based cross sectional study was conducted in an urban area of Rishikesh. Sample size was calculated to be 478. Data was entered and analyzed using SPSS Version 20.0. Chi-square test was used to examine the association between categorical variables. A p value of

Multiple myeloma (MM) is a plasma cell malignancy frequently accompanied with skeletal co-morbidity. Vitamin D (1,25(OH)2D) is an important mediator of skeletal homeostasis that mediates its effect by binding to vitamin D receptor (VDR), a steroid family receptor and modulates various downstream pathways. Multiple polymorphisms have been determined in VDR gene that witnessed significant association with cancer development and progression. Therefore, in this maiden study, we recruited 75 newly diagnosed MM patients and 75 control subjects. 25-hydroxy vitamin D (25(OH)D) levels were measured in all recruited study subjects. Further, PCR-RFLP was performed in DNA samples of recruited study subjects. Results demonstrated significantly decreased 25(OH)D levels in MM patients compared to controls. Additionally, decreased 25(OH)D levels in MM patients inversely associated with disease severity. Further, single nucleotide polymorphism (SNP) analysis of VDR gene showed significantly higher risk of MM disease development in Ff + ff, Aa + aa, and Bb + bb genotypes. Additionally, FokI f, ApaI a and BsmI b alleles were significantly associated with MM occurrence. In conclusion, this study provided initial evidences of association between 25(OH)D insufficiency, VDR gene polymorphism and MM development. Thus, we suggest that a study involving assessment of 25(OH)D levels and VDR gene polymorphism in large patients’ cohort might substantiate their role in MM development which would further provide impetus to give 25(OH)D supplementation along with conventional chemotherapeutic agents for myeloma treatment in future.

Background: Noncommunicable diseases include heart disease, stroke, cancer, diabetes, and chronic lung diseases and are collectively responsible for almost 70% of all deaths worldwide. Metabolic syndrome (MetS) predisposes to coronary artery disease irrespective of age, gender, or family history of diabetes. Aim and Objectives: The aims of this study were as follows: (1) to assess the prevalence and its predictors of obesity among the urban population, (2) to analyze the association of obesity with MetS, and (3) to analyze the correlation of obesity with different components of MetS. Materials and Methods: A community-based cross-sectional study was conducted in an urban area of Rishikesh. The World Health Organization STEPS instrument and protocol were used for the assessment of risk factors and measurements. The sample size was calculated to be 478. Data were analyzed using SPSS version 20.0. Appropriate statistical tests for bivariate and multivariate analysis were done. P < 0.05 was considered statistically significant. Results: The prevalence of MetS among obese individuals was significantly higher (57%) according to the National Cholesterol Educational Program Adult Treatment Panel 3 definition (P < 0.001). The prevalence of MetS in male and female obesity was 56.8% and 57.1%, respectively. Body mass index was significantly correlated with systolic blood pressure (BP) (r = 0.238, P = 0.001), diastolic BP (r = 0.281, P = 0.001), Fasting blood glucose (FBG) (r = 0.136, P = 0.003), and triglycerideTriglycerides (TG) (r = 0.12, P = 0.009) and negatively correlated with High Density Lipoproteins (HDL) (r = −0.041, P = 0.37). Whereas, waist–hip ratio was significantly correlated with systolic BP (r = 0.277, P = 0.001), diastolic BP (r = 0.251, P = 0.001), FBG (r = 0.232, P = 0.001), and TG (r = 0.273, P = 0.001) and not with HDL (r = 0.033, P = 0.466). Conclusions: As the prevalence of MetS is higher among obese individuals, health interventions required to reduce the morbidity/mortality and need to be addressed in adult populations.

INTRODUCTION: Lung cancer (LC), among all other cancers, is the leading cause of death worldwide, while the third most common cancer-causing mortality in India. Several techniques of the assay for early detection of cancer that improve survival rates have been employed in tissues and cell lines. Reverse transcriptase quantitative polymerase chain reaction (RTqPCR) is one of the most common techniques employed for gene expression studies for the normalization of a target gene using a reference gene (RG). The present study used the three most common RGs: glyceraldehyde-3-phosphate dehydrogenase (GAPDH), β-Actin, and 18s ribosomal ribonucleic acid (18s rRNA), which were assessed by qPCR to validate, as of which is a more effective RG in blood samples of LC patients. MATERIALS AND METHODS: A total of thirty participants with LC of non-small cell and small cell type were included along with twenty healthy controls. Ribonucleic acid (RNA) isolated from peripheral blood mononuclear cells was quantified, prepared for complementary deoxyribose nucleic acid synthesis, and analyzed for expression of three RG on RTqPCR. RESULTS: Expression levels as Ct values of studied RG were reported as mean ± standard deviation for GAPDH (26.97 ± 5.107), β-actin (20.5 ± 2.3), and 18s rRNA (25.10 ± 4.075). GAPDH showed the lowest expression, whereas β-actin showed the highest expression among the studied RG in subjects of LC. The expression of GAPDH and 18s rRNA were statistically significantly lower than β-actin (p < 0.0001), whereas expression levels of GAPDH and 18s rRNA were comparable. However, the expression level of only β-actin in LC patients was comparable with healthy controls with P < 0.1611 at 95% confidence interval. CONCLUSION: It is concluded that β -actin may be considered the most suitable RG isolated and studied from peripheral blood mononuclear cells using RT qPCR in LC.

As per the third consensus meeting of Indian Menopause Society reports, the number of postmenopausal women in India is approximately 43 million and it is projected to be 103 million by 2026. While the average age for menopause in India is 47.5 years, there is an alarming increase of premature menopause among the Indian women has been reported recently. It has been observed that, nearly four per cent women of age group of 29-34 years attain menopause and its incidence increases to eight per cent in women of age group between 35 and 39 years. The reason for this early menopause is still unclear, but it is a major public health problem because of its influence on the development of components of metabolic syndrome. Despite HRT improves postmenopausal complications, the prolonged use of HRT was not recommended now due to its influence on the development of certain types of cancers; endometrial cancer and breast cancer in addition to its negative impact on cardiovascular diseases. Hence, understanding the cellular and molecular mechanisms which amenable for the pathogenesis of postmenopausal complications may open new clinical therapeutic targets for the management of these complications. Soy isoflavones, a natural phytoestrogen, which shares the structural and functional homogeneity with estrogen. Several studies have reported that soy isoflavones have beneficial effects against ovariectomy (surgical menopause) as well as diet induced metabolic complications in animal models; however, its efficacy in terms of improving metabolic complications associated with postmenopausal state is largely unclear.

Background.Status of folic acid use in pregnant women of the hilly regions in North India was little known. This study was carried out to assess the folic acid use and estimate folate metabolites in pregnant women of this region.Materials and Methods. This cross-sectional study is comprised of 76 pregnant women, whose folic acid supplementation was assessed by a questionnaire and serum levels of homocysteine, tetrahydrofolic acid (THFA), and dihydrofolate reductase (DHFR) were estimated using Enzyme Linked Immunoassays.Results.The study data revealed awareness of folic acid use during pregnancy was present in 46.1% and 23.7% were taking folic acid supplements. The study depicted that there was no statistically significant difference between serum levels of THFA and DHFR in pregnant women with and without folic acid supplements (p=0.790). Hyperhomocysteinemia was present in 15.78% of the participants.Conclusion.Less awareness about folic acid supplementation and low use of folic acid by pregnant women were observed in this region. Sufficient dietary ingestion may suffice for the escalated requirements in pregnancy, but since this cannot be ensured, hence folic acid supplementation should be made as an integral part of education and reproductive health programs for its better metabolic use, growth, and development of fetus.