Aparna Misra

Neurocysticercosis: a review on status in India, management, and current therapeutic interventions

Tapeworms (cestodes) are segmented flatworms responsible for causing diseases that may prove fatal and difficult to treat in the absence of proper treatment and efficient drugs. Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system and a major contributor to epilepsy caused by the metacestode (larva) of the human tapeworm Taenia solium, characterized by a range of pathological symptoms including epileptic seizures, headaches, and hydrocephalus. Cysticercosis is considered as a “biological imprint” of the socioeconomic development of a community in general and a country in particular. It is the single most common cause of epilepsy in the resource-poor endemic regions of the world, including most of South and Central America, India, Southeast Asia, China, and sub-Saharan Africa. A vast degree of variation in the neuropathology and clinical symptoms of NCC often makes it difficult to diagnose and manage. To add to it, emerging drug resistance to known anti-parasitic agents, together with the inability of these agents to prevent re-infection and relapse, further complicates the disease scenario. The aim of the current review was to provide the latest update on NCC with special emphasis on the Indian scenario, along with current and novel methods of diagnosis as well as scope of development for novel detection techniques, novel targets for drug development, and therapeutic interventions, as well as future challenges.

Association of creatine kinase and its isoenzymes (CK-MB, CK-BB) activity with high risk pregnancy

Background: Creatine kinase (CK) is a key enzyme of energy metabolism, especially in muscle tissue. CK has two polypeptide chains of M and B, and three isomers, CK-BB, CK-MB and CK- MM. In some conditions like acute myocardial infarction and neuromuscular disorders, increased CK activity is used as a part of diagnosis. CK can also be elevated in absence of neuromuscular diseases or cardiac injury, such as strenuous exercise, intramuscular injections etc. Several reports indicate elevated activity of serum CK in the maternal blood during child birth. This study aimed to correlate total CK and its isoenzymes activity in the cord blood with high risk pregnancies. Methods: This was a Prospective observational study conducted in the Obstetrics and Biochemistry Department of Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. Cord blood of 100 full term newborns was collected and serum was analyzed for total CK and its isoenzymes activity by modified IFCC method. SPSS software was used in data analysis. Results: CK-total and its isoenzymes (CK-MB, CK-BB) activities were observed higher in cases with risk as compared to those without risk. Total CK activity was observed independent while CK-MB and CK-BB were found dependent on different risk factors like pregnancy induced hypertension and fetal distress etc. Conclusions: Present study revealed that high risk pregnancies are associated with increased total CK, CK-MB as well as CK-BB activity.