A Statistical Analysis and Comparison of the spread of Swine Flu and COVID-19 in India

@#Introduction: The world is currently experiencing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [COVID-19], however, this is not a new phenomenon; it occurred in 2009-2010 in the form of novel influenza A. (H1N1). The H1N1 virus primarily afflicted people between the ages of 26 and 50, but SARS-CoV-2 primarily afflicted those over the age of 60, increasing the number of deaths owing to their weakened immunity. The report provides a case study of the impact of H1N1 and SARS-CoV-2 in India. Methods: Data is obtained from The Hindustan Times newspaper, GoI press releases and World Health Organization (WHO) reports. Results: The incidence rate was initially low and it was only by the 10-15th week that it started increasing. There is an initial upward trend before levelling out followed by a second wave and third wave. COVID-19 exhibited a steeper growth, where the steps taken by the Government were ineffective leading to higher death cases. Kerala was affected due to the travellers returning from the Middle East, while Maharashtra and Delhi saw large incidence rates due to the migrant influx and communal gathering. Conclusion: The most effective and practical approach is to test the symptomatic patients and aggressive testing to contain the transmission. Awareness campaigns to educate the public about social distancing and personal hygiene is more practical. There is still scope of improvement with regards to the public health care support, preparedness and response. Lockdown measures could have been avoided if the initial screening was conducted properly.

Effects of nerve cells and adhesion molecules on nerve conduit for peripheral nerve regeneration

BACKGROUND: For peripheral nerve regeneration, recent attentions have been paid to the nerve conduits made by tissue-engineering technique. Three major elements of tissue-engineering are cells, molecules, and scaffolds. METHODS: In this study, the attachments of nerve cells, including Schwann cells, on the nerve conduit and the effects of both growth factor and adhesion molecule on these attachments were investigated. RESULTS: The attachment of rapidly-proliferating cells, C6 cells and HS683 cells, on nerve conduit was better than that of slowly-proliferating cells, PC12 cells and Schwann cells, however, the treatment of nerve growth factor improved the attachment of slowly-proliferating cells. In addition, the attachment of Schwann cells on nerve conduit coated with fibronectin was as good as that of Schwann cells treated with glial cell line-derived neurotrophic factor (GDNF). CONCLUSIONS: Growth factor changes nerve cell morphology and affects cell cycle time. And nerve growth factor or fibronectin treatment is indispensable for Schwann cell to be used for implantation in artificial nerve conduits.

Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States

PURPOSE: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. MATERIALS AND METHODS: Data was analyzed on men diagnosed with localized prostate cancer between 2004–2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. RESULTS: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was 725 cGy × 5 fractions (49.6%) followed by 700 cGy × 5 fractions (21.3%). CONCLUSIONS: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently 700-725 cGy × 5 fractions appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

Comparative effect of cane syrup and natural honey on abdominal viscera of growing male and female rats.

The high intake of refined sugars, mainly fructose has been implicated in the epidemiology of metabolic diseases in adults and children. With an aim to determine whether honey can substitute refined sugars without adverse effect, the long-term effects of natural honey and cane syrup have been compared on visceral morphology in growing rats fed from neonatal age. Honey increased the caecum and pancreas weights in male rats, which could enhance enzymatic activities of pancreas and digestive functions by intestinal microflora of caecum. Unlike honey, cane syrup caused fatty degenerations in the liver of both male and female rats. Honey enhanced intestinal villi growth, and did not cause pathology in the rodents’ abdominal viscera, suggesting potential nutritional benefit as substitution for refined sugars in animal feed.

Continuous ambulatory peritoneal dialysis catheter placement: is omentectomy necessary?

There are different methods of continuous ambulatory peritoneal dialysis [CAPD] catheter placement. Open surgical technique is a widely followed method. The complication rate following catheter placement varies and catheter blockage due to omental plugging is one of the main reasons. To analyze the need for routine omentectomy during CAPD catheter placement. This was a retrospective analysis of 58 CAPD catheter placements performed between July 2002 and June 2007. Tenckhoff double cuffed catheter was used in all. The postoperative complications were analyzed. There were 44 males and 14 females. The mean age was 51 years ranging from 15 to 76 years. Of these, 40 [69%] patients underwent omentectomy [group A] and 18 [31%] did not [group B]. Laparoscopic and open techniques were performed in 5 and 53 patients, respectively. Omentectomy was not performed in 13 patients with open technique and all the five in the laparoscopic group. One patient in group A developed hemoperitoneum which was treated conservatively. None from group A developed catheter blockage, whereas five [27.8%] from group B developed catheter blockage postoperatively. The median time interval between the primary procedure and development of catheter blockage was 45 days [ranged from 14 to 150 days]. Omentectomy during CAPD catheter placement prevents catheter blockage and secondary interventions

Cystic artery pseudoaneurysm after laparoscopic cholecystectomy presenting as haemobilia: a case report.

Cystic artery pseudoaneurysm which developed following a cholecystectomy and resulting in upper gastrointestinal bleeding is a rare entity, with only three cases described in the literature. We report the case of a 26-year old man who presented with upper gastrointestinal bleeding approximately three months after laparoscopic cholecystectomy. Emergency abdominal angiogram revealed a cystic artery stump pseudoaneurysm, with no evidence of active contrast extravasation. The pseudoaneurysm was coil embolised and the patient had no further bleeding episodes. In this situation an angiogram and embolisation rather than surgery is the preferred mode of management both in terms of diagnosis and treatment. The presence of a dilated cystic artery stump on angiogram following cholecystectomy is an "ominous sign", even in the absence of active extravasation of contrast.

Aciclovir resistance among Indian strains of Herpes simplex virus as determined using a dye uptake assay.

Resistance to aciclovir (ACV) among Herpes simplex virus (HSV) isolates is increasingly being reported in the literature particularly in immunocompromised patients. However, there is only limited data available from India despite widespread use of ACV in our hospital. A cross-sectional study was hence conducted to determine the aciclovir (ACV) susceptibility of HSV 1 and 2 isolates using a dye uptake (DU) assay. This study showed a 3.0% prevalence of ACV resistance among HSV-1 strains (2/66, median IC 50 0.098 microg/mL) while in HSV-2 strains, it was 7.8% (5/64, median IC 50 0.195 microg/mL). The IC 50 for the HSV-1 and HSV-2 strains resistant to ACV was greater than or equal to 6.25 microg/mL.

Mini Mental State Examination and the Addenbrooke's Cognitive Examination: Effect of education and norms for a multicultural population.

OBJECTIVE: To derive population norms on the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) and the inclusive Malayalam mini mental state examination (M-MMSE). MATERIALS AND METHODS: Education-stratified norms were obtained on randomly selected cognitively unimpaired community elders (n = 519). RESULTS: Valid data on norms was available on 488 subjects (age 68.5 +/- 7.1 and education 7.9 +/- 5.4). Education and age, but not gender had a significant effect on both M-ACE and M-MMSE. When compared to the effect of age, the effect of education was sevenfold more on the M-ACE and ninefold more on the M-MMSE. The mean composite score on the M-ACE (and the M-MMSE) was 42.8 +/- 9.8 (14.9 +/- 3.1) for those with 0 (n = 72), 55.9 +/- 12.5 (19.7 +/- 4.1) with 1-4 (n = 96), 62.6 +/- 11.4 (21.9 +/- 3.7) with 5-8 (n = 81), 77 +/- 10.2 (25.7 +/- 2.4) with 9-12 (n = 136) and 83.4 +/- 7.2 (26.7 +/- 1.6) with> 12 (n = 103) years of formal education. CONCLUSIONS: Education has the most potent effect on performance on both M-ACE and M-MMSE in the Indian cohort. Education-stratified scores on the M-ACE and the M-MMSE, will provide a more appropriate means of establishing the cognitive status of patients. It is also our feeling that these cut-off scores will be useful across India.

A hospital based study on the prevalence of conjunctivitis due to Chlamydia trachomatis.

BACKGROUND & OBJECTIVES: Very few studies have been done in India to determine the prevalence of Chlamydia trachomatis causing conjunctivitis using polymerase chain reaction (PCR) methods. Hence the prevalence of primary conjunctivitis due to C. trachomatis among individuals attending ophthalmic hospitals in Chennai was determined and compared with our earlier results. METHODS: A total of 328 conjunctival swabs from 255 (both eyes 73 and one eye 182) patients were investigated by fluorescent antibody test (FAT) on direct smears, culture and PCRs for cryptic plasmid and major outer membrane protein (MOMPI) gene of C. trachomatis. An infant with ophthalmia neonatorum was also included. RESULTS: Among these 328 specimens processed, 16 (4.9%) from 12 (4.7%) patients were positive by cryptic plasmid PCR. Among these, 3 from 2 patients were positive by FAT (direct smear), culture and PCR for MOMP 1 gene. Both eyes of the infant with ophthalmia neonatorum were positive by all the methods. The sensitivity of FAT and culture (18.8%) was lower compared to PCR. INTERPRETATION & CONCLUSION: A significant decrease in the prevalence of adult chlamydial conjunctivitis has occurred in the 10-year period among patients reporting to the ophthalmic hospitals in Chennai. PCR using cryptic plasmid primers was found to be the most sensitive method to detect C. trachomatis in patients with conjunctivitis.

Prevalence of hyperglycemia among patients taking atypical antipsychotics seen at the UP-Philippine General Hospital

OBJECTIVE: To determine the prevalence of hyperglycemia among patients taking anti-psychotics in a hospital setting. METHODOLOGY: Twenty-one patients seen at the out patient department and admitted to the in-patient service of UP-PGH, who were taking atypical anti-psychotics such as amisulpiride, clozapine, olanzapine, quetiapine, and risperidone, were screened for hyperglycemia using serum fasting glucose. RESULTS: None of the twenty-one patients taking any of the atypical anti-psychotics tested positive for hyperglycemia. CONCLUSION: Hyperglycemia was not prevalent among this sample of patients taking atypical anti-psychotics.

Recomendação de procedimentos da Sociedade Americana de Fisiologia do Exercício (ASEP) I: avaliação precisa da força e potência muscular / Procedures recommendation I: accurate assessment of muscular strength and power

Este manuscrito visa a ajudar o leitor a coletar dados válidos e confiáveis para quantificar a força e a potência muscular. Vários inconvenientes e desvantagens de testes específicos, assim como recomendações para praticantes também são apresentadas. O conteúdo é dividido em seções, abrangendo modos de exercício isométrico, isotônico, testes de campo e isocinéticos. Inerentes a esses modos estão ambas as ações musculares concêntricas e excêntricas, assim como as atividades de cadeia cinética aberta e fechada. Para o teste isométrico, as contrações devem ocorrer com uma duração de quatro a cinco segundos com um período de transição de um segundo no início da contração. Ao menos um minuto de descanso deve ser oferecido entre as contrações. Para cada músculo testado, em cada posição, no mínimo três contrações devem ser executadas, embora outras possam ser executadas se julgadas necessárias pelo examinador. Para o teste isotônico, o teste de 1-RM deve ser executado. Após o aquecimento geral, o indivíduo deve executar uma série de aquecimento específico de 8 repetições a aproximadamente 50% da 1-RM estimada, seguida por outra série de três repetições a 70% da 1-RM estimada. Os levantamentos subseqüentes são repetições simples com cargas progressivamente mais pesadas até a fadiga. Repete-se até que a 1-RM seja determinada com o nível desejado de precisão. O intervalo de descanso entre as séries não deve ser menor que um e maior que cinco minutos. O número ótimo de repetições simples varia de três a cinco. Os dados e diretrizes dos seguintes testes de campo também são fornecidos: salto vertical, supino, Teste ciclístico anaeróbico de Wingate (WAT), e o Teste Margaria de corrida em escada (Teste de potência de Margaria). Para o teste isocinético, são fornecidos detalhes sobre o pico de torque, trabalho, potência, endurance e estimativa dos percentuais dos tipos de fibra.

The content of this manuscript is intended to assist the reader in collecting valid and reliable data for quantifying muscular strength and power. Various drawbacks and pitfalls of specific tests, as well as recommendations for the practitioner are also provided. The content is divided into sections covering isometric, isotonic, field tests, and isokinetic modes of exercise. Inherent in these modes are both concentric and eccentric muscle actions as well as both open and closed kinetic chain activities. For Isometric testing, contractions should occur over a four to five seconds duration with a one second transition period at the start of the contraction. At least one minute of rest should be provided between contractions. For each muscle tested at each position, at least three contractions should be performed although more may be performed if deemed necessary by the tester. For isotonic testing, the 1-RM test should be performed. After the general warm-up, the subject should perform a specific warm-up set of 8 repetitions at approximately 50% of the estimated 1-RM followed by another set of 3 repetitions at 70% of the estimated 1-RM. Subsequent lifts are single repetitions of progressively heavier weights until failure. Repeat until the 1-RM is determined to the desired level of precision. The rest interval between sets should be not less than one and not more than five minutes. The optimal number of single repetitions ranges fADM three to five. Data and guidelines of the following field tests are also provided; vertical jump, bench press, Wingate anaerobic cycle test (WAT), and the Margaria stair-run test. For isokinetic testing, details are provided for testing peak torque, work, power, endurance, and estimation of fiber type percentages.

Tissue engineering in the twenty-first century

In the 20th century, free tissue transfers have been successfully introduced using microvascular anastomosis techniques. Transplants not only include whole organs such as the kidney, liver and lung, but also bone, muscle and skin. However, there are a limited number of organs available for transplantation. This leads to the patient not only suffering from the malfunctioning tissue or organ, but also from the psychological trauma of an indefinite waiting period. The rapidly evolving field of tissue engineering is beginning to have an impact on free tissue transfers including organ. Small biopsy specimens can be grown into a large number of cells. These cultured cells can then be seeded onto biodegradable polymers, which serve several purposes. Firstly, the polymers function as a cell delivery system that enables the transplantation of a large numbers of cells into an organism. Secondly, they create a three-dimensional space for cell growth and serve as a template, thereby providing a structure for the extracellular matrix. These approaches have been demonstrated as practical strategies for the reconstruction of many tissues such as the liver, intestines, heart valve leaflets, bone and cartilage.

Anticonvulsant profile of Siotone granules, a herbal preparation.

Siotone granule, a herbal psychotropic formulation was tested for its effectiveness in various models of convulsions in animals. S. granule (100 and 200 mg/kg) offered significant protection against pentylenetetrazol-, maximal electroshock- and strychnine-induced convulsions. In hypoxic stress-induced convulsions only 200 mg/kg was effective. It also reduced percent mortality per se and rendered total protection when given in combination with sub-protective dose of diazepam (0.5 mg/kg) and MK-801 (0.1 mg/kg) against pentylenetetrazol-induced convulsions. The anticonvulsant action of S. granule was blocked by flumazenil (4 mg/kg) suggesting the involvement of GABAergic mechanism.

A case-control study of human papillomavirus and cervical squamous intraepithelial lesions (SIL) in Harris County, Texas: differences among racial/ethnic groups

Foi realizado um estudo caso-controle para analisar a associaçäo entre lesöes intra-epiteliais escamosas do colo uterino (SIL) e HPV entre mulheres brancas, negras e latinas em Harris County, Texas. Os casos foram identificados na M. D. Anderson Cancer Center Colposcopy Clinic, e os controles foram obtidos realizando-se exame de Papanicolau em duas clínicas do Departamento de Saúde. O HPV foi detectado por meio de ensaio de PCR (primer MY09/MY11). Foram construídos modelos de regressäo logística para estimar as odds ratios ajustadas (AOR), e seus intervalos de confiança de 95 por cento (IC) de SIL entre os grupos étnicos e graus da doença. A prevalência de HPV nas SIL de baixo grau (LSIL) foi de 64 por cento; nas de alto grau (HSIL), 84 por cento; e 19 por cento nos controles. O risco de SIL foi maior em mulheres latinas que em brancas e negras, sendo observadas, respectivamente, as seguintes AOR: 29,5 (12,4-70,5); 15,3 (6,0-33,8); e 5,8 (2,6-12,6). De forma similar, foram observadas diferenças para ambos LSIL (AOR, respectivamente, de 16,6; 7,7 e 4,3) e HSIL (AOR de 78,6; 34,6 e 142). Os resultados apóiam a existência de associaçäo entre SIL e HPV, diferenças na força de associaçäo com SILs e HSILs, e sugerem risco mais elevado para mulheres latinas e menor para mulheres negras.

Biologically active principles isolated from Salacia oblonga wall.

From the petroleum ether extract of the root bark of Salacia Oblonga wall, two biologically active fractions have been isolated by column and thin layer chromatography. The methanol eluted fraction of the extract absorbed on a column of silica gel at a concentration of 50 micrograms/ml showed 100 percent cytotoxicity on Ehrlich ascites tumour cells. The chloroform eluted fraction of the pet. ether extract and a fluorescent compound separated from it by TLC demonstrated about 60% and 76% hypoglycemic potency of an equal dose of tolbutamide (250 mg/kg) in albino rats. The results indicate the therapeutic importance of S. Oblonga wall.

Sources of information influencing physicians prescribing in Saudi Arabia

The objective was to survey physicians' opinions of the degree of importance of the pharmacist among seven common sources of information which had significant influence on their prescribing habits. This study was conducted by on-site visits and distribution of a self-audit questionnaire to physicians at various hospitals in Saudi Arabia. The physicians were asked to rank the seven sources of information according to their degree of importance. A sample size of 500 physicians from 26 Ministry of Health [MOH] hospitals in the eastern, western, northern, southern and central provinces of Saudi Arabia were randomly selected to participate in this study. Kendall's coefficient of concordance was used to test for ranking agreement. A total of 407 [81.4%] physicians responded to the survey. The results indicated that medical training was ranked highest and pharmaceutical company representatives ranked lowest among the seven sources of information influencing physicians' prescribing habits. Among peer influences, the pharmacist ranked below consultant advice and discussion with colleagues. The calculated Kendall's coefficient and the x2 value were indicative of a high degree of agreement among the surveyed physicians in ranking the seven sources of information. The outcome of this study indicates that the pharmacist as a source of information is the least influential on physicians' prescribing and ranked only better than pharmaceutical company representatives. Recommendations are made to promote the pharmacist as a pharmaceutical care provider, and that providing information on drugs should be an integral part of the professional duty and services provided by the pharmacy department of MOH hospitals