Prevalence of Chronic Obstructive Pulmonary Disease and its Association with Tobacco Smoking and Environmental Tobacco Smoke Exposure among Rural Population.

A fi eld survey was conducted for chronic obstructive pulmonary disease (COPD) epidemiology in the rural fi eld practice area of Kempegowda Institute of Medical Sciences, Bangalore, India, which covers a population of 44,387 to fi nd out the prevalence of COPD in adult subjects of 35 years and above using cluster sampling technique and to determine the association of tobacco smoking, environmental tobacco smoking (ETS) exposure and type of cooking fuel used with COPD. The overall prevalence of COPD was 4.36%. The prevalence among males and females were 5.32% and 3.41% respectively. The prevalence was found to be increasing with an increase in age. The tobacco smoke and exposure to ETS was signifi cantly associated with higher odds of COPD with adjusted odds ratio 2.97 and 2.67 respectively. Thus, there was a signifi cant association between tobacco smoking and ETS exposure with COPD.

Optimization of lipid enriched biomass production from oleaginous fungus using response surface methodology.

Oleaginous microorganisms have emerged as potential sources of oils for biodiesel production. To replenish as an alternative to the vegetable oils, higher lipid accumulating strain coupled with process optimization is indispensable. In the present study, response surface methodology (RSM) based central composite design (CCD) was used for optimization of lipid content from oleaginous fungus Aspergillus sp. Maximum lipid yield of 73.07% (w/w) was achieved at 3% (v/v) inoculum volume, pH 5, glucose 1% (w/v), urea 0.5 % (w/v) and incubation time of 5 (days). Biomass (2.08 g/L) having a lipid content of 73.07 % (w/w) with major constituents of hexadecanoic acid methyl ester and 9-Octadecenoic acid methyl ester were obtained. The lipid composition signifies that from the oleaginous microbe are highly encouraging and desirable to be considered as diesel substitute.

Prevalence of bronchial asthma and its association with smoking habits among adult population in rural area.

A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 3194 adult individuals (18-70 years) were selected from 30 villages (clusters) using a cluster-sampling technique. Individuals with symptoms suggestive of asthma were subjected for clinical examination for the diagnosis of asthma. Among the 3194 respondents, 1518 (47.5%) were males and 1676 (52.5%) were females. The prevalence of bronchial asthma was 2.88%. The prevalence of asthma was higher among those reporting a history of current smoking. Among current smokers, the number of cigarettes/bidis/hookah smoked daily did not differ (P > 0.05) between individuals without asthma and with asthma, whereas the mean number of years of smoking did differ (P < 0.001). There was significant association between tobacco smoking and bronchial asthma.

The Babinski sign--a critical review.

In 1896, Josph Babinski, a French neurologist, first described the best known neurologic eponym--"the Babinski sign". This sign is characterised by dorsiflexion of the big toe, by recruitment of the extensor hallucis longus muscle, on stimulating the sole of the foot. He himself emphasised from the outset the intimate relationship between this sign and the shortening movement in other leg muscles, which forms the flexion synergy of the lower limb. The Babinski sign is not a new reflex, rather it is released as a result of breakdown of the harmonious integration of the flexion and extension component of the normal defence reflex mechanism, due to pyramidal tract dysfunction. A pathological Babinski sign should be clearly distinguished from upgoing toes that may not always be a part of the flexion synergy. This article reviews the Babinski sign in detail, focusing on the historical perspectives, role of pyramidal tract dysfunction, art of elicitation and interpretation. The significance of assessing this phenomenon in the entire leg and the clinical clues that will help to dispel the myths regarding the Babinski sign has been emphasized.

Use of radiofrequency ablation in the modified maze procedure.

Atrial fibrillation secondary to long-standing mitral valve disease is very common. The maze procedure carried out along with mitral valve surgery reverts many of these patients back to sinus rhythm. Using radiofrequency ablation to carry out the maze procedure during mitral valve surgery gives results comparable to those from the Cox surgical maze procedure. We present our experience with 3 patients of rheumatic mitral valvular disease in whom radiofrequency ablation was used for the maze procedure.

The Babinski sign--a reappraisal.

In 1896, Joseph Babinski, a French neurologist, first described the best known neurologic eponym 'the Babinski sign'. This sign is characterised by dorsiflexion of the big toe and recruitment of the extensor hallucis longus muscle, on stimulating the sole of the foot. He has emphasised from the outset, the intimate relationship between this sign and the shortening movement in other leg muscles, which form the flexion synergy of the lower limb. The Babinski sign is not a new reflex, rather it is released as a result of breakdown of the harmonious integration of the flexion and extension components of the normal defence reflex mechanism, due to pyramidal tract dysfunction. A pathological Babinski sign should be clearly distinguished from upgoing toes that may not always be a part of the flexion synergy. This article reviews the Babinski sign in detail, focusing on the historical perspectives, role of pyramidal tract dysfunction and art of elicitation and interpretation. The significance of assessing this phenomenon in the entire leg, and the clinical clues that will help to dispel the myths regarding the Babinski sign, have been emphasised.

Profound hypothermic circulatory arrest in management of aortic aneurysms.

A total of 15 patients having aneurysms of aorta were operated from June 1997 to December 1998 using deep hypothermic circulatory arrest as a modality of brain protection. There were 12 males and 3 females. The age ranged from 19 years to 74 years and the mean age was 44.9 years. Nine patients had aneurysms of ascending aorta (group I), one had aneurysm of ascending aorta and arch of aorta (group II), four had aneurysm of the distal aortic arch (group III) and one patient had thoracoabdominal aortic aneurysm (group IV). In group I, six patients underwent Bentall procedure, two underwent Wheat procedure and one patient had repair of pseudoaneurysm of ascending aorta. The only patient in group II had his ascending aorta and arch replaced, with reimplantation of left common carotid and innominate artery. In group III, three patients had interposition Gelseal graft and one had repair of the tear in distal aortic arch. The lone patient in group IV had interposition Gelseal graft of thoracoabdominal aorta. The hypothermic circulatory arrest was used in all of them for brain and/or spinal cord protection. Retrograde cerebral perfusion was used in two patients. There were two (13%) operative deaths. One patient died of cerebrovascular accident on eighth post-operative day and second died of inadequate surgical repair. There was one instance of left hemiparesis secondary to an infarct in right frontoparietal region. To conclude, hypothermic circulatory arrest could provide an adequate brain protection for aortic aneurysm surgery. Retrograde cerebral perfusion could be an adjuvant when the anticipated time of hypothermic circulatory arrest is likely to exceed 45 minutes.

"Changing trends (clinico-biochemical) in gall-bladder stone disease"--an observation.

Present study has been undertaken to know the causative factors responsible for change in trend of gall-stone disease from middle aged, fertile, fat females to young asthenic females in twenties. Our findings reveal high incidence of gall stone formation in non-obese young females. Average fat consumption in non-obese patients was less (17%) than that of obese (26%). However, use of oral contraceptives was high in non-obese females and maximum users were in young age group while in obese in middle age group. Bilirubin content in gall bladder stones of non-obese was significantly more than that of obese (p < 0.01) whereas cholesterol content in gall bladder stones of obese was significantly high when compared to non-obese subjects. Analysis of bile showed significant increase in bilirubin and calcium level of non-obese when compared to control and obese subjects whereas phosphorus levels were significantly decreased in the bile of non obese subjects. These findings suggest that in non-obese females less intake of fat, early use of oral contraceptives, higher contents of bilirubin and calcium and low content of phosphorus in bile may be responsible for gall stone formation.