Respiratory Hazards to Occupational Exposure of Poultry Dust in Poultry Farm Workers in Northern India

Background: Occupational exposure of farmers are known to cause many respiratory illness and manifestgreater rates of asthma and respiratory symptoms than other workers. The poultry farm workers are exposedto organic dust, endotoxins and hazardous gases. Longer the duration of exposure to the dust, greater thehealth hazard. Therefore, the objective of this study was to record and compare the various pulmonaryfunction parameters in poultry farm workers on the basis of duration of exposure to poultry dust. Methods:The study was conducted on 66 poultry farm workers after taking written informed consent. Pulmonaryfunction tests was performed using Autospirometer (Helios 701: Chandigarh). The workers were groupedaccording to duration of exposure into five sub groups (Group A upto 5 years, Group B >5-10 years, GroupC >10-15 years, Group D >15-20, Group E >20 years exposure). Data was analyzed using one way ANOVAand post-hoc by Bonferroni test. Results: We found that the pulmonary functions started deterioratinggradually in poultry farm workers after 5-10 years of exposure (Group B) to poultry dust with maximumdecrease on exposure to more than 20 years (Group E). There was statistically significant decrease in FVC,FEV0.5, FEV1, FEV3 with normal FEV1/FVC suggesting restrictive ventilatory changes in poultry workers.There was significant decrease in FEF25-75% and FEF0.2-1.2, PEFR suggesting early small and largeairway obstruction respectively. Conclusion: Poultry dust adversely affects the respiratory function and thisimpairment is associated with duration of exposure to poultry dust. The present study intends to raise publicawareness about occupational exposure to poultry dust in poultry farm workers.

Identification of functional SNPs in human LGALS3 gene by in silico analyses

Background: Galectin-3 protein, an S-type lectin, is encoded by LGALS3 gene. It consists of carbohydrate recognition domain [CRD], collagen like tandem repeats of nine amino acids and N-terminal 12-mer peptide. Its serum levels as well as some genetic variants were reported to be involved in various disease conditions like cancer, autoimmune diseases, heart diseases etc. Being viewed as an important molecule in biological responses and its association with various diseases, the present study was designed. This is the first in silico analyses of LGALS3

Aim: To systematically explore the plausible effects of LGALS3 genetic variants on structure and functions of galectin-3

Material and methods: Both sequence based and structure based approaches were adopted for analyses of non-synonymous single nucleotide polymorphisms [nsSNPs]. Putative methylation and other post translational modifications were also analyzed using different tools. Muster and Swiss-PDB Viewer were used for modeling of predicted functional variants

Results: Out of 1130 SNPs reported in dbSNP, only validated SNPs were chosen for analyses. A total of nine nsSNPs which included, 3 of N-terminal region and 6 of CRD encoding region, were found to have deleterious effect as predicted by various softwares. Analyses of regulatory SNPs predicted five functional SNPs in 3?UTR having putative miRNA binding sites and 3 intronic SNPs in potential transcription factor binding sites

Conclusion: Based on these analyses, the present study suggested that the reported functional SNPs may act as potential targets in genetic association studies

Bacopa monnieri extracts prevent hydrogen peroxide-induced oxidative damage in a cellular model of neuroblastoma IMR32 cells / 中国天然药物

Neurodegenerative diseases are the consequences of imbalance between the production of oxidative stress and its nullification by cellular defense mechanisms. Hydrogen peroxide (HO), a precursor of deleterious reactive oxygen species, elicits oxidative stress, resulting in severe brain injuries. Bacopa monnieri is well known for its nerve relaxing and memory enhancing properties. The present study was designed to evaluate the protective effects of extracts from Bacopa monnieri against HO induced oxidative stress using a cellular model, neuroblastoma IMR32 cell line. The protective potential of methanolic, ethanolic, and water extracts of B. monnieri (BM-MEx, BM-EEx, and BM-WEx) was evaluated using MTT assay. Although, all the B. monnieri extracts were found to protect cells against HO-mediated stress but BM-MEx showed significantly greater protection. UPLC analysis of BM-MEx revealed various polyphenols, including quercetin, catechin, umbelliferone, and caffeic acid predominance. Further, BM-MEx was found to possess considerable greater neuroprotective potential in comparison to the standard polyphenols such as quercetin, catechin, umbelliferone, and caffeic acid. The levels of antioxidant enzymes were significantly elevated after the pretreatment of BM-MEx and quercetin. The expression levels of oxidative stress markers, such as NF200, HSP70, and mortalin, were significantly alleviated after the pretreatment of BM-MEx as shown by immunofluorescence and RT-PCR. In conclusion, the present study demonstrated the protective effects of BM-MEx, suggesting that it could be a candidate for the development of neuropathological therapeutics.

comparative evaluation of intravenous with intramuscular clonidine for suppression of hemodynamic changes in laparoscopic cholecystectomy

Clonidine diminishes stress response by reducing circulating catecholamines and hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. The aim of this study was to compare intravenous [IV] clonidine [2 microg/kg] with intramuscular [IM] clonidine [2 microg/kg] for attenuation of stress response in laproscopic surgeries. Eighty adult patients classified as ASA physical status I or II, aged between 20 and 60 years undergoing elective cholecystectomy under general anesthesia were enrolled for a prospective, randomized, and double-blind controlled trial. They received either IV clonidine [2 microg/kg] 15 min prior to the scheduled surgery [Group I] or IM clonidine [2 microg/kg] 60-90 min prior to the scheduled surgery [Group II]. Hemodynamic variables [Heart rate, systolic [SBP], diastolic [DBP], mean arterial pressure [MAP]], SpO[2] and EtCO[2] were recorded at specific times - baseline, prior to induction, 1 min after intubation, before CO[2], insufflation, after CO[2] insufflation at 1, 5, 10, 20, 30, 45, 60 min, after release of CO[2], at 1 and 10 minutes after extubation. Secondary outcomes included evaluation of adverse effect profile of the two groups. No significant difference was observed in the HR throughout the intraoperative period in between the two groups [P>0.05]. There was statistically significant difference in SBP between the two groups starting from 1 minute after induction till 1 min after extubation [P<0.05] but not in DBP except at 1 minute after intubation [P=0.042]. Significant difference in MAP was noted at 1 minute after intubation [P=0.004] and then from 5 minutes after CO[2] insufflation to 1 minute after extubation [P<0.05]. Incidence of adverse effects were higher in group II [P=0.02] especially incidence of hypertension requiring treatment [0.006]. We conclude that under the conditions of this study, hemodynamic parameters [SBP, DBP and MAP] were better maintained in the IV as compared to the IM route that had significantly higher incidence of hypertension requiring treatment

Assessment of hemostatic changes after crystalloid and colloid fluid preloading in trauma patients using standard coagulation parameters and thromboelastography

The choice of an ideal fluid administered post trauma and its subsequent influence on coagulation still poses a clinical dilemma. Hence, this study was designed to assess the influence of in vivo hemodilution with various fluid preparations [4% gelatin, 6% hydoxyethyl starch [HES], Ringer's lactate, 0.9% normal saline] on coagulation using standard coagulation parameters and real-time thromboelastography [TEG] in patients undergoing elective surgery post trauma. In a randomized, double-blind study, 100 patients of either sex and age, belonging to ASA Grades I and II, scheduled for elective surgeries were allocated into four groups of 25 each according to the type of fluid infused. Group G [4% gelatin], Group N [0.9% normal saline], Group R [Ringer's lactate], and Group H [6% HES] received preloading with 1 L of fluid according to the group. The coagulation status of the patients was assessed during perioperative period [before surgery, after fluid preloading, and at the end of the surgery] using both conventional coagulation analysis and TEG. Analysis of variance [ANOVA], post hoc and Pearson Chi-square test were used. In all the patients preloaded with gelatin, there was a significant increase in prothrombin time index [PTI; 14.88 +/- 0.90 vs. 13.78 +/- 3.01, P<0.001] and international normalized ratio [INR; 1.12 +/- 0.09 vs. 1.09 +/- 0.19, P<0.05] compared to the baseline value. An increase was observed in these parameters in the postoperative period also. In the HES group, there was statistically significant increase in PT time [15.70 +/- 1.51 vs. 13.74 +/- 0.75, P=0.01] and INR [1.20 +/- 0.15 vs. 1.03 +/- 0.17, P<0.001] as compared to the baseline. In the intergroup comparisons, the patients preloaded with HES had a significant increase in INR [1.20 +/- 0.15 vs. 1.12 +/- 0.09, P=0.04] and reaction time [R time; 6.84 +/- 2.55 min vs. 4.79 +/- 1.77 min, P=0.02] as compared to the gelatin group. The fall in coagulation time [k time; 2.16 +/- 0.98 vs. 3.94 +/- 2.6, P=0.02], rise in maximum amplitude [MA; 61.94 +/- 14.08 vs. 50.11 +/- 14.10, P=0.04], and rise in A20 [56.17 +/- 14.66 vs. 43.11 +/- 14.24, P=0.05] were more in patients preloaded with RL as compared to the HES group. 100% patients in the gelatin group, 84.2% patients in the NS group, 94.4% patients in the RL group, and 66.7% patients in the HES group had hypocoagulable [R time > 14 min] state in the postoperative period. Crystalloids are optimal volume expanders in trauma, with RL having beneficial effects on coagulation system [decrease in k time and increase in MA and A20]. Among the colloids, HES 6% [130/0.4] affects coagulation parameters [increase in PTI, INR, R time, k time] more than gelatin. Trial registration [protocol number-IEC/NP-189/2011]

Child with aplastic anemia: anesthetic management

Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anesthetic considerations in aplastic anemia patients in the literature. The anesthetic management is challenging because of the rarity of the disease, associated pancytopenia and immunosuppression

comparison of midazolam and clonidine as an oral premedication in pediatric patients

To compare oral midazolam [0.5 mg/kg] versus oral clonidine [4 micro g/kg] as a premedication in pediatric patients aged between 2-12 years with regard to sedation and anxiolysis. Sixty pediatric patients belonging to the American Society of Anesthesiologists class I and II between the age group of 2-12 years scheduled for elective surgery were randomly allocated to receive either oral midazolam [group I] 30 min before induction or oral clonidine [group II] 90 min before induction of anesthesia. The children were evaluated for levels of sedation and anxiety at the time of separation from the parents, venepuncture, and at the time of mask application for induction of anesthesia. After premedication, the percentage of children who were sedated and calm increased in both the groups. The overall level of sedation was better in the children in the clonidine group, but children in the midazolam group had a greater degree of anxiolysis at times of venepuncture and mask application. In addition, midazolam did not cause significant changes in hemodynamics unlike clonidine where a significant fall in blood pressure was noted, after premedication, but preinduction. We conclude that under the conditions of the study, oral midazolam is superior to clonidine as an anxiolytic in pediatric population. Clonidine with its sedative action especially at the time of separation from parents along with its other perioperative benefits cannot be discounted

Carinal injury: an airway challenge for anesthesiologists

Tracheobronchial disruption is a potentially life-threatening airway challenge for all the anesthesiologists. Carinal rents, although rare, if not timely managed can be catastrophic. We describe a patient with carinal rent being managed successfully by prompt diagnosis, use of low pressure ventilation, and bronchoscopic sealing using tissue glue

Cerebral fat embolism: a diagnostic challenge

Fat embolism syndrome [FES] is a rare but a serious clinical catastrophe occurring after traumatic injury to long bones. Cerebral involvement in the absence of pulmonary or dermatological manifestation on initial presentation may delay the diagnosis of cerebral fat embolism [CFE]. We discuss a case series of CFE which posed a challenge in diagnosis. The clinical presentations of these patients did not satisfy the commonly used clinical criteria for aiding the diagnosis of FES. Early MRI brain [DWI and T2 weighted sequences] in patients with neurological symptoms after trauma even in the absence of pulmonary and dermatological findings should be the goal

comparative evaluation of intrathecal bupivacaine alone, sufentanil or butorphanol in combination with bupivacaine for endoscopic urological surgery

The objective of the present study was to compare the onset, degree and recovery time of sensory and motor block and hemodynamic effects of intrathecal bupivacaine alone and bupivacaine with sufentanil or butorphanol in endoscopic urological surgeries. In a randomized, double-blind study, 90 patients of either sex and age, belonging to ASA Grades I and II, scheduled for elective endoscopic urological surgeries under spinal anesthesia, were allocated into three groups of 30 each. Patients received either 2.5 ml of 0.5% hyperbaric buypivacaine 12.5 mg [Group A], 1.5 ml of 0.5% hyperbaric bupivacaine 7.5 mg with 10 ?g sufentanil [Group B] or 1.5 ml of 0.5% hyperbaric bupivacaine 7.5 mg with 25 ?g butorphanol [Group C]. Vital parameters, level, duration and regression of sensory block and motor block and side-effects were recorded and compared. Analysis of variance [ANOVA], post hoc test and Chi-square test were used. Intrathecal addition of sufentanil/butorphanol prolonged the duration of sensory block [DOSB] compared with bupivacaine alone [DOSB being 156.83 +/- 23.83 min, 170.87 +/- 22.21 min and 171.17 +/- 23.99 min in groups A, B and C, respectively] without altering the duration of motor blockade. Bromage score 3 was achieved in 100%, 90% and 54.4% patients in groups A, B and C, respectively. The time to first request for analgesia was 112 +/- 46.3 min, 323 +/- 65.0 min and 299 +/- 73.9 min in groups A, B and C, respectively. Complications were reduced by the addition of butorphanol, which also has a lower tendency than sufentanil to produce pruritus [60%].The analgesia was significantly prolonged in groups B and C; group C had a less-intense motor block. Complications were reduced by the addition of butorphanol, which also has a lower tendency than sufentanil to produce pruritus. Thus, this combination of butorphanol with low-dose bupivacaine is especially beneficial in the geriatric group of patients who have multiple co-morbid conditions

effects of aerobic versus resistance training on cardiovascular fitness in obese sedentary females

The present study was designed to evaluate the effects of aerobic and strength training on cardiac variables such as blood pressure, heart rate [HR], and metabolic parameters like cholesterol, high density lipoprotein [HDL], triglycerides and anthropometric parameters of obese women of Punjab. This study was performed as an experimental study, in which subjects were randomly selected. There were thirty obese women, aged between 35-45yrs with body mass index [BMI] of above 30. Subjects were grouped into control [n=10], aerobic training [n=10] and resistance training [n=10]. Aerobic training was given for three days a week at 60-70% of maximum HR for 6 weeks. Resistance training [Delorme and Watkins Technique] was given for alternate days for 6 weeks. HR and blood pressure were measured before and after the exercise. Recovery HR was also measured. The findings of the study indicate statistically significant differences in recovery heart rate [Pre-exercise: 97.40 +/- 5.378 [mean +/- standard deviation [SD]], post-exercise: 90.70 +/- 4.599, t=8.066, P<0.001] and in post-diastolic blood pressure [Pre-exercise: 85 +/- 3.265, post-exercise: 86.20 +/- 2.820, P<0.001] in aerobic training and in systolic blood pressure [Pre- and post-exercise] in both training groups [P<0.001]. Significant differences were observed in very low-density lipoprotein [pre-exercise: 28.10 +/- 1.415, post-exercise: 26.86 +/- 0.760, t=6.318] and HDL [pre-exercise:45.40 +/- 3.533, post-exercise:53.60 +/- 3.134, t=6.318] levels in aerobic training group with P<0.001. BMI and body fat percentage showed significant improvements in both training groups. Aerobic training is more beneficial and can be used as a preventive measure in patients who are at risk of developing cardiovascular diseases due to obesity

Tissue engineering and its implications in dentistry.

Tissue engineering is a novel and highly exciting field of research. With tissue engineering techniques it may be possible to repair damaged tissues or even create replacement organs. This article reviews the principles underlying key tissue engineering strategies and the typical components used. Examples of tissue engineering include passive approaches, such as dental implants, and inductive approaches, in which specific molecular signals are used to activate cells.