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.

A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite / 대한뇌졸중학회지

No abstract available.

A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite / 대한뇌졸중학회지

No abstract available.

Oral ribofl avin versus oral propranolol in migraine prophylaxis: An open label randomized controlled trial

Background: Migraine is a chronic, often debilitating disease. The treatment of migraine with propranolol (80-240 mg/day) is limited by side effects and lack of tolerability. Ribofl avin (vitamin B2) is the precursor of fl avin mononucleotide and fl avin adenine dinucleotide which are involved in mitochondrial transport chain. The use of ribofl avin in migraine prophylaxis is based on the hypothesis of a defi cient mitochondrial energy reserve as a causal factor in migraine pathogenesis, and on the fi ndings of its safety and effectiveness at high doses (400 mg/day) in the treatment of migraine like headaches in classic mitochondriopathies. Objectives: To compare the effi cacy of lower dose oral ribofl avin at 100 mg/day with oral propranolol 80 mg/day in the reduction of migraine frequency and severity. Methods: One hundred patients diagnosed with migraine were randomized to receive either oral ribofl avin 100 mg/day or propranolol 80 mg/day for a period of 3 months. Patients were issued a migraine diary and explained how to record the frequency of migraine attacks, headache intensity, duration and to report any side effects. Follow-up was at the end of 3 and 6 months. Results: Both study groups showed a reduction of migraine frequency, duration and severity of headache by visual analogue scale (VAS), and disability by migraine disability questionnaire (MIDAS) score at 3 months. No signifi cant difference was seen between the two study groups in most of the measures. Side effects were signifi cantly less in the ribofl avin group (P=0.035). Conclusion: Oral ribofl avin 100mg/day is a safe, equally effective and well tolerated alternative in migraine prophylaxis.

Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii.

PURPOSE: To study the qualitative and quantitative methods for the investigation of biofilm formation and to examine the correlation between biofilm and antibiotic resistance among the clinical isolates of Acinetobacter baumannii . We also verified the association between biofilm and presence of extended spectrum beta-lactamases, particularly, bla PER-1 . METHODS: A total of 55 isolates were subjected to susceptibility testing by disc diffusion method for 13 clinically relevant antibiotics. Screening for biofilm production was done by both qualitative and quantitative methods through tube and microtitre plate assay respectively. The presence of bla PER-1 was checked by PCR. RESULTS: A. baumannii isolates showed very high resistance (>75%) to imipenem, cephotaxime, amikacin and ciprofloxacin. Only cefoperazone, netillin and norfloxacin were found to be effective agents. Results of microtitre and tube methods were concordant with 34 isolates (62%) showing biofilm formation. Resistance to four antibiotics such as amikacin (82% vs. 17.6%, P < 0.001), cephotaxime (88% vs. 11%, P P < 0.001), ciprofloxacin (70% vs. 29%, P =0.005) and aztreonam (38% vs. 11%, P =0.039) was comparatively higher among biofilm producers than non-biofilm producers. Microtitre assay additionally detected 14 weakly adherent isolates. Only 11 isolates had bla PER-1 gene and among these two were strong biofilm producers, while remaining were weakly adherent isolates. CONCLUSION: Microtitre plate method was found to be a more sensitive method for biofilm detection. This study demonstrates a high propensity among the clinical isolates of A. baumannii to form biofilm and a significant association of biofilms with multiple drug resistance. Presence of bla PER-1 appears to be more critical for cell adherence than for biofilm formation.

Keyhole craniectomy in the surgical management of spontaneous intracerebral hematoma

Although the surgical management of spontaneous intracerebral hematoma (SICH) is a controversial issue, it can be life saving in a deteriorating patient. Surgical techniques have varied from the open large craniotomy, burr hole and aspiration to the minimally invasive techniques like stereotactic aspiration of the SICH, endoscopic evacuation and stereotactic catheter drainage. The authors report their experience with a keyhole craniectomy for the surgical evacuation of SICH. Ninety-six cases of SICH were treated using the keyhole craniectomy technique. A small craniectomy of 2-2.5 cm diameter was made using a vertical incision over a relatively ‘silent area’ of the cortex closest to the clot. Using a small cortical incision the hematoma was evacuated and decompression was achieved. Hemostasis was achieved using standard microneurosurgical techniques. Good to excellent outcome was achieved in 55 cases. Mortality was noted in 23 patients. Blood loss was minimal during the procedure. Good evacuation of the clot was seen in all but 5 cases as judged by the postoperative CT scan. The keyhole craniectomy technique is minimally invasive, safe and can achieve good clot evacuation with excellent hemostasis. It can be combined with microscopic or endoscopic assistance to achieve the desired result.

Purification of L-asparaginase from a bacteria Erwinia carotovora and effect of a dihydropyrimidine derivative on some of its kinetic parameters.

L-Asparaginase shows antileukemic activity and is generally administered in the body in combination with other anticancer drugs like pyrimidine derivatives. In the present study, L-asparaginase was purified from a bacteria Erwinia carotovora and the effect of a dihydropyrimidine derivative (1-amino-6-methyl-4-phenyl-2-thioxo, 1,2,3,4-tetrahydropyrimidine-5-carboxylic acid methyl ester) was studied on the kinetic parameters Km and Vmax of the enzyme using L-asparagine as substrate. The enzyme had optimum activity at pH 8.6 and temperature 35 degrees C, both in the absence and presence of pyrimidine derivative and substrate saturation concentration at 6 mg/ml. For the enzymatic reaction in the absence and presence (1 to 3 mg/ml) of dihydropyrimidine derivative, Km values were 7.14, 5.26, 4.0, and 5.22 M, and Vmax values were 0.05, 0.035, 0.027 and 0.021 mg/ml/min, respectively. The kinetic values suggested that activity of enzyme was enhanced in the presence of dihydropyrimidine derivative.

Congenital hypomyelinating neuropathy.

An eleven-month-old baby born out of non-consanguineous parentage presented with history of delayed motor milestones. The weakness was predominantly distal; there was intercostal muscle weakness, generalized hypotonia and areflexia. The nerve conduction velocities were unobtainable in all the four limbs. Sural nerve biopsy was consistent with the diagnosis of congenital hypomyelinating neuropathy, a rare form of hereditary motosensory neuropathy.