Feasibility study of stroke surveillance: Data from Bangalore, India.

Background & objectives: Stroke is a leading cause of deaths, and disabilities in India. Reliable and good quality data on epidemiological characteristics of stroke are essential to plan, implement and evaluate stroke prevention and control programmes. A feasibility study was undertaken in Bangalore to examine the possibility of establishing stroke surveillance and to develop methodology for a larger programme. Methods: The study adapted WHO STEPs-STROKE methodology to collect data on hospitalized stroke events and fatal stroke events in the city of Bangalore. In STEP I, Information was collected from 1,174 stroke patients in three large hospitals and were followed till discharge and 28 days; outcome was measured as death or disability. Stroke cases fulfilling diagnostic criteria, evaluated by neurologists and CT/MRI confirmed cases were included. Brief information on major risk factors was collected from all stroke patients / family members and from medical records by trained research officers. In STEP II, death records of Bangalore Mahanagara Palike for 2004 (n=23,312) were analyzed to identify stroke related deaths. Results: Using WHO-STEPs approach, a methodology was developed for stroke surveillance in a geographically defined population. By STEP 1 method - 7 per cent of medical and 45 per cent of neurological admissions were due to stroke with a fatality rate of 9 per cent at hospital discharge and 20 per cent at 28 days. With a mean age of 54.5 (± 17.0) yr and male preponderance, nearly half had one or more risk factors. Weakness or paresis (92%) was the commonest presentation and ischaemic stroke was most frequent (73.8%). One third of total stroke patients were dependent at both discharge and 28 day follow up. By STEP II method the proportional mortality rate for Bangalore city was observed to be 6 per cent and more than 50 per cent of total stroke deaths had occurred in 10 major hospitals. Interpretation & conclusions: The present study has shown that stroke surveillance is possible and feasible. Institution based (hospitals and vital registry data) stroke surveillance supplemented with periodical population based information can provide comprehensive information on vital aspects of stroke like mortality, risk factors, disability and outcome. There is a need to develop stroke surveillance in a phased manner along with mechanisms to apply data for prevention and control programmes.

Purification and characterization of extracellular lipase from a new strain: Pseudomonas aeruginosa SRT 9 / Purificação e caracterização de uma lipase extracelular produzida por uma nova cepa: Pseudomonas aeruginosa SRT9

An extra cellular lipase was isolated and purified from the culture broth of Pseudomonas aeruginosa SRT 9 to apparent homogeneity using ammonium sulfate precipitation followed by chromatographic techniques on phenyl Sepharose CL- 4B and Mono Q HR 5/5 column, resulting in a purification factor of 98 fold with specific activity of 12307.8 U/mg. The molecular weight of the purified lipase was estimated by SDS-PAGE to be 29 kDa with isoelectric point of 4.5. Maximum lipase activity was observed in a wide range of temperature and pH values with optimum temperature of 55ºC and pH 6.9. The lipase preferably acted on triacylglycerols of long chain (C14-C16) fatty acids. The lipase was inhibited strongly by EDTA suggesting the enzyme might be metalloprotein. SDS and metal ions such as Hg2+, Zn2+, Cu2+, Ag2+ and Fe2+ decreased the lipase activity remarkedly. Its marked stability and activity in organic solvents suggest that this lipase is highly suitable as a biotechnological tool with a variety of applications including organo synthetic reactions and preparation of enantiomerically pure pharmaceuticals. The Km and Vmax value of the purified enzyme for triolein hydrolysis were calculated to be 1.11 mmol/L and 0.05 mmol/L/minrespectively.

Uma lipase extracelular foi isolada e purificada a partir de um caldo de cultura de Pseudomonas aeruginosa SRT9 até homogeneidade visível empregando-se precipitação com sulfato de amônia, seguida de técnicas cromatográficas em colunas de fenil sefarose CL-4B e Mono Q HR 5/5, obtendo-se um fator de purificação de 98 vezes, e atividade especifica de 12307,8 U/mg. Por SDS_PAGE, estimou-se que o peso molecular da lipase purificada é 29kDa, com um ponto isoelétrico de 4,5. A lipase apresentou atividade máxima em uma ampla faixa de temperatura e pH, com ótimos a 55ºC e pH 6,9. A lípase foi mais ativa sobre triacilglicerois de cadeia longa (C14-C16). A lipase foi fortemente inibida por EDTA, o que sugere que a enzima pode ser uma metaloproteína. SDS e íons metálicos, como Hg2+, Zn2+,Cu2+, Ag2+ e Fe2+, diminuíram marcadamente a atividade da lipase. Sua grande estabilidade e atividade em solventes organicos sugerem que esta lípase pode ser uma excelente ferramenta tecnológica com várias aplicações como reações organosintéticas e preparação de produtos farmacêuticos enantiomericamente puros. Os valores de Km e Vmax para a enzima purificada na hidrólise de trioleina foram 1,11 mmol/L e 0,05 mmol/L/min, respectivamente.

A comparative study of median nerve somatosensory evoked potential in the totally blind and normal subjects.

The totally blind individuals are often considered to be compensated for their visual loss by augmentation in the auditory and tactile perceptions as against the normal sighted individuals. The objective of the present work was to study the somatosensory evoked potentials (SEPs) after median nerve stimulation in the wrist of totally blind and normal sighted individuals. SEPs were recorded after median nerve stimulation in the wrist of 15 Braille reading totally blind females and compared with 15 age matched normal sighted females. Latency and amplitudes of SEPs (N9, N13, and N20) were measured and analyzed statistically. Amplitude of N20 SEP was significantly larger in the totally blind than in normal sighted individuals (P < 0.05). The amplitudes of N9 and N13 SEPs and the latencies of all SEPs showed no significant differences. The congenitally blind individuals have larger N20 amplitude, suggestive of greater somatosensory cortical representation than normal sighted individuals.

Correlation of Patient Weight and Cross-Sectional Dimensions with Subjective Image Quality at Standard Dose Abdominal CT

OBJECTIVE: We evaluated the association between patients' weight and abdominal cross-sectional dimensions and CT image quality. MATERIALS AND METHODS: We prospectively evaluated 39 cancer patients aged more than 65 years with multislice CT scan of abdomen. All patients underwent equilibrium phase contrast-enhanced abdominal CT with 4 slices (from top of the right kidney) obtained at standard tube current (240 280 mA). All other scanning parameters were held constant. Patients' weight was measured just prior to the study. Cross-sectional abdominal dimensions such as circumference, area, average anterior abdominal wall fat thickness and, anteroposterior and transverse diameters were measured in all patients. Two subspecialty radiologists reviewed randomized images for overall image quality of abdominal structures using 5-point scale. Non-parametric correlation analysis was performed to determine the association of image quality with patients' weight and cross-sectional abdominal dimensions. RESULTS: A statistically significant negative linear correlation of 0.46, 0.47, 0.47, 0.58, 0.56, 0.54, and 0.56 between patient weight, anterior abdominal fat thickness, anteroposterior and transverse diameter, circumference, cross-sectional area and image quality at standard scanning parameters was found (p< 0.01). CONCLUSION: There is a significant association between image quality, patients' weight and cross-sectional abdominal dimensions. Maximum transverse diameter of the abdomen has the strongest association with subjective image quality.

Mycotic keratitis: a study in coastal Karnataka.

Fungi were isolated from 67 cases out of the 295 cases of corneal ulcers investigated. Aspergillus species and species of Candida were the major fungal members isolated. Allescheria boydii was isolated from 3 cases, having no previous history of injury to the eye or infection with bacterial or viral agents. A boydii corneal infection is a rare occurrence. Higher incidence of mystic keratitis was seen among females than males. No relationship to seasonal changes could be established. Bacterial infection was associated in 46. 27% of the cases of mycotic keratitis and Staphylococcus was the predominant bacterial pathogen observed.