ABSTRACT
BACKGROUND The traditional coronary calcium score (CCS) is a time-tested tool for the evaluation of coronary atherosclerosis and predictor of future cardiovascular events. Non-traditional tools can also have a value in predicting and detecting subclinical coronary artery disease (CAD). METHODS We studied the role of CCS, the traditional CAD risk predictor, and the less-recognized, non-traditional risk factors, i.e. epicardial fat volume (EFV) and thoracic extracoronary calcium (ECC), to assess the degree of subclinical CAD. In this cross-sectional observational study, we included 950 Indian patients (suspected to have CAD). Coronary computed tomography angiography was performed. Estimation of CCS, EFV and thoracic ECC was done. RESULTS A CCS of 0 was seen in 583 patients (61.4%). Of these, 492 patients had normal coronary angiogram but 91 patients had CAD. The median values of EFV were statistically significantly higher in the ‘CAD present and CCS 0’ group compared to the ‘CAD absent and CCS 0’ group (p<0.001). The presence of thoracic ECC involving at least a single site was seen in only 6 of these 91 patients. When both EFV and CCS were considered together for the detection of CAD, the sensitivity and negative predictive value (NPV) were improved compared to either of these in isolation. When ECC was taken together with CCS and EFV, no further improvement in sensitivity or NPV was observed. CONCLUSION The combined use of traditional CCS along with non-traditional EFV may guide us in better profiling cardiovascular risk and supplement the various traditional cardiovascular risk factors/scores.
ABSTRACT
Necrotizing fasciitis is a severe, progressive, rapidly spreading infection of the subcutaneous soft tissue and underlying fascia. Periorbital necrotizing fasciitis is rare owing to the excellent blood supply of the area. Ocular amyloidosis is relatively uncommon- that of the eyelid is typically associated with systemic associations whereas amyloidosis of the conjunctiva is often localised with no other associations. Authors report a case of a 40-year-old female with a 4-year history of eyelid and conjunctival amyloidosis who presented with necrotic ulcers and eschars in the upper and lower lid with purulent discharge, conjunctival mass and a dry looking cornea in the left eye. She was a known case of rheumatoid arthritis (RA) on treatment in the last 2 years. The presentation, investigations and management are described.
ABSTRACT
Background: Adverse drug reactions (ADRs) are noxious and unintended effects of a drug that occurs at doses normally used in humans. ADRs may also result in diminished quality of life, increased physician visits, hospitalizations, and even death. The objectives of this study are to analyze and assess the causality and severity of reported ADRs.Methods: A cross sectional study of ADRs reported to Pharmacovigilance cell of MNR Medical College and Hospital Sangareddy in a year. The details of the various ADRs were statistically analyzed to find out pattern of ADRs. The WHO-UMC causality category and Hartwig-Seigel Scale were used to assess causality and severity of ADRs respectively.Results: The study shows, out of 60 suspected ADRs, the majority of ADRs were adults (68.3%) and out of whom 56% were females. According to the WHO-UMC Causality categories, 43.3% of the ADRs were categorized under Probable/likely, followed by possible (35%). The Hartwig-Siegel severity assessment scale shows that the majority (90%) of suspected ADRs were of mild category.Conclusions: The pattern of ADRs reported in our study is comparable to other studies. The commonest organ system affected was gastrointestinal tract, nervous and cutaneous system. Antimicrobial agents were causing maximum ADRs and medicine and allied departments have more number of ADRs. This study provides a valuable database for ADRs due to all commonly used drugs at hospitals and also helps in creating awareness regarding safe & judicious use of drugs to prevent ADRs.
ABSTRACT
Seasonal population dynamics of bacteria, actinomycetes and fungi was studied in rhizosphere and non-rhizosphere soil of chir pine (Pinus roxburghii Sarg.) seedlings growing in polybags and in situ (forest). In greenhouse experiment bacteria and actinomycetes were present in higher numbers and their populations fluctuated with season. Fungal population, although lower in numbers, remained stable throughout the year. Population fluctuations with lower numbers were more prominent in rhizosphere and non-rhizosphere soils of forest plants. Differential bacterial population characteristics viz. sporeformers, fluorescent colony producers, methylene blue reducers, ammonifiers and glucose fermenters were also taken into account. The population of sporeformers was comparable with methylene blue reducers, which was higher than fluorescent colony producers, ammonifiers and glucose fermenters, respectively. The rhizosphere soil bacterial count of nursery seedlings ranged from 4.36 x 106 – 6.37 x 106 g-1 dry soil weight and from 8.8 x 105 – 2.64 x 106 g-1 soil on dry weight basis in forest plants during various seasons. Sporeformers were a magnitude lower than total bacterial population and fluorescent colony producers were magnitude lower than sporeformers. Actinomycetes count ranged from 6.0 x 105 – 3.02 x 106 g-1 dry soil weight in the nursery plants and from 6.4 x 105 – 1.17 x 106 g-1dry soil weight in forest plants. Fungal population was a magnitude lower than bacterial and actinomycetes population, which ranged from 9.0 x 104 – 2.9 x 105 g-1 dry soil weight in the nursery plants and from 9.0 x 104 – 3.1 x 105 g-1 soil in forest plants. A similar trend of microbial population fluctuation but with lower numbers was observed in forest non-rhizosphere soil. Aims: To compare the seasonal population fluctuations of rhizosphere and nonrhizosphere soil for better understanding of population dynamics of soil microorganisms. Study Design: The observations were taken from nursery grown and forest grown seedlings. The microbial populations of pine seedling rhizosphere and non-rhizosphere soil were seasonally enumerated for one year at the intervals of three months for four times. Place and Duration of Study: The study was conducted at Sardar Bhagwan Singh (PG) Institute of Biomedical Sciences and Research (S.B.S.P.G.I.), Dehradun, Uttarakhand, India, situated at foothills of central Himalayas, for one year during January to December, 2005. Methodology: The seeds of Pinus roxburghii Sarg. were collected from natural chir pine forest from one healthy plant to minimize genetic variability in the experiment. The seeds were germinated on water agar medium and saplings were planted in polybags and kept in greenhouse nursery. Microbial colony forming units (CFUs) of the rhizosphere and nonrhizosphere soil of nursery grown and forest seedlings were enumerated for one year. Their populations were correlated with the meteorological data of the Dehradun valley. Results: The total bacterial population in terms of CFUs was comparatively higher in all seasons followed by actinomycetes, both these populations fluctuated with season. Fungal population, although lower in numbers, was consistent throughout the period. Microbial populations were found to be dependent on environmental factors like soil and air temperature, relative humidity and precipitation. The population of each microbial type reached maximum during third trimester, just after the end of monsoon season. Conclusion: The microbial population of chir pine rhizosphere soil and non-rhizosphere soil fluctuates seasonally. Microbial populations were found to be dependent on soil temperature, air temperature, precipitation and relative humidity.