The effects of high heeled shoes walking in on energy expenditure and oxygen consumption in healthy young female

Background: Walking in high-heeled shoes is widespread dress behavior of women of modern society. It increases lower limb muscles activity and energy cost. The need to generate larger muscular forces during walking increases the metabolic demand, thus oxygen consumption (VO2) is increased when wearing high heels. Aims and Objectives: To access effect of high-heeled shoes on Energy Expenditure (EE) and VO2 in Healthy Young female. Materials and Methods: This cross-sectional study was conducted among fifty apparently healthy female students between the ages of 20 and 26 yrs. Resting arterial blood pressure and heart rate (HR), VO2, heat production, and EE were recorded. Then, subjects walked barefooted a distance of 76.5 meters in 2 min. Following the barefooted walk, cardiac and metabolic parameter were recorded again. The subjects walked 76.5 meters in high-heeled shoes of 2, 4, and 6 inches. These parameters were recorded immediately after 76.5 meters of walking in high-heeled shoes. Results: The results from the present study indicate that walking a distance of 76.5 meters barefooted resulted in a significant increase only in mean arterial pressure, HR and rate pressure product. The EE and VO2 after walking a distance of 76.5 meters in high-heeled shoes of 2, 4, and 6 inches heel heights was significantly higher than walking a distance of 76.5 meters barefooted. Conclusion: Walking barefooted required lesser effort than walking in high-heeled shoes of different heel heights. Effort should therefore be made to encourage women to reconsider the habitual use of high-heeled shoes.

Bilateral Narrow Internal Auditory Canal With Duplication: High Resolution CT And MRI Findings

Inner ear malformations account for only 20 % of cases of congenital sensorineural hearing loss.A narrow internal auditory canal (IAC) with duplication is a very rare congenital anomaly that can be associated with other malformative ear abnormalities. Identification and characterization of these abnormalities will be crucial for the proper management of patients.We report two cases of bilateral duplicated internal auditory canal with other associated inner ear anomalies.

Burkholderia sepsis mimicking flare of ANCA-associated vasculitis: A rare presentation

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune condition that primarily targets smallto medium sized vessels in multiple organ systems, with sinonasal, pulmonary and renal involvement being common.The present case study discusses a known case of ANCA associated vasculitis, type 2 diabetes and hypertension, whopresented with altered sensorium and weakness of the left side of the body. Few months before the onset of symptoms,the patient received rituximab injection for treating cutaneous panniculitis and high pANCA titers. MRI of brain and CECTof chest were suggestive of vasculitis and blood culture showed the growth of Burkholderia cepacia. She was treated withbroad spectrum antibiotics and other supportive treatment. Despite all the efforts including ionotropic and ventilatorsupports, the patient succumbed to the infection.

Safety of photodynamic therapy involving optic nerve head

We present a case of large peripapillary polypoidal choroidal vasculopathy treated with standard-fluence photodynamic therapy (PDT) as other treatment options were unsuccessful or not justified. Due to large lesion size, treatment spot included part of optic disc also. PDT resulted in regression of polyp and visual improvement (from 20/300 to 20/20) without any collateral damage to optic nerve as evidenced by visual-field test and visual-evoked potential with a follow-up till 2 years. This case highlights the role of PDT as a safe alternative for treatment of large peripapillary lesion, even though the treatment spot encompasses part of the optic nerve head.

Clinical applications of the retinal functional imager: A brief review

The advances in treating blinding conditions often depends on the development of new techniques that allows early detection, treatment, and follow-up of the disease. Functional changes often precede structural changes in many retinal disorders. Therefore, detecting these changes helps in early diagnosis and management, with the intention of preventing permanent morbidity. The Retinal Functional Imager (RFI) is a non-invasive imaging system that allows us to assess the various functional parameters of the retina. The RFI quantitatively measures the retinal blood-flow velocity, oxygen saturation, metabolic demand and generates a non-invasive capillary perfusion map that provides details similar to a fluorescein angiography. All of these parameters correlate with the health of the retina, and are known to get deranged in retinal disease. This article is a brief review of published literature on the clinical utility of the RFI.

Radiation therapy outcomes in muscle invasive urinary bladder cancer: A single institution experience.

INTRODUCTION: To audit the survival outcomes and loco‑regional control in muscle invasive urinary bladder cancer patients treated with external beam radiation therapy (RT). MATERIALS AND METHODS: From November 2008 through December 2011, 50 consecutively diagnosed muscle invasive urinary bladder carcinoma (T2‑4a N0‑2, M0) patients were included in this retrospective study. All these patients received external beam RT to a median dose of 60 Gy (range 30‑66 Gy), and were not suitable for radical surgery due to patients’ preference or medical comorbidities. A stepwise procedure using proportional hazard regression was used to identify prognostic factors with respect to survival. RESULTS: Completion trans‑urethral resection of bladder tumor was done in 38 (76%) patients of the cohort and 47 (94%) had transitional cell carcinoma on histopathology. Clinical stage T2 was diagnosed in 40 (80%) patients. The median follow‑up for the entire cohort was 14 ± 8.9 months (range 1‑36 months). In conclusion, 24 patients (48%) were free of disease, 5 patients (10%) had residual disease, and 13 patients (26%) had died of disease. Two‑year and 3 year overall survival of intact bladder for the entire cohort was 58% and 43.6%, respectively. Cox regression modeling strongly suggested clinical stage (P = 0.01) and RT dose (P = 0.001) as being predictors for overall survival. CONCLUSION: RT shows reliable outcomes and excellent compliance in this advanced disease. Prescribing a higher RT dose could potentially correlate to better intact bladder control rates while maintaining good quality of life in selected patients.

Prevalence of Human metapneumovirus infection among patients with influenza‑like illness: Report from a Tertiary Care Centre, Southern India.

Background: Human metapneumovirus (HMPV), discovered in the 21st century, has emerged as an important cause of influenza‑like illness in children and adults causing mild upper respiratory tract infection to severe bronchiolitis and community‑associated pneumonia. The aim of this study was to determine the prevalence of HMPV in the Union Territory of Puducherry, India, as part of National Influenza Surveillance Programme. Materials and Methods: From November 2011 to December 2013, a total of 447 nasopharyngeal samples were collected from patients with acute respiratory infections and tested for HMPV RNA by real‑time polymerase chain reaction. Results: HMPV was identified in 23/447 (5%) samples with 11/23 in the age group of 14–30 years. Most of the HMPV infections were mild with no fatalities. Two patients were co‑infected with the respiratory syncytial virus and one with influenza B virus. The seasonal distribution showed increasing HMPV infection cases in rainy months except for a peak in summer of 2012. Phylogenetic analysis based on the sequences of the nucleoprotein gene of one HMPV strain showed a high degree of sequence identity with Indian strains obtained during 2006 and 2011. Conclusion: This study shows that HMPV infection is more common in adults than in children. Sequence homology suggests the circulation of closely related HMPV strains within the country.

Twin pregnancies: Maternal and perinatal outcome in a tertiary health centre

Background: Twin gestation brings double happiness but at the same time implies twice the unforeseen complications to the health of the mother and the fetus. Objective: To study the maternal and neonatal outcome in multi fetal pregnancy in a tertiary health centre. Materials and methods: A retrospective observational analysis of 30 twin pregnancies admitted and managed in our centre. Patients were studied for any adverse antenatal complications, mode of delivery and maternal and perinatal outcome. Results: In our study, maximum patients were in age group of 31-35 years (33.3%) and primigravida (46%), admitted with gestational age 32-37 weeks (46.6%). Commonest maternal complication observed was anemia (60%) followed by preterm labour (53.3%), premature rupture of membranes (40%), pregnancy induced hypertension (33.3%). Cesarean section was mode of delivery in maximum (60%), with common indication being Malpresentation (50%). Out of 56 live births, 51.6% were admitted in neonatal ICU for causes like prematurity (58.06%). Prematurity was the leading cause of perinatal mortality and morbidity in twin gestation. Conclusion: Twin gestation has significantly increased risk to both the mother and the fetus. Early recognition and adequate management of twin gestation can decrease associated complications and betterment of maternal and neonatal outcome.

Poor performance characteristics of conventional PCR in detection of respiratory syncytial virus-experience of a tertiary care centre in Southern India.

Respiratory syncytial virus (RSV) is a significant cause of contagious acute respiratory infections in children and older adults. Since there are contradictory reports regarding the efficacy of different methods to detect RSV, we evaluated the performance of the conventional PCR versus real‑time PCR in 222 patients with acute respiratory infections (ARI) recruited between January 2012 and March 2013. Conventional PCR had a very poor sensitivity of 40% (95% CI: 19.2-63.9%) and failed to detect RSV in respiratory samples with low viral load. Thus, it may be prudent to replace it with real‑time PCR to achieve precise diagnosis.

Ascariasis in the Gall Bladder - A Rare Case.

Settlement of adult form ascariasis parasite in the gall bladder is rare constituting 2.1 % of hepatobiliary ascariasis4. Radiologic imaging methods play an important role in the diagnosis of the parasite in the biliary tree. Computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic retrograde cholangiopancreatography (ERCP) are used in the diagnosis of hepatobiliary ascariasis. However, ultrasonography is still the first method and most preferred due to its ease of applicability and the fact that it is inexpensive and non-invasive. We report a rare case of Ascariasis lumbricoides present in gall bladder.

Cerebroprotein hydrolysate: Innovation in Neurodegenerative disorders.

Stroke, traumatic brain injury and neurodegenerative disorders are one of the leading causes of death and disability in both developing and developed countries. A number of drugs including neurotrophic drugs are available for these disorders. Cerebroprotein hydrolysate is the latest one offering new hopes to patients suffering from these disorders. Its superiority is because of different actions which help in faster and more complete nerve repair and growth than other neurotrophic agents. It acts by multiple mechanisms viz.-regulation and improvement of the neuronal metabolism, modulation of the synaptic plasticity, promoting neuronal differentiation and protection against ischemic and neurotoxin lesion, reducing excitotoxic damage, blocking over activation of calcium dependent proteases, and scavenging free oxygen radicals. Till now no serious adversity has been reported.

hair an unusual foreign body in airways presenting with haemoptysis in an adult patient.

Haemoptysis is defined as expectoration of blood originating from the lungs or tracheo-bronchial tree. It is attributed to various causes like tuberculosis, bronchiectasis, lung cancer, mycetoma, foreign bodies etc. Various types of foreign bodies have been reported in the literature. We report the case of an adult female patient who presented with an episode of haemoptysis (150 mL) in whom flexible fibreoptic bronchoscopy revealed a single long hair at the carina going to left main bronchus. Following successful removal of this hair there were no further episodes of haemoptysis and the patient manifested clinical and radiological improvement.

Screening of efficient arbuscular mycorrhizal fungi for Azadirachta indica under nursery condition: a step towards afforestation of semi-arid region of western India

To optimize nursery practices for efficient plant production procedures and to keep up to the ever growing demand of seedlings, identification of the most suitable species of arbuscular mycorrhizal fungi (AMF), specific for a given tree species, is clearly a necessary task. Sixty days old seedlings of Neem (Azadirachta indica A. Juss) raised in root trainers were inoculated with six species of AMF and a mixed inoculum (consortia) and kept in green house. Performances of the treatments on this tree species were evaluated in terms of growth parameters like plant height shoot collar diameter, biomass and phosphorous uptake capabilities. Significant and varied increase in the growth parameters and phosphorous uptake was observed for most of the AMF species against control. Consortia culture was found to be the best suited AMF treatment for A.indica, while Glomus intraradices and Glomus mosseae were the best performing single species cultures. It is the first time in the state of Gujarat that a wide variety of AMF species, isolated from the typical semi-arid region of western India, were tested for the best growth performance with one of the most important tree species for the concerned region.

Diagnostic yield of computed tomography-guided percutaneous fine needle aspiration cytology of radiological suspected cases of lung mass lesions.

Computed tomography (CT)-guided fine needle aspiration cytology (FNAC) provides high diagnostic yield in lung mass lesions, with acceptable rate of complications. In a retrospective review of data of 32 patients, the cytological diagnostic yield was found to be 90.7% of which 93% were malignant and remaining 7% were tubercular. Procedure-related complications were observed in three cases (9%); minimal haemoptysis in two and pneumothorax in one. The study confirms that CT-guided FNAC of lung mass lesions is a very useful procedure with minimal complications.

Study on Clinico -Laboratory Profile of Children with Scrub Typhus.

Scrub typhus is an acute, febrile, infectious illness caused by Orientia (formerly Rickettsia) tsutsugamushi,an obligate intracellular gram-negative bacterium. Humans are accidental hosts in this zoonotic disease.The present retrospective study describes clinical profile of the children hospitalized in hospital with Scrub Typhus infection during period 2010-2011. 19 hospitalized children with clinical features suggestive of Rickettsial disease (fever, generalized rash) who tested ELISA positive for IgM against Scrub Typhus were included in the present study between the age of 1 years and 15 years. All children presented with fever (100%). 42.10% had lymphadenopathy, 47.36% had eschar and 57.89% patients had cough. 26.31, 21.05%, 10.52%, had hepatomegaly, pain abdomen, and respiratory distress and gastrointestinal bleed respectively. All of the children were investigated and treated with as per protocol. None of them died. We think that Rickettsial infection is not quite common in this region but study showed that it is not an uncommon entity and thus, high degree of suspicion, knowledge of geographical distribution and clinical features of Rickettsial disease helps in its early diagnosis and treatment.

Can Metabolic Factors be Used Prognostically for Short-Term Mortality in HIV-Infected Patients?

Background: Metabolic abnormalities are common throughout the course of human immunodeficiency virus (HIV) infection and may occur either due to HIV infection or as a result of side effects of antiretroviral therapy. It has been established that dyslipidemia and dysglycemia associated with HIV disease reduce the long-term survival of the patients; but their role for predicting prognosis of short-term mortality in HIV patients is unknown. Aim: To study dyslipidemia and dysglycemia as a prognostic indicator for short-term mortality (3 months) in HIV patients. Subjects and Methods: An observational; prospective study was conducted at a tertiary care center over a period of 6 months. Consecutive HIV-positive patients hospitalized (both; HIV status known prior to hospitalization and the diagnosis made for the first time at admission) in medical wards from March to May 2010 were studied. All patients had their random blood sugars; fasting blood sugars (if possible); fasting lipid profile; and cluster of differentiation 4 (CD4) counts tested at the time of enrollment. The patients were followed for a period of 3 months; at the end of which they were categorized as survivors and non-survivors; and the demographic; clinical; and investigational parameters were compared between the above groups. Data was analyzed by applying Mann-Whitney U test; two sample t-test; Fisher-Exact test; and stepwise logistic regression analysis of significance; using the computer-based program; Stata; version 11.1. Results: A total of 82 patients were enrolled for the study of which 64 (78.05) were males and 18 (21.95) were females; with a mean (SD) age of 34.00 (7.0) years. The mean CD4 count was 206.23 (129.5) cells/mm 3 . The overall mortality within 3 months was 20.7 (17/82). Mycobacterium tuberculosis as opportunistic infection was found in 42 patients; out of which 13 expired (P