Gamma radiation induced changes in expression of heat shock proteins (Hsc70 and Hsp83) in the dengue vector Aedes aegypti (L.)

We aimed to assess the effect of gamma radiation on the expression of heat shock proteins Hsc70 and Hsp83 in Aedes aegypti. Adult males were irradiated with 50Gy of gamma radiation, and changes in the expression of proteins in SDS-PAGE gel bands corresponding to molecular weights ~60–75kDa and ~80–95kDa were analyzed at two different time points 6 and 12-hour post-irradiation, using a temporal mass spectrometry based semi-quantitative analysis. A 2-3-fold increase was observed in both proteins Hsc70 and Hsp83, at both time points. In addition, the experiment also revealed the overexpression of several other molecules such as Arginine Kinase - known to be upregulated in certain insects during stress, Esterase B1- implicated in insecticide resistance, and also down-regulation of the 26S proteasome non-ATPase regulatory subunit 1 and ubiquitin-activating enzyme E1 - both known to be involved in ubiquitin-mediated protein degradation. The results taken together with existing data on Hsp83 and Hsc70, indicate that these proteins may enhance the survival of Ae. aegypti following gamma radiation and could serve as molecular markers for the detection of radiation-induced stress.

A Study Of Paranasal Sinus Complications In Post Covid Patients At A Tertiary Care Centre

Background:Paranasal sinus complications in patients recovering from COVID 19 ison the rise. This study is to evaluate the clinically suspected cases of Post Covid Sinusitis patients.Material And Methods:Total 200 cases of Post Covid Sinusitis patients were included in this study. The demographic profile, clinical and radiological presentation, underlying immunocompromised status, laboratory results and treatment outcome of the patients was analysed.Result:Post Covid Sinusitis was observed mainly in the fifth and sixth decade of life with a male predominance. Most common associated disease was diabetes mellitus (77%). Laboratory analysis revealed infection with Mucor and Aspergillus species most commonly. Sino-nasal, orbital, cerebral, palatine and skin involvement found in 100%, 40%, 12.5%,37% and 2.5% of patients, respectively. Symptoms and signs are headache (62.5%), cheek swelling(40%),and decreased vision(26.5%). All patients were treated by surgical debridement, antibiotics and antifungal medications. Overall survival rate was 87.5%.Conclusion:Clinical suspicion and early diagnosis in post covid patients followed by surgical debridement of diseased tissue, antifungal and antibiotic medications are crucial for better prognosis and improved survival rates.

A Study Of Mandible Fracture Cases A - Prospective Observational Study

Background:Mandible fractures constitutethe substantial proportion of cases of maxillofacial trauma . This study is to evaluate and compare cases of mandibular fracture based on its etiology, age, gender, anatomical distribution and treatment modalities.Material And Methods:The study was carried out on 72 cases of mandible fracture patients who were admitted in Otorhinolaryngology department of Sir.T.Hospital and Government Medical College, Bhavnagar from August 2019 to August 2020.Result:Age: <10years –12.8%, 11 to 20years –24.8%, 21 to 30years -29%, 31 to 40years –22%, 41 to 50years –6.4%, >50years-5%.Gender:Male-81.3%, Female-18.7% .Etiology:Road traffic accidents-62%, fall down-22%, assault-12.8%, sports-3%. Site Of Fracture:Body of mandible -30%, angle-25%, condyle-20%, parasymphysis-14%, symphysis-6%, ramus-3%, coronoid-2%.Treatment:Plating-24%, wiring-11.9%, Plating+wiring-60%, conservative –4.1%. Conclusion:Age:The age group between 21 to 30years of age were most commonly affected.Gender: Males are more commonly affected than females.Cause:Road Traffic Aaccidentsbeing the most commom cause of mandible fracture.Site:Body of mandible being the most common site to be fractured followed by angle and condyle of mandible. Mode Of Treatment:Plating And Wiring was the most common surgical method required for the fracture treatment.

Study to determine serum vitamin D levels in patients with congestive heart failure

Background: It was to evaluate the association of serum levels of vitamin D in patients with congestive heart failure.Methods: The present study was conducted in the department of Medicine at Chattrapati Shivaji Subharti Hospital among 100 patients, aged 18 years and above diagnosed as congestive heart failure on the basis of clinical and echocardiographic evidence. Clinical manifestations looked for CHF were: Dyspnea, orthopnea, acute pulmonary edema, cerebral symptoms, cheyne-stokes respiration, cyanosis, sinus tachycardia, raised jugular venous pressure, congestive hepatomegaly and pedal edema. In the present study deficiency/ insufficiency of vitamin D was considered when the presence of levels of 25-hydroxyvitamin D was <30 ng/ml. Laboratory tests performed to diagnose congestive heart failure and serum vitamin D levels were complete blood count, KFT (urea, serum creatinine), serum electrolytes, ECG, chest X ray and echocardiogram. Data were tabulated and examined using the statistical package for Social Sciences Version 22.0.Results: When data was assessed for comparison in relation to NHYA grades and vitamin D levels, it was found to be statistically significant. The Mean±SD scores of serum urea (mg/dL) was found to be 44.7±56.4, 47.3±63.8 and 36.4± 18.3 in whole study sample, vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference. The Mean±SD scores of CPK MB (IU/L) was found to be 33.1±20.8 and 18.6±13.3 among the subjects having vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference.Conclusions: The results of the present study suggest that low levels of vitamin D may adversely affect the cardiovascular system.

Prevalence and risk factors associated with prehypertension and hypertension among attendants of patients at a rural tertiary care institute of Haryana

Background: Hypertension (HTN) is the leading risk factor for death and disability globally and disproportionately impacts low-and middle-income countries. HTN is present in 25% of urban and 10% of rural subjects in India. Our objective was to estimate the prevalence of pre-HTN and HTN among the attendants of patients at a rural tertiary care institute of Haryana.Methods: This was a hospital-based cross-sectional study. A total of 309 attendants of patients were enrolled for this study. Diagnosis of pre-HTN and HTN was done on the basis of seventh joined national committee guidelines. Data were collected on a semi-structured proforma and were analysed by using R software.Results: The prevalence of pre-HTN and HTN was 18.4% and 21.4% respectively. Both the pre-HTN and HTN were significantly higher in males (p=0.002) and in the age group of 45 to 55 years (p<0.001). The multinomial logistic regression analysis revealed that sex, age >55 years and BMI >23 kg/m2 were significantly associated with pre-HTN and HTN.Conclusions: The prevalence of both prehypertension and hypertension is high in rural Haryana. This makes the people of this area vulnerable to several chronic diseases. The findings warrant urgent measures to lower the risk factors in rural communities. So, programs are needed to improve the surveillance systems and implementation of community based screening programs for early detection of hypertension.

Assesment of Insulin Resistence in Different Stages of Chronic Kidney Disease

Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.

Cherubism – A case report.

Cherubism is an autosomal dominant fibro-osseous lesion of jaws involving more than one quadrant that stabilizes after growth period, usually leaving some facial deformity and malocclusion.Here we present a case of 7 years old male patient who came with complaint of bilateral enlargement of lower face since 4 years. A thorough physical and radiographic examination was done and a diagnosis of cherubism was made.

Solid State Characterization and Effect of PEG 20000 and Lecithin on Particle Size Reduction and Stability of Complexed Glibenclamide Nanocrystals.

Aims: To formulate and characterize GLB-PEG-LEC NCs (lecithin complexed Glibenclamide nanocrystals) and to analyze the effect of PEG 20000 and lecithin on drug properties, particle size reduction and stability of GLB NCs. Study Design: Precipitated (GLB-PEG) and complexed nanocrystals (GLB-PEG-LEC) of glibenclamide were characterized for particle size, size distribution, zeta potential and stability assessment using photon correlation spectroscopy. The crystallinity was analyzed by X-ray powder diffraction spectroscopy and differential scanning calorimetry. The chemical stability was assessed by means of infrared spectroscopy and surface morphology by scanning electron microscopy. Place and Duration of Study: Asian Institute of Medicine Science and Technology, Malaysia, between May 2102 and June 2013. Methodology: GLB-PEG NCs were prepared by precipitation technique using PEG 20000 and complexed by soybean lecithin. The effect of lecithin in particle size reduction, change in crystallinity, stability and surface properties of NCs were analyzed and compared with pure glibenclamide (GLB) and precipitated NCs. The formulations were optimized and its stability was assessed during a 3 month period. Results: Pure GLB exhibited an average particle size of 1551 nm. The average particle size of precipitated NCs was between 236 - 7000 nm, while that of complexed NCs was between 155 - 842 nm. The particle size of NC was found to decrease, whereas its zeta potential was found to increase after complexation. DSC studies showed no change in crystalline structure. PXRD studies proved that crystallinity was maintained in NCs. SEM analysis showed presence of spherical shape particles with a lipid coat on the surface after complexation. Stability studies revealed no change in particle size during 3 month period. FTIR studies showed the compatability of excipients with the drug. Conclusion: These results show that lecithin complexed GLB NCs could be utilized as promising carriers in development of various formulations due to its high stability and decreased particle size.

Estimation of salivary glucose level and plasma glucose level in subjects with and without diabetes mellitus: a comparative study.

Objective: The objective of this study was to estimate and correlate salivary glucose levels and plasma glucose levels in non-diabetic subjects, controlled and uncontrolled diabetic subjects and to assess if salivary glucose can be a potentially useful non-invasive tool in diagnosing diabetes mellitus and in monitoring of glycemic control in diabetic patients. Materials and methods: A total of 90 subjects aged between 40-60 years participated in the study. Diabetic status was determined by estimation of random non-fasting plasma glucose levels and Glycosylated haemoglobin levels. Both unstimulated and stimulated saliva were collected and investigated for glucose levels. Salivary glucose levels were measured using the glucose oxidase method. Results: Salivary glucose levels were significantly higher in diabetics than non-diabetics. Mean un-stimulated salivary glucose level was 1.15 mg/dL in control group, 2.04 mg/dL in controlled diabetic group and 3.99 mg/dL in un-controlled diabetic group. There was a significant positive correlation between salivary and plasma glucose levels. Conclusion: These results show that salivary glucose concentration can be used as a potentially useful non-invasive tool for diagnosing diabetes mellitus and monitoring glycemic control in diabetic patients.

Treatment Seeking in Reproductive Age Women with RTIs/STIs : A Community based Cross-sectional Study.

The socio-cultural and economic contexts in developing countries influence the epidemiology or STls and helps in making them an important public health priority. This study was carried out to explore the health care seeking pathway of the women suffering from RTls/STls. influence or major socio-demographic variables on treatment seeking pattern. This cross sectional study was carried out comprising or eight hundred reproductive age (15-49 years) women selected following a multistage sampling procedure. The information pertaining to health seeking behaviour were collected from them using a pre-designed pretested interview schedule. Quantum of RTls/STls in the study group was estimated and symptomatics were asked specially about time lag between appearance of symptoms and seeking acre; reason for not seeking care; outcome of treatment they have taken if any. Out of total 359 subjects with symptoms of RTls/STls only about one-third (37.3%) had sought treatment. Only a few (4.5%) had sought treatment within 1 month of appearance of symptoms. Considering it to be physiological about half of the subjects (45.3%) did not seek treatment. The treatment seeking pattern was highly associated with the level of education (p=0.000). Reluctance in seeking treatment, delay in its initiation, prelerencc for unqualified practitioners in first consultation and significant association between education and treatment seeking pattern emphasize BCC and service provision for control and prevention of RTls/STls.

Knowledge about Condoms among Adolescents in Kathmandu Valley.

Introduction: The issues of sexual and reproductive health (SRH) remain the leading cause of ill health among adolescents worldwide and are of growing concern in Nepal. The correct knowledge of condoms is integral part of SRH. The present study was carried out to assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Aim: To study, assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Methods: The study was a cross-sectional questionnaire-based survey. The sample was derived through cluster sampling of the secondary schools in the Kathmandu valley. Schools were selected randomly and two hundred and fifty adolescents were taken from each government and non-government high schools. Result: Altogether 500 adolescents were recruited for this study. A total of 298 (53.0%) participants said that condoms reduced pleasure. Most women don’t like to use condoms was agreed by 291 (55.6%) people and it was statistically significant (p value < 0.05) when compared between males and females. Using condoms with new partner is a good idea was agreed upon by 448 (81.0%) participants. Women should ask their partners to use condoms was answered by 480 (88.1%) and discussing condom use with prospective partner is easy was agreed by 417(79.0%) and both the issues were also statistically significant (p value < 0.05). Conclusion: It was found that the knowledge about condoms was not adequate and the knowledge among male participants was in general better than females.

Introduction: The issues of sexual and reproductive health (SRH) remain the leading cause of ill health among adolescents worldwide and are of growing concern in Nepal. The correct knowledge of condoms is integral part of SRH. The present study was carried out to assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Aim: To study, assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Methods: The study was a cross-sectional questionnaire-based survey. The sample was derived through cluster sampling of the secondary schools in the Kathmandu valley. Schools were selected randomly and two hundred and fifty adolescents were taken from each government and non-government high schools. Result: Altogether 500 adolescents were recruited for this study. A total of 298 (53.0%) participants said that condoms reduced pleasure. Most women don’t like to use condoms was agreed by 291 (55.6%) people and it was statistically significant (p value < 0.05) when compared between males and females. Using condoms with new partner is a good idea was agreed upon by 448 (81.0%) participants. Women should ask their partners to use condoms was answered by 480 (88.1%) and discussing condom use with prospective partner is easy was agreed by 417(79.0%) and both the issues were also statistically significant (p value < 0.05). Conclusion: It was found that the knowledge about condoms was not adequate and the knowledge among male participants was in general better than females.

Non-hypertensive intracerebral haemorrhage: some interesting observations.

Hypertension is the commonest cause of intracerebral hemorrhage (ICH) but non-hypertensive intracerebral hemorrhages (NHICH) are not rare. We report three interesting cases of NHICH subsequent to amyloid angiopathy, alcoholic hepatitis and amphetamine abuse. They suggest the importance of recognizing these conditions and need for urgent specific therapy which may play a vital role in therapeutic planning and prevention of ICH.

Thallium poisoning presenting as paresthesias, paresis, psychosis and pain in abdomen.

Due to involvement of multiple systems, thallium poisoning is notorious for complexity and seriousness as symptoms of toxicity are non-specific and diverse. Alopecia and painful neuropathy are its cardinal features, others being gastrointestinal disturbances, encephalopathy, tachycardia, ataxia, hepatorenal and cardiac damage etc. We report a case of thallium poisoning who presented initially with gastrointestinal symptoms and later developed neurological features (peripheral neuropathy and delirium). Various diagnoses were entertained in this case and thallium poisoning was suspected only after he developed alopecia and neuropsychosis. He made a significant recovery by conservative management in spite of delay in diagnosis. We conclude that a high level of suspicion should be kept for thallium poisoning, especially in patients with painful, peripheral neuropathy and gastrointestinal symptoms which appear earlier than alopecia, since prognosis is more rewarding with early diagnosis, leading to complete recovery.

Leber's hereditary optic neuropathy with molecular characterization in two Indian families.

PURPOSE: Leber's hereditary optic neuropathy (LHON) presents in early adulthood with painless progressive blindness of one or both eyes. Usually there is a positive family history of similar disease on the maternal side. Definitive diagnosis can be established by finding the change in the mitochondrial gene. No molecular studies have been reported from India. MATERIAL AND METHODS: Clinical, ophthalmologic and molecular studies were carried out in two patients from different families and available first degree relatives. The subjects were tested for the three common mutations seen in LHON by molecular techniques of polymerase chain reaction using mutation specific primers. RESULTS: The mutations G3460A and G11778A in the mitochondrial genes MTND1 and MTND4, known to be causative for LHON, were found in one family each. CONCLUSION: Diagnosis of LHON should be considered in familial cases and in young adults with optic atrophy. Confirmation of diagnosis should be sought by molecular gene analysis. Genetic counselling should be offered to all 'at risk' relatives of a patient harbouring the mutation.

Clinical spectrum, pitfalls in diagnosis and therapeutic implications in herpes simplex encephalitis.

OBJECTIVES: High index of suspicion is mandatory for early diagnosis of Herpes Simplex Encephalitis (HSE), since acyclovir therapy can prevent its mortality and limit morbidity. We report our observations on clinical spectrum, pitfalls in diagnosis and therapeutic aspects in patients of HSE. METHODS: There were 34 patients of HSE (26 males and eight females) in age range 6 -72 (mean 23.8 +/- 8.9) years. Diagnosis was confirmed by cranial MRI, EEG and PCR in CSF. Acyclovir was given to 24 patients. Carbamazepine and sodium valproate were the antiepileptic drugs used. RESULTS: Most of the patients were referred either as Japanese encephalitis, cerebral malaria or tubercular meningitis. High fever, seizures, behavioral abnormality and encephalopathy were present in all, either at onset or later. EEG, CSF abnormality and cranial MRI were abnormal in all 34 patients. PCR for Herpes Simplex virus was positive in 65 % cases CT was performed in 10 cases but abnormality was detected only in four. We observed features of Kluver Bucy syndrome in three patients, suffering from HSE. Following complete acyclovir therapy in 24 patients, 12 recovered completely and four partially. There was no improvement in four patients including two patients who had features of Kluver Bucy Syndrome, while four expired. Among the seven patients who refused therapy of acyclovir, five expired, while two remained in unaltered status. Treatment could not be completed in three patients as they expired during therapy. CONCLUSION: HSE is commonly misdiagnosed. Important factors influencing mortality and morbidity of HSE were; early acyclovir therapy, age, immune status of patient, duration of illness, and consciousness level before initiation of therapy. We conclude that acyclovir should be given to all patients as soon as suspected, while confirmatory investigations are in progress.

Intravenous sodium valproate in status epilepticus.

A study was conducted to observe the effect of intravenous sodium valproate in status epilepticus. Eleven patients with status epilepticus, who were resistant to conventional drugs, underwent treatment with intravenous sodium valproate. The seizures were controlled in 10 patients within 24-48 hrs of starting treatment. No complications were observed during therapy. We conclude that intravenous sodium valproate can be recommended for Myoclonic status epilepticus and non-convulsive status epileticus.

Herpes simplex encephalitis: some interesting presentations.

Herpes Simplex Encephalitis (HSE) is the most common cause of fatal viral encephalitis. A high index of suspicion is mandatory for early diagnosis and successful therapy to restrict morbidity and mortality. We report 4 patients of HSE, with interesting presentations, viz. brainstem involvement in an immunosuppressed patient, Kluver-Bucy Syndrome-a consequence of untreated HSE, HSE in the postpartum period mistaken as cortical venous thrombosis, and response to inadequate treatment. They demonstrate the wide spectrum of clinical features, pitfalls in diagnosis, and a variable response to therapy in HSE.