Descriptive analysis of sleep quality and its determinants among rural population of coastal Karnataka

Background: A good quality of sleep helps to maintain mood, memory and cognitive performance. Aim & Objective: To assess quality of sleep and its determinants among rural adults. Settings and Design: A community based cross sectional study was carried out in rural field practice area of a medical college Methods and Material: Pittsburg sleep quality index scale was used to assess quality of sleep. Semi-structured questionnaire was used to collect information from participants. Anthropometric and blood pressure measurements were taken. Statistical analysis used: Chi-square test was used to find out association between poor sleep and specific morbidities. Univariate and multivariate logistic regression was done to assess predictors of poor sleep. Results: Among the 614 study subjects, 60.3% had good sleep. Presence of morbidity was significantly associated with poor sleep [AOR=1.48; 95%CI=1.05-2.08]. Presence of a dark room, taking a bath or having milk before bed time were top reasons cited to be facilitating good sleep. Presence of mosquitoes, having young children or adolescent at home and vital events in last one year were reported to hinder good sleep. Conclusions: A sizeable proportion of rural adults have poor sleep. Presence of morbidity was a significant predictor of poor sleep.

Bulk segregant analysis identifies SSR markers associated with Alternaria blight resistance in linseed (Linum usitatissimum L.)

Aim: Alternaria blight caused by Alternaria lini is one of the major diseases of linseed which severely affects the yield and productivity. Here, we utilizes F2 mapping population derived from a resistant (JRF-4) and a susceptible (Chambal) genotypes of linseed and SSRs to identify the markers associated with Alternaria blight resistance using bulk segregant analysis approach. Methodology: A population consisting of 154 F2 individuals was developed from the cross between JRF-4 (resistant) and Chambal (susceptible). All 154 F2 individuals were screened with 100 polymorphic SSRs to identify extreme phenotype. Two bulk of extremes phenotypes (disease resistant and disease susceptible) from F2 mapping population were used for the bulked segregant analysis. The SSR primers that distinguished the parental lines were used to amplify the DNA from two bulks and banding pattern was observed to identify the SSRs that can differentiate the resistant and susceptible phenotypes bulk for Alternaria blight. Markers validation was carried out by amplifying DNA from individual plants of each bulk. Results: Out of 100, only 10 markers showed polymorphism among the bulks and of which only three markers viz., LUSc 898_3_12, Lu 2472 and Lu 3078 were able to differentiate the disease resistant and susceptible individuals from F2 population. Further, single marker linear regression approach was used to validate the association of selected polymorphic markers with the disease. The markers LUSc 898_3_12 and Lu 2472 showed significant regression which confirmed their linkage with Alternaria blight resistance. Interpretation: The two markers having significant regression can be used for diseases resistance breeding during marker assisted selection.

Perceptions and Suggestions of II year M.B.B.S. Students Regarding Updated Pathology Teaching Curriculum: An Analytic Study

Introduction: In most of the medical colleges of India, the knowledge regarding basic science subjects is taught mainly through didactic lectures, tutorials and practicals. And hence the system is more of teacher centered with less interaction or involvement from the students. There is a need to explore innovations, so as to sustain interest. Objectives: To introduce interactive teaching and assessment methods during lectures and examinations respectively and to elicit student’s perception about them. Materials and Method: A number of interactive methods were introduced in the pathology curriculum in a batch of 153 medical students of 2nd year M.B.B.S. Later the perceptions of the students were elicited regarding these sessions using a questionnaire based on Likert scale. Results: Validation of the scale indicated good internal consistency with Crohnbach’s alpha coefficient of 0.9. Majority (83%) of the students agreed or strongly agreed to like the interactive sessions. Similarly, 86% agreed or strongly agreed to like teamwork in group discussions and quiz sessions. Most popular interactive mode was MCQ’s followed by Cinemeducation. Most students were also of the view that interactivity during lectures keeps them active, more attentive in the class, makes the atmosphere more lively, also improved their communication skills, helps in retention of the topic, clearing doubts, improves attention span and hence results in better understanding of the subject. Conclusion: This project clearly proves that updated pathology curriculum is preferred by students. So, teacher should take a new role of facilitating the process of interactive learning rather than delivering elaborative lectures.

Comparison of McGurk Effect across Three Consonant-Vowel Combinations in Kannada

BACKGROUND AND OBJECTIVES: The influence of visual stimulus on the auditory component in the perception of auditory-visual (AV) consonant-vowel syllables has been demonstrated in different languages. Inherent properties of unimodal stimuli are known to modulate AV integration. The present study investigated how the amount of McGurk effect (an outcome of AV integration) varies across three different consonant combinations in Kannada language. The importance of unimodal syllable identification on the amount of McGurk effect was also seen. SUBJECTS AND METHODS: Twenty-eight individuals performed an AV identification task with ba/ ga, pa/ka and ma/n· a consonant combinations in AV congruent, AV incongruent (McGurk combination), audio alone and visual alone condition. Cluster analysis was performed using the identification scores for the incongruent stimuli, to classify the individuals into two groups; one with high and the other with low McGurk scores. The differences in the audio alone and visual alone scores between these groups were compared. RESULTS: The results showed significantly higher McGurk scores for ma/n· a compared to ba/ga and pa/ka combinations in both high and low McGurk score groups. No significant difference was noted between ba/ga and pa/ka combinations in either group. Identification of /n· a/ presented in the visual alone condition correlated negatively with the higher McGurk scores. CONCLUSIONS: The results suggest that the final percept following the AV integration is not exclusively explained by the unimodal identification of the syllables. But there are other factors which may also contribute to making inferences about the final percept.

Comparison of Outcomes using Pediatric Index of Mortality (PIM) -3 and PIM-2 Models in a Pediatric Intensive Care Unit

Objectives: To compare patient outcomes using the Pediatric Index of Mortality-3 (PIM-3)model with PIM-2 model for children admitted to the intensive care unit. Methods: Weprospectively recorded the baseline characteristics, variables of PIM-3 and PIM-2 atadmission, and outcomes of children ?17 years over a period of 11 months. We used AreaUnder Receiver Operating Characteristics (AU-ROC) curves and Goodness-of-fit (GOF)tests to determine which of the two models had better discrimination and calibration.Results: Out of 202 children enrolled, 69 (34%) died. Sepsis and pneumonia were thecommon admitting diagnoses. The AU-ROC was better for PIM-3 (0.75) as compared to PIM-2 (0.69; P=0.001). The GOF-P value was 0.001 for both models, that indicated poorcalibration of both (P<0.001). The AU-ROC curves were acceptable across different age anddiagnostic sub-groups. Conclusion: PIM-3 had better discrimination when compared toPIM-2 in our unit. Both models had poor calibration across deciles of risk.

Left ventricular mass: A tumor or a thrombus diagnostic dilemma.

Left ventricular (LV) mass is a rare condition, of which the most common is thrombus. Echocardiography is a very useful modality of investigation to evaluate the LV mass. We are reporting a case of LV mass presenting with neurological symptom. The diagnosis of this mass was dilemma as the echocardiographic features were favoring tumor as well as thrombi. Mass (a) measuring 3.8 cm × 1.9 cm attached to the left ventricle apex appeared to be pedunculated tumor and mass (b) measuring 2.4 cm × 1.8 cm attached to the chordae of anterior mitral leaflet resembled a thrombus or an embolized tumor entangled in the chordae. A differential diagnosis for the LV mass is thrombus, tumors such as fibroma, and vegetation. Preoperative detection of a thrombus leads to an alteration in surgical steps. A large and mobile thrombus with or without a hemodynamic alteration is an indication for surgical removal to prevent stroke, myocardial infarction, mesenteric ischemia, renal infarction, gangrene of the limbs, and mortality.

Influence of different abutment diameter of implants on the peri‑implant stress in the crestal bone: A Three‑dimensional finite element analysis ‑ In vitro study.

Purpose of the Study: The study was designed to evaluate and compare stress distribution in transcortical section of bone with normal abutment and platform switched abutment under vertical and oblique forces in posterior mandible region. Materials and Methods: A three‑dimensional finite element model was designed using ANSYS 13.0 software. The type of bone selection for the model was made of type II mandibular bone, having cortical bone thickness ranging from 0.595 mm to 1.515 mm with the crestal region measuring 1.5 mm surrounding dense trabecular bone. The implant will be modulated at 5 mm restorative platform and tapering down to 4.5 mm wide at the threads, 13 mm long with an abutment 3 mm in height. The models will be designed for two situations: (1) An implant with a 5 mm diameter abutment representing a standard platform in the posterior mandible region. (2) An implant with a 4.5 mm diameter abutment representing platform switching in the posterior mandible region. Force application was performed in both oblique and vertical conditions using 100 N as a representative masticatory force. For oblique loading, a force of 100 N was applied at 15° from the vertical axis. von Mises stress analysis was evaluated. Results: The results of the study showed cortical stress in the conventional and platform switching model under oblique forces were 59.329 MPa and 39.952 MPa, respectively. Cortical stress in the conventional and platform switching model under vertical forces was 13.914 MPa and 12.793 MPa, respectively. Conclusion: Results from this study showed the platform switched abutment led to relative decrease in von Mises stress in transcortical section of bone compared to normal abutment under vertical and oblique forces in posterior mandible region.

Aspergillus colonisation of pulmonary rheumatoid nodules: a rare cause of 'bull's eye' appearance.

Pulmonary rheumatoid nodules [PRNs] are a well described manifestation of rheumatoid arthritis [RA]. Fungal colonisation of these nodules is a rare phenomenon. We report a case of Aspergillus colonisation of multiple cavitary rheumatoid nodules in a young female patient with long-standing seropositive RA with 'bull's eye' appearance on computed tomography [CT]. The 'bull's eye' appearance inside PRNs should raise the suspicion of possible fungal colonisation. In patients with RA, a high index of suspicion for the fungal colonisation should be considered by the clinicians treating pulmonary cavitary nodules.

Assessment of atherosclerosis by carotid intimomedial thickness in patients with rheumatoid arthritis.

OBJECTIVES: To determine the prevalence of subclinical (asymptomatic) atherosclerosis in patients with rheumatoid arthritis (RA) and to study the variables affecting such an occurrence. METHODS: Case control study which included 100 patients with RA having disease duration more than 5 years and 100 healthy age and sex matched controls. Cases and controls symptomatic for atherosclerosis or having traditional risk factors for atherosclerosis were excluded. Both cases and controls were subjected to carotid ultrasound examination in addition to detailed history and physical examination. RESULTS: The study population (both cases and controls) included 94 females and 6 males. The mean age of cases and controls was similar (44.06 +/- 11.32 years and 44.1 +/- 11.52 years). The mean disease duration was 155.04 +/- 48.8 months. The mean carotid intimo-medial thickness (CIMT) of the RA patients (0.519 +/- 0.18 mm) was significantly greater than the controls (0.387 +/- 0.085). Age and disease duration were the only factors found to significantly affect CCIMT. RA patients had higher prevalence of carotid plaques (21%) compared to controls (1%). Erosions on hand radiographs were the only significant predictor of plaques in patients with RA. CONCLUSION: Patients with RA exhibit premature atherosclerosis by way of increased CIMT and carotid plaques when compared to age and sex matched controls.

Panniculitides--a clinicopathologic study.

OBJECTIVES: To describe the clinical and pathologic features of panniculitides, an uncommon group of diseases, where the available Indian literature is sparse. MATERIAL AND METHODS: Prospective four years study of patients presenting with panniculitis to a large teaching hospital in North India. RESULTS: Erythema nodosum (EN) was the commonest panniculitis (79.3% cases) in our cohort. Other causes included erythema induratum, Weber Christian disease, cutaneous polyarteritis nodosa and panniculitis associated with Takayasu's arteritis and dermatomyositis-lupus overlap. Elevated ESR and leukocytosis were the common laboratory abnormalities encountered. Septal panniculitis without vasculitis was the most frequent histopathologic pattern observed. Patients of EN did well on nonsteroidal anti-inflammatory drugs while corticosteroids with or without azathioprine were used to treat other panniculitides. CONCLUSIONS: Physician awareness, clinical pattern recognition and histopathological confirmation, all play a key role in the identification and management of panniculitis.

Role of HLA antigens in Rh (D) alloimmunized pregnant women from Mumbai, Maharashtra, India.

Immunogenetic studies in various diseases provide potential genetic markers. We have studied the incidence of HLA A, B, C, DR and DQ loci antigen in Rh (D) antigen isoimmunized mothers compared to those nonimmunized isoimmunized Rh negative mothers. Seventy six mothers who were immunized to Rh (D) antigen due to pregnancy (responders) and fifty four mothers who did not develop Rh (D) isoimmunization despite positive pregnancies (nonresponders) were selected for the study. Standard methods of serological HLA typing, ABO and Rh (D) groups, and screening for Rh D antibodies were used. 392 unrelated individuals from the population were compared as controls. In addition 45 unrelated individuals from the same population were typed for HLA DRB and DQB gene using PCR-SSP kits. The genotype frequencies of HLA A2, A3, A28, B13, B17, B35, B52, B60, Cw2, Cw6, DR4, and DQ3 were significantly increased, while the frequencies of the HLA A11, A29, A31, B7, B37, B51, Cw1 and DR9 were decreased in the responder women when compared to the non-responder women. HLA A30 (19) split antigen was not identified in immunized women while HLA A23 (9) split antigen was not identified in non immunized women. HLA A3, B17, Cw2 and DR4 showed a significant relative risk among the immunized responder women. When compared with Rh immunized women (responders) reported from USA, England and Hungary the phenotype frequencies of HLA A11, A24, A28, B5, B17, B40, DR2 and DR5 were increased while HLA A23, B8, B18, and DR6 were decreased in the Indian Rh immunized women. Two locus haplotype frequency analysis observed among the responders women revealed that among the significant haplotypes expressed A2-B5, B7-Cw1, DR2-DQ1 were highly significant haplotypes in positive linkage, while A1-B5, and A1-B7 were in significant negative linkage disequilibrium. The haplotype frequencies were <or= one when these common hapoltypes were compared with control population. Thus in the present study it is evident that the inheritance of HLA A3, B17, Cw2 and DR4 increases the relative risk factor by 2.6 times among Indian Rh isoimmunized women. Further, it is evident that there are significant differences in the observed HLA antigen frequencies and two locus haplotypes in Rh isoimmunized women when compared to women from USA, UK and Hungary due to extreme HLA polymorphism in different populations of the world.

Inhibitory effect of 1-benzyl-5[(C)-2,6-dimethyl-1,5-heptadienyl] imidazole (KK-42) on desert locust, Schistocerca gregaria forsk.

Imidazole compound KK-42 was tested for its inhibitory effect on Schistocerca gregaria. The compound caused 80% mortality after 19 days of treatment with 100 microg of KK-42/insect. It also caused the production of deformed adults at even lower doses. Ecdysteroid content, when estimated by RIA, declined due to KK-42 treatment in both haemolymph and ovaries of the insect. Reduction in ecdysteroid titer was maximum at 100 microg of KK-42/insect. The value estimated by RIA was 0.34 ng/pL haemolymph as compared to 0.97 ng/microL in case of controls. Similarly,ecdysteroid content of ovaries detected was 0.48 ng/mg in treated ones as compared to 0.61 ng/mg in controls. Histological studies, however, revealed no alteration in the ovarian tissues due to KK-42 treatment.

Covert bacteriuria in nephrotic syndrome.

Prevalence of covert bacteriuria in patients of nephrotic syndrome admitted for kidney biopsy was studied in 205 patients. Age ranged from 10 years to 65 years. 148 patients were male and 57 were female. Prevalence of covert bacteriuria was found in 38 patients (18.53%). In bacteriuric patients 30 were male, 8 were female. Escherichia coli was the commonest organism grown in bacteriuric patients (30 or 78.9%). Serum albumin was low and 24-hour urinary protein excretion was high in bacteriuric patients in comparison to abacteriuric patients. In bacteriuric patients membranous nephropathy was the commonest histopathological finding present in 15 patients (39.47%).