An in vivo electromyographic evaluation of pain relief using different therapies in masticatory myalgia patients

Objectives@#This study is aimed to evaluate and compare the effect of moist heat fomentation therapy with ultrasound therapy in patients with the masticatory myalgia. @*Materials and Methods@#The study was conducted on 42 patients with masticatory myalgia, dividing them into two groups; Group A (21 patients), received moist heat therapy and Group B (21 patients), received ultrasound therapy for seven effective days. Prior and after the treatment the numeric rating scale (NRS) and the electromyography (EMG) scores were recorded and compared. The observations were analyzed clinically and statistical support was taken to assess the NRS and EMG data. @*Results@#Irrespective of the groups, patients testified a significant reduction in pain after the treatment. From the EMG readings; even though the standard deviation for each group was varied considerably, EMG recorded an improved muscle activity. Statistical analysis was used to assess and identify the best treatment methodology between the two modalities. @*Conclusion@#From the statistical analysis, it is concluded that, though both the therapies had significantly reduced the symptomatic response, it is moist heat fomentation that improved muscle activity both statistically and clinically in comparison to ultrasound.

Influence of biofilm-forming lactic acid bacteria against methicillin-resistant Staphylococcus aureus (MRSA S547)

Objective To investigate the antibacterial effect of selected lactic acid bacteria (LAB) biofilms on the planktonic and biofilm population of methicillin-resistant Staphylococcus aureus (MRSA) (S547). Methods In this study, biofilm-forming LAB were isolated from tairu and kefir. Isolate Y1 and isolate KF were selected based on their prominent inhibition against test pathogens (using spot-on-agar method and agar-well-diffusion assay) and efficient biofilm production (using tissue culture plate method). They were then identified as Lactobacillus casei (L. casei) Y1 and Lactobacillus plantarum (L. plantarum) KF, respectively using 16S rDNA gene sequencing. The influence of incubation time, temperature and aeration on the biofilm production of L. casei Y1 and L. plantarum KF was also investigated using tissue culture plate method. The inhibitory activity of both the selected LAB biofilms was evaluated against MRSA (Institute for Medical Research code: S547) using L. plantarum ATCC 8014 as the reference strain. Results L. casei Y1 showed the highest reduction of MRSA biofilms, by 3.53 log at 48 h while L. plantarum KF records the highest reduction of 2.64 log at 36 h. In inhibiting planktonic population of MRSA (S547), both L. casei Y1 and L. plantarum KF biofilms recorded their maximum reduction of 4.13 log and 3.41 log at 24 h, respectively. Despite their inhibitory effects being time-dependent, both LAB biofilms exhibited good potential in controlling the biofilm and planktonic population of MRSA (S547). Conclusions The results from this study could highlight the importance of analysing biofilms of LAB to enhance their antibacterial efficacy. Preferably, these protective biofilms of LAB could also be a better alternative to control the formation of biofilms by pathogens such as MRSA.

Influence of biofilm-forming lactic acid bacteria against methicillin-resistant Staphylococcus aureus (MRSA S547)

Objective:To investigate the antibacterial effect of selected lactic acid bacteria (LAB) biofilms on the planktonic and biofilm population of methicillin-resistant Staphylococcus aureus (MRSA) (S547).Methods:In this study,biofilm-forming LAB were isolated from tairu and kefir.Isolate Y1 and isolate KF were selected based on their prominent inhibition against test pathogens (using spot-on-agar method and agar-well-diffusion assay) and efficient biofilm production (using tissue culture plate method).They were then identified as Lactobacillus casei (L.casei) Y1 and Lactobacillus plantarum (L.plantarum) KF,respectively using 16S rDNA gene sequencing.The influence of incubation time,temperature and aeration on the biofilm production of L.casei Y1 and L.plantarum KF was also investigated using tissue culture plate method.The inhibitory activity of both the selected LAB biofilms was evaluated against MRSA (Institute for Medical Research code:S547) using L.plantarum ATCC 8014 as the reference strain.Results:L.casei Y1 showed the highest reduction of MRSA biofilms,by 3.53 log at 48 h while L.plantarum KF records the highest reduction of 2.64 log at 36 h.In inhibiting planktonic population of MRSA ($547),both L.casei Y1 and L.plantarum KF biofilms recorded their maximum reduction of 4.13 log and 3.41 log at 24 h,respectively.Despite their inhibitory effects being time-dependent,both LAB biofilms exhibited good potential in controlling the biofilm and planktonic population of MRSA (S547).Conclusions:The results from this study could highlight the importance of analysing biofilms of LAB to enhance their antibacterial efficacy.Preferably,these protective biofilms of LAB could also be a better alternative to control the formation of biofilms by pathogens such as MRSA.

Application of a rapid assay to detect targeted numerical and structural anomalies in patient with congenital malformations

Bacterial artificial chromosomes [BACs]-on-Beads [BoBs] is one of the novel and rapid technologies that has been a part of recent advances in genomic technologies. BACs-on- Beads technology [Trade Mark] that assists in speedy detection of copy number changes [CNVs] in targeted genomic regions from minimal amount of DNA. We compared this molecular multiplex, bead-based suspension array that is used in prenatal invasive testing, with conventional cytogenetic and G-banded karyotype techniques. We present the initial BoBs analysis data of 4 patients referred to CABRI with congenital malformations. As per the manufacture's information the targeted region covers at least 4-5 bacs for each region. The selected loci represent the relatively common chromosomal syndromes associated with deletions that can be missed by karyotype analysis. The syndromes are known with definable phenotype and deletion as the major means giving rise to the syndrome. In addition to this the BAC's for the common aneuploidies of chromosomes 13, 18, 21, X, and Y are also present. The method not only detected the known trisomy 21 but also identified a deletion on the long arm of chromosome 7 at q11.2 region that represents the Williams - Beuran Syndrome [WBS] critical region in a patient with suspected trisomy 21. BoBs is potentially a very useful first row test for aneuploidy detection because of its lower cost and rapid detection with minimal amount of DNA especially in newborns with suspected congenital malformations. The results suggest that it is a reliable technique to detect common microdeletions that get missed out by conventional chromosomal analysis

comparison of in-house hemoglobin DNA mutation analysis for beta thalassemia by ARMS PCR with a commercial line probe assay

This study was done with a view to find a correlation between two molecular tests for beta Thalassemia, our in-house developed haemoglobin DNA mutation analysis using ARMS PCR and a Commercial Line Probe Assay. De-identified samples from known beta thalassemia patients characterised by HPLC for HbA2, Peripheral smear [Target cells] and CBC [microcytosis and erythrocytosis] were used for the study. DNA was extracted using the DTAB/CTAB method. Amplified DNA from the samples was hybridised for mutations using a line probe assay. The extracted DNA was also examined for wild type genes and mutant genes using an Amplification refractory mutation system [ARMS] PCR. In this study fifteen beta Thalassemia patients were involved. The in-house ARMS PCR tested for six mutations and detected thalassemia trait in 66.7% of the samples tested for. The line probe assay tested for 22 mutations and detected thalassemia trait in 93.7% of cases examined. One case was missed by both methods and will require sequencing. The importance of stratification of testing for a cost effective strategy for Thalassemia diagnostics is discussed

DNA sequencing and molecular modelling of HLA-B 27 gene sub types in patients with acute anterior uveitis and ankylosing spondylitis

HLA-B 27 is a human leukocyte antigen [HLA] class I cell surface molecule located on the short arm of chromosome 6. It is strongly associated with Acute anterior uveitis [AAU] and Ankylosing spondylitis [AS], the disorders are not only by genetic inherited disease. Several genetic and environmental factors likely play a vital role in determining the risk of developing these disorders. In this study, we try to find out the structure and functional relationship of HLA-B 27 sub types [HLA B[asterisk]27:112, HLA B[asterisk]27:04:01, HLA B[asterisk]27:06, HLA B[asterisk]27:05:02]. The molecular modeling [3D structure] of these subtypes are constructed and ligand binding sites are predicted. The HLA-B 27 gene were amplified from the DNA isolated from the patients with AS and AAU are sequenced. The protein sequences of the HLA-B 27 subtypes obtained from the IMGT/HLA database are aligned with each other and structure of all the subtypes models were constructed by in-silico method. The binding sites of the HLA-B 27 protein and their subtypes was predicted using 3DLigandSite server. The accurate prediction of ligand binding sites on the HLA-B 27 protein surface can be very helpful for rational drug design of AAU and AS

Line probe assay for detection of alpha thalassemia: a pilot study

This pilot study was initiated with a view to find alpha thalassemia genotypes on de-identified samples from patients diagnosed with anaemia at the Centre for Advanced Biomedical research and Innovation [CABRI] at Gulf Medical University [GMU] in June 2015. Amplified DNA from the samples was probed for mutations using a line probe assay. Results obtained are presented. The study has shown the 3.7 single gene deletion in three cases, and alpha 2 IVS1 [-5nt] mutation seen in one case suggesting these cases have alpha + thalassemia. One sample showed wild type alpha 2 Poly A missing along with the alpha 2 poly a-1 [AATAAA>AATAAG] mutation with a suggestive diagnosis of HbH disease. A SEA double gene deletion was seen in one case suggesting alpha 0-thalassemia. Further studies are being carried out to enhance the data base

Impact of metabolic syndrome on global left ventricular function: As evaluated by the myocardial performance index

Background: Metabolic syndrome is associated with the development of diabetes mellitus and cardiovascular disease

The impact of metabolic syndrome on the progression of atherosclerosis has been well documented

This study was designed to evaluate the impact of metabolic syndrome on global left ventricular function by using left ventricular myocardial performance index [LVMPI]

Methods: The diagnosis of metabolic syndrome was made as per the criteria of the International Diabetes Federation. Echocardiography was performed with a Philips IE33 machine using a 1-5 MHz transthoracic probe

LVMPI was calculated by adding isovolumic contraction time with isovolumic relaxation time and dividing it by ejection time

Results: The mean LVMPI value in metabolic syndrome was 0.64 +/- 0.09, while that in controls was 0.48 +/-0.06 [p < 0.001]

Metabolic syndrome was seen to have more significant influence on LVMPI

Conclusions: Metabolic syndrome is a strong predictor of sub-clinical myocardial dysfunction in subjects free of clinically apparent heart disease

Evaluation of in vitro aldose reductase inhibitory potential of different fraction of Hybanthus enneaspermus Linn F. Muell

<p><b>OBJECTIVE</b>To evaluate the aldose reductase inhibitory (ARI) activity of different fractions of Hybanthus enneaspermus for potential use in diabetic cataract.</p><p><b>METHODS</b>Total phenol and flavonoid content of different fractions was determined. ARI activity of different fractions in rat lens was investigated in vitro.</p><p><b>RESULTS</b>The results showed significant level of phenolic and flavonoid content in ethyl acetate fraction [total phenol (212.15±0.79 mg/g), total flavonoid (39.11±2.27 mg/g)] and aqueous fraction [total phenol (140.62±0.57 mg/g), total flavonoid (26.07±1.49 mg/g)] as compared with the chloroform fraction [total phenol (68.56±0.51 mg/g), total flavonoid (13.41±0.82 mg/g)] and petrolium ether fraction [total phenol (36.68±0.43 mg/g), total flavonoid (11.55±1.06 mg/g)]. There was a significant difference in the ARI activity of each fraction, and it was found to be the highest in ethyl acetate fraction [IC50 (49.26±1.76 µg/mL)] followed by aqueous extract [IC50 (70.83±2.82 µg/mL)] and it was least in the petroleum ether fraction [IC50 (118.89±0.71 µg/mL)]. Chloroform fraction showed moderate activity [IC50 (98.52±1.80 µg/mL)].</p><p><b>CONCLUSIONS</b>Different fractions showed significanct amount of ARI activity, where in ethyl acetate fraction it was found to be maximum which may be due to its high phenolic and flavonoid content. The extract after further evaluation may be used in the treatment of diabetic cataract.</p>

Surgical repair of congenital diaphragmatic eventration in a septugerian lady / Reparo cirúrgico de eventração diafragmática congênita em paciente septuagenária

Congenital diaphragmatic eventration in an elderly is a rare anomaly. We describe a case of congenital diaphragmatic eventration causing respiratory insufficiency in a 72 year lady who underwent successful surgical repair.

A eventração diafragmática congênita em um idoso é uma anomalia rara. Descrevemos um caso de eventração diafragmática congênita que causava insuficiência respiratória em uma idosa de 72 anos, que passou, com sucesso, por uma cirurgia de reparo.

Severe Respiratory Sequelae Of H1N1 : Clinical Features, Management And Outcome – A Review

Since the outbreak of the novel influenza H1N1 in April 2009 in Mexico, more then half a million cases have been recorded with more then 6000 deaths. In contrast to seasonal flu, this virus appears to have a predilection for the young, obese and pregnant. It’s most important and almost fatal complication is Acute Respiratory Distress Syndrome (ARDS). Intensive care units (ICU) around the world have scrambled to upgrade various treatment modalities including high frequency oscillation ventilation, inotropes, antivirals and antibiotics in an effort to reduce the mortality arising out of this complication. More importantly, this complication appears reversible if adequate and early therapy is instituted. In particular, rescue therapies that allow the lung to rest appear to have brought success in some clinical settings. This article describes the experiences of seven centers that have used various modalities as rescue therapy in patients having Acute Respiratory Distress Syndrome (ARDS). The experiences in 13 patients at the University of Michigan, 58 in Mexico, 168 in Canada, 180 patients at Leicester UK, 194 in Australia and New Zealand and case reports from Hong Kong and Singapore are described.

Ophthalmic regional block

Cataract surgery is the commonest ophthalmic surgical procedure and a local anaesthetic technique is usually preferred but the provision of anaesthesia in terms of skills and resources varies worldwide. Intraconal and extraconal blocks using needles are commonly used. The techniques are generally safe but although rare, serious sight- and life-threatening complications have occurred following the inappropriate placement of needles. Sub-Tenon's block was introduced as a safe alternative to needle techniques but complications have arisen following this block as well. Currently, there is no absolutely safe ophthalmic regional block. It is essential that those who are involved in the care of these patients have a thorough knowledge of the techniques used. This review article outlines the relevant anatomy, commonly used techniques and their safe performance and perioperative care.

Retrobulbar alcohol injection for orbital pain relief under difficult circumstances: a case report

<p><b>INTRODUCTION</b>A case is presented of a patient with severe and chronic pain in the orbital region, which was relieved by retrobulbar injection of absolute alcohol. The management of chronic pain in the orbital region has received little attention and the literature is reviewed.</p><p><b>CLINICAL PICTURE</b>A 52-year-old man with adenoid cystic carcinoma of the maxillary sinus was suffering from severe pain, especially in the left orbital region. There was also pain from ocular exposure and compression caused by the tumour. Magnetic resonance imaging (MRI) revealed spread of tumour to both orbits, particularly on the left. Multiple debulking surgery and various treatment modalities offered no relief from his pain.</p><p><b>TREATMENT</b>A single retrobulbar injection of 2 mL of absolute alcohol, was placed into the putative orbital apex.</p><p><b>OUTCOME</b>As a consequence of the injection, he had complete resolution of his pain in the 6 months prior to his death.</p><p><b>DISCUSSION</b>Retrobulbar injection of alcohol offers effective pain relief in certain specific conditions characterised by chronic orbital pain when other treatments do not help.</p><p><b>CONCLUSION</b>We have demonstrated that the retrobulbar technique still has a place in our armamentarium.</p>