Treatment of acute avulsion of posterior cruciate ligament of left knee with bony fragment by Siddha Varmam therapy and traditional bone setting method

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reportedto Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciateligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma,positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with SiddhaVarmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture gothealed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCLwith bony fragment.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Transcriptome profiling of coriander: a dual purpose crop unravels stem gall resistance genes

Stem gall (Protomyces macrosporus Unger), a serious disease that affects leaves, petioles, stems and fruits of coriander (Coriandrum sativum L.) causing heavy loss in yield. Genetic improvement of coriander for stem gall disease is indispensable. Coriander cultivars of stem gall resistance (ACr-1) and susceptible (CS-6) leaf samples were utilized and transcriptome sequenced using Illumina NextSeq500 platform. After trimming low-quality reads and adapter sequences, a total of 49,163,108 and 43,746,120 high-quality reads were retained and further assembly resulted validated transcripts of 59,933 and 56,861. We have predicted 52,506 and 48,858 coding sequences (CDS) of which 50,506 and 46,945 were annotated using NCBInr database. Gene ontology analysis annotated 19,099 and 17,625 terms; pathway analysis obtained 24 different functional pathway categories; signal transduction, transport, catabolism, translation and carbohydrate metabolism pathways etc. were dominated. Differentially expressed genes analysis predicted 13,123 CDS commonly expressed of which 431 and 400 genes were significantly upregulated and downregulated, respectively, in which Rgenes, stress inducible transcription factors such as ERF, NAC, bZIP, MYB, DREB and WRKY and antifungal related genes were predicted. The real-time PCR analysis of HSP20 gene expression in resistance showed upregulation by 10-fold over susceptible sample and 18s used as a housekeeping gene for normalization. The present results provide an insights into various aspects underlying the development of resistance to stem gall in coriander.

Evaluation of BODE index as a predictor of Pulmonary Hypertension in COPD patients.

Background: The severity of COPD is usually assessed on the basis of a single parameter – forced expiratory volume in one second (FEV1). However, the patients with COPD have systemic manifestations that are not reflected by the FEV1. The present study was undertaken to determine the predictive value of BODE index (Body-mass index (B), the degree of airflow obstruction (O) ,dyspnea (D), and exercise capacity (E) for development of pulmonary hypertension and as a predictor of severity in COPD patients. The original BODE index is a simple multidimensional grading system which is superior to FEV1 alone for prediction of mortality and hospitalization rates among COPD patients. Methods: This study was done from January 2013 to December 2014.Total one hundred male patients who attended the chest medicine department, with the symptoms suggestive of COPD were included in this study and the study was done to evaluate the BODE index and correlated with echo-cardigraphic findings suggestive of pulmonary hypertension as a predictor of severity in patients with COPD. Result: Among patients with COPD, there were (21%) patients who had mild COPD with a BODE score between 0 – 2, Moderate COPD (BODE score of 3 – 5) were (23%), Severe COPD (BODE score more than or equal to 6) groups had (56%) patients. The study results showed that as the BODE index scores severity increases the incidence of pulmonary hypertension increases as identified by echocardiography RVSP (Right ventricular systolic pressure) findings. The average RVSP was 59.6 in severe COPD patients (BODE index more than 6) 47.2 in moderate severe COPD (BODE index 3-5), while it was less than 36 in mild groups. These values were found to be significant on comparison to other groups. Conclusion: BODE index may offer superior and alternative reliable method to predict severity in patients with COPD in terms of pulmonary hypertension and for following up after medications. Since the assessment of BODE index requires only a spirometer, which is relatively inexpensive and can easily be made available, this index could be of great practical value in a primary health care setup to identify individuals who are at need for further evaluation in a higher referral center. Thus, BODE index can be used for judicious referral of patients with COPD thereby preventing the wastage of the limited resources available.

Study on perception of food items as hot or cold in the rural area of Pondicherry.

Introduction: It has been observed in our society that the theory of hot and cold is believed in and practiced by almost all section of the society. It is necessaary to know the prevalence of such belief in the community from time to time. Objectives: To know the prevalence of perception of hot or cold food items and their impact on t health status of the community. Material and methods: It was a cross sectional study done between the time period of March and April 2015 among 317 families and their members at t their doorsteps. Pretested questionnaire was filled with the information given by the subjects after their verbal consent. Descriptive questions regarding the family’s perception of hot and cold foods were asked in the categories of cereals, pulses, oils, vegetables, dairy products, non-vegiterian, fruits, beverage, spice and water. Results: Sixty six percent of the families told Brinjal, 84% told chicken and 34.6% told curd are hot foods and produces Gastrointestinal tract (74%) and Genitourinary tract (73%) illnesses. Similarly 15.6% of the families told carrot, 26.33% told grapes, 20% told fish and 58.6% told buttermilk are cold foods leading to development of respiratory tract illnesses. Only one percent of the families did not have any idea about hot or cold food items. Conclusion: The prevalence of misconception of hot or cold foods exist among families and misunderstanding about the nutritive value of food items which are likely to cause deficiency in vitamins, minerals in their family diet.

Evaluation of HbA1c and tuberculin test in wound complications of surgical patients with diabetes.

Background: Diabetes is a global epidemic and India is regarded as the “diabetes capital of world”. Wound healing deficit are often seen in patients with diabetes mellitus. Aims & Objective: The present study was undertaken to correlate HbA1c level and plasma glucose level with wound complications in postoperative wounds in diabetic patients, to find out relationship of HbA1c and tuberculin test with wound complications, to correlate the role of HbA1c and tuberculin test in prediction of wound complications. Materials and Methods: The study is a prospective analysis of 100 patients from June 2006 to June 2008, in University Hospital in North India. All known diabetic and recently diagnosed diabetic patients with surgical illness were included in the study. All patients were investigated for HbA1c (by micromatTM Hemoglobin A1c test), Mantoux test (intradermally injecting 0.1 ml Tuberculin PPD with tuberculin syringe), blood sugar F/PP, serum albumin. Wound complications have been noted in postoperative period along with co-morbid condition of patients. Selected patients are divided in four group (i) clean wound; (ii) clean contaminated; (iii) contaminated and (iv) diabetic foot / dirty wound. Results: Out of 100 diabetic patients, male to female ratio was 3:2. Maximum number of patients are in age group of 51-60 years, 51 out of 100 patients were associated with comorbid condition. HbA1c level in diabetic patients were < 6 in 13%, 6-8 in 43%, 8-10 in 30% and >10 percent in 14% patients. Mantoux test was positive in 31 out of 92 patients. Wound complication was present in 54 patients, mostly in uncontrolled diabetes. Out of 99 patients, 41 have clean wound, 31 have clean contaminated, 6 contaminated and 21 patients having dirty / diabetic foot. Conclusion: Study show a fair correlation between HbA1c, Mantoux test and wound complication. There is decrease in cell mediated immunity leading to decrease in mantoux test positivity and increase in wound complication.

Studies on genetic divergence among Indian varieties of a spice herb, Coriandrum sativum.

Coriander (Coriandrum sativum L.) is an annual spice herb that belongs to umbel family Apiaceae with diversified uses. We investigated the extent of variability among 22 Indian varieties of coriander using phenotypic and genetic markers. Multilocus genotyping by nine RAPD primers detected an average of intraspecific variations amounting to 66.18 % polymorphism in banding patterns. Analysis of molecular variance indicated that a greater proportion of total genetic variation exists within population (98%) rather than among populations (2%). Higher values of Nei’s gene diversity (h) and Shannon Information Index (i) and genetic distance analysis validate wider genetic diversity among Indian coriander varieties. Besides total internal transcribed spacer (ITS) length variations and single nucleotide polymorphisms, insertions/deletions (INDELS) were detected at seven sites in ITS-1 region. Multiple sequence alignment of 12 sequenced varieties revealed cent per cent identities of 5.8S gene region (162 bp) that validates its conserved nature. Multiple sequence alignment of ITS-1 region may be of phylogenetic significance in distinguishing and cataloguing of coriander germplasm. The representative sequences of each subgroup and all distinct varieties of RAPD clusters have been submitted to NCBI database and assigned Gen Accession numbers HQ 377194-377205. The measures of relative genetic distances among the varieties of coriander did not completely correlate the geographical places of their development. Eventually, the knowledge of their genetic relationships and DNA bar coding will be of significance.

Role of rose Bengal-tea system for generation of electrical energy in photo galvanic cell.

Rose Bengal is used as a photo sensitizer in photo galvanic cell for solar energy conversion and TEAis used as an electron donor in this study. The effects of various parameters like pH, light intensity, diffusion length, reductant concentration and dye concentration on the electrical output of the cell is studied. The photo potential and photocurrent generated by this cell are 840 mV and 145μA, respectively. The current voltage (i–V) characteristic of the cell is also studied and a mechanism for the generation of photocurrent is proposed.

Asymptomatic lymphangitis carcinomatosis due to squamous cell lung carcinoma.

Lymphangitis carcinomatosa most commonly due to primary malignancy originating in the breast, stomach, pleura and prostate but may also originate from the lung itself. It is clinically characterised by progressing dyspnoea with or without cough even at an early stage. We report the case of a patient with squamous cell lung cancer presenting with asymptomatic lymphangitis carcinomatosa.

Chylothorax in a patient with ovarian tumour.

A rare case of chylothorax complicating sex cord tumour of ovary in a young girl is being reported here. It was successfully managed by using a multipronged strategy consisting of chemotherapy, total parentral nutrition and bleomycin pleurodesis.

Comparative study of visceral and parietal pleural biopsy in the etiological diagnosis of pleural diseases.

OBJECTIVE: The present study was planned to evaluate the efficacy and diagnostic reliability of conoctional parietal pleural biopsy to a technique of visceral pleural biopsy. METHOD: Study comprises of 54 diagnosed cases of pleural effusion and after establishing the clinical diagnosis for probable etiological causes. Then parietal pleural biopsy using absents punch biopsy needle and vesceral pleural biopsy using Prabhudesai et al technique was taken in all these patients. Size of the tissue yield; percentage of biopsies; diagnostic yield and sensitivity for these two techniques were compared. RESULTS: A definitive etiological diagnosis could be reached in 52 out of 54 patients on the basis of pleural biopsy (33 tuberculous, 16 malignant and 3 pyogenic), 23 (69.7%) tuberculous effusion patients were diagnosis by visceral pleural biopsy and 14 (42.4%) by parietal pleural biopsy out of 33 diagnosed tuberculous effusion cases. While for the 16 malignant effusions the visceral pleural biopsy showed suggestive histological change in 13 (81.25%) patients and the parietal pleural biopsy in seven (43.8%) with five (31.25%) of these patients being positive by both. All three pyogenic effusions showed only nonspecific inflammatory change in both pleurae. CONCLUSION: The mean size of biopsy sample obtained with modified Prabhudesai et al technique was significantly larger than that of the parietal pleural biopsy with Abrams punch (4.85 mm2 V/s 2.5 mm2 with P < 0.01). Adequate pleural tissue was identifiable in 94.4% and 90.7% of cases, respectively. The modified Prabhudesai et al technique proved to be effective safe and easily learnt. Visceral pleural sampling using this technique is a definite superior addition to the present diagnostic armamentarium of an idiopathic pleural effusion and its routine application together with parietal pleural biopsy will help to establish a definitive diagnosis in majority of patients with idiopathic pleural effusions.

A ten years analysis of 500 intertrochantric fractures of the femur with impression to residual deformity and shortening.

A study of 500, cases with follow up period of 1 to 10 years were treated by conservative and operative means. The result of conservative treatment in type III and IV fractures were comparatively favourable with result of operative treatment in same grade of fractures. It can be concluded that if an anatomical reduction was achieved by proportioned vertical and horizontal traction forces and the reduction was monitored by periodic skiagram till sound clinical and reasonable radiological union, good functional end result could be obtained.

Evaluation of a deaf child.

One should be aware that the measurement of hearing is really an evaluation of a child's behavioural responses in a controlled setting to the presentation of various acoustic stimuli. The determination of hearing loss in some children is an ongoing process and may require more than one test session. Difficult to test children should be evaluated with as many techniques as possible for accurate cross checking of test results. Flexibility, patience and understanding and persistence are the watch words of successful hearing testing with children. For the bulk of patients who require audiological assessment however, the test battery (BOA, IMPEDANCE & BSER) approach seems to be the best available present day approach coupled with long term follow ups and careful management.

Acute scleredema with fatal outcome.

Death due to scleredema is rare. We report a patient with scleredema, which had an acute onset and rapid progression, leading to death within a month. Such an acute course terminating in fatality has not been described earlier.