A Comparative Study On The Effect Of Paraffin Wax Therapy With Manual Mobilization Versus Ultrasound Therapy With Manual Mobilization On Pain, Range Of Motion And Functional Status Of Shoulder In Diabetic Subjects With Adhesive Capsulitis

Background: The shoulder is a complex joint that plays a crucial role in many activities of daily living. Adhesive capsulitis is defined as a painful and disabling condition in which the capsule and the connective tissue surrounding the glenohumeral (GH) joint becomes inflamed, leading to restriction of range of motion in the joint. A wide range of physical therapy interventions are used to improve the joint range of motion in subjects with adhesive capsulitis. Earlier, isolated studies were done on the effectiveness of paraffin wax therapy and ultrasound therapy in subjects with adhesive capsulitis. The need of the present study was to compare the effect of paraffin wax therapy with manual mobilization and ultrasound therapy with manual mobilization on pain, shoulder ROM and functional status in diabetic subjects with adhesive capsulitis. Methods: Subjects for the study were recruited from the outpatient department of endocrinology and physiotherapy. The size of the sample is 80 (eighty subjects) 40 in each group, and study design is an experimental study design (Non-randomized open-label study). The pretreatment values of pain and functional status of the shoulder were assessed using Shoulder Pain and Disability Index (SPADI) scale and ROM was assessed using a universal goniometer. The subjects in the paraffin wax therapy group received wax therapy for 10 minutes and undergone manual mobilization. The subjects in the ultrasound therapy group received ultrasound therapy (3MHz) for 10 minutes and undergone manual mobilization. The treatment was given for 3 sessions per week for 6 weeks and post-treatment values were noted for the subjects of both the groups. Results: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group (p< 0.05). Conclusion: There was an improvement of ROM of external rotation, pain & functional status of the shoulder in subjects who underwent paraffin wax therapy with mobilization and ultrasound therapy with mobilization. When comparing both the groups, the subjects who underwent paraffin wax therapy with mobilization have better outcomes than ultrasound therapy with the mobilization group.

DNA fingerprinting of Mycobacterium tuberculosis isolates from Agra region by is 6110 probe.

DNA fingerprinting using IS 6110 probe has been used all over the world quite successfully to characterize M. tuberculosis strains. The present study has been carried out to study the polymorphism among isolates of M.tuberculosis from Agra region from patients attending the clinics at SN Medical College and TBDTC, Agra. Sputa were collected in sterilized containers and brought to CJIL, Agra. Samples were processed and cultured on Lowenstein Jensen (LJ) slants. M. tuberculosis isolates were identified by standard biochemical tests. DNA from these isolates were purified by a physicochemical procedure, restricted with Pvu II enzyme and hybridized with PCR amplified and DIG labeled 245 bp IS 6110 probe. With a view to study IS 6110 polymorphism, M. tuberculosis isolates obtained from different geographical areas of Agra region were analyzed. Among the 60 isolates taken in study, 5 had no copy of IS 6110, 8 had 1-4 copies and 47 had multiple copies of IS 6110. DNA fingerprinting using this probe was found to be quite discriminating for typing of most of the strains (80%) which had multiple copies. RFLP profiles did not correlate with geographical areas, contacts or the resistance pattern of the strains. While this data shows the potential of IS 6110 based RFLP for strain characterization of M.tuberculosis in Agra, to understand the molecular epidemiology of tuberculosis in this region, a larger number of isolates from defined geographical areas need to be studied.

Correlation of mutations detected by INNO-LiPA with levels of rifampicin resistance in Mycobacterium tuberculosis.

BACKGROUND & OBJECTIVES: Due to emergence of drug resistance in Mycobacterium tuberculosis, there is a need to have accurate and rapid methods for detection of drug resistance to important drugs like rifampicin. The present study was aimed at evaluation of a commercially available INNO-LiPA assay, for the detection of mutation in rpoB gene region of M. tuberculosis and correlate these mutations with levels of rifampicin resistance for assessing their clinical relevance. METHODS: Fifty five well-characterized isolates of M. tuberculosis deposited from various regions of India in Mycobacterial Repository Centre at the CJILOMD, Agra were subjected to susceptibility testing for rifampicin at various concentrations of drug viz., 10, 40, 64, 128 microg/ml on Lowenstein- Jensen (LJ) medium. rpoB gene fragment (260 bp) was amplified using Rif-TB amplification kit and after hybridization, detection was done by using INNO-LiPA Rif TB kit. RESULTS: The rpoB gene could be amplified from DNA extracted from all the 55 culture isolates and showed clear hybridization pattern with M. tuberculosis complex specific probes on LiPA strips. Mutations detected were correlated with degree of rifampicin resistance. All the sensitive isolates (identified by MIC) were identified as rifampicin sensitive (100%) by INNO-LiPA as they exhibit positive for wild type 'S' probes and negative for 'R' probes. Two of the 5 isolates, resistant at 10 microg/ml and 40 microg/ml had either D516V, H526Y mutations or unknown mutations. Thirty (85.71%) isolates resistant at clinically relevant levels (64,128microg/ml) exhibited double, triple or more 'R' type mutations (R(2(D516V)), R(4a(H526Y)), R(4b(H526D)), R(5(S531L))) as well as unknown mutations present at 'S' probes region whereas remaining isolates did not show any mutation by this method. This method could identify with definitiveness 60 per cent ( 21/35) isolates as rifampicin resistant as mutations observed in others were also present in isolates with low levels of resistance. INTERPRETATION & CONCLUSION: The results indicate that INNO-LiPA Rif TB test is a rapid and easy to use method for detection of mutations associated with rifampicin resistance in M. tuberculosis. However, as some of these mutations are also present in isolates with low degree of resistance which are still microbiologically sensitive to rifampicin, there is a need to improve this assay by exclusion of some of the current probes and inclusion of more probes.

Physiological, biochemical and histological changes due to physostigmine in monkeys.

Physostigmine (Phy), a short-acting reversible anticholinesterase agent is considered to be a potent prophylactic antidote for the highly toxic organophosphorous (OP) compounds. The toxic effects, if any, of the probable prophylactic doses of Phy have been evaluated by studying its physiological, biochemical and histological effects in monkeys. Phy only at 100 micrograms/kg resulted in certain cholinergic signs such as salivation, lacrymation and muscular faciculations; physiological changes such as mild tachycardia, tachypnea, higher amplitude in electrical activity of the brain, clinico-chemical effects like fall in PO2, PCO2 and alkalosis and histologically an inflammatory reaction in the lungs. On the other hand, the lower dose, i.e. 50 micrograms/kg appeared to be devoid of cholinergic signs and symptoms. However, we observed a significant inhibition of both plasma and erythrocyte ChE and increase in the rectal temperature in both the Phy treated groups. From this study, Phy at a dose of 50 micrograms/kg could be inferred as a safe, sign free intramuscular dose and may probably be used in pretreatment regimen against nerve agents.

Effects of chelation therapy on hepatic glutathione, lipid peroxidation and phospholipid contents in lead-poisoned rats.

Hepatic lipid peroxidation, glutathione and phospholipid contents of homogenate prepared from the liver of lead-intoxicated male rats treated with 0.3 m mol/kg CaNa2EDTA and DMSA for 8 weeks, either alone or in combination, were investigated. A significant increase in hepatic malondialdehyde (MDA) and a reduction in glutathione levels was noticed. While a marginal decrease in phosphatidyl choline (PC) level was noticed, no effect on phospholipid contents was seen. Treatment with all the three chelating agents elicited decrease in PC level. DMSA alone was partially effective in restoring lead-induced altered hepatic glutathione and MDA levels. Combined treatment may have an adverse effects on hepatic tissue and does not seem to produce immediate recoveries in the lead-induced hepatic damage.

Efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions.

The efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions were studied in 42 patients. The diagnostic yield of unguided aspiration was 83.3%. The yield in malignant lesion was 85.7% while in benign lesion it was 78.6%. There was no false positive report. Complications seen were asymptomatic pneumothorax and blood tinged sputum in a few cases following aspiration. The procedure was well accepted by the patients. Unguided FNAC is a simple, quick, economical, safe and reliable procedure for the diagnosis of peripheral lung lesions.

Cyanide induced changes in dynamic pulmonary mechanics in rats.

Effect of subcutaneously (s.c.) administered potassium cyanide (0.5 and 1.0 LD50) and inhalation of hydrogen cyanide (55 ppm or 60.6 mg/m3) for 30 minutes was studied on various physiological parameters related to dynamic pulmonary mechanics in anaesthetized rats. Total pulmonary phospholipid with its fractions were also estimated. Both s.c. (1.0 LD50) and inhalation exposures increased air flow, transthoracic pressure and tidal volume accompanied by significant decrease in pulmonary phospholipids. Inhalation of hydrogen cyanide also exhibited direct effect on the pulmonary cells as evidenced by decreased compliance. The study suggests that inhalation of cyanide is more injurious compared to parenteral route.