Correlation of serum uric acid with severity of airflow limitation in the patients of chronic obstructive pulmonary disease

Background: Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA in COPD patients and to evaluate whether sUA level can be used as predictors of exacerbation risk and disease severity.Methods: This cross-sectional study included COPD patients and healthy controls. The sUA levels in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk were reported.Results: The study included 106 COPD patients and 110 healthy controls. The mean sUA levels were significantly higher in patients with COPD compared to healthy controls (p<0.05). Mean sUA levels were compared with different stages of COPD according to GOLD criteria. Stage 4 COPD subjects had highest sUA levels compared to other stages. Statistically significant trend was observed for GOLD staging of disease (p<0.05). Surprisingly non-smokers were having higher uric acid level than smokers (p<0.05). The ROC analyses indicated that sUA levels can be useful in predicting exacerbation risk (AUC, 0.412) especially at higher cut-off values, but with low specificity.Conclusions: Study suggested that sUA levels increased in patients with COPD compared to healthy controls. At higher cut-off values sUA levels might be useful in predicting COPD exacerbation risk and disease severity. However, more prospective cohort studies with large number of participants are needed to further analyse the possible different prognostic roles of hyperuricemia.

Serological Evaluation of Clinically Suspected Leptospirosis Cases in a Tertiary Care Hospital

Leptospirosis is a zoonotic infection caused by the spirochaete Leptospira, which has worldwide distribution. Laboratory diagnosis is routinely performed by serological tests like dipstick assay, lateral flow assay and latex agglutination which are rapid tests recommended for screening the disease. Microscopic Agglutination Test (MAT) is the standard test for serological diagnosis of leptospiral infection which is not included in the test panel in most of the peripheral laboratories as the procedure is laborious and it requires to maintain live leptospira. Therefore, one of the rapid tests is routinely employed for demonstration of leptospiral antibodies. Our objective was to screen the acute cases of leptospirosis by Leptochek WB IgM and PanBio IgM Elisa and compare the findings with the MAT and correlate the clinical findings with the serological tests.METHODSThis study was conducted in a tertiary care hospital in Mangalore from August 2010 to September 2013. A total of 314 cases of clinically suspected leptospirosis were included based on the Faine’s criteria. Patients’ serum was screened for leptospiral antibodies by Leptochek WB IgM, PanBio IgM ELISA and Microscopic Agglutination Test (MAT).RESULTSOut of 314 clinically suspected cases screened, seropositivity for leptospirosis by Leptochek WB-IgM, PanBio IgM ELISA and MAT was found to be 49 (15.6%), 65 (20.7%) and 78 (24.8%) respectively. Thus, an overall prevalence rate of leptospirosis was 24.8% (78/314) based on the MAT test. Sensitivity, specificity, positive predictive value and negative predictive value of Leptocheck WB IgM was 53.8%, 97%, 85.7 and 86.4% with MAT while the comparative values of PanBio-ELISA IgM with respect to MAT test was 74.5%, 97 %, 89.2% and 92% respectively. Common clinical features among MAT positive cases were fever, chills and rigors, oliguria, vomiting, jaundice and headache.CONCLUSIONSMAT is a standard serological test for Leptospirosis. This test is not always available for peripheral health centres, as the test is time consuming and cumbersome. Thus, screening tests are now being employed for screening the patients. Rapid tests like Leptocheck -WB can be supplemented with an ELISA test for screening of clinically suspected cases of Leptospirosis and later confirmed with the MAT at reference centres.

A Prospective Study Of Fixation Of Fracture Lateral End Clavicle By A Novel Technique & Its Early Results

Background: Fracture Lateral end clavicle can be managed by various treatment modalities, with different pros & cons. Our study is a prospective study, showing a novel technique & its early results. We found initial results to be very encouraging. Material & Methods: We had utilized this novel fixation technique on 16 patients & operative indication in all patients was Neer type 2 lateral end clavicle fractures. In this study, 14 patients were male while 2 were female in age group 25 to 58 years (mean 41 years). All the patients were operated within 2 weeks of sustaining trauma to clavicle .Early results were encouraging in these patients with minimum follow up of 4 months & maximum of 12 months. Constant murley scores measured & compared were found to be approaching at the opposite shoulder levels at the end of 6 months after surgery. Results: All 16 patients were available for evolution after minimum follow up of 4 months and maximum of 12 months. All the patients regained pain less shoulder with bony union & returned to pre–injury activity level after a mean of 4 months. During post operative follow up after 2 weeks, 2 months & 4 month post–operative radiographs demonstrated good hold of initial bony reduction Conclusion: The concept of this technique is novel and provides for a strong fixation across the fracture site in addition to other benefits outlined above. Further studies with longer follow up and more number of patients need to be done to elucidate out correct surgical utility of technique over others.

Fluorescence of Candida in diagnosis of oral candidiasis.

Background: Many pathogenic fungi fluoresce in hematoxylin and eosin stained sections, and Papanicolaou (PAP)‑stained smears under ultraviolet illumination. In theory, this phenomenon could aid in the diagnosis of common fungal infections without the delay which is usually associated with special stains. Objective: To evaluate the role of fluorescence as a rapid screening technique for oral infections caused by Candida organisms in exfoliative smears of oral candidiasis. Materials and Methods: Two smears and one swab were collected from each of 62 clinically diagnosed cases of oral candidiasis. Smears were stained with (PAP) and periodic acid–Schiff stain (PAS). Both smears were evaluated under light microscopy (LM). Later, PAP smears were observed under fluorescent microscopy (PAP‑FM). The swab was inoculated on Sabouraud’s agar plate. Each technique was evaluated for sensitivity and specificity. Results: It was found that the PAS‑stained smears were more reliable for detection of Candida species than other methods (sensitivity = 100%; specificity = 66.7%). The PAP‑LM and PAP‑FM showed less sensitivity (67.9% and 85.7%) and specificity (66.7% and 33.3%), respectively. Combined results of both light and fluorescent microscopy of PAP (LM + FM) showed increased sensitivity (89.3%) but reduced specificity (16.7%). Conclusion: PAP autofluorescence is less sensitive than PAS, still it accentuates the distinct morphological features of Candida.

Anatomical Variations of Cerebral MR Venography: Is Gender Matter? / 신경중재치료의학

PURPOSE: Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations. MATERIALS AND METHODS: A retrospective study was conducted to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences. RESULTS: A total of 1654 patients (582 men, 1072 women, age range 19 to 86 years, mean age: 37.98±13.83 years) were included in the study. Most common indication for MR venography was headache (75.4%). Hypoplastic left transverse sinus was the most common anatomical variation in 352 (21.3%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to female (24.9% versus 19.3%, p = 0.009). Most common variation of superior sagittal sinus (SSS) was atresia of anterior one third SSS (15, 0.9%). Except hypoplastic left transverse sinus, rest of anatomical variations of the transverse and other sinuses were not significantly differ among both genders. CONCLUSION: Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders.

Delonix regia: historic perspectives and modern phytochemical and pharmacological researches / 中国天然药物

Delonix regia (Bojer ex Hook) Raffin (Fabaceae), also known as flame of forest, is a semi-deciduous tree, distributed throughout Madagascar, India, Africa, and Northern Australia. Various parts of the plant are traditionally used for the treatment of different ailments such as inflammation, rheumatism, bronchitis, diabetes, anemia, fever, gynecological disorders, and pneumonia. The plant possess antioxidant, hepatoprotective, gastroprotective, wound healing, antiarthritic, larvicidal, antimalarial, antiemetic, antibacterial, antifungal, antiinflammatory, analgesic, antidiarrhoeal, antiheamolytic, diuretic, and anthelmintic activities. This review is an up-to-date compilation on its traditional uses in context to phytochemical and pharmacological perspectives.

Determination of phenotypic expression of the fimbriae and hemolysin of uropathogenic Escherichia coli (UPEC).

The bacterial strains that cause symptomatic urinary tract infections possess diverse distinctive properties that enable them to overcome the local host defences. In Escherichia coli, virulence results from the cumulative impact of several virulence factors, which can vary according to the patient populations. The study was undertaken to assess the prevalence of the virulence factors by phenotypic assays in the E. coli isolates which were isolated from patients with UTI from a tertiary care hospital in Kerala. Methods: A total of 300 E. coli isolates were obtained from symptomatic cases of urinary tract infections and 30 E. coli faecal isolates were obtained from apparently healthy individuals and they were tested for phenotypic properties like haemolysin production, mannose resistant hemagglutination to indicate P fimbriae, cell surface hydrophobicity. Results: Among the 300 E. coli isolates from the cases group, 135 (43.5%) were hemolytic, 106 (35.5%) were MRHA positive, 123 (41%) were hydrophobic. Among the 30 controls, 2 (6%) were hemolytic, 02 (6%) were MRHA positive and 04 (10%) were hydrophobic. The difference between the cases and the control group was significant (P <0.001). Multiple virulence factors were observed in 51% of the isolates. Conclusion: The present study showed varied phenotypic expression of the virulence factors in the urinary isolates as compared to the fecal isolates.

Transmanubrial transclavicular approach to CTJ

The aim of the present study was to improve the feasibility of anterior decompression and stabilization of the cervico-thoracic junction with transmanubrial transclavicular approach and also to study the problems encountered in anterior reconstruction of the cervico-thoracic junction [CTJ]. Nine patients [mean age 32 +/- 7.33, range 13-60 years; mean duration of symptoms 6.06 +/- 3.07, range 1.5 -12 months; male to female ratio of 4:5] of various pathologies involving the CTJ who were operated by transmanubrial transclavicular approach were analyzed. Preoperative disability was scored using Harsh myelopathic grading system. Eight cases belonged to grade 3 and 4, one to grade 1. On radiology there was mean involvement of 2.2 +/- 0.97 vertebral levels [range 1 - 4]. Eight patients were operated from the left side with an average decompression of 2.11 +/- 0.93 [range 1 - 4] vertebral bodies. Clavicular graft was used in 8 .patients and iliac tricorticate graft in one with plating [instrumentation] done in 8 cases. All the patients showed improvement in immediate postoperative period with significant improvements in their Harsh grades and no major complication. The mean follow-up duration was 9.22 +/- 4.60 [range 1-16 months]. Transmanubrial transclavicular approach provides an excellent exposure of vertebrae and paravertebral spaces of CTJ [lower 2 cervical and upper 2 thoracic vertebrae] allowing anterior spinal cord decompression, grafting and instrumentation without any increase in morbidity and mortality as compared to the conventional approaches

Phytopharmacological evaluation and anti-asthmatic activity of Ficus religiosa leaves

OBJECTIVE@#To discuss phytopharmacological potential and anti-asthmatic activity of Ficus religiosa (F. religiosa) (L.).@*METHODS@#Fresh leaves of F. religiosa were obtained from Vastrapur Lake, Ahmedabad, and dried to obtain powder. Histamine and acetylcholine were used to guinea pigs to establish bronchospasm model. In in vivo study, the aqueous extract of F. religiosa leaves (AEFR) at doses of 150 and 300 mg/kg was administrated to guinea pigs, and the broncho-protective activity of AEFR was compared with aminophylline at 25 mg/kg. While in in vitro study, and 10 g/mL, 20 g/mL, 30 g/mL of AEFRL was administrated to guinea pigs, respectively, and mast cell stabilizing activity of AEFR was compared with ketotifen at 10 g/mL.@*RESULTS@#In the in-vivo model, pre-treatment with aminophylline (25 mg/kg, ip.) could significantly delay the onset of histamine induced pre-convulsive dyspnea, compared with vehicle control. Administration of AEFRL (150 and 300 mg/kg, ip.) also produced significant effect on latency to develop histamine & acetylcholine induced pre-convulsive dyspnea. In the mast cell stabilizing model, AEFRL at 10, 20 and 30 μg/mL could significantly increase the number of intact cells.@*CONCLUSIONS@#It can be concluded that AEFRL is effective on histamine & acetylcholine induced bronchospasm in guinea pigs. In addition, AEFRL can potentiate the number of intact cells in the mast cell stabilizing model.

Efficacy of Tukhm-e-Kahu [seeds of lactuca scariola linn.] on mixed anxiety depressive disorder. [a randomized placebo controlled double-blind trial]

Objective of the study was to evaluate the efficacy of seeds of Lactuca scariola Linn, on DSM IV defined mixed anxiety depressive disorder. This study was carried out by conducting a 8 weeks, double blind, placebo controlled trial at New Delhi. A total of 54 patients were registered randomly in test group [N=30] and placebo group [N=24]. Symptoms of anxiety and depression were measured using the 14-item Hamilton Rating scale for anxiety and 17-item Hamilton Rating scale for depression respectively. Reduction in the total score was statistically analyzed and adverse event tabulated. The test drug was found to be comparably effective and superior to placebo in reducing anxiety and depressive symptoms. Statistically significant improvement was observed in the test group [p<0.001] in both anxiety and depression. But a marginal significant improvement was observed in anxiety in placebo group

Acute intestinal obstruction due to solitary jejunal diverticulum.

We report a 26-year-old man who presented with acute intestinal obstruction. Laparotomy revealed a solitary jejunal diverticulum with a meso-diverticular band, through which a loop of bowel had herniated. He underwent wedge resection of the diverticulum and excision of the band.