Application of multiple linear regression and machine learning algorithms to elucidate the association of poor glycemic control and hyperhomocysteinemia with microalbuminuria

Microalbuminuria is an early biomarker of general vascular dysfunction and a predictor of risk for cardiovascular and renal diseases. It is also considered as a marker of insulin resistance in both diabetic and non-diabetic patients. The rationale of this study was to elucidate threshold values of fasting blood glucose (FBS) and glycosylated hemoglobin (HbA1c) that are associated with microalbuminuria. In the parallel association of microalbuminuria with hyperhomocysteinemia was investigated. Machine learning algorithm and multiple linear regression were applied to study the association of poor glycemic control on microalbuminuria and hyperhomocysteinemia. In non-diabetic subjects with FBS <102 mg/dL and HbA1c <6.3%; and in diabetic subjects with good glycemic control (FBS: 102-118 mg/dL; HbA1c: 6.3-7.0%), urinary microalbumin levels were <40µg/mg creatinine. Poor glycemic control (FBS >172 mg/dL and HbA1c >9.0%) was associated with microalbumin >40µg/mg creatinine. Age, gender, HbA1c and FBS were shown to explain variability in urinary microalbumin to the extent of 54.4% as shown by multiple linear regression model. Analysis of variance (ANOVA) revealed higher levels of FBS (F: 39.77, P <0.0001), HbA1c (F: 64.31, P <0.0001) and total plasma homocysteine (F: 3.69, P =0.04) in microalbuminuria and clinical microalbuminuria groups when compared to subjects with normal microalbumin levels. Diabetic patients with poor glycemic index had a more B12 deficiency. Poor glycemic index and hyperhomocysteinemia were associated with clinical microalbuminuria.

Association of Oral Lichen Planus and Electrocardiographic P-Wave Dispersion - An Original Research

Abstract Lichen planus (LP) is considered to be a T-cell-mediated inflammatory disorder. Inflammation is considered to produce disturbances of lipid metabolism which may affect the myocardium. Increased P-Wave Dispersion (PWD) is demonstrated as an independent risk factor for developing atrial fibrillation (AF). Hence the present study has been conducted to explore the possible relationship of oral lichen planus (OLP) with AF by the evaluation of PWD. Twelve-lead electrocardiographs (ECG) were obtained from 45 OLP patients and 45 age and gender-matched healthy controls. The P-wave durations (Pmax and Pmin) were calculated in all 12 leads. The difference between Pmax and Pmin was defined as P-Wave Dispersion (PWD). After the PWD was recorded, the results were statistically analyzed. The study showed that PWD increased on surface ECG measurements in OLP patients who were otherwise asymptomatic in relation to cardiac conditions. The p value obtained was <0.001 which was highly significant. The present study suggests a highly statistically significant association of OLP with increased P-wave dispersion. Hence the patients with OLP should undergo cardiac evaluation and follow up for early detection of atrial fibrillation.

Resumo O líquen plano oral (LPO) é considerado um distúrbio inflamatório mediado por células T. Acredita-se que a inflamação produza distúrbios do metabolismo lipídico que podem afetar o miocárdio. Uma dispersão de onda-P (DOP) aumentada é demonstrada como um fator de risco independente para o desenvolvimento de fibrilação atrial. Assim, o presente estudo foi conduzido para explorar a possível relação de LPO com fibrilação atrial pela avaliação por meio de DOP. Eletrocardiogramas (ECG) de 12 derivações foram obtidos de 45 pacientes com LPO e 45 controles saudáveis com idade e sexo equiparados. As durações das ondas P (Pmax e Pmin) foram calculadas em todas as 12 derivações. A diferença entre Pmax e Pmin foi definida como DOP e os valores analisados estatisticamente. O estudo mostrou que DOP aumentada nos ECG de superfície dos pacientes com OLP que eram assintomáticos em relação a condições cardíacas. O valor p obtido foi <0,001, altamente significativo. O presente estudo sugere uma associação altamente significativa estatisticamente entre OLP a DOP aumentada. Assim, os pacientes com OLP devem ser submetidos a avaliação cardíaca e acompanhamento para detecção precoce da fibrilação atrial.

Macroenvironmental influence on Hepatozoon lacertilis infectivity to lizard Hemidactylus flaviviridis.

Hemidactylus flaviviridis Ruppell, 1835 (n= 199) sampled during different seasons from Bareilly, (Uttar Pradesh, India) were infected with a sporozoan parasite belonging to the genus Hepatozoon Miller, 1908. Four morphovariants of the parasite, Type I, II, III and IV were identified on their growing pattern. When compared with earlier reported species, the parasite could be characterized taxonomically by its comparatively greater length 17.35 (13.57-21.30) μm and width 7.51 (5.59-10.11) μm, unusual larger size of parasite nuclear length 8.86 (4.75- 15.83) μm and width 3.55 (2.14-5.11) μm and cytomorphological differences. These characteristics warrant creation of a new species and was named Hepatozoon lacertilis sp. nov. The morpho-variants, their effect on host cell and host nuclei are clearly illustrated. The influence of macroenvironmental factor (host sex) on parasitic infectivity indicated that it was 7.14% prevalant in male and 6.25% in female Hemidactylus flaviviridis.

Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: a multicentre study.

PURPOSE: Methicillin resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. We report the prevalence and antibiotic susceptibility pattern of MRSA in major southern districts of Tamilnadu. METHODS: A total of 7172 clinical specimens and 1725 carrier screening samples were collected from different centers and subjected to MRSA screening using conventional microbiological methods. Subsequently the antibiotic sensitivity test was performed for the confirmed MRSA isolates. RESULTS: Out of 906 strains of S. aureus isolated from clinical and carrier samples, 250 (31.1%) and 39 (37.9%) were found to be methicillin resistant respectively. Almost all clinical MRSA strains (99.6%) were resistant to penicillin, 93.6% to ampicillin, and 63.2% towards gentamicin, co-trimoxazole, cephalexin, erythromycin, and cephotaxime. All MRSA strains (100%) of carrier screening samples had resistance to penicillin and about 71.8% and 35.9% were resistant to ampicillin and co-trimoxazole respectively. Multidrug resistance was observed among 63.6% of clinical and 23% of carrier MRSA isolates. However, all strains of clinical and carrier subjects were sensitive to vancomycin. CONCLUSION: The determination of prevalence and antibiotic sensitivity pattern of MRSA will help the treating clinicians for first line treatment in referral hospitals.

Subtenons infection by Dirofilaria repens.

Zoonotic filariasis caused by Dirofilaria repens, a parasite of carnivores occurs mainly in countries surrounding Mediterranean region. The infection occurs in and around eye among animal handlers through vector transmission. We are reporting a case of human Dirofilariasis affecting subtenons region in a 63 year-old woman from Coimbatore, South India. The purpose of this article is to review the clinical course and management of ocular Dirofilariasis.

Speciation of coagulase negative staphylococcus causing bacterial keratitis.

Thirty-five coagulase negative Staphylococcus (CoNS) cultured from corneal ulcer were speciated and antibiotic sensitivity tested. S epidermidis was the commonest isolate and it was sensitive to ampicillin and vancomycin.

Acanthamoeba keratitis - A six year epidemiological review from a tertiary care eye hospital in South India.

PURPOSE: This study analyses the prevalence, demography, predisposing factors and seasonal variation of Acanthamoeba keratitis. METHODS: A retrospective review of all cases presenting with keratitis at the cornea clinic, Aravind Eye Hospital, Coimbatore, from August 1997 to July 2003, was done for screening patients with a provisional diagnosis of Acanthamoeba keratitis. Their records were further analyzed for microbiological details. Cases with culture proven Acanthamoeba keratitis were included for epidemiological analysis. RESULTS: From a total of 4519 patients who attended cornea clinic 32 (33 eyes) patients were confirmed to be positive for Acanthamoeba keratitis. Twenty cases (62.5%) were males. Majority (18; 54.2%) of the Acanthamoeba keratitis eyes reported corneal trauma by solid objects. No peak period was observed in a year, as the number of cases was almost uniform in all months. CONCLUSION: This study indicates the increasing prevalence of Acanthamoeba keratitis among non-contact lens users in this region during the 6-year period.

Detection of pneumolysin in cerebrospinal fluid for rapid diagnosis of Pneumococcal meningitis.

BACKGROUND & OBJECTIVES: Pneumolysin, a toxin produced by Streptococcus pneumoniae is associated with virulence and is found in all invasive isolates. Its role as a diagnostic tool has recently been exploited. Most of the methods used are based on molecular techniques and are not cost-effective. The present study was undertaken to evaluate a simple, rapid and cost-effective method to detect pneumolysin in CSF as a diagnostic test for pneumococcal meningitis. METHODS: A total of 75 CSF samples from children with presumptive diagnosis of acute pyogenic meningitis or encephalitis were subjected to Gram stain, culture and pneumolysin detection by Cowan 1 staphylococcal protein A co-agglutination technique. RESULTS: Pneumolysin was detected in 26(78.8%) of 33 culture proven CSF samples and 4(9.5%) of 42 culture negative samples. Antigen detection by Co-A had a specificity of 90 per cent and a sensitivity of 79 per cent when compared with culture. Compared to Gram stain, pneumolysin Co-A had a specificity and sensitivity of 91.0 and 92.0 per cent respectively. INTERPRETATION & CONCLUSION: Detection of pneumolysin was found to be a simple, low cost antigen detection assay for rapid diagnosis of pneumococcal meningitis, for routine use in the developing countries.

Influence of zinc on cardiac and serum biochemical parameters in rabbits.

The pattern of lipid profiles and organic constituents of cardiac and serum tissues of rabbits were studied on treatment with cholesterol, zinc and zinc + cholesterol. Total carbohydrate and total protein levels were decreased with elevated lipid levels in cholesterol fed rabbits. However, the zinc and cholesterol + zinc fed rabbits showed decreased lipid fractions in cardiac and serum tissues leading to reduced atherosclerotic process in rabbits. These results suggest that the zinc is acting as a hypolipidaemic and anti atherogenic agent in experimental rabbits.

Prevalence of beta hemolytic streptococci carrier rate among schoolchildren in Salem.

A preliminary study was conducted to identify the carriers of beta hemolytic streptococci (BHS) among school children. BHS were identified, grouped by latex agglutination test and tested for susceptibility to penicillin, erythromycin and cefazolin from their throat swabs. Prevalence of BHS was found to be 21.6% with group G (43.2%) as the predominant group followed by group A (28.8%). All the isolates were sensitive to the antibiotics tested. Health cards were issued to the carriers of group A beta hemolytic streptococci.

Antioxidants, lipid peroxidation and lipoproteins in primary hypertension.

The antioxidants and lipid peroxidation products are being extensively studied because of their potential importance and pathogenetic role in several non-communicable diseases like cardiovascular diseases and cancer, but the data on hypertension is scanty. Therefore, the present study aimed to assess the levels of lipid peroxidation and antioxidants besides dislipidemia changes among 32 newly diagnosed male hypertensives by comparing them with an equal sample of normotensives. Significant increase in serum lipid peroxide levels and decrease in antioxidant enzyme superoxide dismutase and vitamins E and A were observed among hypertensives than the controls. Hypertensives had higher total cholesterol, low-density lipoprotein cholesterol, triglycerides, body mass index and low high-density lipoprotein cholesterol levels than normotensives. The percentage prevalence of hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol and obesity was higher in study subjects. Obese hypertensives had significantly higher levels of lipid peroxides and lipids with no change in antioxidant status than normal-weight hypertensives. Our results suggest that hypertensive patients may have elevated lipid peroxidation, lipids and reduced protection from antioxidants, which may contribute to the propensity in such patients to develop cardiovascular diseases, and to correct this, antioxidant supplementation besides weight reduction may be helpful to reduce the severity of burden.

Detection of antipneumolysin in invasive childhood pneumococcal infections.

Antibody levels against pneumolysin, a virulence factor in pneumococcal infections were evaluated by a neutralization test, using crude pneumolysin. A study population of 28 hospitalised children with culture proven pneumococcal meningitis and pneumonia were tested for detection of antipneumolysin antibodies in their serum. Results were compared with age and sex matched controls who were admitted with infections other than pneumococcal. Geometric mean titer (GMT) of antipneumolysin in serum of patients with pneumococcal infections showed a significant difference when compared with controls, GMT of 196.1 and 185.2 were noted in patients with meningitis and pneumonia respectively, in contrast to a titer of 40.32 among controls. A difference of more than 4-fold antibody titers between patients and controls was considered significant. Detection of antipneumolysin in serum can therefore be considered as a useful laboratory investigation in diagnosing invasive pneumococcal infections.

The role of cadmium in induction of atherosclerosis in rabbits.

Experiments were carried out in rabbits to determine the effects of prolonged treatment of cadmium (8 mg/kg/day) for a period of 6 months on histopathological changes and biochemical alterations of lipid profiles in various tissues compared to normal rabbits. No ECG changes were observed before and at the end of cadmium treatment. Histopathological studies of the coronary artery revealed atherosclerotic changes. Total lipids, cholesterol, free fatty acids and phospholipids were significantly increased in heart and kidney, but decreased in serum and liver. Triglyceride content was increased significantly in heart and kidney with a significant depletion in liver and serum. It is postulated that atherosclerotic changes in rabbits probably occurred through toxic effects of cadmium but the exact mechanism needs to be elucidated.

Midline communicating spinal extradural arachnoid cyst

A case of communicating spinal extradural arachnoid cyst arising from the thoracic midline dural defect is reported in a 17-year-old lad. The condition is a rare cause of spinal cord compression, and usually presents with progressive spastic paraparesis in adolescence. Fifty-eight per cent of the cases reported are of the communicating type. Myelography establishes the diagnosis if the cysts can be filled with contrast medium. Surgical removal of the cyst and obliteration of the communication usually lelads to prompt improvement in neurological symptoms

Giant cranial intradiploic epidermoid cyst

A case of giant cranial intradiploic rpifrtmoif cyst in a 53-year-old man is reported. These cysts are uncommon and very rarely attain giant sixe

Skeletal muscle carbohydrate metabolism during short-term and prolonged in vivo electrical stimulations.

Electrical stimulations were applied to the gastrocnemius muscle of intact frog. Rana hexadactyla (Lesson) for short-term (SMS) and prolonged (PMS) periods. Short-term muscular stimulations resulted in decreased glycogenolysis and glycolysis with depleted glycogen and lactic acid contents in the muscles and increased lactic acid content in the blood. The activity levels of SDH and MDH were decreased in SMS muscles. Prolonged muscular stimulations, on the other hand, increased glycogenolysis and glycogenolysis was suggested to be due to stepped-up glycogenesis. Tissue oxidative metabolism was also correlated with regulation of activities of enzymes concerned with anaerobic pathways.