Clinical profile of patients with hypertensive emergencies in a tertiary care hospital

Background: Hypertensive emergency is defined by systolic blood pressure (SBP) ?180 mmHg and/or diastolic blood pressure (DBP) ?120 mmHg with acute target organ damage. Hypertensive emergencies can be life threatening and fatal unless timely treated. In the present study we aim to study the clinical profile and outcome of patients admitted with hypertensive emergency in the medical intensive care unit in our hospital. Methods: A cross-sectional observational study of all cases with hypertensive emergency admitted in Medical Intensive care unit (ICU) in Government General Hospital, Srikakulam during the study period was conducted. The clinical profile and outcome of the patients were assessed. Results: Out of the fifty patients in the present study, about 36 (72%) were males and 14 were females (28%) and about one third of the patients (36%) belonged to the age group of 60-69 years. Diabetes mellitus (30%) and dyslipidemia (40%) were the commonly encountered comorbidities in the study population. Most frequent presenting symptoms were neurological deficits (50%) followed by dyspnoea (32%) and chest pain (24%). Intracerebral haemorrhage was the commonest target organ damage found in 30% of the patients. Patients presenting with hypertensive emergencies with neurological target organ damage had statistically significant increased chance of mortality (p=0.007). Conclusions: As hypertension emergencies are consequence of uncontrolled hypertension, it is important to educate and bring awareness among public regarding the screening, early detection, and adherence to prescribed medication for hypertension to avoid adverse clinical outcomes.

Cross-country transport and isolation and identification of Streptococcus pneumoniae by use of alternate sources of blood supplemented media among laboratories in India

Background: The isolation of S. pneumoniae (Sp) depends on specimen integrity / transport, media and expertise. The non-availability of sheep blood agar poses a challenge in identification of colonial morphology and identification in India. Methods: Laboratories processed swabs containing either pure Sp or Sp in mixed cultures with a second (confounding) bacterium shipped across the country in cold conditions. Duplicate set of swabs was shipped back to the central laboratory to assess the impact of shipping on culture viability. The identical swab was cultured on sheep, human blood and one additional agar plate used in the laboratory. Results: 46/60(77%) of cultures containing only Sp were correctly identified. In specimens where Sp was present in mixed culture, the proportion of isolates in which Sp was correctly identified varied, with most variability attributed to the particular confounding organism rather than the media. There was no discernible impact of temperature-controlled (4-6°C) transport on the isolation of Sp from culture swabs. Conclusions: The study clearly elucidates the ability of laboratories for isolation of S. pneumoniae on human blood agar in resource limited settings. The results highlight the difficulties inherent in correctly identifying pathogens in mixed cultures in needs improvement using standardized tests across the study centers. The study also reaffirms the ability to transport biological specimens over long geographical distances without loss.

Dilute acid pretreatment and enzymatic hydrolysis of sorghum biomass for sugar recovery—A statistical approach.

Sorghum is one of the commercially feasible lignocellulosic biomass and has a great potential of being sustainable feedstock for renewable energy. As with any lignocellulosic biomass, sorghum also requires pretreatment which increases its susceptibility to hydrolysis by enzymes for generating sugars which can be further fermented to alcohol. In the present study, sorghum biomass was evaluated for deriving maximum fermentable sugars by optimizing various pretreatment parameters using statistical optimization methods. Pretreatment studies were done with H2SO4, followed by enzymatic saccharification. The efficiency of the process was evaluated on the basis of production of the total reducing sugars released during the process. Compositional analysis was done for native as well as pretreated biomass and compared. The biomass pretreated with the optimized conditions could yield 0.408 g of reducing sugars /g of pretreated biomass upon enzymatic hydrolysis. The cellulose content in the solid portion obtained after pretreatment using optimised conditions was found to be increased by 43.37% with lesser production of inhibitors in acid pretreated liquor.

Genetic variability for seed yield and its components in linseed (linum usitatissinum l.).

Thirty diverse genotypes were studied for variability analysis with respect to yield and yield components in linseed under three environmental conditions viz., rain fed, irrigated and late sown, respectively. Seed yield per plant showed highest genotypic coefficient of variation under all the three environments. High heritability was recorded for days to maturity under irrigated condition, while high genetic advance as per cent of mean was recorded for seed yield per plant under rain fed condition as well as under irrigated condition. High heritability coupled with high genetic advance was observed for 100-seed weight under irrigated condition.

Energy cost of graded work loads & mechanical efficiency of sportsmen.

This study was undertaken to determine oxygen consumption at rest and constant graded work loads while exercising on a bicycle ergometer and to compute mechanical efficiency of sportsmen. Thirteen healthy, active, well trained young sportsmen from sports hostel, Sports Authority of India, Hyderabad, were selected and were requested to pedal the bicycle ergometer at 50 watts and 100 watts (300 and 600 kpm) work loads for 18-20 min. The energy cost of the activity at the respective work loads was measured by means of indirect, open circuit respiratory exchange method. The workouts resulted in the oxygen consumption of about 920.4 +/- 77.5 ml and 1475.2 +/- 101.7 ml at 300 and 600 kpm respectively. The gross or absolute mechanical efficiency (AME) were calculated at these work loads. The delta mechanical efficiency (DME) was also computed for the work increment from 300 to 600 kpm by using the amount of oxygen consumed at these work loads. The AME was about 23-24 per cent in both the loads while the DME was found to be 26 per cent. The relationship between anthropometry, resting metabolic rate (RMR), AME and DME was assessed. It was observed that both AME and DME values of these subjects were in the normal range of Swedish and Canadian active young men. These parameters can be used as indicators for assessing sports persons efficiency both in the active and lean periods.

Mosquito repellency & toxicity of isomeric N, N-diethyltolylacetamides.

Three isomers of N, N-diethyltolylacetamides were synthesized and evaluated against Aedes aegypti and Culex quinquefasciatus for repellency and with mice for LD50, as an indicator of mammalian toxicity. Of these, N, N-diethyl-p-tolylacetamide (DEPTA) showed comparatively better repellency against C. quinquefasciatus. All the compounds showed higher repellency against C. quinquefasciatus than Ae. aegypti. In addition, N, N-diethyl-m-tolylacetamide (DEMTA) was found to be least toxic to mice.

Acute oral toxicity of insect repellent N,N-diethylphenylacetamide in mice, rats and rabbits and protective effect of sodium pentobarbital.

Median lethal dose (LD50) of undiluted liquid insect repellent N,N-diethylphenylacetamide (DEPA) in male mice, rats and rabbits was 900, 825 and 635 mg/kg respectively when administered by gavage. Signs of DEPA intoxication point to stimulation of central nervous system (CNS). Acetazolamide (10 mg/kg), sodium bicarbonate (40 mg/kg), and atropine (5 mg/kg) when injected (ip) 5 min after a lethal oral dose of DEPA (1700 mg/kg) did not prevent mortality, while sodium pentobarbital (SPB; 20 mg/kg) when injected 5 min after or 15 min before DEPA provided greater protection to the animals. SPB pretreatment elevated the LD50 of DEPA to 1780 and 1535 mg/kg in mice and rats respectively and 85% rats survived when SPB was injected 5 min after acute oral exposure to DEPA (1000 mg/kg). Carboxylesterase (CaE) inhibition is not a factor in the protection mechanism of SPB. DEPA (1000 mg/kg) when given orally elevated blood PCO2 and reduced pH, O2 content and per cent O2 saturation, while administration of SPB after the same dose of DEPA reduced the degree of acidosis and raised PCO2, and increased the O2 content and per cent O2 saturation to near normal status. The CNS depressant action of SPB may be a crucial factor in protection of rats from DEPA poisoning.

Childbirth spacing in a rural community of Delhi: profile in various marriage cohorts by decades.

Complete retrospective fertility histories of 843 ever married women of two villages in Delhi, obtained through house to house survey, were analysed to study various marriage cohorts by decades for trends of child birth spacing over a period of 60 years from 1921 to 1980. Spacing between consummation of marriage and first child birth gradually declined over the last 6 decades. For all other subsequent livebirths remained constant at an average of nearly 30 months. Irrespective of the reasons for such a trend, much more efforts are required to be put in to increase child spacing.

Relevance of male hormonal status with antiulcer effect of cimetidine in pylorus ligated rats.

Ulcer formation after pylorus ligation was assessed in control, testosterone treated and castrated male rats after cimetidine treatment. The stomach was studied for incidence of ulcers and its contents analysed for pH, volume, total acidity, free acidity, pepsin and mucin activity. Testosterone and cimetidine when used alone protected from ulceration while when used in combination the degree of protection was decreased. Castration per se ead no effect on ulcer index but potentiated cimetidine induced gastric ulcer protection.

Pain threshold in relation to sex hormones.

Pain threshold to mechanical stimulus was determined in 140 subjects comprising of healthy volunteers of both sexes and of different ages, females taking oral contraceptives and bilaterally oopherectomised females. Pain threshold was observed to be low in oopherectomised females, boys and girls and intermediate in healthy males. It was high in menstruating females aged 18-21 years. There was a marked fluctuation in pain threshold in menstruating females. It was low at menstrual phase. In females taking oral contraceptives it was high at pre and midmenstrual phases. In females not taking oral contraceptives it was low at pre-menstrual and high as midmenstrual phases.

Influence of testosterone on morphine analgesia in albino rats.

Pain threshold for thermal stimulus after morphine, naloxone alone and naloxone in combination with morphine was studied in male rats before and after three days treatment with testosterone. It was also determined 15 days after gonadectomy and administration of testosterone in such rats. There was significant reduction in morphine analgesia after administration of testosterone and also after gonadectomy. Naloxone increased the pain threshold in gonadectomised rats and it enhanced morphine induced analgesia instead of antagonising it. Naloxone, however, had no effect on morphine analgesia in testosterone treated control rats and gonadectomised rats.