A comparative study of automated versus manual measurement of blood pressure in a tertiary care hospital

Background: Measurement of arterial blood pressure (BP) is one of the routine procedures performed both in outpatient and inpatient services of the hospital. Even though BP estimation is routinely done, its values are vital to assess the health status of the patients. Accurate recordings of BP can be estimated by adhering to all the precautions and instructions relating to the specific method employed for BP measurement. In recent years, many health-care setups are replacing the traditional manual BP apparatus with automated machines (digital) for BP estimation. Hence, there is a need to compare these two techniques in relation to their accuracy. Aims and Objectives: In a quest to replace manual mercury sphygmomanometers with automated machines, there is a need to see the reliability of automated machines of BP measurements especially which are currently available in India. Hence, the present study will help us to see the accuracy of automated machines by simultaneously comparing them with manual mercury sphygmomanometer. Materials and Methods: A total of around 224 patients which include 124 males and 100 females within the age group of 25–35 years are recruited for the study. Informed consent was taken from all the subjects. Institute ethical clearance was obtained before conducting the research study. Both manual and automated BP apparatus were used for BP recording. Results: The mean systolic BP (SBP) recorded in males using the mercury sphygmomanometer was found to be 113.19 ± 10.60 mmHg, 113.08 ± 10.08 mmHg, and 117.16 ± 11.14 mmHg, and the mean diastolic BP (DBP) was found to be 68.76 ± 8.34 mmHg, 70.50 ± 8.66 mmHg, and 72.69 ± 8.35 mmHg in sitting, standing, and recumbent postures, respectively. The mean SBP recorded using digital sphygmomanometer was found to be 113.90 ± 10.93 mmHg, 117.24 ± 10.23 mmHg, and 117.16 ± 11.14 mmHg and the mean DBP recorded was found to be to be 68.50±8.43 mmHg, 70.50 ± 8.66 mmHg, and 72.39±7.89 mmHg in sitting, standing, and recumbent postures, respectively. The difference between mean SBP and DBPs in males recorded using the two devices was found to be statistically insignificant. Similarly, the difference between mean SBP and DBP in females recorded using the two devices was not statistically significant. Conclusion: From the above results, it is concluded that there were no significant differences in recorded values of manual mercury sphygmomanometer and automated digital sphygmomanometer.

Influence of Silicon on Reduction of Methane Emissions for Sustainable Rice Production

The increasing human population requires greater rice production and methane is the second most potent greenhouse gas emitted from rice soils under anaerobic conditions. To address this, an experiment was carried out in two phases. In the first phase of the experiment, Si content accessed in the rice index leaves and recorded the mean values of 2.50, 2.48, 2.51 and 2.43% at Jagtial, Warangal, Rajendranagar and Rudrur varietal display plots in Telangana. For the second phase of field experiment, one with high Si (JGL-3855) and another with low Si (RNR-2354) content genotypes were selected with each four levels of N (0, 80, 120 & 160 kg ha-1) and Si (0, 200, 400 & 600 kg ha-1) in strip plot design. Conjunctive application of N and Si to both genotypes, JGL-3855 recorded significantly higher grain and straw yield compared to RNR-2354, among the different combinations of Si and N, application 160 kg N + 600 kg Si ha-1 recorded significantly higher grain and straw yields (7180 and 9693 kg ha-1). The treatments which received a higher dose of Si@600 kg ha-1 in combination with N@ 80, 120 and 160 registered the lower emission of methane@ 25.7, 24.6 and 24.3 mg m-2 hr-1 and there was a significant scaling down of pest and disease incidence was noticed in treatments wherever increased Si doses (0, 200, 400 and 600 kg ha-1) were included.

A study on prevalence of hypertension and its relationship with overweight and obesity in adolescents and young adults, Nizamabad city

Background: The overall imbalance between unhealthy diet intake and physical activity leads to obesity which contributes to high blood pressure and high cholesterol. It is multi factorial disease and changes in the levels of blood pressure and blood lipids differ by age sex and race and are influenced by body fat and dietary patterns. These risk factors need to be monitored and evaluated in childhood and adolescents. So identifying and modifying the risk factors in early age reduces the incidence in adolescents and adult. Prevalence of hypertension varies across countries and states. The prevalence of hypertension in India is reported as ranging from 10 to 30.9%. The objective of the present study is to observe the prevalence hypertension among study population and to study contributing factors for hypertension among study population.Methods: A cross sectional study done on 100 adolescents and young adults of both sexes in the age group 17 to 25 years from 2 degree colleges randomly selected in Nizamabad city, Telangana, India.Results: In the present study population 52 were males and 48 were females, 22 students belongs to rural area and 78 belongs to urban area, pre-hypertension and hypertension was found 8% in both age groups. Overweight and obesity (>25) was found 7% in 17-19 age group and 9% in 20-25 age group. Pre-hypertension and hypertension was found among 10% of alcoholics.Conclusions: The result of our study concluded that there is increasing prevalence of hypertension with increase in age and is associated with overweight and obesity.

Tumor necrosis factor-alpha and pregnancy complications: a prospective study

The aim of this study was to compare the levels of tumor necrosis factor-alpha [TNF-alpha] produced by peripheral blood mononuclear cells in normal pregnancies and pregnancies with complications. Materials and Maternal peripheral blood mononuclear cells from women with a recurrent spontaneous miscarriage [n = 35], premature rupture of fetal membranes [n = 30], preeclampsia [n = 27] and intrauterine fetal growth retardation [IUGR; n = 36] were stimulated with mitogen or antigen, and the levels of TNF-alpha produced were compared to those produced by peripheral blood mononuclear cells from a normal pregnancy [n = 35]. The median levels of mitogen-induced TNF-alpha at the 1st, 2nd and 3rd trimester, and at normal delivery were 1,176.4, 4,320.9, 7,307.4 and 2,463.0 pg/ml, respectively, while those produced in the recurrent spontaneous miscarriage, premature rupture of membranes and preeclampsia cases were 4,159.8, 3,489.5 and 4,149.2 pg/ml, respectively. The differences were statistically significantly higher in these pregnancy complications [p = 0.04, 0.024 and 0.014] as compared to the levels in normal pregnancy. Furthermore, antigen-induced TNF-alpha levels were produced at statistically significantly higher levels by women with IUGR [120.4 pg/ml] compared to women with normal pregnancies [17.9 pg/ml; p = 0.041]. Higher levels of TNF-alpha seem to play a role in these pregnancy complications, suggesting its pathogenesis in such conditions

Foetal stem cell derivation & characterization for osteogenic lineage.

Background & objectives: Mesencymal stem cells (MSCs) derived from foetal tissues present a multipotent progenitor cell source for application in tissue engineering and regenerative medicine. The present study was carried out to derive foetal mesenchymal stem cells from ovine source and analyze their differentiation to osteogenic linage to serve as an animal model to predict human applications. Methods: Isolation and culture of sheep foetal bone marrow cells were done and uniform clonally derived MSC population was collected. The cells were characterized using cytochemical, immunophenotyping, biochemical and molecular analyses. The cells with defined characteristics were differentiated into osteogenic lineages and analysis for differentiated cell types was done. The cells were analyzed for cell surface marker expression and the gene expression in undifferentiated and differentiated osteoblast was checked by reverse transcriptase PCR (RT PCR) analysis and confirmed by sequencing using genetic analyzer. Results: Ovine foetal samples were processed to obtain mononuclear (MNC) cells which on culture showed spindle morphology, a characteristic oval body with the flattened ends. MSC population CD45-/CD14- was cultured by limiting dilution to arrive at uniform spindle morphology cells and colony forming units. The cells were shown to be positive for surface markers such as CD44, CD54, integrinβ1, and intracellular collagen type I/III and fibronectin. The osteogenically induced MSCs were analyzed for alkaline phosphatase (ALP) activity and mineral deposition. The undifferentiated MSCs expressed RAB3B, candidate marker for stemness in MSCs. The osteogenically induced and uninduced MSCs expressed collagen type I and MMP13 gene in osteogenic induced cells. Interpretation & conclusions: The protocol for isolation of ovine foetal bone marrow derived MSCs was simple to perform, and the cultural method of obtaining pure spindle morphology cells was established. Criteria proposed for defining MSCs by this study includes the cell adherence to culture plates, specific surface protein profiles and differentiation to osteogenic lineage. The MSCs and osteogenic differentiated cells in this ovine animal model may serve as a large source for stem cell applications in regenerative medical therapies.

Studies on radionuclides 228Ra, 238U, 228Th and 40 K in selected seaweeds of coastal Tamil Nadu, India.

Studies on natural and anthropogenic radioactivity assume greater importance in the context of human health and development. Hence two species of seaweeds viz: Gracilaria edulis and Ulva lactuca, from three high background radiation areas (Arockiapuram, Kadiapattinam and Kurumpanai) on the southwest coast of Tamil Nadu, and Mandapam as low background radiation area of the southeast coast of Tamil Nadu were studied for variations in activity concentration of 228 Ra, 40 K, 238 U and 228 Th. Among these radionuclides, 40K recorded significant inter-species variation while 238 U and 228 Th showed significant association. The overall mean concentration of radionuclides was found high in G.edulis (5.31, 57.49, 36.05, 356.55 Bq kg-1 for 228 Ra, 40K, 238U, 228 Th respectively), while the mean concentrations for U.lactuca were 4.88, 42.35, 34.40, 347.70 Bqkg-1 for 228 Ra, 40K, 238U, 228 Th respectively. The mean concentration of radionuclides was uniformly found low during northeast monsoon season in both the seaweed species.

Three-dimensional finite element analysis of the stress distribution pattern in the design modifications of U-shaped palatal major connector.

Background: The U-shaped maxillary major connector is considered to be the least-desirable design by many prosthodontists as it lacks rigidity, which is a primary requisite for a major connector. Aims and Objectives: Design modifications in the U-shaped palatal major connector are desired because it lacks rigidity. The study also aimed to determine the best design when a U-shaped palatal major connector is indicated for clinical use. Materials and Methods: The normal design and the design-modified models (modification 1, 2, 3, 4) were loaded at the functional cusps of the premolars and the molars with a magnitude of 200 N, 250 N and 300 N at angulations of 60 o and 90 o on both sides of the maxillary arch. Results for each loading were obtained as stress distribution colored images and numerical values were recorded. A three-dimensional finite element analysis study of the design-modified models was performed using two finite element softwares, namely PRO-E and IDEAS. Results: The least stress value of 7.86 Megapascals (MPa) at 200 N, 60 o was recorded for the double-thickness design, followed by design 1, which was 8.03 MPa. The least stress value for the palatal mucosa and ligament was provided by design modification 1 (0.5 mm-thick U-shaped connector, 9 mm anteroposteiorly, 14.6 mm laterally), which was 9.78 MPa and 2.98 MPa, respectively. Conclusion: The double-thickness group exhibited the least internal stress for the U-shaped major connector. However, it delivered the greatest stress to the palatal mucosa and the periodontal ligaments.

An incidental case of breast cysticercosis associated with fibroadenoma.

It is unusual for cysticercosis to occur in the substance of the breast. Only a few cases have been described in the literature. We report a case of cysticercosis perched on fibroadenoma of breast found on surgical excision in a 35 year old Nepali woman. The patient had no discernible evidence of cysticercosis in the other organs.

Quality assurance programme in haematology at a teaching hospital in the eastern region of Nepal.

Quality assurance in haematology laboratory is intended to ensure the reliability of the laboratory tests. A quality assurance programme has two main aspects, namely, internal quality control and external quality assessment. A two year experience of quality assurance in haematology laboratory at B.P. Koirala Institute of Health Sciences, Nepal, is presented here. As a part of internal quality control, test results in the laboratory were scrutinized before release on a daily basis. Inconsistent result were checked for the given values with control material. In addition, the laboratory is a participant of the 'External Haematology Quality Assurance Programme' conducted by WHO regional reference centre at AIIMS, New Delhi, India. Variations related to errors in manual and autopipetting, calibration and inter-observer differences have been noted from time to time and rectified. The programme has helped us to deliver quality service in haematology laboratory at BPKIHS.

Isolation & cryo-preservation of human foetal articular chondrocytes.

An attempt to determine the ideal temperature and duration of storage of human foetal chondrocytes yielded highly cellular preparations with no alteration in morphology or loss of viability. Initial digestion with activated papain was followed by incubation in 0.5 per cent collagenase. Trypan blue exclusion test revealed a viability count of 95-99 per cent and radioactive thymidine uptake a corresponding labelling index. On TEM no subcellular damage was evident. The isolated viable chondrocytes were further banked at varying temperatures of +4 degrees, -4 degrees, -30 degrees, -79 degrees and -196 degrees C, in Eagles MEM with 10 per cent dimethyl sulfoxide. Post storage morphology and viability of these cells, thawed after durations of 20 h, 1 wk, 1, 2, 3, 4 and 6 months, were compared with prestorage readings in an attempt to define the ideal temperature for banking. Storage in liquid nitrogen at -196 degrees C demonstrated excellent preservation even at the end of six months with minimal subcellular change. Electron microscopy and labelling index were found to be superior to Trypan blue exclusion test in assessing the stored chondrocytes for retention of their functions.

Toxicity of dimethoate on urinary hydroxyproline in rats.

The effect of the administration of three different concentrations (2.25, 1.13 and 0.56 mg/100 g body weight) of dimethoate on the urinary excretion of total, non dialysable and free hydroxyproline were studied in female albino rats. Compared to controls, the urine contents were significantly lower in higher concentration (2.25 mg/100 g body weight) of dimethoate treated rats. The results clearly indicate that the urine contents were not much affected in lower concentration (0.56 mg/100 g body weight) of dimethoate treated rats compared to the other concentrations (1.13 and 0.56 mg/100 g body weight) of dimethoate treated rats.

Toxic effects of different concentrations of dimethoate on lysosomal enzymes of female albino rats.

The effect of three different concentrations of dimethoate on the activity of certain lysosomal enzymes, viz. beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin B and cathepsin D in serum, skin, liver, kidney and spleen and the stability of liver and kidney lysosomes was studied in female albino rats. The activity of beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin D was found to increase in serum and tissues in higher concentration (2.25 mg/100 g body weight) of dimethoate treated rats. A significant increase in the rate of release of beta-glucuronidase was found in the liver and kidney of higher concentration of dimethoate treated rats compared to controls. The results demonstrate that the activity of lysosomal enzymes increased in higher concentration of dimethoate treated rats than the lower concentration (0.56 mg/100 g body weight) of dimethoate treated rats.