Effect of CO2 Insufflation on Corrected QT Interval Prolongation during Laparoscopic Surgeries: A Prospective Observational Study

Introduction: Laparoscopic surgeries in various surgical specialties are most routinely performed with general anesthesia. Thephysiological effects of intra-abdominal CO2 insufflation combined with the variations in patient positioning can have a majorimpact on cardiorespiratory function. Prolongation of corrected QT interval (QTc) has been known to predispose torsades depointes, a potentially fatal ventricular arrhythmia may occur during CO2 insufflation. Our aim is to evaluate the effect of insufflationof CO2 on QT interval and QTc during prolonged laparoscopic surgeries.Methodology: Fifty patients of American Society of Anesthesiologists physical status 1 and 2, of either sex, between the agesof 25 and 65 years posted for laparoscopic surgeries included in the study. After general anesthesia, we measured mean arterialpressure, heart rate, SpO2 and ETCO2 before anesthesia induction, before CO2 insufflation, 30, 60, 120, and 150 min after CO2insufflation, 5 min after CO2 deflation, and at the end of surgery. We observed statistically significant increase of QTc intervalaround 120 min after CO2 insufflation.Conclusion: The cause of this QTc interval prolongation is multifactorial and clinical significance of producing life-threateningcardiac arrhythmias has to be determined.

A study of quality of life and economic dependency in physically disabled population in a rural area

Background: Human life is enriched by mechanical, recreational and innovative activities performed by an individual. Disability is a complex phenomenon, reflecting the interaction between features of a person’s body and the society in which he or she lives. Quality of life is defined by a subjective evaluation of the life circumstances of an individual with respect to his/her values. The objective of the study was to study the prevalence of physical disability and their economic dependence and quality of life in Orathur rural population.Methods: Data was collected by house to house survey of rural population, Orathur, Cuddalore district, Tamil Nadu through pre structured questionnaire and clinical examination .The tools used include interview schedule and sickness impact profile (SIP) scale with modification. Data was analyzed statistically.Results: A total of 4508 population were surveyed in this study to find out the prevalence of disability and burden of disability. Totally 308 physically disabled persons were identified (6.8% prevalence rate). It was found that visual disability was most common disability. Economic dependency and impact on quality of life was found to be more in visual disability than other types of disability. Information on extent of impact of disabilities is required to formulate future policies aiming at improving quality of life of disabled people and making them economically independent.Conclusions: Visual disability was the most prevalent disability in the present study and Cataract being the leading cause. Vocational rehabilitation measures specifically for rural disabled people should be initiated by government and non governmental agencies to improve the economic status.

Etiological Factors For The Development Of Lung Cancer In Non-Smokers: An Overview

Lung cancer is the most frequent malignant tumour with the highest mortality rate around the world, leading to greater than a million deaths annually. The number of deaths due to lung cancer is expected to increase to ten million deaths per year in 2030. The major risk factor for the development of lung cancer is cigarette smoking but relatively high rates of lung cancer occur among non-smoking women and 10-25% of lung cancer observed in never smokers. The lung cancer deaths occur in never smokers have been estimated to be the 7th leading cause of cancer mortality. This article mainly discusses the important etiological factors of lung cancer in never smokers such as the environmental factors, occupational exposure, history of lung disease, family history and genetic factors, unbalanced diet and high consumption of saturated fat, radiation exposure, socioeconomic status, and infections. Gender, obesity and metabolic syndrome, race and ethnicity and interstitial lung diseases also have effects on the development of lung cancer in never smokers.

Antioxidant potential and oxidative DNA damage preventive activity of unexplored endemic species of Curcuma.

Free radical scavenging activity, ferrous ion chelating capacity, reducing power and genoprotective effect of the aqueous leaf extracts of four unexplored endemic Curcuma spp. (C. vamana, C. neilgherrensis, C. mutabilis, C. haritha) were found to be dose-dependent and were highest in C. vamana. DNA protection property of the extracts was evaluated against H2O2/UV-induced oxidative damage. DNA-methyl green displacement assay showed that these extracts were free of DNA intercalating compounds. Further, hemolysis assay also showed that the extracts were non-toxic to human erythrocytes. The results highlight C. vamana as a promising source for herbal preparations possessing high antioxidant potential and genoprotective activity.

Cell cycle inhibitory effects of leaf extract from Curcuma vamana M. Sabu & Mangaly on mitotically synchronous cultures of Physarum polycephalum Schw.

Leaf extracts of C. vamana, endemic to Kerala state in India, were found to inhibit cell cycle progression in synchronous cultures of P. polycephalum in a concentration and phase-specific manner. Crude alkaloid extract (CAE) elicited maximum cell cycle delays in comparison to soxhletted chloroform, acetone and aqueous extracts. Total alkaloid content of CAE was found to be 64.9 mg/g. CAE showed lowest DPPH radical scavenging activity. Other extracts with higher free radical scavenging activity exhibited lesser cell cycle inhibiting potential. Upto 21% decrease in nuclear DNA was observed in CAE treated samples. However, genotoxicity as evidenced by comet assay was not observed. The extracts were also found to be non-toxic to human RBCs at the highest concentration tested (750 µg/mL). CAE treatment completely suppressed a 63 kDa polypeptide with a concomitant, but weak induction of a 60 kDa polypeptide suggesting that these may be cell cycle related. CAE was found to possess potent antiproliferative activity against PBLs. The study clearly demonstrates the cell cycle inhibitory activity of C. vamana leaf extracts, with CAE being the most potent of them.

In vitro antibacterial activity of Psidium guajava Linn. leaf extract on clinical isolates of multidrug resistant Staphylococcus aureus.

In the present study, antibacterial activity of aqueous and organic extracts of Psidium guajava leaves was evaluated against multidrug resistant (MDR) clinical isolates of Staphylococcus aureus strains collected from hospitals in northern (Malabar region) Kerala. The strains which exhibited resistance against all the antibiotics tested was selected for antibacterial assays. Minimum inhibitory concentration (MIC) for methanolic and aqueous extracts was found to be 625 ug/ml and 7.5 mg/ml, respectively. Minimum bactericidal concentration (MBC) recorded for methanolic and aqueous extracts was 1.25 and 12.5 mg/ml, respectively. Methanolic extract at minimum bactericidal concentration inhibited the growth of MDR strain by 80%. Time-kill assay revealed that methanolic extract (4 mg/ml) killed MDR bacteria within 10 hr. Total polypeptide profiling of bacterial cultures by SDS-PAGE indicated a high degree of protein degradative activity of the extract. Finally, a human RBC based haemolytic assay showed absence of haemolysis even at concentrations higher than that of MBC, advocating thereby its safety in therapeutic use.

Detection of Helicobactor pylori by polymerase chain reaction: A comparison in sample preparation.

Gastric biopsy samples obtained from 14 patients with upper abdominal pain, clinically diagnosed as acid peptic disease, were analysed for the presence of Helicobacter pylori (H. pylori) by Polymerase Chain Reaction (PCR) using partially (template A) and completely purified DNA (template B). Antigen specific primer was used to analyse the sample by PCR method. The presence of H. pylori in the samples was confirmed by running a positive control. The presence of H. pylori was also detected by urease method using standard protocol. Among the 14 samples studied, 8 showed the presence of H. pylori with both templates A and B. Among these 8 samples only 3 showed positive for the presence of H. pylori with urease method. The present work discusses the results obtained in the detection of H. pylori in template A and B by PCR method.

Effect of cigarette smoking on muscle strength of flexibility of athletes.

Kraus-Webber test which indicates muscle strength and flexibility of certain group of muscles showed significant decrease in cigarette smoking athletes in the age group of 19-30 years compared to nonsmoking athletes. The results indicate tobacco smoke inhalation affects muscle flexibility and strength required for athletes.

Tetralogy of Fallot with flap valve ventricular septal defect producing suprasystemic right ventricular pressure: echocardiographic observations.

Tetralogy of Fallot with restrictive ventricular septal defect and suprasystemic right ventricular pressure is an uncommon anomaly with high mortality rate. Very few such cases have been reported pre-operatively. This report describes echocardiographic features of five patients with restrictive ventricular septal defect due to flap valve in tetralogy of Fallot. In all the five cases, accessory or excessive tricuspid valve tissue obstructed the defect. Recognition of restrictive ventricular septal defect in tetralogy of Fallot is important because it appears to have poor prognosis.

Thermal stabilization of multimeric proteins: a case study with alpha-globulin.

Preferential interaction parameters of multisubunit protein, alpha-globulin and monomeric protein human serum albumin (HSA) were determined in different cosolvents using precision densitymetry. The apparent partial specific volumes were determined under both isomolal and isopotential conditions for alpha-globulin in 0.02 M glycine-NaOH buffer at pH 10 and the values were 0.692+/-0.002 and 0.688+/-0.001, ml/g, respectively, at 20.00+/-0.01 degrees C. From the partial specific volume data with cosolvents the preferential interaction parameter (xi3) and other thermodynamic parameters were calculated at different solvent concentrations. The (xi3) values increased with an increase in the solvent concentration up to 30% and reached a maximum with the values of-0.111+/-0.018 g/g and -0.076+/-0.012 g/g in sucrose and sorbitol, respectively. In glycerol the (xi3) values decreased with an increase in solvent concentration. The above data is further supported by thermal denaturation profiles in which the apparent thermal denaturation temperature (apparent Tm) of alpha-globulin shows an increase from 63 degrees C to higher temperatures in the order of sucrose, sorbitol and glycerol. Alpha-globulin showed coagulation due to protein interaction at temperatures above 50 degree C. The apparent Tm of 63 degrees C for control protein was increased significantly up to 75 degrees C in 40% sorbitol with two fold increase in the delta(S) values showing the increased structural stability of alpha-globulin. At high solvent concentration the protein gets dissociated and the resultant monomers are hydrated which was evident by fluorescence data and the difference spectral results with a 6nm red shift in the emission maximum and 2 nm blue shift in UV-absorption maximum arising out of perturbation of aromatic chromophores. The studies were performed both at native pH of 7.9 where the protein is in its oligomeric form and at pH of 10 where it is dissociated form and the results compared. The data showed that the solvent is excluded more from the protein vicinity in the dissociated state.

Synergistic effect of heat-shock and UV-irradiation on mitosis and protein synthesis in G2-phase plasmodia of Physarum polycephalum Schw--reduction in UV-induced mitotic delay in a preheat-shocked system.

The synergistic effect of UV irradiation and heat-shock during the last 3 hr of G2 phase of the cell cycle in the plasmodia of P. polycephalum, in terms of mitotic delay and inhibition of protein synthesis, has been evaluated. The mitotic delay due to both perturbers coordinately increased closer to mitosis. Maximum mitotic delay was obtained in plasmodia heat-shocked after UV irradiation, indicating the presence in this system of either a heat-labile mitogenic substance which is comparatively less susceptible to UV or a substance which is made more susceptible to hyperthermia by UV. A protective role for heat-shock applied before irradiation has been observed in that, radiation-induced mitotic delay is significantly reduced in this combination. There was severe inhibition of translation in all the perturbed classes. Organelle level effects which are independent of major protein synthetic activities or different levels of heat-shock protein production could be the reason for the lack of correlation between percentage inhibition of general protein synthesis and the extent of mitotic delay with respect to the two double-perturbed systems.