Bio-efficacy of Bacillus subtilis against Damping off Disease in Brinjal

Bacillus sp is one of the biocontrol agents are extensively used in management of fungal diseases of crop plants, exhibiting mycoparasitism against a wide range of plant pathogens. In the present investigation Efficacy of Bacillus subtilis was tested against Pythium aphanidermatum under glass house and field conditions. With regard to the germination and seedling growth parameters, the treatment T2 (liquid formulation of Bacillus subtilis @10 ml/L) recorded the highest germination percentage (92.59%), shoot length (59.3 cm), root length (24.3 cm), vigor index (7740.52) and yield (22.67 mt/ha). This was followed by the treatments T3, T1 and T4 in the decreasing order of merit. In the biometric observations also, 10 ml/L and 20 ml/L concentration of liquid formulation of Bacillus subtilis recorded statistically significant results. Observations on total protein content in brinjal plants treated with different concentrations of Bacillus subtilis revealed that treatment T2 was found best in both field and glass house conditions yielded highest protein as 0.44mg/ml and 0.30mg/ml respectively. The least values of germination, growth parameters, protein content and yield were observed in untreated control.

Impacts of transfusion in β-thalassemia major patients receiving multiple blood transfusions

Background: Beta-thalassemia major is one of major public health problems in India. Thalassemia major is a transfusion-dependent severe anemia and these children experience various problems if the transfusion is inadequate but at the same time repeated blood transfusions are associated with hazards like iron overload.Methods: This study was conducted at thalassemia ward of S.M.S Hospital and J.K.LON paediatrics Hospital, Jaipur from April 2012 to Nov. 2013. 145 thalassemia patients on transfusion therapy attending outdoor or being admitted were assessed after obtaining due permission from the authorities and consent from the guardian or parents of patients.Results: Present study comprised 145 beta-thalassemia major patients with 51 (35%) females and 94 (65%) males in which youngest patient is 3 years old and the oldest 33 years. 104 (72%) were Hindus and 41 (28%) were Muslims. Consanguinity was found in a significant proportion 16% (23) of the parents of the patients. 137 (94%) patients had serum ferritin ³1000ng/ml. Out 145 thalassemic patients, 108 (74.5%) have total serum bilirubin >1(mg/dl), 103 (71%) have SGPT level >35IU, 103 (71%) have SGOT level >40IU), 38 (26.2%) have serum alkaline phosphatase level >390 IU, 35 (24.1%) have serum creatinine level >1.6mg/dl, 42 (29%) have serum urea level >45mg/dl, 28 (19.3%) have serum uric acid level >6mg/dl.Conclusions: It is suggested to revise and devise suitable transfusion regime so that a balance between adequate transfusion and minimum side effects of multiple transfusions is maintained. Systemic effects of multiple transfusions should be rigorously and meticulously studied.

Epigenetic deregulations of Wnt/β-catenin and transforming growth factor beta-Smad pathways in esophageal cancer: Outcome of DNA methylation

Background: Promoter methylation of tumor suppressor genes (TSGs) is a well-reported portent in carcinogenesis; hence, it is worthy to investigate this in high-risk Northeast population of India. The study was designed to investigate methylation status of 94 TSGs in esophageal squamous cell carcinoma (ESCC). Further, the effect of OPCML promoter methylation on gene expression was analyzed by immunohistochemistry. Moreover, in silico protein–protein interactions were examined among 8 TSGs identified in the present study and 23 epigenetically regulated genes reported previously by our group in ESCC. Materials and Methods: Methylation profiling was carried out by polymerase chain reaction array and OPCML protein expression was examined by tissue microarray-based immunohistochemistry. Results: OPCML, NEUROG1, TERT, and WT1 genes were found hypermethylated and SCGB3A1, CDH1, THBS1, and VEGFA were hypomethylated in Grade 2 tumor. No significant change in OPCML expression was observed among control, Grade 1, and Grade 2 tumor. Conclusively, hypermethylation of the studied OPCML promoter in Grade 2 tumor produced no effect on expression. Unexpectedly, OPCML expression was downregulated in Grade 3 tumor in comparison to other groups signifying that downregulation of OPCML expression may lead to higher grade of tumor formation at the time of diagnosis of ESCC in patients. Significant interactions at protein level were found as VEGFA:PTK2, CTNNB1:CDH1, CTNNB1:VEGFA, CTNNB1:NEUROG1, CTNND2:CDH1, and CTNNB1:TERT. These interactions are pertinent to Wnt/β-catenin and TGF-β-Smad pathways. Conclusions: Deranged OPCML expression may lead to high-grade ESCC as well as epigenetically regulated genes, that is, CDH1, CTNNB1, CTNND2, THBS1, PTK2, WT1, OPCML, TGFB1, and SMAD4 may alter the Wnt/β-catenin and TGF-β-Smad pathways in ESCC. Further study of these genes could be useful to understand the molecular pathology of ESCC with respect to epithelial-mesenchymal transition (EMT) mediated by Wnt/β-catenin and TGF-β signaling pathways

Esthetic Rehabilation of Anterior Teeth Using Ceramic Veneers : A Case Report.

Ceramic laminate are a predictable treatment option for esthetic anterior restorations. This restorative modality can be offered as the treatment option in a wide variety of different cases such as correcting tooth defects, abrasion, orthodontics, diastema, tooth discoloration, coronal fracture or to adjust occlusion. Due to its color and optical properties, ceramic represents the material of choice when a high level of esthetics is required. This article reports the management of a case in which ceramic veneer used to achieve the desired esthetic results.

Extended-spectrum β-lactamase and AmpC β-lactamase Production among Gram-negative Bacilli Isolates Obtained from Urinary Tract Infections and Wound Infections.

Extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases continue to be a major problem in healthcare settings. Due to the scarcity of information regarding the antibiotic susceptibility patterns particularly from urinary tract infections (UTIs) and wound infections, the current study was carried out to assist the clinicians to prescribe appropriate antibiotics against gram-negative clinical isolates. In the current study, urine (n = 620) and pus (n = 228) samples were collected from different sites (at various clinical departments) and subjected to direct microscopic examination, culture and antibiotic susceptibility testing (AST). In the AST testings, the isolates that exhibited reduced zone of inhibition to one or more of the antibiotics such as cefotaxime (≤27 mm), ceftriaxone (≤25 mm), ceftazidime (≤22 mm), cefpodoxime (≤17 mm) and aztreonam (≤27 mm) were considered as potential ESBL producers and the ESBL production was confirmed using phenotypic screening test (doubledisk synergy test) and phenotypic confirmatory test (combined-disk test). However, isolates showing resistance or decreased sensitivity to cefoxitin, cefotaxime, ceftriaxone, ceftazidime, cefpodoxime or aztreonam and sensitive to cefepime were considered as a screen positive AmpC producer and subjected to AmpC disk tests. The current study concluded that 72.41% and 21.76% of ESBL and AmpC producers were detected, respectively in our hospital. It was also observed that the double-disk synergy and combined-disk tests were equally effective for ESBL detection. Further, AmpC disk test is simple, easy to perform and interpret, requiring less expertise for the rapid detection of AmpC isolates.

Clinical profile of pneumonia and its association with rain wetting in patients admitted at a tertiary care institute during pandemic of influenza A (H1N1) pdm09 virus infection.

Background. Influenza pneumonia often occurs as epidemics in the Asian countries and have significant impact on the health of world population. Methods. We studied the association of rain-wetting with occurrence of pneumonia during the outbreak of the influenza A (H1N1) pdm09 virus infection. All patients admitted with community-acquired pneumonia during the period 13th September to 10th October 2010 were recruited in the present study. The diagnosis of influenza was established by realtime polymerase chain reaction (RT-PCR). The demographic data and clinical profile of the patients were recorded with a special consideration to record of possible risk factors. Results. Of the 123 patients studied, 39 (32%) patients had tested positive for influenza A (H1N1) pdm09; 12 (10%) tested positive for influenza A and remaining 72 (58%) patients were negative for influenza virus. Pattern of illness was almost identical in H1N1-positive and-negative groups. History of rain-wetting was present in 48 patients (39%) preceding the onset of illness. Getting wet in the rain was significantly higher in patients with pneumonia than control subjects [odds ratio 2.53, 95% confidence intervals (CI) 1.301 - 4.91; p=0.009)]. The number of pneumonia patients was also higher on rainy days and the numbers started declining a week later. Conclusion. More pneumonia patients are admitted during the periods of greater rainfall and rain-wetting may be an important risk factor for the occurrence of pneumonia.

Pre- & post- bronchodilator pulmonary function test in Indian females: a survey in and around Jaipur.

Background: Nonsmoker COPD in people is a continued point of concern. Recent standards prescribe that spirometry should be population specific, recent origin and methodically derived (prescribed by GOLD) with influencing factors specified – which this study aims to do. Methods: From a random sample of 4,500 adults, subjects were invited into study through a 16 point questionnaire. After inclusion/ exclusion criteria applied to 3,733 total responders, 244 rural and 240 urban healthy non-smoker females were enrolled. Spirometry with reproducibility testing before and after bronchodilator (salbutamol) was done as per GOLD prescription. As normality of distribution was disproved, non-parametric methods were used in statistics. Results: Mean FEV1 and FVC were 2.25 and 2.69 liters respectively in rural females, while it was 2.06 and 2.44 liters in urban females. Post-bronchodilator (after 0.3 mg salbutamol) values in rural females were 2.32 and 2.70 liters respectively while the same were 2.13 and 2.45 liters in urban cases. Conclusion: PFT of rural females resulted better on FEV1 and FVC, pre as well as post-bronchodilator. Possibly biomass fuel exposure in the rural females might not be causing a generalized decrease in PFT parameters or urban chemical pollution which might have more than counterbalanced in urban side.

Primary Nasopharyngeal Tuberculosis.

Tuberculous infection of the upper respiratory tract is an uncommon clinical condition and in that nasopharyngeal involvement is struck with rarity per se. This condition is often prevalent in people of low socioeconomic strata living in endemic areas, especially in developing countries. It has a silent and indolent course and most commonly mimicks nasopharyngeal carcinoma in its clinical presentation. In absence of concurrent pulmonary involvement, it is often misdiagnosed or diagnosed only after the biopsy has been taken. Nevertheless, high index of suspicion is required on part of the clinician to diagnose this comparatively rare entity.

Spectral analysis of heart rate variability in bronchial asthma patients.

The study was carried in the Departments of Physiology and Medicine at S.M.S. Medical College, Jaipur. Thirty patients of bronchial asthma, aged 20-30 years attending outpatient clinics of S.M.S. Hospital and thirty healthy volunteers were recruited in the present study for spectral analysis of Heart Rate Variability (HRV) using impedance peripheral pulse in the right forearm. Two spectral components were recorded namely high frequency (HF) component (0.15–0.4 Hz), an indicator of vagal efferent activity and low frequency (LF) component (0.04–0.15 Hz), replicator of composite sympatho-vagal interplay. These components were analyzed as LF nu (Low Frequency normalized unit), HF nu (High Frequency normalized unit) and LF/HF ratio. Low frequency component in absolute units of the asthmatic patients differed insignificantly (P>0.05) from LF of the subjects, whereas the same calculated as normalized units was found to be significantly low in the patient group (P<0.01), as compared to that of the control group. The High Frequency (in absolute units) index of HRV was significantly high in asthmatics (P<0.01) as compared to the HF (absolute units) of controls. Similar trend was observed in the normalized units of HF (P<0.01). LF/HF ratio was not significantly different in patient and control groups (P>0.05). It was concluded that a significantly raised central vagal outflow and a concomitant significantly low central sympathetic efferent could be appreciated in asymptomatic asthmatic patients as compared to that in the control group. This deranged sympathovagal interplay with parasympathetic dominance could be a plausible pathophysiological mechanism leading to airway obstruction, the hallmark of bronchial asthma.

Endoscopic Repair of Spontaneous Cerebrospinal Fluid Rhinorrhoea Via Paraseptal Approach.

CSF rhinorrhoea poses a significant challenge even to most astute and experienced surgeons in its accurate localization and management. The diagnosis of CSF leak is ascertained on proper history, neurologic and otorhinolaryngologic examination, laboratory tests and endoscopic findings supplanted by appropriate radiologic studies. The exact visualization and atraumatic surgical technique using endoscope provides better lighting with magnified view, even in lateral recesses giving an edge over other techniques, thus enhancing the surgical outcome.

Tuberculous Otitis Media.

Considerable variation exists between the clinical presentation of tuberculous otitis media (TOM) seen nowadays and what was described earlier. Confusing clinical picture and subsequent delay in diagnosis of TOM permits it to progress unhindered and results in permanent disabling conditions like facial paralysis and profound hearing loss. Hence an early diagnosis of TOM and timely commencement of appropriate therapy remains a challenging task. A high index of suspicion is required on part of the clinician to diagnose this fabled entity.

Sildenafil improves six-minute walk distance in chronic obstructive pulmonary disease: A randomised, double-blind, placebo-controlled trial.

Background. Sildenafil has been found to improve exercise capacity and haemodynamic parameters in patients with various pulmonary disorders. This study was undertaken to evaluate its efficacy in severe chronic obstructive pulmonary disease (COPD). Methods. In this double-blind, randomised, placebo-controlled study, 37 patients with severe COPD received either sildenafil or placebo for 12 weeks. Distance covered in six-minute walk test (6MWD) was taken as primary end-point. Pulmonary artery pressure (PAP) was measured as secondary end point. Results. Thirty-three patients (15 in sildenafil arm and 18 in placebo arm) completed the study. Non-parametric tests were used for comparison. There was significant increase in 6MWD from baseline after three months of follow-up in sildenafil users (median change in distance covered in six-minute walk test (Δ6MWD)=190m) as compared to placebo users (Δ6MWD=0m, p< 0.05). The PAP decreased significantly (χ2=14.94, p<0.05) in sildenafil group after three months, while it did not change significantly among placebo group (χ 2=3.84, p>0.05). Conclusion. Sildenafil improved 6MWD and PAP in patients with severe COPD. This trial has been registered with Indian Council of Medical Research (ICMR) Trial Registry. [CTRI Registry Number: CTRI/ 2009/091/000017]

Breath carbon monoxide levels in different forms of smoking.

Background and Objectives. Bidi, cigarette, hookah and chillum are common modes of tobacco smoking in India. Many people consider hookah and chillum smoking less toxic because smoke is filtered through water or wet cloth. We evaluated the toxicity of tobacco smoking by measuring end-tidal carbon monoxide (eCO) levels after various modes of smoking. Methods. Eighteen healthy smokers who smoked bidi, cigarette, hookah and chillum on six days were studied. They smoked one bidi, one cigarette, five minutes hookah, one serve (15 minutes) hookah, five minutes chillum and one serve (15 minutes) chillum on six days randomly. The eCO values were measured before initiation of smoking and for a period of one hour after the smoking session. Increase in eCO values in comparison to baseline after different modes of smoking was compared. Results. In comparison to baseline, mean eCO levels were raised by 4.94 (0.96) parts per million (ppm) immediately and 4.17 (1.07) ppm 60 minutes after cigarette smoking. Bidi smoking caused slightly less increase in mean eCO levels (3.17 [0.82]). One serve of hookah and chillum smoking caused elevation of mean eCO values by almost eight-folds higher than that of cigarette smoking. Five minutes of smoking with hookah (22.18 [5.29]) and one serve of hookah (33.0 [8.76]) and chillum (40.14 [12.73]) caused significantly higher values of mean increase in eCO in comparison to cigarette smoking (p<0.001). Conclusion. With regard to eCO levels, hookah and chillum smoking are much more toxic than cigarette smoking.

Brush cytology in malignant biliary obstruction.

Tissue diagnosis is essential for the management of patients with malignant biliary obstruction. We prospectively studied brush cytology in 30 patients with malignant biliary obstruction. Wire guided brush cytology was obtained from the stricturous segment during endoscopic retrograde cholangio-pancreatography. The study comprised of 30 patients (16 males, 14 females), with a mean age of 55 years (range 30-75 years). The obstruction was caused by carcinoma gallbladder in 16 cases, carcinoma head of the pancreas in 10 cases, and cholangiocarcinoma in 4 cases. Brush cytology was positive for malignancy in 8 cases (26.7%). Another 3 samples (10.3%), 1 from each group of tumors, were suspicious for malignancy. Cytology was positive in 25% of gallbladder cancers, 50% of pancreatic cancers, and 50% of cholangiocarcinomas. Brush cytology was positive in 6 of 18 (33.3%) proximal and 5 of 12 (41.7%) distal strictures. Brush cytology yielded a sensitivity of 36.7% in the diagnosis of malignant biliary strictures. However, a larger study is required to confirm these findings.