Serial Changes in Platelets and Outcomes in Dengue

Introduction: With marked growth of the population, rapidurbanization, inappropriate sanitisation and proliferatingtrend of mosquitoes, there is substantial increase in dengueinfections. The fatality rate due to dengue shock syndrome(DSS) can be brought down to as low as <0.2% with carefulmanagement. Understanding the factors which are responsiblefor progression of the disease to the severe stage and death isessential in determining the triage and management steps.Material and methods: All patients suspected to haveprobable dengue / probable dengue fever with warning signswere admitted in government hospital attached to KasturbaMedical College, Mangalore and were given an option ofenrolment in the study. After obtaining informed consent,all potentially eligible patients were screened for enrolment.All necessary blood samples needed to confirm dengue feverand other causes of fever were drawn on the first day. Plateletcounts were done every day till they reach stable levels or tilldischarge.Results: Out of 105 cases (Dengue Fever withoutcomplications), platelet counts (median values) were taken asa parameter. It was observed that the platelet counts are at alowest level on day 2 and day 3 and later on day 4 and day5 it improved. Friedman’s test value = 228.612 and p value<0.001 which was highly significant.Discussion: Thrombocytopenia is a distinctive feature ofdengue and it has been described that its intensity correlateswith the degree of viremia and with the magnitude of theimmune response. It has been suggested that a progressivedecrease in platelets may anticipate the severe form of dengue.

Clinico-Etiological Profile of Electrolyte Imbalance among Patients in a Government Hospital in Dakshina Kannada

Introduction: Hyponatremia is a state of electrolyteimbalance with a high prevalence rate, it is one of the leadingcause of morbidity and mortality in our settings. The aim ofthis study was to evaluate the clinical features and etiology ofhyponatremia in patients admitted in our government hospital.Material and methods: A 1-year prospective cross-sectionalobservational study was conducted on adult patients withmoderate-to-severe hyponatremia admitted to the hospital.Patients demographics were recorded and investigations weredocumented. Data were analyzed using independent samplet-test.Results: Vomiting (28) followed by confusion (26) was themost common complaint. Confusion was significantly highin patients with severe hyponatremia as compared to patientswith moderate. Increased urine sodium levels were observedin these patientsConclusion: Patients with hyponatremia secondary to aninfectious cause should be meticulously screened and timelyand effective treatment of hyponatremia is determined by theeffective understanding of pathophysiology and associatedrisk factors of hyponatremia.

Profiling of major biochemical compounds for identification of nutritionally rich genotypes in mango

Aim: Mango is a major fruit crop grown in India with wide variability for fruit colour, size, shape and fruit quality. The main objective of this study was profiling of mango genotypes and their genetic estimates for major biochemical compounds to identify superior genotypes as parents for developing nutritionally rich hybrids in future. Methodology: Fifty mango varieties were analysed for biochemical compounds such as total antioxidants, total phenols, total flavonoids and total carotenoids. The L*, a*, b* values were recorded for pulp colour, and genetic estimates were also worked for genetic parameters such as genotypic variance, phenotypic variance, GCV, PCV, heritability and genetic advance. Correlation matrix for major biochemical compounds and L*, a*, b* values were also calculated. Results: The present study revealed the presence of wide genetic variability in mango gene pool for biochemical compounds and pulp colour. The total phenolics ranged from 24.44 to 148.33 mg 100g-1 of pulp, total flavonoids 10.33-49 mg 100g-1, total carotenoids 0.48-7.50 mg 100g-1 and total antioxidants 0.14-1.59 µmol Trolox 100g-1 of pulp. The future genetic estimates showed that the phenotypic coefficient of variation (PCV) for all the characters was slightly higher than genotypic coefficient of variation (GCV), indicating the presence of environmental influence to some degree in the phenotypic expression of characters. However, the difference between PCV and GCV for all the traits was narrow suggesting that the traits were less influenced by environment. The broad sense heritability (H2b) for all the compounds was high which indicates the phenotype of that trait strongly reflects its genotype. Interpretation: High values of PCV, GCV and heritability for total antioxidants, total phenols, total flavonoids and total carotenoids indicated high genetic variability and better scope for selection and improvement through hybridization.

Ayurvedic Approach Towards Ankylosing Spondylitis– A Case Study

Ankylosing Spondylitis is a chronic, systemic, inflammatory disease that can cause the vertebrae to fuse in advanced stages. Ankylosing Spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. This affects primarily the sacroiliac joints and spine. Certain peripheral joints and tendons can also be affected, and extra-articular manifestations may be present. The HLA B27 gene is commonly present, and there is a strong familial association. Due to the irregular dietary habits and Irregular activities like doing exercise soon after consuming food etc., leads to indigestion and formation of Amarasa. Through this article we are going to understand a case of Ankylosing Spondylitis in the line of Amavata through detailed history taking the course of the Samprapti is understood clearly and treated accordingly. A 37 years old male patient was presenting with the complaints of Low Back Pain associated with stiffness on low back region since 1 and 1/2 years and Neck pain associated with stiffness since 8 years. Though the Vyakta Lakshanas were at low back region, the initial Samprapti started from the Ama, Ajirna and so on. So in this case these factors are concentrated, assessed carefully and managed accordingly through various Abhyantara and Bahya Prayogas. Thereby following observations like reduction in Stiffness and pain, regularized and satisfactory bowel evacuation etc., were noted.

Conceptual Understanding Of Amlapitta (gastritis)

Ayurveda has given utmost importance to optimal dietary regimen and its variation as per the season, Agni, Prakruti. When these are not followed, leads to imbalance in Doshas in turn leading to the manifestation of disease. Other contributing factors for the change in food habits are frequent traveling and change of environment which in turn has an effect on an individual’s health. So it can be clearly understood that imbalanced food habits are considered as the prime cause of the manifestation of disease in an individual. Amlapitta is such a clinical entity manifesting in the Annavaha Srotas. Amlapitta can be correlated with Acid Peptic Disorders which comprises of Gastro-Oesophageal Reflux Disease, Gastritis, Functional Dyspepsia described in modern science. According to several authors of contemporary science states that, the combination of physiological, environmental, genetic and psychological factors definitely occupy a prime role in the manifestation of the disease. Through this article an attempt is made to compare and understand the Nidana, Samprapti, Purvarupa, Rupa mentioned by various Acharyas and also to analyse through the current lifestyle modifications contributing to the manifestation of the disease Amlapitta.

Our Experiences With Human Body Composition Estimations; Low Discriminatory Power Of Body Mass Index To Segregate Body Fatness

Body mass index, though globally a very popular and frequently used surrogate measure of body fatness, has come under some scrutiny and serious criticism in recent years for its inability to reflect the same. This is particularly disconcerting with health risks involved in cardiometabolic diseases associated with obesity. Therefore, it is suggested that actual measurement of body fat levels be used and there are simple and easier techniques available. The measurements of body volume index in replacing body mass index may provide better information on human body composition for future research.

Phytochemical Screening and Anti Microbial Studies of Hemidesmus Indicus.

Many forms of alternative medicines were available for those who cannot be helped by conventional medicine. Ayurvedha and Herbal medicine were two important forms of alternative medicine that was widely available in India. This work was mainly concerned with the identification of the therapeutic properties of Hemidesmus indicus. The ethanolic extract of hemidesmus indicus root was used for its anti oxidant and antimicrobial activity. Hemidesmus indicus root extract has very well anti oxidant and anti microbial activity. The ethanolic extract of Hemidesmus indicus was checked for anti microbial activity against pathogenic bacteria such as staphylococcus aures, pseudomonas aeruginosa and fungi Aspergillus niger.

Prevalence of microalbuminuria in patients with non-diabetic acute ischemic stroke.

Background: Microalbuminuria has been associated with clinical risk factors for stroke like diabetes, hypertension, aging, history of myocardial infarction, obesity, smoking and left ventricular hypertrophy. The present study is aimed to determine the potential use of microalbuminurea, as a marker of stroke risk and its outcome in non-diabetic population. Methods: The present study was conducted in the department of internal medicine and department of neurology after the institutional ethical clearance and the informed consent from all the subjects. A total of 116 patients admitted with acute ischemic stroke presenting within 24 hours of stroke onset were recruited for the study. The microalbuminurea was assayed by immunoprecipitation. The stroke severity was assessed by NIH Stroke Severity Statistical Software Package. P value less than 0.05 was considered the level of significance. Results: There was graded co-relation between NIHSSS score and urine albumin creatinine ratio with significant P value of <0.001 in group A, but no such co-relation was seen in group B (P value 0.2). This suggests more the elevated urine ACR more the neurodefecit implying its utility as prognostic marker in acute ischemic stroke. Conclusion: Urine albumin excretion had the strongest correlation with the NIHSSS Score of the patient in acute ischemic stroke. Therefore, measurement of microalbuminurea may help to assess those who are at increased risk and to triage those who may need a more aggressive management protocol.

Combined pulmonary fibrosis and emphysema with pulmonary arterial hypertension: A Rare Case Report.

Combined pulmonary fi brosis and emphysema (CPFE) is a recently recognized radiologically defi ned syndrome characterized by simultaneous coexistence of both upper lobe emphysema and lower lobe pulmonary fi brosis. We present a case of CPFE in a 57-year-old male smoker who presented with dry cough, progressive breathlessness, and swelling of feet. His chest X-ray revealed bilateral lower Zone reticulonodular opacities with hyperlucent upper Zones. Pulmonary function tests showed wellpreserved lung volumes and reduced diff using capacity of the lung for carbon monoxide. High-resolution computed tomogram showed bilateral lower lobe subpleural honeycombing along with fi brosis and traction bronchiectasis with bilateral upper lobe emphysema predominantly paraseptal type. His 2D echo was suggestive of moderate pulmonary arterial hypertension.

A study on the Pattern of Genetic Inheritance of Polycystic Ovarian Syndrome.

Aims: Inheritance of polycystic ovary syndrome (PCOS) is still a controversy. Our study aims to analyze the family history of PCOS features and related metabolic disturbances including the male members to determine the mode of their inheritance. Study Design: A cross sectional study with convenient sampling. Place and Duration of Study: Department of Medicine, Kasturba Medical College, Mangalore between 2009 and 2012. Methodology: Demographic data such as body weight and age was recorded. Menstrual, obstetric and medical history of 85 PCOS females was collected. Presence of metabolic syndrome (MetS) was confirmed. Blood pressure and waist circumference were measured. Biochemical and hormonal estimations were done. Relevant information required for the study of 604 members of first and second generation relatives was collected. SPSS (version 17.0) was used to analyze the data. Results: Seventy eight percent of the PCOS patients were either overweight or obese and 98% of them had hirsutism. Approximately, 33% of them had MetS which was higher in the first generation (62%) of PCOS relatives. An equal transmission of MetS characteristics from the paternal and maternal side indicated that it was not X- linked inheritance. Segregation analysis of nine families PCOS of patients suggested that MetS inheritance was autosomal dominant although PCOS inheritance was not. Conclusion: PCOS daughters come from families of MetS suggesting that parental MetS features may be related to the occurrence of PCOS in their off-springs.

Learning style preferences of preclinical medical students in a Malaysian university.

Background: Academic demands of medical students are quite high. They require several skills involving sensory components such as visual, auditory, reading-writing and kinesthetic modes. The academic performance naturally differs in students and depends on their study habits including the learning style. It is believed that self- confidence is the first requisite to great achievements. Objective: We undertook this study to establish our hypothesis based on the assumption that students’ self-confidence and academic performance are directly related and the differences in learning style of each student could influence the academic performance. Method: To explore the pattern of preferred learning styles of 82 students, we administered the VARK questionnaire to the participants. To assess self-esteem, Rosenberg self-esteem questionnaire was used and the academic performance was based on the overall results of the formative assessments. Results: Among the respondents, 84% preferred multimodal style of learning. Out of that, dual, trimodal and quadrimodal styles were preferred by 8.5%, 2.4% and 73.2% respectively. The remaining 16% of the students preferred single mode. Female students had more diverse learning style preferences with several VARK combinations. A large proportion of our students were in the average group in terms of self- confidence and academic performance. Conclusion: Most students in this study preferred multimodal inputs in their learning process. Our study did not reveal any major gender differences in preferred learning styles. The results of selfesteem, learning style preference and academic performance did not have any bearing on each other.

Gastroprotective effect of Desmodium gangeticum roots on gastric ulcer mouse models

In the present study, the ethanolic root extract of Desmodium gangeticum (L.) DC., Fabaceae, (EDG), have been studied in various acute and chronic ulcer mouse models. Oral administration of root extract, significantly decrease the ulcer index and lesion number in a dose dependent manner against ethanol induced acute gastric ulcer in mice. In gastric ulcerated animal that received high dose of 150 mg/kg EDG, the mucosa showed no ulceration with slight focal congestion and the glands appeared normal. Pylorus ligated mice, pretreated with EDG showed significant decrease in ulcerous activity under chronic condition. The highest dose (150 mg/kg) of the extract provoked a marked increase in protein and glutathione levels, when compare to control. Furthermore, gastric juice, free acidity and total acid output were inhibited in a dose-dependent manner at p<0.05 level. Our results indicate that the EDG possess gastroprotective activity and increasing regeneration of damaged gastric mucosa and thus safe for human use.

Anesthetic implications of total anomalous systemic venous connection to left atrium with left isomerism.

Total anomalous systemic venous connection (TASVC) to the left atrium (LA) is a rare congenital anomaly. An 11-year-old girl presented with complaints of palpitations and cyanosis. TASVC with left isomerism and noncompaction of LV was diagnosed after contrast echocardiogram and computed tomography angiogram. The knowledge of anatomy and pathophysiology is essential for the successful management of these cases. Anesthetic concerns in this case were polycythemia, paradoxical embolism and rhythm abnormalities. The patient was successfully operated by rerouting the systemic venous connection to the right atrium.

Recent advances in human brown fat physiology.

Of the two variants of adipose tissue, white fat is traditionally known as a lipid rich tissue which undergoes pathological expansion in obese conditions. To counter the excess accumulation of white fat in states of energy imbalance, the second and unique type of brown fat plays a key role by burning extra energy into heat through a special metabolic pathway. In addition brown fat also plays a vital role in thermoregulation in animals and newborn humans and infants. Recent progress in research areas of these two types of fat tissue has provided compelling evidence to show that they secrete a large number of chemicals that play an important role in body weight control that involves several mechanisms. Brown fat was considered absent in the adult humans until recently. But new techniques have provided ample support for its active existence. Based on the very recent data it has been suggested that brown fat can be a target organ in the treatment of obesity which can lead to exciting and informative outcomes in the future.

Prophylactic treatment with Bacopa monnieri leaf powder mitigates paraquat- induced oxidative perturbations and lethality in Drosophila melanogaster.

Environmental exposure to the oxidant-producing herbicide, paraquat (PQ) (1, 1’-dimethyl-4, 4’-bipyridinium dichloride) has long been implicated as a risk factor in Parkinson’s disease (PD). PQ-induced oxidative stress has been exploited as a model to screen putative neuroprotective compounds employing Drosophila. In the present study, we investigated the prophylactic efficacy of Bacopa monnieri (BM) against PQ-induced oxidative stress, mitochondrial dysfunctions and lethality. Exposure of adult male flies (Oregon K) to PQ alone (40 mM in 5% sucrose) resulted in 50% mortality at 48 h. Prophylaxis (7 days) with BM extract (0.1%) offered significant protection (40%) against PQ-induced mortality. Further, oxidative impairments and mitochondrial dysfunctions were monitored among Drosophila exposed to PQ (20, 40 mM) for 24 h. Significant induction of oxidative stress was observed in terms of enhanced malondialdehyde and hydroperoxide levels, and elevated activities of antioxidant enzymes (catalase and SOD). Mitochondrial dysfunctions included of significant reduction in the activities of succinate dehydrogenase (23%), complex I-III (26%), and complex II-III (30%) enzymes. Interestingly, prophylaxis with BM extract prevented the oxidative stress induction by PQ and restored the activity of ETC complexes, suggesting clearly its specific effect on the mitochondria. While the precise mechanism of action of BM needs further investigations, it may be related to its ability to enhance antioxidant defences and thus mitigate PQ-induced oxidative stress in Drosophila.

GC-MS analysis of Nigella sativa seeds and antimicrobial activity of its volatile oil

The present study dealt with the hydro distillation of Nigella sativa seeds and GC-MS analysis. The total composition of the oil was 86.7 percent. The seed volatile oil was tested against 19 microbes (Gram positive, Gram negative and fungi), which showed that Gram negative bacteria Haemophilus influenza, Klebsiella pnemoniae, and Proteus vulgaris were highly sensitive against the antimicrobial agent, whereas the fungi such as Trichoderma vibriae,. Pencillium rubrum; and Dermatophyte: Trichophyton mentagrophytes; had no response at the 20µl concentration.

Absence of in vivo mutagenic potency of heated and fried oils in mice.

The mutagenic potency of heated and fried oils (under laboratory conditions), viz. peanut, sesame and coconut oils were studied employing two well validated in vivo mammalian assays, viz. bone marrow micronucleus assay and the sperm morphology assay in albino mice. In the bone marrow micronucleus assay oral doses of fresh, heated and fried oils (7.5 ml and 30.0 ml/kg body weight) did not induce any increase in the incidence of micronucleated polychromatic erythrocytes. Intragastric administration of oils at the highest dose (30.0 ml/kg body weight/day) for 5 consecutive days in male mice did not produce any morphological effect either on the testicular or epididymal weights and histology. No significant alterations were observed in the caudal sperm counts at any of the sampling intervals and also there was no treatment related increase in the incidence of sperm head abnormalities. It is concluded that controlled thermal treatment as well frying of these oils did not produce appreciable amount of mutagens which could be detected under in vivo situations.

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.

Differing response of body weight gain to high fat diet treatment in the mouse.

Forty-eight mice maintained on a high fat diet supplement in addition to regular laboratory rodent chow responded differently in terms of body weight gain over a period of six weeks. Eleven mice gained weight that was comparable to body weights of mice given only chow for the same period of time while the others gained significantly higher body weights and became obese despite similar level of energy intakes. The increase in body weight was due to increase in body fat content as noted by carcass analysis. The differential response of the mice to identical dietary treatment in causing obesity or not in mice is discussed.

Body fat and lean body mass assessment in human subjects--a comparison of two different techniques.

Body fat and lean body mass was assessed in young college students by two different techniques involving NIR method and body circumference measurements. NIR technique significantly over-estimated the body fat as compared to the results obtained by the other method. The difference between the methods was 23-30% high for fat and the variation was 5-9% low for lean body mass for the whole group. Results obtained by the body girth size measurements agreed well with fat and lean body mass values from other studies on Indian subjects which had employed different methods.