Harvester’s palsy – bilateral common peroneal nerve palsy: A descriptive case report

Peroneal neuropathy is the common mononeuropathy of the lower extremities in adults. The documented etiologies for peroneal nerve injury include trauma, traction, and external compression. Fibular neck is the most common site of common peroneal nerve (CPN) injury as the nerve lies superficial and vulnerable for injury. A 50-year-old male presented with foot drop in his left leg after working in squatting position for prolonged hours along with sensory disturbance in dorsum of left foot. Clinical examination showed poor dorsiflexion in both side ankle with preserved plantar flexion. Electrophysiological findings locate the site of lesion to be CPN at the level of fibular neck. We conclude that CPN is injured due to knee flexion in farmers repeatedly squatting for long hours. Superficial peroneal nerve may be spared due to their interfascicular arrangement at the level of fibular neck placing deep peroneal nerve near the fibula making them more susceptible to compression type of injury. Peroneal nerve may be damaged at multiple sites including ankle. The condition can be reversed with conservative treatment, primarily by avoiding the precipitating position.

Comparison of body composition using body mass index, body fat percentage (bioimpedance), waist circumference, hip circumference, and somatotyping across complete glycemic spectrum

Background: The association between adiposity and diabetes has been widely assessed using body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR), whereas these variables are inadequate to differentiate between muscle mass, fat mass, and bone mass. Aims and Objectives: The objective of the present study is to assess the somatotype pattern (subcutaneous fat mass distribution) and body fat percentage (%) in complete glycemic spectrum. Materials and Methods: Skinfold thickness, BMI, WC, hip circumference (HC), and WHR were measured in normoglycemic non-first-degree relatives of diabetes (Group 1), normoglycemic first-degree relatives of diabetes (Group 2), prediabetes (Group 3), and type 2 diabetes patients (Group 4). Results: The groups are comparable based on gender distribution, age, height, weight, physical activity, BMI, WC, HC, WHR, and somatotyping. Body fat percentage is significantly high in first-degree relatives of diabetes, prediabetes, and diabetes group as compared to control, in while all other groups are comparable among themselves. Conclusion: Body fat percentage can be considered as a better indicator of metabolic derangement than BMI, WC, HC, WHR, and somatotyping in the complete glycemic spectrum.

An analysis on the study habits among undergraduate medical students

Introduction: Study habits is one important factor which influences the academic performance of students. The learning strategies of high achievers are likely to be more effective. The study was aimed to analyse the study habits among undergraduate medical students and compare the study habits of high, average and low achieving undergraduate medical students. Application of effective learning strategies may be helpful in achieving better academic outcomes. Materials and Methods: The study was conducted as a cross sectional, observational study with 118 Final year MBBS students as study participants using Dennis Congos Study Skills Inventory Questionnaire consisting of 51 study habits questions classified according to domains of Text Book reading, Notes taking, Memory, Test Preparation, Concentration, Time management. Results: The percentage of students scoring above the cut off levels in each domain were: Memory: 61/118 (51.69%), Concentration: 67/118 (56.77%), Notes taking: 7/118 (5.93%), Time management: 17/118 (14.40%), Test preparation: 31/118 (26.27%), Text book reading: 35/118 (29.66%). The only Study habit that showed significant difference across the high, medium and low achievers was: Ability to pay attention in the class (p: 0.006). Conclusion: Though the students are talented and fare better in Memory and Concentration skills, there is glaring lack of attitudinal skills like Notes taking, Time management, Test preparation and Textbook reading skills. Paying attention in the class seems to be one most important distinguishing learning strategy determining the academic performance. Teaching– Learning methodologies need to be made more interesting so as to actively engage the attention of low achievers also.

Study on the effect of maternal anemia on birth weight of term neonates among rural population India

Background: Maternal anemia in pregnancy is common and has several deleterious effects on the health of the mother and the fetus. Maternal anemia is an important risk factor for LBW babies and preterm babies. There exists an insufficient information regarding the adverse effect of anemia during pregnancy especially among rural population. The aim of the study was to determine whether maternal anemia would affect the birth weight of the baby.Methods: The study was conducted in post-natal ward in Sri Venkateshwara Medical College Hospital and Research centre, Ariyur, Puducherry, India a tertiary care hospital in a rural area.Results: About 85% of low birth weight babies were born to mothers with severe maternal anemia with a p value of <0.001 which is statistically significant. None of the mothers who didn't have maternal anemia had low birth weight babies.Conclusions: Maternal anemia is directly proportional to fetal growth. Maternal anemia being an important risk factor for low birth weight should be prevented as early as possible thus helpful in de-creasing the incidence, mortality and morbidity of LBW babies.

GC-MS Determination of Organochlorine Pesticides in Bovine Milk from Tiruchirappalli, South India- A Preliminary Assessment.

The study was aimed to determine the concentrations of organochlorine pesticides (OCPs) in bovine milk (both branded and unbranded) collected from in and around Tiruchirappalli city, Southern India. The results of the present investigation indicated that these milk specimens were found to be contaminated with 7 different pesticides. Mirex (higher incidence), Heptachlor, o,p’-DDD, o,p’- DDE, Aldrin, cis and trans-chlordane were detected in the milk samples. The residues were quantitatively determined using Gas Chromatograph-Mass Spectrometer-Quadrupole on electron ionization (EI) mode. The study showed that unbranded milk samples contained higher concentrations of residues than branded. The derived average daily intake of aldrin and DDT has exceeded WHO’s Acceptable Daily Intake.

Impact on prevalence of intestinal helminth infection in school children administered with seven annual rounds of diethyl carbamazine (DEC) with albendazole.

Background & objectives: One third of the world’s population is infected with one or more of the most common soil-transmitted helminths (STH). Albendazole (ALB) is being administered with diethyl carbamazine (DEC) in filariasis endemic areas to eliminate lymphatic filariasis (LF) and helminth infections. In this study, the cumulative impact of seven annual rounds of mass drug administrations (MDA) of DEC and ALB on STH infection in school children in selected villages in southern India was determined. Methods: During 2001-2010, seven MDAs were implemented by the Tamil Nadu state health department, India. LF and STH infections were monitored in school children from 18 villages of the two treatment arms (viz, DEC alone and DEC+ALB). Kato-Katz cellophane quantitative thick smear technique was employed to estimate STH infections at three weeks, six months and one year post MDA. Results: Prior to treatment, an overall STH prevalence was 60 per cent. After each MDA, infection markedly reduced at three weeks post-treatment in both the arms. The prevalence increased at six months period, which was maintained up to one year. After seven rounds of MDA, the infection reduced from 60.44 to 12.48 per cent in DEC+ALB arm; while the reduction was negligible in DEC alone arm (58.77 to 52.70%). Interpretation & conclusions: Seven rounds of MDA with DEC+ALB reduced the infection load significantly, and further sustained low level of infection for 10 years. However, complete parasite elimination could not be achieved. To curtail STH infection in the community, MDA should be regularized and environmental sanitation measures need to be improved by effective community-based campaigns.

Bioaccumulation of metals in muscle, liver and gills of six commercial fish species at Anaikarai Dam of River Kaveri, South India.

Metals are an inherent component of the environment that pose a potential hazard to human beings and animals. The consumption of fish from the polluted site may result in bioaccumulation of persistent pollutants in ultimate recipient of the food web. In the present investigation muscle tissue, gill and liver of six species of fish collected from Anaikarai dam (11°8’N latitude and 79°27’E longitude) of River Kaveri, South India were analyzed to study the metal accumulation in various tissues. The mean concentrations of Co, Cr, Mn and Zn were found to be higher in gills, but Cu, Ni and Fe were more in liver of all fishes. The mean concentrations of Cr (11.8 μg g-1), Mn (4.4 μg g-1) and Fe (139 μg g-1) in the muscle were exceeding the permissible limit of FAO and WHO which is 1, 0.5 – 1.2 and 1.0 – 4.5 μg g-1 for Cr, Mn and Fe respectively. The fish Parastromateus niger has shown higher concentration of zinc in all the tissues and thus it can be used as a bioindicator species for zinc pollution in aquatic environment.

In situ Carica papaya stem matrix and Fusarium oxysporum (NCBT-156) mediated bioremediation of chromium.

Removal of heavy metal chromium was carried out using the fungus Fusarium oxysporum NCBT-156 strain isolated from soil of leather tanning effluent in in situ condition using potassium dichromate solution with 10 per cent Czapek-dox liquid medium. Biosorbent matrix was developed using Carica papaya plant dry stem to colonize the fungal strain to facilitate bioabsorption process. Bioabsorption of chromium was by metabolically mediated intracellular accumulation process. Maximum efficiency of chromium removal by biosorption upto 90 per cent was achieved at the end of 5th day of incubation (120 h of contact time) for 100 and 200 ppm concentration, upto 80 per cent for 300 and 400 ppm, and upto 65 per cent for 500 ppm to 1000 ppm concentrations with pH ranging from 5.8, 5.6, 5.5, 5.4 and 5.2, respectively for 100, 200, 300, 400, 500-1000 ppm concentration. SDS-PAGE protein profile showed significant difference in 34 kDa protein band after chromium absorption by the fungus. ftir spectroscopic analysis revealed that the main functional groups involved in the uptake of chromium by F. oxysporium strain were carbonyl, carboxyl, amino and hydroxyl groups.

Biosynthesis of gold nanoparticles by actinomycete Streptomyces viridogens strain HM10.

Biosynthesis of gold nanoparticles by Streptomycetes from Himalayan Mountain was undertaken for the first time. Out of 10 actinomycete strains tested, four strains (D10, HM10, ANS2 and MSU) showed evidence for the intracellular biosynthesis of gold nanoparticles, among which the strain HM10 showed high potency. Presence of spherical and rod shaped gold nanoparticles in mycelium of the strain HM10 was determined by transmission electron microscopy (TEM) and X-ray diffraction analysis. The average particle size ranged from 18-20 nm. UV spectral analysis indicated that the reduction of chloroauric acid (HAuCl4) occurred within 24 h of reaction period. Further, the strain HM10 showed enhanced growth at 1 and 10 mM concentration of HAuCl4. The gold nanoparticles synthesized by the strain HM10 showed good antibacterial activity against S. aureus and E. coli in well-diffusion method. The potential actinomycete HM10 strain was phenotypically characterized and identified as Streptomyces viridogens (HM10). Thus, actinomycete strain HM10 reported in this study is a newly added source for the biosynthesis of gold nanoparticles.

Tracing disease gene(s) in non-syndromic clefts of orofacial region: HLA haplotypic linkage by analyzing the microsatellite markers: MIB, C1_2_5, C1_4_1, and C1_2_A.

BACKGROUND: Cleft lip with or without cleft palate (CL/P) is the most frequent craniofacial malformation seen in man. The etiology of CL/P is complex involving both genetic and epigenetic (environmental) factors, and the genes play an almost deterministic role in the normal development of craniofacial structures. This study was aimed at ascertaining the association of HLA microsatellites in CL/P patients. MATERIALS AND METHODS: Case DNA was obtained from 76 patients (40M and 36 F, average age 7.8 years, range 1-16 years). Unaffected individuals from the same geographical area without population mixing included as controls (n=154, 76 M and 78 F, average age 8.2 years, range 2-17 years). All DNA samples were purified from peripheral blood by standard techniques. RESULTS: Four microsatellites were compared in this case-control study. C1_2_5 locus was the most polymorphic marker with 15 observed alleles while C1_4_1 had the least number of alleles. Three of the four markers viz MIB,C1_4_1 and C1_2_5 showed a significant association of microsatellite alleles with CL/P. Five alleles (MIB_326,332,350; C1_4_1 – 213 and C1_2_5-204) were seen with an increased frequency among the test samples, whereas two alleles (C1-4_1_217, and C1_2_5_196) had an increased frequency among the control samples. One allele (C1-4-1-209) had an increased frequency in patient group but was not observed in the controls. CONCLUSION: The role of HLA complex in the pathogenesis of CL/P is speculative and has not been established so far. The result of this study shows that a few alleles have an increased frequency of expression in the diseased group which suggests that these alleles may predispose the individuals to clefting. This finding may be beneficial to aid in early diagnosis and plan intervention strategies.

Polymer biocomposite nanoparticles for sustained drug delivery.

Nanoparticles of ~10 nm in diameter made with chitosan or lactic acid-graftedchitosan were developed for high drug loading and prolonged drug release. A drug encapsulation efficiency of 94.4% and a release rate of 28% from chitosan nanoparticles after 24 hours were demonstrated with bovine serum protein. A drug encapsulation efficiency of 97% and a release rate of 38% from chitosan nanoparticles after 24 hours were demonstrated with Diclofenac sodium. To further increase drug encapsulation, prolongdrug release, and increase chitosan solubility in solution of neutral pH, chitosan was modifiedwith lactic acid by grafting D,L-lactic acid onto amino groups in chitosan without using a catalyst.The lactic acid-grafted chitosan nanoparticles demonstrated a drug encapsulation efficiency of96% and a protein release rate of 15% after 24 hours. And in case of diclofenac,drug encapsulation efficiency of 98% and a diclofenac release rate of 25% after 24 hours. Unlike chitosan, whichis generally soluble only in acid solution, the chitosan modified with lactic acid can be preparedfrom solutions of neutral pH, offering an additional advantage of allowing proteins or drugs tobe uniformly incorporated in the matrix structure with minimal or no denaturization.

Synergistic activity of ofloxacin and ornidazole on biomedical fabrics against nosocomial pathogens.

Nosocomial infections in the hospitals disseminated from the cotton fabrics of health care professionals and patients leads to severe complications like respiratory, gastrointestinal and urinary tract infections. Since the hospital based textile materials like nylon and polyester has good surface properties, it can harbour large number of microorganisms. Hence in this study, two different antibacterial drugs showing synergistic properties were attached to different fabricsusing tocopherol acetate as a cross-linker with the aim that, treated fabric could act as barriers against transmission of challenge organisms. Inorder to decrease the drug resistant property of the nosocomial pathogens, a fluoroquinolone and a nitroimidazole compounds were mixed at suitable composition based on their synergistic behaviour. Both the compounds were modified to act as reactive dyes and were covalently bonded to the surface of nylon and polyester in order to impart antibacterial properties. The assay used for measuring antibacterial properties was based on the AATCC Test Method-100. The treated fabric was also subjected to multiple washings to determine its durability based on the AATCC Test Method-124. To determine the mode of action of these drugs, DNA of the drug exposed and unexposed challenge organisms were extracted and analysed by agarose gel electrophoresis. The difference in the number of viable bacteria after ‘0’ contact time and 18 hours contact time with treated fabrics were statistically calculated with P<0.05 considered significant.

Wolbachia endobacteria in a natural population of Culex quinquefasciatus from filariasis endemic villages of south India and its phylogenetic implication

Understanding Wolbachia mosquito interactions have been recognized as an important concept to develop novel vector control strategies. The prevalence of Wolbachia endobacteria in a natural population of the filariasis vector Culex quinquefasciatus was determined by the polymerase chain reaction method. Earlier workers had estimated the infection rates of Wolbachia with only one or very few individuals per species. In our study large number of specimens were assayed, and a total of 750 adult Culex quinquefasciatus mosquitoes were collected from three south Indian villages of Tirukoilur and Mugaiyur blocks, monthly for a period of five months (December 2006 to April 2007) and screened for the presence of Wolbachia. The percentage prevalence in adult males ranged from 88% to 96%; while in females from 84% to 100%. An overall prevalence of 91.2% was observed. There was no significant difference observed in the proportion of mosquitoes positive for Wolbachia between males and females, and also between different months of the survey; except during the month of February ‘07. The wsp gene sequence of the Wolbachia strain of Cx. quinquefasciatus detected was BLAST analysed and showed 99% sequence similarity with Wolbachia sp. of Culex pipiens isolated from different geographical regions. Phylogenetic analysis based on wsp gene fragments showed that the present Wolbachia isolate was closely related with Wolbachia from Culex pipens pipiens, Niphotettix virescens (Order: Hemiptera) and Cnaphalocrosis medinalis (Order: Lepidoptera).

Transforming growth factor-β-1 polymorphisms are infrequent but exist at selected loci in oral submucous fibrosis.

Background : Oral submucous fibrosis (OSF) may be considered a collagen metabolic disorder resulting from areca-nut alkaloid exposure and individual variation in collagen metabolism. Due to the complexity of OSF pathogenesis, it is important to elucidate independent and interactive effects of polymorphisms of collagen-related genes on OSF risk. Materials and Methods : This study is focused on seven polymorphisms (SNPs) of transforming growth factor-beta-1 (TGF-beta-1) gene in patients with oral submucous fibrosis (OSF), belonging to south Indian ethnic extraction. The mean age at presentation was 43.9 years, range 23-72 years (n=50, M:F ratio, 2.6:1). DNA samples from 50 subjects of the same ethnic group and comparable demographic features who have had practiced the habit of areca-chewing of almost equal duration, but remained free of disease constituted the controls. All DNA samples were collected progressively and purified from peripheral blood employing standard protocols and tested for SNPs. They included two polymorphisms in the promoter region (C-509T and G-800A), three polymorphisms in exon-1 (Arg25Pro(G915C), Leu10Pro(T869C), Glu47Gly(A979G) and two in 5 ͲUTR regions (C→T(rs13306708) and G→A (rs9282871). The extracted DNA samples along with the primers underwent PCR amplification and the genotypic and allelic frequencies were calculated. All calculations were performed using the SPSS software. The PCR products were purified and subsequently sequenced using Flour S™ multi-imager system (Biorad). The sequenced data were analyzed using the BioEdit sequence analysis software. Results : Out of the seven polymorphisms analyzed, six such as two in the promoter region, three in exon-1 and one in 5¢UTR were found to have a " P" value above 0.05 and hence were not significant. The C→T transition (rs13306708) in the 5¢UTR region recorded a " P" value of 0.03 on comparison and hence was found to be significant. The allelic frequencies for this C→T transition in patients were 68.7% C and 31.2% T (27CC, 15CT, 8TT) and that in controls were 89.5% C and 10.4% T (42CC, 6CT, 2TT). Conclusions : The polymorphism in 5¢UTR C-T in TGF beta 1 gene has a significant association with OSF, being a prime determinant in the pro-angiogenic pathway which has got direct bearing with the pathophysiology of the disease. The proximity of this polymorphism to the transcription site and the associated risk involved is discussed.

Studies on community knowledge and behavior following a dengue epidemic in Chennai city, Tamil Nadu, India

In 2001, a major dengue outbreak was recorded in Chennai city, with 737 cases (90%) out of a total of 861 cases recorded from Tamil Nadu state. A KAP survey was carried out to assess the community knowledge, attitude and practice on dengue fever (DF), following the major dengue outbreak in 2001. A pre- tested, structured questionnaire was used for data collection. The multistage cluster sampling method was employed and 640 households (HHs) were surveyed. Among the total HHs surveyed, 34.5% of HHs were aware of dengue and only 3.3% of HHs knew that virus is the causative agent for DF. Majority of the HHs (86.5%) practiced water storage and only 3% of them stored water more than 5 days. No control measures were followed to avoid mosquito breeding in the water holding containers by majority of HHs (65%). Sixty percent of HHs did not know the biting behaviour of dengue vector mosquitoes. The survey results indicate that the community knowledge was very poor on dengue, its transmission, vector breeding sources, biting behavior and preventive measures. The lack of basic knowledge of the community on dengue epidemiology and vector bionomics would be also a major cause of increasing trend of dengue in this highly populated urban environment. There is an inevitable need to organize health education programmes about dengue disease to increase community knowledge and also to sensitize the community to participate in integrated vector control programme to resolve the dengue problem.

Study on The Eco-epidemiology of Chikungunya in U T of Lakshadweep.

An unusual increase in the incidence of viral fever was noticed in Androth and Kalpeni Island, U.T of Lakshadweep during November 2006. The Ecoepidemiology of the disease was studied in detail. The study indicated that Aedes albopictus is the predominant species (98.74%) and it exhibited a wide spectrum of breeding preferences with a clear-cut predilection for rat-damaged coconuts (RDCs). All the entomological indices were very high in both the Islands with a marked increase in Kalpeni Island. The clinical presentation of the cases was typical of chikungunya and the laboratory study confirmed this. Based on the investigation, control and preventive measures were planned, advised and implemented. The details regarding the bio-ecology of vectors, clinical presentation, laboratory investigations and effectiveness of control measures are discussed.

A study on chikungunya outbreak during 2007 in Kerala, south India.

Background & objectives: The first chikungunya outbreak occurred in Kerala during 2006 affecting 14 districts, followed by another during May 2007 affecting almost whole of the State. Four of the worst affected districts viz, Pathanamthitta, Idukki, Kottayam and Thrissur were surveyed during 2007 to understand the magnitude of the problem of chikungunya fever, particularly clinical signs and symptoms. Methods: A total of 1265 persons from 310 houses were surveyed door-to-door in 20 different localities representing four affected districts. The history and examination findings from 354 clinically diagnosed chikungunya cases were recorded. The symptoms recorded were fever, headache, myalgia, arthralgia, itch/rash, oedema, eye congestion, eye pain, oral ulcers, distaste, nausea, vomiting and haemorrhage. Results: The major symptoms were fever (100%), headache (97.5%), arthralgia (99.4%) and myalgia (99.4%). A significant difference was observed in oedema, distaste, nausea and headache among different age groups and these symptoms were reported to be lower (12.2-89.8%) in younger age group than in older age group (90.4-100%). No genderwise difference was observed for any of the symptoms. In clinically diagnosed chikungunya cases higher age group (>35 years) found with higher rate of severity with symptoms of oedema, distaste, nausea and headache when compared with lower age group (1-35 yr). Interpretation & conclusions: Chikungunya invaded Kerala State for the first time in 2006 and continues to be a major vector borne disease in the State. The clinical symptoms in affected cases highlighted high fever, sever myalgia and prolonged arthralgia, with occasional history of skin itch/rash (petechiae).

Natural vertical transmission of dengue viruses by Aedes aegypti in Chennai, Tamil Nadu, India.

BACKGROUND & OBJECTIVE: Dengue viruses are spread and maintained in an Aedes aegypti-human- Ae. aegypti cycle in urban areas of the tropics. Dengue viruses are also maintained in nature by vertical transmission by Ae. aegypti. A study was undertaken in Chennai, a known endemic city in south India, to comprehend the natural vertical transmission dynamics in Ae. aegypti and to assess its epidemiological importance. METHODS: Ae. aegypti males collected in resting and landing collections were tested for dengue virus infection by antigen-capture enzyme-linked immunosorbent assay (ELISA) and further examined by insect bioassay, Toxorhynchites splendens inoculation-indirect immunofluorescence technique (Toxo-IFA) using serotype-specific monoclonal antibodies (Mabs), if found positive by ELISA. RESULTS: Of the 509 pools of Ae. aegypti males (n=5408) screened, 15 pools, collected in April, June- July, November-December in 2003 and March, May in 2004, were found positive for dengue virus infection and the minimum infection rate (MIR) among adult males was high in June 2003 (28.0/ 1000). Three positive pools could be serotyped as dengue-2 (2 pools) and dengue-3 (1 pool). INTERPRETATION & CONCLUSION: Dengue virus isolations from wild caught males of Ae. aegypti indicate the occurrence of transovarial transmission. Vertical transmission was mainly observed in summer months when dengue infections in humans were low suggesting that dengue viruses adopt a novel strategy of surviving adverse climatic conditions.