Correction: Elucidation of hydrogen bonding formation by a computational, FT-IR spectroscopic and theoretical study between benzyl alcohol and isomeric cresols.

[This corrects the article DOI: 10.1039/C5RA26298D.].

Sagittal Balance Correction in Cervical Compressive Myelopathy: Is it Helpful?

BACKGROUND: Laminectomy with lateral mass and transfacet fixation are widely accepted surgical techniques for cervical compressive myelopathy (CCM). OBJECTIVE: To evaluate multilevel fixation with additional fixation of C7-T1 transfacet junction may help achieve better surgical outcome both in short- and long-term follow-up. MATERIAL AND METHODS: Based on utilizing C7-T1 transfacet junction fixation, 102 consecutive patients undergoing surgery for CCM were divided into Group A: cervical laminectomy with lateral mass fixation only, and Group B: cervical laminectomy and lateral mass fixation including C7-T1 transfacet junction in fixation. The groups were compared for at 3 months and 2 years postsurgery for persistence of preoperative symptoms, neurological outcome, and sagittal balance (T1 slope) of cervical spine. RESULTS: The average age of the study population was 59.11 ± 12.05 years with 71 (69.6%) men. There were no significant differences between the groups neither for presenting complaints nor for postoperative complications. Patients in group B had lesser length of postsurgical hospital stay (7.57 ± 6.61 vs 5.55 ± 1.81; P = 0.018). At 3 months follow-up, patients in group B had higher motor power of upper limb (3.64 ± 1.91 vs 4.47 ± 0.57; P < 0.001), lower limbs (5.07 ± 1.72 vs 5.92 ± 1.13; P = 0.005), and total modified Japanese orthopedic association score (MJOS) score (13.68 ± 3.42 vs 15.51 ± 1.87; P = 0.001). Patients in groups B had lower postoperative T1 slope scores (26.93 ± 8.73 vs 17.60 ± 4.97; P = <0.001). At 2 years follow-up of 53 patients, patients in group B had a better upper limb motor function (3.77 ± 1.14 vs 4.44 ± 0.50; P = 0.021) and total MJOS score (13.85 ± 3.49 vs. 15.37 ± 1.86; P < 0.052). CONCLUSION: Normalizing sagittal balance in patients with CCM by cervical laminectomy and posterior fixation including cervical thoracic junction (C7-T1 transfacet junctional fixation) may significantly improve neurological outcome both in short-term and long-term follow-up.

Structural, magnetic, grain and grain boundary mediated conduction features of low dimensional LaFeO3 nanoparticles.

A detailed investigation of crystal structure, magnetic and electrical conduction properties of a low dimensional LaFeO3 is reported. The sample is synthesized by Sol-Gel method with a low preparation temperature. Synchrotron x-ray diffraction, Raman and FTIR spectroscopy methods were used to establish the structural phase and vibrational modes present in the sample. The low dimensionality and morphology of the prepared sample is probed through transmission electron microscopy. From the explicitly field and temperature dependent magnetization, the magnetic phase exhibited by the nanoparticle is weak ferromagnetic which is further evidencing from the Fe57 Mossbauer spectroscopy. To gain further understanding of electrical conduction mechanism and related features of AC conductivity, impedance spectroscopy techniques are used. It is noticed that, the grain effect is dominated while the electrode effect is suppressed with temperature. The activation energies due to grain and grain boundary effect are found to be 0.0780 eV, 0.175 eV for T < 90 °C and 0.451 eV, 0.525 eV for T > 90 °C respectively. Finally, jump relaxation model and Jonscher's power law are used to explain the frequency-dependent conduction behavior in the system.

Effect of pranayama and suryanamaskar on pulmonary functions in medical students.

BACKGROUND: Pranayama improved lung functions in numerous studies. Yoga involve isometric contraction and improves skeletal muscle strength. Yoga training improves the strength of expiratory as well as inspiratory muscles. AIM: The present study is planned to find the effect of pranayama on pulmonary functions in medical students. MATERIALS AND METHODS: This study is conducted on 50 students doing lst year M.B.B.S. Consent form has been taken from them. They have been given yoga training 30 min daily for 2 mnth under the guidance of a trained yoga instructor. Vital capacity (VC), Tidal volume (TV), Expiratory Reserve volume (ERV), Breath holding time (BHT), 40 mm endurance, Peak expiratory flow rate (PEFR) are measured before & after yoga training. RESULTS: VC has increased from 2972 ± 213.151 to 3372 ± 528.7722. TV has increased from 496 ± 84.06347 to 588 ± 150.8863. ERV also shows increase in values from 888 ± 183.303 to 1096 ± 386.7385. BHT also shows increase in values from 33 ± 5.773503 to 58.6 ± 12.78019. 40 mm endurance also shows increase in values from 30.8 ± 5.139715 to 53.52 ± 15.68736. PEFR also shows increase in value from 388.8 ± 15.36229 to 425.2 ± 38.74274. CONCLUSION: There is a statistically significant increase in all the above mentioned pulmonary functions following yoga training. Yoga practice can be advocated to improve pulmonary functions in healthy individuals and hence to prevent respiratory diseases in future.

Preformed beading and boxing appliance.

Conventional beading and boxing procedure is time consuming and involves application of heat that might distort green stick compound used for border molding. Earlier studies regarding beading and boxing methods have shown usage of various materials that were disposable and that cannot be recycled. To reduce the time consumed for beading and boxing procedure and to make this procedure cost-effective by using recyclable beading material, "Preformed boxing appliance" with moldable clay meant for beading the secondary impression was used. Secondary impression was supported by 3 studs provided on the floor of the boxing appliance. The cast was poured. The duration for the entire procedure was much less than the conventional procedure.

Multidrug-resistant Vibrio cholerae O1 in Belgaum, south India.

An outbreak of acute diarrhoea occurred in the Belgundi area (population 3896) of Belgaum Taluka (population 815 581) in Karnataka, South India, in June 2010. An estimated 16.22 % of people were affected and 0.16 % deaths were reported. Vibrio cholerae O1 El Tor was isolated from 18 of the 147 stool samples cultured. Seven out of eight drinking water samples collected from different sources were found to be grossly contaminated with faecal coliforms. All isolates were multidrug resistant, with some showing resistance to quinolones, gentamicin and cephalosporins in addition to co-trimoxazole and tetracycline, the drugs that were being used by the state health authorities for empirical treatment. Two serotypes and at least eight genotypes of V. cholerae were observed among the isolates. Cholera was confirmed as one, if not the only, cause of the outbreak, which, to our belief, is the first report of cholera from this region. It might have occurred due to a 'flare up' in the number of endemic strains triggered by shortage of portable water, onset of monsoon rains and breakdown of sanitation systems, rather than being a de novo outbreak arising out of new exogenous infectious sources. A change in the empirical treatment, coupled with chlorination, improvement in sanitation measures and extensive Information Education Communication activities, resulted in decline of the outbreak and prevention of further deaths.

Increasing burden of hospital acquired infections: resistance to cephalosporin antibiotics among klebsiella and Escherichia coli.

The drug susceptibility pattern of klebsiella species and Escherichia coli to cephalosporins was examined in the year 2004 and 2005. A total of 180 klebsiella and 220 E coli in 2004 and 95 klebsiella and 210. E coli in the year 2005, isolated from various clinical specimens were studied. Resistance rates among the klebsiella species, ranged from 50.00%-86.36% and 42.10%-84.21% in 2004 and 2005 respectively. Resistance rates among E coli ranged from 46.66%-90.8% and 50.0%-86.66% in 2004 and 2005 respectively. In the year 2005 resistance to cefixime and cefpodoxime significantly increased. Resistance marginally increased to cephalexin, cefuroxime and ceftazidime. Resistance to cefotaxime was considerably low (42.10%) in 2005 compared to 62.96% in 2004. The study highlights the importance of exercising caution in the choice of empirical therapy. It also points towards the need for regular monitoring of resistance pattern in the hospital and temporary withholding of the antibiotic with high resistance so as to prevent the spread of multidrug resistant strains in the hospital and the community.

Comparison of disc diffusion methods for the detection of extended-spectrum Beta lactamase-producing enterobacteriaceae.

BACKGROUND: Resistance to broad-spectrum ß lactams, mediated by extended-spectrum ß lactamases (ESBLs), is an increasing problem world wide. This resistance poses problems for in vitro testing and reporting. Increased prevalence of ESBLs among Enterobacteriaceae creates a great need for laboratory testing methods that will accurately identify their presence. MATERIALS AND METHODS: During the study, the Enterobacteriaceae isolated were tested for the presence of ESBL by the National Committee for Clinical Laboratory Standards (NCCLS) screening test, Jarlier double disc synergy (approximation) test (DDST) and NCCLS phenotypic confirmatory test (PCT), and compared their efficiency in detection. RESULTS: A total of 313 Enterobacteriaceae were isolated and tested for the presence of ESBL. NCCLS PCT identified 200 (63.89%) as ESBL producers and DDST identified 176 (56.23%), with a P-value of <0.001. Among the screening agents, ceftazidime had a better sensitivity (89.49%) and specificity (95.74%). CONCLUSIONS: Close monitoring of the susceptibility pattern of isolates and careful spacing with specific discs can identify many ESBL producers. Ceftazidime has a better sensitivity and specificity as a screening agent. A combination of different tests can be useful for accurate identification.

Tuning intermolecular interactions in dioctyl-substituted polyfluorene via hydrostatic pressure.

Polyfluorenes (PFs) represent a unique class of poly-para-phenylene-based blue-emitting polymers with intriguing structure-property relationships. Slight variations in the choice of functionalizing side chains result in dramatic differences in the inter- and intrachain structures in PFs. Dioctyl-substituted PF (PF8) is characterized by different backbone conformations that depend upon the torsion angle between the monomers. We present photoluminescence (PL) and Raman scattering studies of bulk samples and thin films of dioctyl-substituted PF (PF8) under hydrostatic pressure. The bulk sample was further thermally annealed and studied as a function of pressure. The PL energies of the as-is and thermally annealed samples both red shift but at very different rates, and the difference between their pressure coefficients elucidates the role of the backbone torsional angle. This is further corroborated by density functional theoretical calculations of a fluorene oligomer, where the energy gap is calculated as a function of both the torsion angle as well as compression. The Raman peaks harden with increasing pressures; the intraring C-C stretch frequency at 1600 cm(-1) has a pressure coefficient of 7.2 cm(-1)/GPa and exhibits asymmetric line shapes at higher pressures, characteristic of a strong electron-phonon interaction.

Detection and antifungal susceptibility testing of oral Candida dubliniensis from human immunodeficiency virus-infected patients.

CONTEXT: Candida dubliniensis, an opportunistic yeast that has been implicated in oropharyngeal candidiasis (OPC) in patients infected with Human Immunodeficiency Virus (HIV) may be under-reported due to its similarity with Candida albicans. Resistance to Fluconazole is often seen in C. dubliniensis isolates from clinical specimens. AIMS: To know the prevalence of C. dubliniensis in OPC in patients infected with HIV and their antifungal susceptibility pattern. SETTINGS AND DESIGN: One hundred and thirty-two HIV seropositive individuals and 50 healthy controls were included in the study. MATERIALS AND METHODS: Two oral swabs were collected from the site of the lesion from 132 HIV-infected patients. Oral rinse was obtained from 50 healthy controls. Samples were inoculated on Sabouraud's dextrose agar (SDA) medium and on HiCrome Candida Differential Agar (CHROM agar) medium. Isolates were speciated by standard tests. Dark green-colored, germ tube positive isolates, which failed to grow at 420C and negative for xylose assimilation were identified as C. dubliniensis. Antifungal susceptibility test was performed by Macro broth dilution technique (National Committee for Clinical Laboratory Standards guidelines). RESULTS AND CONCLUSIONS: From 132 patients, 22 (16.3%) C. dubliniensis were isolated; samples from healthy controls did not reveal their presence. Antifungal susceptibility test showed higher resistance among C. dubliniensis isolates to azoles compared to C. albicans. Five (22.7%) isolates of C. dubliniensis were resistant to Fluconazole followed by four (18.2%) to Ketoconazole. This study emphasizes the importance of identification and antifungal susceptibility testing of C. dubliniensis in HIV-infected patients.

Changing characteristics of Vibrio cholerae: emergence of multidrug resistance and non-O1, non-O139 serogroups.

The serogroups and antimicrobial susceptibility patterns of V. cholerae isolated in Hubli, India during the years 2000 to 2004 were monitored. A total of 256 V. cholerae isolates were obtained during the study period, of which 129 (50.4%) belonged to serogroup O1 while the O139 and non-O1, non-O139 serogroups constituted 61 (23.8%) and 66 (25.8%) isolates, respectively. V. cholerae O1 Ogawa was the predominant isolate during the first 2 years of the study. However, this was replaced by V. cholerae non-O1, non-O139 serogroups in the following years. The V. cholerae, which was susceptible to most enteric antimicrobials in 2000, was found to be multidrug resistant in subsequent years, with the development of fluroquinolone resistance since 2002. Surveillance of the epidemiological and microbiological characteristics of V. cholerae provides useful information for managing cholera cases. The V. cholerae non-O1, non-O139 serogroups coupled with multiple antimicrobial resistance may form a group of emerging diarrheal pathogens in the tropics.

Significance of isolation and drug susceptibility testing of non-Candida albicans species causing oropharyngeal candidiasis in HIV patients.

Oropharyngeal candidiasis (OPC) continues to be a common opportunistic infection in patients infected with Human Immunodeficiency Virus (HIV) and is predictive of increasing immunosuppression. Though Candida albicans remains the predominant isolate, a rise in the frequency of isolation of non-albicans Candida (NAC) species is being observed. The levels of virulence and the sensitivities to available antifungal drugs vary among these species. Of 340 HIV seropositive patients in this study, 132 (38.8%) had oral lesions suggestive of candidiasis. Samples were collected from the lesion using sterile cotton swabs. Isolation and speciation were done by standard techniques. Antifungal drug susceptibility testing was done by macro broth dilution. The total number of Candida isolates was 135, of which, 45 (33.3%) were NAC species and 90 were C.albicans (66.6%). Of the NAC species, C. dubliniensis was the predominant pathogen (22,48.9%). Antifungal susceptibility testing showed that 14 (31.1%) of the NAC species and 11 (12.2%) of C. albicans were resistant to fluconazole (MIC > 8 microg/ml). A very high MIC of > 32 microg/ml was noted among the NAC species resistant to fluconazole.

Listeria monocytogenes meningitis: an uncommon opportunistic infection in HIV/AIDS.

OBJECTIVE: To report an interesting case of meningitis caused by Listeria monocytogenes meningitis in an HIV seropositive individual. MATERIALS & METHODS: A previously healthy 45 years old HIV seropositive man, presented with atypical clinical features of meningitis. Blood and Cerebrospinal fluid (CSF) were obtained for biochemical and microbiological investigations. RESULTS: CSF analysis showed pleocytosis with lymphocytic predominance. Gram stain of CSF was negative; however culture yielded growth of gram positive bacilli with tumbling motility. Based on relevant biochemical tests the isolate was identified as Listeria monocytogenes. Patient was treated with i.v. ampicillin and recovered completely. CONCLUSION: Listeriosis is relatively rare in HIV/AIDS among the immunodeficient populations. Atypical clinical and laboratory findings make the diagnosis difficult and these infections may go undiagnosed. Since it is easily treated with readily available antibiotics, it is important to diagnose them at the earliest and thereby prevent treatment failure.

Genotoxicity assessment in oncology nurses handling anti-neoplastic drugs.

Many anti-neoplastic drugs are used globally during chemotherapy in the treatment of cancer. However, occupational exposure to anti-cancer drugs can represent a potential health risk to humans. Investigations on the genotoxicity of these drugs are inconsistent. Further, information on the genotoxic potential of anti-neoplastic drugs in medical personnel from India is not available. Hence, the aim of this study was to carry out genotoxicity monitoring of nurses from the oncology department of a hospital in South India, occupationally exposed to anti-neoplastic drugs under routine working conditions. The level of genome damage was determined in whole blood with the comet assay as well as micronucleus test (MNT) and in buccal epithelial cells with MNT alone of 60 nurses handling anti-neoplastic drugs and 60 referents matched for age and sex. Urinary cyclophosphamide (CP), used as a marker for drug absorption, was also measured in the urine of the nurses. The DNA damage observed in the lymphocytes of exposed nurses was significantly higher than the controls. Similarly, a significant increase in micronuclei (MN) frequency with peripheral blood lymphocytes and buccal cells was observed in the exposed nurses compared to controls (P < 0.05). Multiple regression analysis showed that occupational exposure and age had a significant effect on mean comet tail length as well as on frequency of MN. The mean value of CP in urine of the nurses handling anti-neoplastic drugs was (mean +/- standard deviation; 0.44 +/- 0.26 microg/ml). Our study has shown that increased genetic damage was evident in nurses due to occupational exposure to anti-neoplastics. This data corroborate the need to maintain safety measures to avoid exposure and the necessity of intervention in the case of exposure when using and handling anti-neoplastic drugs.

Extended spectrum beta lactamase producing Klebsiella pneumoniae in neonatal intensive care unit.

OBJECTIVE: As infections due to Extended Spectrun beta Lactamase (ESbetaL) producing Klebsiella pneumoniae were increasing in the NICU at Karnataka Institute of Medical Sciences Hospital, Hubli, India, the present study was carried out to identify any environmental sources and the mode of transmission. METHODS: Environmental samples from various sites were collected monthly for a period of six months. RESULTS: ESbetaL producing K. pneumoniae were isolated from all the sites except room air at least on one occasion. ESbetaL producing K. pneumoniae was always isolated from one of the incubators, medicine trolley and sink; while at least one of the health care workers carried it in the hands four out of six times tested. ESbeta L producing K. pneumoniae with similar antibiogram were also isolated from the clinical samples obtained from the neonates. CONCLUSION: Widespread use of third generation cephalosporins as a pre-emptive antibiotic for suspected cases of septicaemia may have contributed to emergence of ESbetaL producing K. pneumoniae in addition to other risk factors. ESbetaL producing K. pneumoniae have extensively colonised the environment of the NICU. Transmission of these pathogens to the neonates has probably occurred through the healthcare workers. Efforts to improve hand hygiene among the healthcare workers and mothers are urgently needed.

Methicillin resistant Staphylococcus aureus infections-implications in hospital infection control.

BACKGROUND: A significant part of nosocomial infections are caused by methicillin resistant Staphylococcus aureus (MRSA). Nosocomial MRSA are known to be multidrug resistant and thus difficult to treat. METHODS: A 2 year study was conducted between January 2001 and December 2002 at Karnataka Institute of Medical Sciences Hospital, Hubli to assess the prevalence of MRSA and its antibiotic susceptibility pattern in various wards. RESULTS: S. aureus was isolated from 714 patients, 283 (37.53%) of which exhibited methicillin resistance. Although these MRSA were multidrug resistant in all the wards, the problem was more severe in NICU and orthopedic wards. CONCLUSION: The results highlight the need for effective implementation of infection control measures in the hospital. There is a need for the judicious use of antimicrobial agents in the hospital and outside as their indiscriminate use can exert pressure in selecting out MRSA and other multidrug resistant organisms.

Genotoxic evaluation of workers employed in pesticide production.

Pesticides are widely used throughout the world in agriculture to protect crops and in public health to control diseases. Nevertheless exposure to pesticides can represent a potential risk to humans. Pesticide manufacturing unit workers are prone to possible occupational pesticide exposure. Therefore, this study was performed to evaluate the genotoxic effect of pesticide exposure in these workers. In the present investigation 54 pesticide workers and an equal number of control subjects were assessed for genome damage in blood lymphocytes utilizing the chromosomal aberration analysis and the buccal epithelial cell by adopting the micronucleus test. The results suggested that pesticide workers had a significantly increased frequency of chromosomal aberrations when compared with controls (mean+/-S.D., 8.43+/-2.36 versus 3.32+/-1.26; P<0.05). Similarly, the pesticides exposed workers showed a significant increase in micronucleated cells compared with controls (1.24+/-0.72 versus 0.32+/-0.26; P<0.05). Analysis of variance revealed that occupational exposure to pesticides had a significant effect on frequency of micronuclei (P<0.05), whereas smoking, age, gender and alcohol consumption had no significant effect on genetic damage (P>0.05). However, no association was found between years of exposure, smoking, age, gender, alcohol consumption and higher levels of genetic damage as assessed by the chromosomal aberration assay (P>0.05). Our findings indicate that occupational exposure to pesticides could cause genome damage in somatic cells.

Evaluation of genetic damage in operating room personnel exposed to anaesthetic gases.

Information on potential genetic damage in humans after exposure to waste anaesthetic gases in Indian hospitals is scarce. To evaluate the possible genotoxic effects of waste anaesthetic gases, the chromosomal aberrations analysis and comet assay were studied in peripheral blood lymphocytes in 45 operating room personnel currently employed at a hospital in South India. In addition, the micronucleus test on buccal epithelial cells was also carried out in the same subjects. The exposed group was compared with a group of 45 non-exposed group, matched by age, sex, alcohol consumption and smoking habits. The results showed a statistically significant increase in DNA damage by the comet assay in the exposed group. Chromosome aberrations and micronucleus frequencies also increased significantly in the study subjects in comparison to the controls. Analysis of variance showed that smoking had a significant effect on DNA mean tail length, whereas alcohol consumption, duration of exposure to anaesthetic agents, age and gender had no significant effect. All the confounding factors had significant effect by the micronucleus test. However, smoking, alcohol consumption, age, gender and years of exposure showed no significant effect by the chromosome aberrations test. The results of our study suggest that exposure to waste anaesthetic gases has the potential to cause changes in the human genome.

Fluoroquinolone-resistant Vibrio cholerae isolated during a cholera outbreak in India.

During the cholera epidemic of 2002 in and around Hubli, south India, Vibrio cholerae strains resistant to fluoroquinolones were isolated. Among the isolates of V. cholerae non-O1, non-O139 serogroups, 55.9% and 47.1% were resistant to norfloxacin and ciprofloxacin, respectively. However, only 12.5% of the O1 serogroup strains were resistant to both norfloxacin and ciprofloxacin. Though the O139 serogroup strains were susceptible to these antibiotics, they exhibited multidrug resistance. Emergence of fluoroquinolone-resistant V. cholerae that also exhibited multidrug resistance is of great significance in the epidemiology and control of cholera.

Neonatal sepsis caused by Salmonella enterica serovar Weltevreden.

Salmonella enterica serovar Weltevreden is an uncommon cause of gastroenteritis occurring worldwide. For the first time, we report 2 cases of neonatal sepsis caused by S. Weltevreden from Hubli, India. In the first case, the neonate had features of septicemia and S. Weltevreden was isolated from a blood culture. The other neonate had omplalitis and clinical features of septicemia. S. enterica serovar Weltevreden was isolated from the umbilical swab culture of this neonate. Even though extensive investigations were conducted, the source of infection could not be identified. Both neonates recovered completely after appropriate antibiotic and supportive therapy.