Tamil Translation, Cross-Cultural Adaptation, and Pilot Testing of the Disabilities of Arm, Shoulder, and Hand Questionnaire.

BACKGROUND: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a commonly used patient-reported outcome measure of symptoms and function in people with upper limb conditions. The objectives of this study were to translate and cross-culturally adapt the DASH questionnaire for Tamil population in India and pilot test the questionnaire for feasibility and acceptability. MATERIALS AND METHODS: The translation and cross-cultural adaptation process recommended by the developers of the DASH questionnaire was followed. The prefinal Tamil DASH was tested in people with a wide range of upper limb conditions. Acceptability and feasibility was evaluated by patient feedback and the time taken to complete the questionnaire. RESULTS: Around 11 items were adapted to improve the relevance of the questionnaire for Tamil population. Thirty patients were recruited for pilot testing. The prefinal Tamil DASH was found to be relevant and comprehensible to patients (n = 29, Males/Females: 21/8; mean (SD) age: 34 (11.3) years) and feasible to administer. One item "Sexual activities" had more non-respondents (n = 16, 55%). Upon consultation with the developers, an item "Wash and blow dry hair" was further modified and the final Tamil DASH was produced. CONCLUSION: Evaluation of reliability, validity and responsiveness in a large sample would inform the use of Tamil DASH in clinical and research settings.

Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

Ectopic thyroid tissue masquerading as a lateral neck mass: a case report.

The tissue bud that ultimately becomes the thyroid gland arises initially as a midline diverticulum in the floor of the pharynx. When the median thyroid analage does not descend in normal fashion, a lingual thyroid can result. It is thought that any thyroid tissue found in the lateral aspect of the neck, including around the vascular structures of the neck, may represent metastatic deposits from well-differentiated thyroid carcinoma. This is a case report of a 35 year old male presenting to the out-patient department with a swelling in the lateral aspect of the neck. The MRI report showed an enlarged level 2 lymph node in the lateral aspect of right side of the neck for which surgery was done and the specimen sent for HPE. Histopathological report gave a surprising report of thyroid tissue with normal follicular cells. But literature says that thyroid tissue lateral to the normal thyroid tissue is essentially metastatic papillary carcinoma. Only very few previous case reports showing the existence of ectopic thyroid in the lateral aspect of the neck have been documented (1,2,3). This case has been reported for its rarity.

Characterization of indoor bioaerosols from a hospital ward in a tropical setting.

OBJECTIVES: Study was conducted to assess whether temporal variation exists in airborne microbial concentrations of a hospital ward (west-Chennai, India) using active and passive methods, and characterise the microorganisms. METHODS: Air samples (duplicates) were collected simultaneously using exposed-plate, impingement (BioSampler) and filtration (personal sampling filter cassette loaded with gelatin filter) methods over different periods of the year. Bacterial plates were incubated at 37°C and observed for growth after 48h; fungal plates were incubated at 25°C and 37°C and observed upto 7 days. Microorganisms were identified using standard microbiological procedures. RESULTS: Microbial loads were found to vary with the sampling method. Concentrations of bacteria were higher (exposed-plate: 45-150 CFU/plate; impingement: 1.12E+03-1.6856E+05 CFU/m(3); filtration: 3.788E+03-1.91111E+05 CFU/m(3)) than fungi (exposed-plate: 0-13 CFU/plate; impingement: 0-3.547E+03 CFU/m(3); filtration: 0-1.515E+04 CFU/ m(3)). Coagulase-negative Staphylococci and Micrococci were the predominant Gram-positive cocci in active and passive samples. Enterobacter and Pseudomonas were the predominant Gram-negative bacilli. Among fungi, Aspergillus niger was isolated throughout the year. There was no significant temporal variation in airborne microbial loads irrespective of methods. CONCLUSIONS: Exposed-plate method was found to capture microorganisms efficiently with little variation in duplicate samples, suggesting its use in hospitals for preliminary assessment of indoor air quality and determine pathogenic microorganisms due to particle fall-out.

Identification of copy number variants on human chromosome 22 in patients with a variety of clinical findings.

The aims of this study were to create a copy number variant (CNV) profile of human chromosome 22 and to establish a genotype-phenotype correlation for patients with genomic abnormalities on chromosome 22. Thus, 1,654 consecutive pediatric patients with a diversity of clinical findings were evaluated by high-resolution chromosomal microarray analysis (CMA). We identified 25 individuals with abnormal CNVs on chromosome 22, representing 1.5% of the cases analyzed in this cohort. Meanwhile, we detected 1,298 benign CNVs on this chromosome in these individuals. Twenty-one of the 25 abnormal CNVs and the majority of the benign CNVs occurred through involvement of the 8 unstable genomic regions enriched with low copy repeats (LCR22A-H). The highly dynamic status of LCR22s within the 22q11 region facilitates the formation of diverse genomic abnormalities. This CNV profile provides a general perspective of the spectrum of chromosome 22 genomic imbalances and subsequently improves the CNV-phenotype correlations.

Investigation of optical nonlinearities of an azo dye using a 532nm diode-pumped Nd:YAG laser.

Solid-state dye-doped polymers are attractive alternatives to the conventional liquid dye systems. In this paper, the third order nonlinear optical property of Sudan III, an azo dye in solvents and dye doped polymer films measured using the Z-scan technique is reported. Multiple diffraction rings were observed when the dye doped in both the liquid and solid media was exposed to a diode-pumped Nd:YAG laser at 532nm.

Nonlinear studies of acid fuchsin dye in liquid and solid media.

Solid-state dye-doped polymers are attractive alternative to the conventional liquid dye solutions. In this paper, nonlinear properties of the dye Acid Fuchsin has been studied. The third-order nonlinear optical properties of Acid Fuchsin dye in 1-butanol and dye-doped polymer film were measured by the Z-scan technique using 532 nm diode pumped Nd:Yag laser. This material exhibits negative optical nonlinearity. The dye at 0.4 mM concentration exhibited nonlinear refractive coefficient (n(2)=-8.72 x 10(-8) and -10.308 x 10(-8) (cm(2)/W) in liquid and solid media, respectively), nonlinear absorption coefficient (beta=-7.69 x 10(-4) and -8.294 x 10(-4)cm/W in liquid and solid media, respectively) and susceptibility (chi(3)=4.33 x 10(-6) and 5.13 x 10(-5)esu in liquid and solid media, respectively). These results show that Acid Fuchsin dye has potential applications in nonlinear optics.

Studies of third-order optical nonlinearities and optical limiting properties of azo dyes.

In order to protect optical sensors and human eyes from debilitating laser effects, the intensity of the incoming laser light has to be opportunely reduced. Here, we report our results on the third-order optical nonlinearity and optical limiting properties of three azo dyes exposed to a 532nm continuous wave laser. We have observed low power optical limiting based on nonlinear refraction in our samples.

Single-beam Z-scan measurement of the third-order optical nonlinearities of azo dyes.

Organic dyes are very attractive optical materials for photonics and biophotonic applications. To quantitatively characterize their third-order nonlinear coefficients we have performed the experiments on two different azo dyes using a diode-pumped Nd:YAG laser at 532 nm. The |chi(3)| is of the order of 10(-6) esu. The relative contributions from nonlinear absorption (NLA) and nonlinear refraction (NLR) are dependent on the chemical structure and linear absorption of the dyes.

Nonlinear studies of Pararosanilin dye in liquid and solid media.

Solid-state dye-doped polymers are attractive alternative to the conventional liquid dye solutions. In this paper, nonlinear properties of the dye Pararosanilin has been studied. The third-order nonlinear optical properties of Pararosanilin dye in 1-butanol and dye-doped polymer film were measured by the Z-scan technique using 532 nm diode pumped Nd:Yag laser. This material exhibits negative optical nonlinearity. The dye at 0.4 mM concentration exhibited nonlinear refractive coefficient (n(2) = -6.8 x 10(-8) and -7.11 x 10(-8) (cm(2)/W) in liquid and solid media, respectively), nonlinear absorption coefficient (beta = -7.7 x 10(-4) and -7.93 x 10(-4)cm/W in liquid and solid media, respectively) and susceptibility (chi((3))=3.38 x 10(-6) and 3.53 x 10(-5)esu in liquid and solid media, respectively). These results show that Pararosanilin dye has potential applications in nonlinear optics.

Coagulase-negative staphylococci in very-low-birth-weight infants: inability of genetic markers to distinguish invasive strains from blood culture contaminants.

Selected coagulase-negative staphylococci from the blood of very-low-birth-weight infants in the Neonatal Intensive Care Unit at the Royal Women's Hospital, Melbourne, collected over a 5-year period were examined. Isolates were classified as invasive or contaminants, speciated, typed by pulsed-field gel electrophoresis, and examined for biofilm genes (icaA, icaC, and icaD), adhesion genes (atlE, fbe), and the number of copies of IS256. Of the 24 isolates studied, there were 13 contaminants and 11 invasive isolates. The collection included 15 Staphylococcus epidermidis, eight Staphylococcus capitis, and one each of Staphylococcus warneri and Staphylococcus haemolyticus. Two small clusters of S. epidermidis that belonged to the same molecular type were identified. All S. capitis isolates belonged to the same molecular type or subtype, suggesting that a particular clone was circulating in the unit. There was no significant difference in the species found, the presence of icaA, icaC, icaD, atlE, or fbe, or the number of copies of IS256 between invasive isolates and contaminants. A series of nasal isolates from nonhospitalized adults differed from hospital isolates in the absence of IS256 and the low prevalence of icaC. There was no evidence of IS256-mediated insertion into ica genes as a mechanism of phase variation. These findings suggest that contaminants and invasive isolates derived from the same pool of hospital strains capable of causing sepsis in compromised hosts and that other mechanisms of phase variation exist, apart from IS256 insertion into ica genes.

Spectral characteristics and nonlinear studies of crystal violet dye.

Solid-state dye-doped polymer is an attractive alternative to the conventional liquid dye solution. In this paper, the spectral characteristics and the nonlinear optical properties of the dye crystal violet are studied. The spectral characteristics of crystal violet dye doped poly(methylmethacrylate) modified with additive n-butyl acetate (nBA) are studied by recording its absorption and fluorescence spectra and the results are compared with the corresponding liquid mixture. The nonlinear refractive index of the dye in nBA and dye doped polymer film were measured using z-scan technique, by exciting with He-Ne laser. The results obtained are intercompared. Both the samples of dye crystal violet show a negative nonlinear refractive index. The origin of optical nonlinearity in the dye may be attributed due to laser-heating induced nonlinear effect.

Role of dipole moment of solvents in formation and stabilization of the TICT states in Coumarin 445 under nitrogen laser excitation.

In this paper we report the observation of dual Amplified Spontaneous Emission (ASE) from solutions of 7-ethylamino-4-methyl coumarin dye (Coumarin 445) in certain solvents such as n-butyl acetate, dioxane etc. when pumped by high power nitrogen laser. The two ASE bands appear to be from two different excited species (ICT and TICT conformation) one of which is the precursor of the other. The spectral characteristics of dye Coumarin 445 depend upon the solvent environment. The TICT coumarin photoisomers, which form exciplexes with the solvent molecules, have enough gain to produce amplified spontaneous emission even when there is apparently no detectable fluorescence. The behaviour of this dye in the excited state is studied by measuring the small signal gain and variation of the gain slope with temperature in different solvents. It is observed that polarity of the solvent plays a more dominant role in formation and stabilization of TICT states.

Photophysics of TICT states of 7-diethylamino-4-methyl coumarin dye by energy transfer techniques.

Coumarin 1 exhibited dual amplified spontaneous emission (ASE) in certain solvents under nitrogen laser excitation. These emissions are known as normal and anomalous emissions. The anomalous emission corresponds to TICT state and it does not have a corresponding fluorescence peak. Energy transfer techniques have been used to study the photophysics of TICT states and the characteristics of dual ASE bands of the dye coumarin 1.

Effect of solvents on the photophysical properties of substituted imidazonaphthyridine derivatives.

The absorption and fluorescence characteristics of three substituted imidazonaphthyridine derivatives are studied in a series of organic solvents. The variation of Stokes shift with the polarity parameter of the solvent is studied and the excited state dipole moment of these derivatives is higher than the ground state dipole moment. The fluorescence lifetime profile shows single exponential decay in all the solvents. The fluorescence quantum yield, radiative and non-radiative rate constants are also calculated and these parameters show much variation in the change in substitution of these derivatives.

Comparative leprosy vaccine trial in south India.

This report provides results from a controlled, double blind, randomized, prophylactic leprosy vaccine trial conducted in South India. Four vaccines, viz BCG, BCG+ killed M. leprae, M.w and ICRC were studied in this trial in comparison with normal saline placebo. From about 3,00,000 people, 2,16,000 were found eligible for vaccination and among them, 1,71,400 volunteered to participate in the study. Intake for the study was completed in two and a half years from January 1991. There was no instance of serious toxicity or side effects subsequent to vaccination for which premature decoding was required. All the vaccine candidates were safe for human use. Decoding was done after the completion of the second resurvey in December 1998. Results for vaccine efficacy are based on examination of more than 70% of the original "vaccinated" cohort population, in both the first and the second resurveys. It was possible to assess the overall protective efficacy of the candidate vaccines against leprosy as such. Observed incidence rates were not sufficiently high to ascertain the protective efficacy of the candidate vaccines against progressive and serious forms of leprosy. BCG+ killed M. leprae provided 64% protection (CI 50.4-73.9), ICRC provided 65.5% protection (CI 48.0-77.0), M.w gave 25.7% protection (CI 1.9-43.8) and BCG gave 34.1% protection (CI 13.5-49.8). Protection observed with the ICRC vaccine and the combination vaccine (BCG+ killed M. leprae) meets the requirement of public health utility and these vaccines deserve further consideration for their ultimate applicability in leprosy prevention.

Women and work in Kerala: a comparison of the 1981 and 1991 censuses.

PIP: This study examines census data on women's work status during 1981 and 1991 in Kerala state in India. During 1981 and 1991, Kerala had a stable female work participation rate (FWPR), which placed Kerala 19th out of 30 states and Union territories. However, Kerala's FWPR declined in size and in the ratio to the male work participation rate during 1951-81. The work participation rate in Kerala was 15.85 for women and 47.58 for men in 1991 and 16.61 for women and 44.89 for men in 1981, which was under the national average. Fertility declined from 3.7 during 1970-75 to 1.7 in 1992. Life expectancy at birth was 74.7 years for women and 68.8 years for men, which is higher than the national average. The proportion of persons aged 15-59 years increased. Several explanations are offered to explain the low FWPR. Women increased in the number of enrollments in higher education. The increase for women was 50% compared to only 24% for men. The number of unemployed women aged 15-34 years rose during 1961-81. A 1987-88 unemployment survey revealed that over 10% of the unemployed in India lived in Kerala state, which had only 3.4% of total Indian population. A 1987 migration survey indicated that 300,929 workers from Kerala migrated to the Middle East, of which 92.5% were men. 31.43% of Kerala's population in 1991 were workers. The increase in the proportion of workers during 1981-91 was due primarily to the increase in male workers. The number of main workers increased over the decade for men and women, although only marginally for women. Marginal workers declined for both genders. Work participation rates of main and marginal workers increased for men and declined for women. Urban employment for women increased. Two districts had very low FWPRs. 48.78% of the female work force worked as cultivators and agricultural laborers. Growth occurred in urban and tertiary activities.^ieng

Glucocorticoid inhibition of fibroblast proliferation and regulation of the cyclin kinase inhibitor p21Cip1.

Glucocorticoids inhibit the proliferation of fibroblastic cells in vivo and in culture; however, the molecular mechanism that accounts for this effect has remained obscure. We have undertaken to elucidate the mechanism whereby glucocorticoids decrease the rate of proliferation of mouse L929 fibroblastic cells. Addition of dexamethasone to mid-log phase fibroblasts prolongs G1 phase. This increase in the G1 interval is associated with, and probably due to, inhibition of phosphorylation of the product of the Rb-1 tumor suppressor gene, pRb. Inhibition of pRb phosphorylation by cyclin D-dependent kinases can be demonstrated in vitro. Nevertheless, there is no detectable change in the expression of cyclin D1, cyclin D2, or cyclin D3. Cyclin-dependent kinase-4 (Cdk4) and Cdk6 are not down-regulated in L929 cells after addition of glucocorticoids, and the abundance of cyclin D/Cdk4 complexes does not change. Inhibition of pRb kinase activity is associated with an increase in the abundance of one of the Cdk inhibitors, p21Cip1. The abundance of another cyclin kinase inhibitor, p27Kip1, remains constant. The amount of Cdk4 that is bound to p21Cip1 increases rapidly after addition of dexamethasone, and the activity of Cdk4-pRb kinase decreases in parallel. These results indicate that glucocorticoid inhibition of fibroblast proliferation is due to induction of p21Cip1, which binds to and inactivates cyclinD/Cdk4 complexes. The abundance of p21 mRNA increases about 5-fold within 2 h after addition of dexamethasone. This effect does not obtain in L929 mutants that are null for the glucocorticoid receptor, and a variant that expresses the glucocorticoid receptor from a tetracycline-repressible expression vector demonstrates induction of p21 mRNA only in the absence of tetracycline. Cycloheximide does not block induction of p21 mRNA, and dexamethasone has no detectable effect on the apparent rate of degradation of p21 mRNA. Nuclear run-on transcription of the Cip1 gene increases within 2 h after addition of dexamethasone. This effect can be blocked by tetracycline-mediated repression of the glucocorticoid receptor.

Inter-observer agreement and clinical diagnosis of leprosy for prophylaxis studies.

Clinical diagnosis is still the most useful tool for detecting early cases of leprosy in field research. In prophylaxis studies accuracy of clinical diagnosis of leprosy is important during intake as well as for measuring efficacy of the intervention. This paper reports our observations regarding the extent of inter-observer variations in clinical diagnosis of leprosy and its implications for a prophylaxis study. Information on 225 suspects and cases of leprosy, each examined independently by three senior workers after initial standardization, was used for this purpose. Agreement among the examiners regarding the presence of skin patch, thickened nerve trunk and sensory deficit was fairly high (Kappa = 0.7). Agreement on the presence of infiltration in a skin patch was not satisfactory (Kappa = 0.4-0.5). It was observed that in clinical diagnosis of leprosy, presence of skin patch and sensory deficit, as well as thickened nerve trunk and related anaesthesia were correlated observations. The influence of inter-observer variations on defining leprosy problem in the community can be quite large. The paper suggests some ways of overcoming the problem.