Tea polyphenol-T. arjuna bark as sperm antioxidant extender in infertile smokers.

BACKGROUND: Antioxidants protect spermatozoa against lipid peroxidation during freezing. OBJECTIVE: The study is designed to elucidate the suitable extender to preserve infertile semen of smokers against ROS damage using natural Tea polyphenol (T. arjuna bark extract). MATERIALS AND METHODS: Forty-two infertile subjects with smoking habit and 28 fertile subjects without smoking habit were considered for the study. Four semen extenders including our naturally derived antioxidant component were prepared and used to preserve semen sample from the study subjects for a period of one month. Standard semen parameters, biochemical and sperm DNA damage marker with inhibition were measured before and after cryopreservation. RESULTS: The motility and morphology of sperm cells were maintained better in E4 extender, and DNA damage is reduced. CONCLUSION: Extender recipe with natural antioxidants (E3 and E4) was found to be apt for infertile semen preservation.

Topography and morphological anatomy of nutrient foramina in human metacarpal bones and their clinical implications.

PURPOSE: To study the morphological and topographic anatomy of nutrient foramina and to determine the foraminal index of metacarpal bones. MATERIALS AND METHODS: The study consisted of 438 unpaired, human metacarpal bones of unknown age and sex. Nutrient foramina in each of the bones were grossly identified in relation to their number and location. The foraminal index was calculated by applying the Hughes formula. A digital vernier caliper was used to perform the measurements. RESULTS: Among our specimens, 93.1% of metacarpals had single foramen, 2% had double foramina, 0.3% of the bones had triple foramina and in 4.6% of cases the foramen was absent. The mean foraminal indexes of the 1st, 2nd, 3rd, 4th and 5th metacarpal were 60.1, 53, 43.1, 43.7 and 45.9 respectively. CONCLUSION: It was observed that the morphology and topography of nutrient foramina vary among different metacarpals. In 1st and 2nd metacarpals, foramina were more common at the medial surface and in other metacarpals, mostly seen on the lateral surface. The knowledge about these foramina is important in certain surgical procedures to preserve the circulation. This data is important to the plastic surgeon for microvascular bone transfer surgeries.

A large outbreak of acute encephalitis with high fatality rate in children in Andhra Pradesh, India, in 2003, associated with Chandipura virus.

BACKGROUND: An outbreak of acute encephalitis of unknown origin with high case fatality (183 of 329 cases) was reported in children from Andhra Pradesh state in southern India during 2003. We investigated the causative agent. METHODS: Cell lines and peripheral blood lymphocyte co-cultures were used to isolate the causative agent from clinical samples. Identity of the agent was established by electron microscopy and serological and molecular assays. FINDINGS: Clinical samples tested negative for IgM antibodies to Japanese encephalitis, West Nile, dengue, and measles viruses, and for RNA of coronavirus, paramyxovirus, enterovirus, and influenza viruses. Virus was isolated from six patients with encephalitis and was identified as Chandipura virus by electron microscopy, complement fixation, and neutralisation tests. Chandipura virus RNA was detected in clinical samples from nine patients. Sequencing of five of these RNA samples showed 96.7-97.5% identity with the reference strain of 1965. Chandipura viral antigen and RNA were detected in brain tissue of a deceased child by immunofluorescent antibody test and PCR. Neutralising, IgG, and IgM antibodies to Chandipura virus were present in some patients' serum samples. Serum samples obtained after 4 days of illness were more frequently positive for IgM to Chandipura virus than were those obtained earlier (p<0.001). A similar trend was noted for neutralising antibodies. INTERPRETATION: Our findings suggest that this outbreak of acute encephalitis in Andhra Pradesh was associated with Chandipura virus, adding to the evidence suggesting that this virus should be considered as an important emerging pathogen.

Objective evaluation of small bowel and colonic transit time using pH telemetry in athletes with gastrointestinal symptoms.

BACKGROUND: Gastrointestinal (GI) disturbances are often reported by long distance runners and are more common in women, particularly after prolonged high intensity exercise. OBJECTIVES: To determine whether these symptoms could be associated with alterations in GI motility. METHODS: Small bowel and colonic transit were measured using pH telemetry in a group of 11 female athletes (age 22 to 53 years), six of whom experienced lower GI symptoms during exercise. Subjects participated in two experimental sessions: a control measurement, where small bowel transit was estimated during a rest period (R) of six hours; and an exercise session (E), where small bowel transit was measured during a one hour period of high intensity exercise (cross country running) at >70% VO(2)max. Colonic transit was estimated indirectly from determinations of whole gut transit time by radio-opaque marker. RESULTS: Small bowel transit time was 3.5 to 10.6 h (R) and 3.0 to 8.7 h (E) in asymptomatic athletes, versus 4.0 to 6.6 h (R) and 4.6 to 7.3 h (E) in symptomatic athletes (NS). Colonic transit time was 35.0 to 62.5 h (R) and 30.5 to 70.9 h (E) in asymptomatic athletes versus 20.4 to 42.9 h (R) and 21.5 to 67.2 h (E) in symptomatic athletes (NS). CONCLUSIONS: Small bowel and colonic transit times were similar in the two groups in the rest and exercise sessions. The diarrhoea seen in this study did not result from accelerated colonic transit. Other mechanisms must be sought.

Linear and nonlinear measures of blood pressure variability: increased chaos of blood pressure time series in patients with panic disorder.

Arterial blood pressure (BP) variability increases progressively with the development of hypertension and an increase in BP variability is associated with end organ damage and cardiovascular morbidity. On the other hand, a decrease in heart rate (HR) variability is associated with significant cardiovascular mortality. There is a strong association between cardiovascular mortality and anxiety. Several previous studies have shown decreased HR variability in patients with anxiety. In this study, we investigated beat-to-beat variability of systolic and diastolic BP (SBP and DBP) in normal controls and patients with panic disorder during normal breathing and controlled breathing at 12, and 20 breaths per minute using linear as well as nonlinear techniques. Finger BP signal was obtained noninvasively using Finapres. Standing SBPvi and DBP BPvi (log value of BP variance corrected for mean BP divided by HR variance corrected for mean HR) were significantly higher in patients compared to controls. Largest Lyapunov exponent (LLE) of SBP and DBP, a measure of chaos, was significantly higher in patients in supine as well as standing postures. The ratios of LLE (SBP/HR) and LLE (DBP/HR) were also significantly higher (P<.001) in patients compared to controls. These findings further suggest dissociation between HR and BP variability and a possible relative increase in sympathetic function in anxiety. This increase in BP variability may partly explain the increase in cardiovascular mortality in this group of patients.

Nonlinear measures of QT interval series: novel indices of cardiac repolarization lability: MEDqthr and LLEqthr.

In this study, we investigated nonlinear measures of chaos of QT interval time series in 28 normal control subjects, 36 patients with panic disorder and 18 patients with major depression in supine and standing postures. We obtained the minimum embedding dimension (MED) and the largest Lyapunov exponent (LLE) of instantaneous heart rate (HR) and QT interval series. MED quantifies the system's complexity and LLE predictability. There was a significantly lower MED and a significantly increased LLE of QT interval time series in patients. Most importantly, nonlinear indices of QT/HR time series, MEDqthr (MED of QT/HR) and LLEqthr (LLE of QT/HR), were highly significantly different between controls and both patient groups in either posture. Results remained the same even after adjusting for age. The increased LLE of QT interval time series in patients with anxiety and depression is in line with our previous findings of higher QTvi (QT variability index, a log ratio of QT variability corrected for mean QT squared divided by heart rate variability corrected for mean heart rate squared) in these patients, using linear techniques. Increased LLEqthr (LLE of QT/HR) may be a more sensitive tool to study cardiac repolarization and a valuable addition to the time domain measures such as QTvi. This is especially important in light of the finding that LLEqthr correlated poorly and nonsignificantly with QTvi. These findings suggest an increase in relative cardiac sympathetic activity and a decrease in certain aspects of cardiac vagal function in patients with anxiety as well as depression. The lack of correlation between QTvi and LLEqthr suggests that this nonlinear index is a valuable addition to the linear measures. These findings may also help to explain the higher incidence of cardiovascular mortality in patients with anxiety and depressive disorders.

Nonlinear measures of respiration: respiratory irregularity and increased chaos of respiration in patients with panic disorder.

BACKGROUND: Respiratory irregularity has been previously reported in patients with panic disorder using time domain measures. However, the respiratory signal is not entirely linear and a few previous studies used approximate entropy (APEN), a measure of regularity of time series. We have been studying APEN and other nonlinear measures including a measure of chaos, the largest Lyapunov exponent (LLE) of heart rate time series, in some detail. In this study, we used these measures of respiration to compare normal controls (n = 18) and patients with panic disorder (n = 22) in addition to the traditional time domain measures of respiratory rate and tidal volume. METHODS: Respiratory signal was obtained by the Respitrace system using a thoracic and an abdominal belt, which was digitized at 500 Hz. Later, the time series were constructed at 4 Hz, as the highest frequency in this signal is limited to 0.5 Hz. We used 256 s of data (1024 points) during supine and standing postures under normal breathing and controlled breathing at 12 breaths/min. RESULTS: APEN was significantly higher in patients in standing posture during normal as well as controlled breathing (p = 0.002 and 0.02, respectively). LLE was also significantly higher in standing posture during normal breathing (p = 0.009). Similarly, the time domain measures of standard deviations and the coefficient of variation (COV) of tidal volume (TV) were significantly higher in the patient group (p = 0.02 and 0.004, respectively). The frequency of sighs was also higher in the patient group in standing posture (p = 0.02). In standing posture, LLE (p < 0.05) as well as APEN (p < 0.01) contributed significantly toward the separation of the two groups over and beyond the linear measure, i.e. the COV of TV. CONCLUSION: These findings support the previously described respiratory irregularity in patients with panic disorder and also illustrate the utility of nonlinear measures such as APEN and LLE as additional measures toward a better understanding of the abnormalities of respiratory physiology in similar patient populations as the correlation between LLE, APEN and some of the time domain measures only explained up to 50-60% of the variation.

Diminished chaos of heart rate time series in patients with major depression.

BACKGROUND: Depression and anxiety have been linked to serious cardiovascular events in patients with preexisting cardiac illness. A decrease in cardiac vagal function as suggested by a decrease in heart rate (HR) variability has been linked to sudden death. METHODS: We compared LLE and nonlinearity scores of the unfiltered (UF) and filtered time series (very low, low, and high frequency; VLF, LF and HF) of HR between patients with depression (n = 14) and healthy control subjects (n = 18). RESULTS: We found significantly lower LLE of the unfiltered series in either posture, and HF series in patients with major depression in supine posture (p <.002). LLE (LF/UF), which may indicate relative sympathetic activity was also significantly higher in supine and standing postures in patients (p <.05); LF/HF (LLE) was also higher in patients (p <.05) in either posture. CONCLUSIONS: These findings suggest that major depression is associated with decreased cardiac vagal function and a relative increase in sympathetic function, which may be related to the higher risk of cardiovascular mortality in this group and illustrates the usefulness of nonlinear measures of chaos such as LLE in addition to the commonly used spectral measures.

Heart rate and QT variability in children with anxiety disorders: a preliminary report.

This study compared beat-to-beat heart rate and QT variability in children with anxiety disorders (n = 7) and normal controls (n = 15) by using an automated algorithm to compute QT intervals. An increase in QT variability appears to be associated with a higher risk for sudden cardiac death. A decrease in heart rate variability is also linked to significant cardiovascular events. Supine detrended QT variability, QT variability corrected for mean QT interval, and QTvi (a log ratio of QT variance normalized for mean QT over heart rate variability normalized for mean heart rate) were significantly higher in children with anxiety compared to controls (P < 0.05). The largest Lyapunov Exponent (LLE) of heart rate time series was significantly lower (P < 0.05) in children with anxiety compared to controls. These findings suggest a relative increase in sympathetic activity and a relative decrease in cardiac vagal activity in children with anxiety disorders, and are discussed in the context of the effects of tricyclics on cardiac autonomic function in children, and the rare occurrence of sudden death during tricyclic antidepressant treatment.

Torsades de pointes ventricular tachycardia associated with overdose of astemizole.

An overdose of astemizole predisposes the myocardium to ventricular dysrhythmias, including torsades de pointes. Herein we describe a case of astemizole-induced torsades de pointes ventricular tachycardia and also review previous case reports in the literature. All the patients were young, and dysrhythmias developed only in those with corrected QT intervals greater than 500 ms. Although several mechanisms have been postulated, no clear explanation has been provided for why astemizole promotes myocardial dysrhythmias. Treatment of astemizole-induced torsades de pointes includes discontinuing use of astemizole, intravenous administration of magnesium sulfate and isoproterenol, temporary cardiac pacing, and, when necessary, direct current cardioversion. A cardiac cause of syncope or convulsions must not be overlooked, especially in patients taking H1 antagonists because they often have these symptoms before hospitalization or detection of torsades de pointes (or both).

A quantitative histological study of neuronal loss from the locus coeruleus of ageing mice.

A quantitative histological study of neurons in the locus coeruleus (LC) was carried out in ASH/TO mice aged 6, 9, 12, 15, 22, 25, 28 and 31 months. Counts were carried out on the right LC in 6 micron parasagittal sections. There was a wide individual variation and also a variation between age groups from 6 and 15 months, but the mean number of neurons in the LC never fell below 1325 until after 25 months. The mean number of neurons in the LC from 6 to 25 months was 1520 +/- 73. The mean number of neurons at 28 and 31 months was 1009 +/- 60 and 854 +/- 146 respectively. This indicates that the pattern of neuron loss in the LC of ASH/TO mice is similar to that found in the normal ageing human brain in a number of quantitative histological studies.

Thallimetric oxidations-IV Estimation of malonic acid.

Malonic acid is quantitatively oxidized to carbon dioxide and water when refluxed for 120 min in sulphuric acid medium (concentration 1.5M) with at least four times as much thallium(III) as that stoichiometrically required for complete oxidation. The thallium(I) formed is estimated bromatometrically in the presence of 1.5-2M hydrochloric acid, with Methyl Orange as indicator. The indicator correction is negligible. The relative mean deviation is 0.2%. Possible side-reactions and their suppression are discussed.

Substoichiometric determination of mercury using 1-(2-pyridylazo)-2-naphthol.

A substoichiometric radiochemical method for the determination of mercury has been developed using 1-(2-pyridylazo)-2-naphthol (PAN) as a chelating agent. The chelate was extracted at pH 9.5 ( Na2CO3NaHCO3 buffer) into chloroform. 15-65 micrograms of mercury was determined with an accuracy +/- 0.9%. Effects of many diverse metal ions have been studied and procedures were developed for the suppression of interference due to these ions.

Redox substoichiometric determination of thallium.

A method for the redox substoichiometric determination of thallium employing chlorate as an oxidant has been developed. The substoichiometric amount of Tl(III) formed was isolated by extraction with isoamyl acetate. 5-50 micrograms of thallium can be determined with an accuracy of +/- 1.3%.

Photochemical thallimetric oxidations-estimation of formic acid.

A simple, rapid and convenient redox method has been developed for the estimation of formic acid. Formic acid is photochemically oxidized with thallium(III) in the presence of bromide as catalyst, and the thallium(I) formed is determined by titration with potassium bromate. The procedure can also be used for the estimation of thallium(III) with formic acid as reductant.

A Photochemical redox method for the estimation of thallium(III).

A convenient photochemical redox method for the estimation of thallium(III) by reduction with oxalic acid followed by oxidation of thallium(I) with potassium bromate has been developed. The reduction is carried out in the presence of small concentrations of chloride and bromide as catalysts.

Extrapolation of IUD retention rates: an evaluation of some models.

PIP: Contraceptive retention rates play a vital role in estimating the number of births averted. Generally, the data based on follow-up studies are of a short duration of 1 or 2 years, necessitating the use of the continuation curves for extrapolating the retention rates. The most widely used curve for extrapolating the IUD retention rates is negative exponential of Mauldin et al. Modified versions of the above curve and other alternative curves have also been proposed. An attempt is made in this discussion to evaluate precited curves so as to find a suitable method of extrapolation for Indian conditions, i.e., to determine a method which would give better results for a short span of 5-6 years and for which estimates of the parameters could be obtained over desk calculators. The evaluation is carried out in 2 stages. At the 1st instance, assuming that the retention rates are available only for a period of 24 months. Extrapolation is done for over a period of 60 months and the results thus obtained are compared with actual life table values. Robustness of these curves are tested by fitting them using only a segment of the data, i.e., using data from 13-24 months. Estimated values of the retention rates for the retrospective and prospective periods are then computed and compared with actual life table values. The curve which has got the minimal sum of squares of the deviations is considered as the best. The curves that are considered for evaluation are negative exponential curve, mixture of 2 exponentials, modified negative exponential, and modified type 3 exponential. The data for the analysis was taken from a retrospective survey conducted by the Population Center, Bangalore. Modified type 3 exponential gives a better fit, compared to single and the modified exponential functions. There is some evidence to show that the total curve of cumulative retention rates is a mixture of 2 or more curves. The analysis reveals that in cases where single exponential must be resorted to, it is advisable to use the later part of the available data, as the extrapolation based on it minimizes the underestimation in the later months.^ieng