Recent Trends and Practices Toward Assessment and Rehabilitation of Neurodegenerative Disorders: Insights From Human Gait.

The study of human movement and biomechanics forms an integral part of various clinical assessments and provides valuable information toward diagnosing neurodegenerative disorders where the motor symptoms predominate. Conventional gait and postural balance analysis techniques like force platforms, motion cameras, etc., are complex, expensive equipment requiring specialist operators, thereby posing a significant challenge toward translation to the clinics. The current manuscript presents an overview and relevant literature summarizing the umbrella of factors associated with neurodegenerative disorder management: from the pathogenesis and motor symptoms of commonly occurring disorders to current alternate practices toward its quantification and mitigation. This article reviews recent advances in technologies and methodologies for managing important neurodegenerative gait and balance disorders, emphasizing assessment and rehabilitation/assistance. The review predominantly focuses on the application of inertial sensors toward various facets of gait analysis, including event detection, spatiotemporal gait parameter measurement, estimation of joint kinematics, and postural balance analysis. In addition, the use of other sensing principles such as foot-force interaction measurement, electromyography techniques, electrogoniometers, force-myography, ultrasonic, piezoelectric, and microphone sensors has also been explored. The review also examined the commercially available wearable gait analysis systems. Additionally, a summary of recent progress in therapeutic approaches, viz., wearables, virtual reality (VR), and phytochemical compounds, has also been presented, explicitly targeting the neuro-motor and functional impairments associated with these disorders. Efforts toward therapeutic and functional rehabilitation through VR, wearables, and different phytochemical compounds are presented using recent examples of research across the commonly occurring neurodegenerative conditions [viz., Parkinson's disease (PD), Alzheimer's disease (AD), multiple sclerosis, Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS)]. Studies exploring the potential role of Phyto compounds in mitigating commonly associated neurodegenerative pathologies such as mitochondrial dysfunction, α-synuclein accumulation, imbalance of free radicals, etc., are also discussed in breadth. Parameters such as joint angles, plantar pressure, and muscle force can be measured using portable and wearable sensors like accelerometers, gyroscopes, footswitches, force sensors, etc. Kinetic foot insoles and inertial measurement tools are widely explored for studying kinematic and kinetic parameters associated with gait. With advanced correlation algorithms and extensive RCTs, such measurement techniques can be an effective clinical and home-based monitoring and rehabilitation tool for neuro-impaired gait. As evident from the present literature, although the vast majority of works reported are not clinically and extensively validated to derive a firm conclusion about the effectiveness of such techniques, wearable sensors present a promising impact toward dealing with neurodegenerative motor disorders.

Presence of fluoride in water diminishes fast the SPR peak of silver nanocrystals showing large red shift with quick sedimentation - A fast sensing and fast removal case.

The medicinal use of fluoride is beneficial up to a low ppm level but regular ingestion at high doses show many adverse effects in human. Fluoride may get ingested through drinking water specially through ground water near the hilly regions, where fluoride content is huge. Hence, fluoride sensing and removal of it from water is very important as fluoride contaminated water is transparent and not easily detectable. Here, we have studied colorimetric and spectrophotometric techniques for sensing of fluoride along with its fast removal from water by using prepared saponin capped silver nanoparticles (AgNPs). Colorimetric study has confirmed the presence of fluoride ions in water samples above the colorimetric detection limit of 10 ppm. But spectroscopic sensing further provides more lower limit of sensing with the total removal of fluoride ions up to 1.2 ppm level. On repeating this this study 15 times, sensing and removal of fluoride is found to be well reproducible. The interaction of fluoride ions with silver nanoparticles has resulted in sedimentation of fluoride ions in the form of fluoride-nanoparticles complex and that interaction has been confirmed by FTIR spectral study of the sedimented part. EDX analysis has also provided the information of easy removal of the fluoride ions from water as presence of fluoride peak has been found in EDX spectra.

Enhancement of antibacterial activity of synthesized ligand-free CdS nanocrystals due to silver doping.

Recently, different nanocrystals have been reported to be the alternative, optimistic, and novel antimicrobial agent against the many antibiotic-resistant bacteria. Here, ligand-free CdS and Ag-doped CdS (Ag/CdS) nanocrystals have been synthesized by chemical methods for the study of the antimicrobial activity on Escherichia coli and Staphylococcus aureus by Kirby-Bauer diffusion method to see the effect against Gram-positive and Gram-negative bacteria. These prepared nanocrystals have been characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), and X-ray diffraction (XRD). TEM and SEM images confirm the spherical morphology of both the sample and the respective XRD patterns indicate polycrystalline nature having a cubic zinc blende structure. Antibacterial activities have been tested with CdS and Ag/CdS, considering concentrations ranging from 10 to 200 µg/ml. After 24 h of incubation, the zone of inhibition (ZOI) is measured for each concentration, which shows that both the nanocrystals are ineffective against E. coli but much effective against S. aureus at this low concentration range. Furthermore, Ag/CdS nanocrystals have been found to show much more ZOI than CdS. Differences in the antibacterial activity can be due to the presence of different cell wall in E. coli and S. aureus.

Enhanced photocatalytic degradation of methyl orange dye on interaction with synthesized ligand free CdS nanocrystals under visible light illumination.

Methyl orange is widely used dye in textile industry and later, it becomes the major component of industrial waste and pollutes different water body. So, its degradation is required especially in the case of drinking water. Here, chemically synthesized ligand free CdS nanocrystals have been utilized as a photocatalyst to degrade this dye in water. The mean size of the CdS nanocrystal has been found to be 7 nm approximately from TEM analysis, and SAED pattern shows that these are crystalline in nature. Further, the XRD patterns confirms the cubic structure of CdS nanoparticles and mean size calculated from XRD analysis matches well with the obtained size from TEM study. NMR study clearly verifies that CdS nanocrystals are ligand free stable nanoparticles. Due to this absence of ligand on the surface of CdS nanocrystals, a much enhanced MO degradation has been observed, as the e--h+ pair in the CdS and subsequent generation of free radicals such as hydroxyl, can efficiently oxidize the organic material MO and therefore, degrade this pollutant faster under visible light illumination. The degradation efficiency is found to be 95% after 300 min of illumination, which is much better than the other similar reports.

Effects of saponin capped triangular silver nanocrystals on the germination of Pisum sativum, Cicer arietinum, Vigna radiata seeds & their subsequent growth study.

In this study, saponin capped triangular silver nanocrystals have been synthesised using fenugreek seed extract, where the extract acts both as a reducing and capping agent. X-ray diffraction study confirms the purity and crystalline nature of the prepared nanocrystals and transmission electron microscopic study shows the triangular morphology with the average edge length of 72 nm, along with the atomic force microscopy study for the height or the width of the triangular nanocrystals. These nanocrystals have been investigated against a few pulses (seeds) such as Pisum sativum, Cicer arietinum and Vigna radiata for their effect on the germination as well as growth of root and shoot. Considering different concentration of silver nanocrystals solution, it has been found that 25 × 10-4 and 80 × 10-4 µg/ml are the minimum and maximum concentrations of silver nanocrystals, within this range, germination and subsequent growth of root and shoot are effective. The result shows significant positive influence on the growth of root and shoot of all seeds in comparison to those of unexposed control germination. Therefore, the result of this experiment has confirmed that the use of saponin capped silver nanocrystals enhances the germination and growth of plants.

Ultrasound assessment of fetal hearing response to vibroacoustic stimulation.

Background: Assessment of fetal responses to external stimuli could be a vital clue for understanding development of fetal neurophysiology, which is extremely challenging to explore. To study hearing development in growing human fetus, we assessed sonographic fetal movement responses to external auditory stimulus at increasing period of gestation.Method: In 123 normal pregnant women between 16 and 40 weeks' gestation, sonographic assessment of fetal movements (gross body movement, isolated limb movement, breathing movement and startle response) was carried out before and after administering vibroacoustic stimulation (VAS). Types and number of fetal movements during 5-min period each - immediately before and after application of VAS - were compared.Results: With increasing gestational age, spontaneous gross body movement decreased significantly between 16-28 and 29-40 weeks of gestation (93.3 versus 66.6%; p < .001). However, VAS significantly increased gross body movement at 29-40 weeks of gestation (66.6 versus 93.6%; p < .001). Incidence of isolated limb movement was inversely related to increasing gestational age. However, VAS was associated with significantly increase in isolated limb movement during 29-40 weeks' gestation (57.1 versus 80.9%; p = .007). VAS induced almost similar pattern of response for both fetal startle and breathing movements.Conclusions: Fetal movement responses to VAS are consistent after 28 weeks' gestation. These findings suggest fetal hearing develops at or before 28 weeks of intrauterine life.

Ligand free surface of CdS nanoparticles enhances the energy transfer efficiency on interacting with Eosin Y dye - Helping in the sensing of very low level of chlorpyrifos in water.

With an aim to sense the presence of chlorpyrifos (CP) pesticide in water, fluorescence resonance energy transfer (FRET) between the chemically synthesized ligand free CdS nanocrystals (donor) and Eosin Y dye (acceptor) has been studied in presence and absence of CP in the FRET pair system. This prepared water soluble CdS nanocrystals have been characterized by Transmission Electron microscopy (TEM), which shows that CdS nanocrystals are spherical in shape with an average size of 5 nm approximately. Further, Fourier Transform Infrared Spectroscopic (FTIR) study confirms that these CdS nanocrystals are ligand free stable nanocrystals. It has been observed that this CdS nanocrystals and Eosin Y FRET pair can strongly sense the presence of chlorpyrifos (CP) pesticide in water up to a very low concentration of 10 ppb, which is the sensitivity of detection or detection limit. This FRET pair is found to be very simple and cost effective for the sensing of toxic pesticide CP.

Prevalence of paratuberculosis in organized and unorganized dairy cattle herds in West Bengal, India.

AIM: The aim of this study was to determine the prevalence pattern of Mycobacterium avium subsp. paratuberculosis, the causative agent of paratuberculosis or Johne's disease, in unorganized as well as organized cattle herds in West Bengal. MATERIALS AND METHODS: Four organized cattle farms with identical management practice in Nadia (n=3) and South 24 Parganas (n=1) districts and three unorganized cattle herds, one each from three districts, namely, Burdwan, North 24 Parganas, and Purba Midnapur, were selected randomly and screened for paratuberculosis by delayed-type hypersensitivity (DTH) and enzyme-linked immunosorbent assay (ELISA). RESULTS: Of 191 animals tested by DTH, 57 (29.8%) were found to be positive in comparison to 72 (37.7%) by ELISA. In organized farms, seropositivity varied from 13.3% to 53.1%, whereas in unorganized sector, it ranged from 5% to 6.7% with one area having exceptionally high prevalence, i.e. 53.3%. The range of positivity detected by DTH both in organized farms and backyard sectors varied from 0% to 46.7%. By employing both DTH and ELISA together, the positivity of animals in organized and unorganized herds was 19.9% and 8%, respectively. CONCLUSION: The results indicate that animals in organized farms are much more prone to paratuberculosis than others. For screening the herd, both DTH and ELISA should be used simultaneously to increase the test sensitivity in order to minimize its further spread adopting control programs.

PVP capped silver nanocubes assisted removal of glyphosate from water-A photoluminescence study.

Glyphosate [N-phosphono-methylglycine (PMG)] is the most used herbicide worldwide and it has been reported very recently that Glyphosate is very harmful and can produce lots of diseases such as alzheimer and parkinson's disease, depression, cancer, infertility including genotoxic effects. As it is mostly present in stable water body and ground water system, its detection and removal is very important. Here, we have shown a fluorescence technique for the removal of glyphosate from water using chemically synthesized polyvinylpyrrolidone (PVP) silver nanocrystals. Transmission Electron Microscopy (TEM) study shows the average size of silver nanocrystals of 100nm approximately with a morphology of cubic shape. Glyphosate does not show absorption in the visible region. But both glyphosate and silver nanocrystals show strong fluorescence in the visible region. So, photoluminescence study has been successfully utilized to detect the glyphosate in water samples and on treating the glyphosate contaminated water sample with silver nanocrystals, the sample shows no emission peak of glyphosate at 458nm. Thus, this approach is a promising and very rapid method for the detection and removal of glyphosate from water samples on treatment with silver nanocubes. NMR spectra further confirms that the silver nanocrystals treated contaminated water samples are glyphosate free.

A Fixed Flow is More Effective than Titrated Flow during Bubble Nasal CPAP for Respiratory Distress in Preterm Neonates.

BACKGROUND: The clinical effects of a pre-fixed flow of air-oxygen versus a flow titrated according to visible bubbling are not well understood. OBJECTIVE: To compare the effects of a fixed flow (5 L/min) and titrated flow (flow just enough to ensure bubbling) at different set pressures on delivered intra-prong pressure, gas exchange and clinical parameters in preterm infants on bubble CPAP for respiratory distress. METHODS: Preterm infants <35 weeks gestational age on bubble CPAP and <96 h of age were enrolled in this crossover study. They were subjected to 30-min periods of titrated flow and fixed flow. At the end of both epochs, gas flow rate, set pressure, FiO2, SpO2, Silverman retraction score, respiratory rate, abdominal girth, and blood gases were recorded. The delivered intra-prong pressure was measured by an electronic manometer. RESULTS: 69 recordings were made in 54 infants. For each of the set CPAP pressures (4, 5, and 6 cm H2O), the mean delivered pressure with a fixed flow of 5 L/min was higher than that delivered by the titrated flow. During the fixed flow epoch, the delivered pressure was closer to and higher than the set pressure resulting in higher PaO2 and lower PaCO2 as compared to titrated flow epoch. In the titrated flow period, the delivered pressure was consistently lower than the set pressure. CONCLUSION: In preterm infants on bubble CPAP with set pressures of 4-6 cm H2O, a fixed flow of 5 L/min is more effective than a flow titrated to ensure adequate visible bubbling. It achieves higher delivered pressures, better oxygenation and ventilation.

Eclapmsia: The Major Cause of Maternal Mortality in Eastern India.

BACKGROUND: Eclampsia is a very serious complication of pregnancy which is responsible for high maternal and perinatal mortality. Worldwide, it accounts for 50,000 maternal deaths annually. In spite of several global and regional interventions and initiatives from governments and other concerned agencies, maternal mortality is still very high in India, with eclampsia as a major cause. This study was conducted to determine the mode of deaths and incidence of maternal mortality associated with eclampsia and to assess how socio-demographic and clinical characteristics of the women influence the deaths. MATERIALS AND METHODS: This is a retrospective study of 111 eclampsia related maternal deaths over a period of 5 years from January 2008 to December 2012. Data pertaining to their age, parity, booking status, gestational age at delivery, and time interval from admission to death were also obtained from the records for analysis. RESULTS: Eclampsia accounted for 43.35% of total maternal deaths, with case fatality of 4.960%. The commonest mode of death in eclampsia is pulmonary oedema. Death due to eclampsia commonly occurs in younger age group of 19-24 years and in primi gravid. Eclampsia related deaths were mostly seen in illiterate and unbooked cases. Maternal deaths were also very common in lower socio economic status. CONCLUSION: Eclampsia still remains the major cause of maternal mortality in this region resulting from unsupervised pregnancies and deliveries. There is a need to educate and encourage the general public for antenatal care and hospital delivery by which we can defeat this powerful enemy.

Investigations on postural stability and spatiotemporal parameters of human gait using developed wearable smart insole.

Measurement of spatiotemporal parameters of human gait is important for designing new, intelligent and efficient prosthetic and orthotic devices. The paper presents a novel application of smart insole for measuring force generated at various pressure points during dynamic gait on a human foot. Besides recording and analysing the spatiotemporal parameters during stance phase, the developed sensor is also used for development of active orthotic devices. Data from the sensors is analysed in LabVIEW software for detection of plantar force and temporal gait parameters. The smart instrumentation allows processing, display and storage of gait parameters and gait events in real time. Variations of pressure pattern reported by gait experiments can also be used in identifying an accidental fall. This information will be used as a feedback signal for controlling the motion of an indigenously developed gait assistive device, i.e. an active orthotic device. Pressure at the heel and great toe points is higher than the metatarsal heads during dynamic walk. It is higher at the heel and metatarsals points than the toe point during standing position.

Dexmedetomidine an adjuvant to levobupivacaine in supraclavicular brachial plexus block: a randomized double blind prospective study.

BACKGROUND: Apha-2 agonists are combined with local anesthetics to extend the duration of regional anesthesia. We evaluated the effect of combining dexmedetomidine with levobupivacine with respect to duration of motor and sensory block and duration of analgesia. METHODS: Sixty patients scheduled for elective forearm and hand surgery were divided into two equal groups in a randomized double blind fashion. The patients received brachial plexus block via supraclavicular route with the help of nerve stimulator. In group L (n=30) 35cc of levobupivacaine with 1ml of isotonic saline and in group LD (n=30) 35cc of levobupivacine with 1 ml of (100 microgram) of dexmedetomidine was given. Duration of motor and sensory block and time to first rescue analgesia were recorded. Data analysis was done by SPSS version 16.0 [SPSS Inc ILLINOIS, USA, 2008]. Categorical variables were analyzed using Pearson"s Chi-square test. Normally distributed numerical variables were analyzed using unpaired "t" test. Skewed numerical variables within the group were analyzed using Man-Whitney "U" test. All tests were two tailed. Statistical significance was defined as P<0.05. RESULTS: Sensory and motor block durations were longer in group LD as compared to L (P<0.01). Duration of analgesia was significantly longer in group LD as compared to group L (p<0.05). CONCLUSION: Dexmedetomidine added to levobupivacaine in supraclavicular brachial plexus block prolongs the duration of block and the duration of postoperative analgesia.

Primary malignant fibrous histiocytoma involving the left pulmonary vein presenting as a left atrial tumor.

A 35-year-old woman presented with 4 months history of progressively increasing intermittent dyspnea and hemoptysis. Transthoracic echocardiography revealed a loculated mass in the left atrium (LA). A provisional diagnosis of LA myxoma was made. Intraoperatively the tumor was found extending into and closely adherent to the left pulmonary vein and could not be completely cleared off from the pulmonary venous wall. The histopathological examination of the tumor revealed it to be a myxoid malignant fibrous histiocytoma.

A rare case of a left atrial hemangioma mimicking a myxoma.

A 68-year-old gentleman presented with a recent history of exertional dyspnea associated with anginal chest pain. Transthoracic echocardiography revealed a well-circumscribed mass in the left atrium attached to the inter-atrial septum. A provisional diagnosis of left atrial (LA) myxoma was made. Coronary angiography revealed significant single-vessel disease. The patient underwent coronary artery bypass grafting and resection of the LA tumor. The histopathological diagnosis of the tumor came out to be a cardiac hemangioma.

A transesophageal echocardiography technique to locate the kidney and monitor renal perfusion.

Monitoring the renal arterial Doppler flow velocity indices, the resistive index and pulsatility index, with ultrasound may help predict renal dysfunction. However, such monitoring has been done intermittently by transcutaneous ultrasound in the postoperative intensive care setting. In the operating room, transesophageal echocardiography (TEE) is an alternative to transcutaneous ultrasound for obtaining indices of renal perfusion. However, it is difficult to locate the right kidney using TEE. We propose a new technique to locate the left kidney that, in our experience, is simple and easy to perform. We believe, starting from a transgastric left ventricular short-axis view, turning left to locate the abdominal aorta, and following it to the origin of the left renal artery may help locate the left kidney faster than previously described techniques. We also propose a new technique to monitor these Doppler indices using TEE during the intraoperative period.

Synthesis of linoleic acid capped copper nanoparticles and their fluorescence study.

Copper nanoparticles have been prepared through the reduction of cupric ions by ethanol with linoleic acid as a capping agent. The morphology and structure of these nanoparticles have been investigated using transmission electron microscopy. The X-diffraction study shows that the nanoparticles are crystalline and mainly composed of face-centered cubic (fcc) copper with a narrow size distribution having an average size of 5 nm. Fluorescence spectra of these copper nanoparticles have been analysed which show two emission peak at 450 nm and 625 nm corresponding to the large energy band and small energy band respectively, when illuminated at 250 nm of an optical source.