Clinical Manifestations and Complications of Scrub Typhus: A Hospital-based Study from North Andhra.

AIMS AND OBJECTIVES: To describe the diversity of clinical manifestations, laboratory findings and outcome of scrub typhus in hospitalised patients of Tirumala Hospital, Vizianagaram during 2014-2015. MATERIAL AND METHODS: All the cases of acute febrile illness diagnosed as scrub typhus were analysed. Diagnosis was based on clinical and serological data. OBSERVATIONS AND RESULTS: A total of 60 patients were studied. All of them presented with fever; the other major symptoms were headache, cough, dyspnoea and myalgia. On examination, Eschar was seen in 10 cases and common sites was trunk and axilla. Patients had hepatosplenomegaly, lymphadenopathy and eschar. On investigation elevated SGOT, SGPT with normal or elevated bilirubin levels were the most common findings. Other laboratory findings were thrombocytopenia and deranged renal function tests. Other complications were MODS, ARDS, hypotension and meningoencephalitis. There was a dramatic response to doxycycline in nearly all the patients. CONCLUSION: Scrub typhus though prevalent is under-reported in our country. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.

Structure-function studies of prothrombin Amrita, a dysfunctional prothrombin characterized by point mutation at Arg553 → Gln.

A dysfunctional prothrombin gene characterized by novel point mutation at Arg553 to Gln residue in Deep vein thrombosis (DVT) patient which we designated as "Prothrombin Amrita" was previously reported from our lab. The mutation occurred at nucleotide 20030 in exon 14 and was confirmed by restriction enzyme digestion. Arg553 has been reported as one of the key residues for the binding of cofactor Na+ ion in the thrombin protein. Structural analysis revealed the molecular mechanism behind the coagulant form of thrombin due to point Arg553Gln mutation near the cofactor Na+ ion region. Molecular electrostatic potential maps and molecular dynamics (MD) simulation of the wild type and mutated thrombin showed the key role played by the Na+ ion for its coagulant mechanism by analysing the charge distribution and nature of the hydrogen bonding at the mutated region of interest. We observed maintenance of the fast or procoagulant form of dysfunctional prothrombin due to changes in the charge distribution by this mutation and thereby also keeping strong hydrogen bonding network revealed by MD simulation between prothrombin and Na+ ion. This molecular mechanism might be the main cause for DVT in patients with this dysfunctional prothrombin gene.

Removal of heavy metals from tannery effluents of Ambur industrial area, Tamilnadu by Arthrospira (Spirulina) platensis.

The present study was carried out with the tannery effluent contaminated with heavy metals collected from Ambur industrial area to determine the phycoremediation potential of Arthrospira (Spirulina) platensis. Two different concentrations (50 and 100 %) of heavy metals containing tannery effluent treated with A. platensis were analysed for growth, absorption spectra, biochemical properties and antioxidant enzyme activity levels. The effluent treatments revealed dose-dependent decrease in the levels of A. platensis growth (65.37 % for 50 % effluent and 49.32 % for 100 % effluent), chlorophyll content (97.43 % for 50 % effluent and 71.05 % for 100 % effluent) and total protein content (82.63 % for 50 % effluent and 62.10 % for 100 % effluent) that leads to the reduction of total solids, total dissolved solids and total suspended solids. A. platensis with lower effluent concentration was effective than at higher concentration. Treatment with the effluent also resulted in increased activity levels of antioxidant enzymes, such as superoxide dismutase (14.58 units/g fresh weight for 50 % and 24.57 units/g fresh weight for 100 %) and catalase (0.963 units/g fresh weight for 50 % and 1.263 units/g fresh weight for 100 %). Furthermore, heavy metal content was determined using atomic absorption spectrometry. These results indicated that A. platensis has the ability to combat heavy metal stress by the induction of antioxidant enzymes demonstrating its potential usefulness in phycoremediation of tannery effluent.

Prevalência, severidade e características da cárie precoce na infância em crianças de 3 a 6 anos de idade de mysore, karnataka, india / Early childhood caries prevalence, severity and pattern in 3-6 year old preschool children of mysore city, karnataka

Objetivo: Determinar a prevalência, severidade e características da cárie precoce na infância em Crianças de 3 a 6 Anos de idade de Mysore, India. Método: Dez pré-escolas, cinco públicas e cinco privadas foram aleatoriamente selecionadas de cinco diferentes áreas da cidade de Mysore. Um total de 500 crianças e seus pais/responsáveis foram incluídas no estudo. A ocorrência de cárie precoce na infância foi diagnosticada com o uso dos critérios NIDCR. A existência de cárie dentária foi feita com o uso dos índices ceo-d e ceo-s.Resultados: A prevalência de cárie precoce foi de 56,6% com um ceo-d e ceo-s médios de 2,20 e 2,97, respectivamente. Do total de crianças, 56% dos meninos e 57,1 % das meninas estavam afetadas. Não se verificou diferença na prevalência de cárie entre os estudantes da rede pública e privada. Cerca de 94,84% do total do ceo-d envolvia o componente cariado. O arco superior foi mais afetado (29,32%) do que o inferior (26,14%). As superfícies oclusais foram as mais afetadas (46%) e as menos afetadas foram as superfícies lisas (16%). Os molares inferiores foram os mais acometidos (39,42%) e os incisivos inferiores os menos afetados (1,84%). Conclusão: O aconselhamento oral deve ser iniciado aos seis meses quando da erupção dos primeiros dentes decíduos.

Objective: To determine Early Childhood Caries (ECC) prevalence, severity and pattern in preschool children of Mysore City, Karnataka. Methods: A total of 10 preschools, five government and five private were selected randomly from 5 different sectors in Mysore. A total of 500 children and their parents were included in the study. Early Childhood caries was diagnosed using NIDCR definition. Dental caries status was recorded using dmft and dmfs indices. Results: The results show that early childhood caries prevalence in 3-6 year old preschool children was 56.6% with a mean dmft and dmfs of 2.20 and 2.97 respectively. Out of the 500 children, 56% males and 57.1 % females were affected .There was no difference in caries prevalence between children of government and private preschools. 94.84% of total dmf was comprised of decayed component. Maxillary arch was affected more (29.32%) than the mandibular arch (26.14%).The most affected surfaces were the occlusal surfaces (46%) and least affected were the smooth surfaces (16%). Mandibular posteriors were affected the most (39.42%) and lower incisors were the least affected (1.84%). Conclusion: The results support the view that oral counseling should begin within 6 months of eruption of 1st primary tooth.