Functional Movement Disorders in Elderly

Background: Functional movement disorders (FMDs) have been rarely described in the elderly population. Methods: This is a retrospective chart review of elderly patients with FMDs (onset >60 years) attending the movement disorders clinic at a tertiary care teaching institute in India. Results: Out of 117 patients diagnosed with FMD at our center, 18 patients had an onset after the age of 60 years. The male-to-female ratio was 10:8 and the duration of symptoms ranged from 1 day to 5 years. Social (10/18) and physical factors (5/18) with an evident temporal relationship with the onset of FMD were identified in 15 out of 18 patients. Six of them had a past history of depression, anxiety, or other psychiatric illnesses. The tremor was the most frequent phenomenology seen in 11 (61.1%) patients, followed by dystonia in seven (38.8%), choreoballism and tics in two each, and hemifacial spasm and functional gait in one each. Seven patients had more than one phenotype. Discussion: Tremor was the most frequent movement disorder seen in our patients with FMD. Surprisingly, tics (n = 2) and choreoballistic (n = 2) movements were also found in our patients with FMD, which has not been reported previously in an elderly population. Both physical and social factors were identified preceding the development of FMDs in majority of our patients

BIDRI WARE: A UNIQUE METAL CRAFT OF INDIA

Handicrafts are valuable; they make our life enriched by their grace. Many times the question rises in our mind, about the origin and concept of the art and craftsmanship, its method and technique, material and attribute of the craftsmanship. The master craftsmanship of Bidri ware has all requisite qualities of excellence. Bidri is a type of encrusted metal ware. It is an intricate process involving several steps. Its preparation process and manufacturing is unique. The decorative designs describe the influences of Mughal impact. Often Bidri ware had inscription Arabic calligraphy of high quality. The metal commonly used is an alloy of copper and zinc. The zinc content gives the alloy deepan black colour. Bidri artist used simple and handmade tools for working. The textural ornamentation by hammering, engraving, inlaying creates the unique decorative effect Mainly six techniques -Aftabi, Koftgiri, Tehnishan, Zarbuland, Munabatkari and Tarkashi are used for ornamentation. Huqqa, Pandan, Surahi, Lota, Thali, Katora, Battle shield, sword etc are the main articles of Bidri ware. Today the Bidri artisans made some changes for new up comings

Clean coal technology—a technical response to the environmental challenges

Coal occurs in 70 countries of the world. Total proved reserve of coal in the world is about 909 billion tonnes. India contributes about 105 billion tonnes of proven coal reserves and ranks fourth in the world after USA, Russia and China. India is also the third largest producer of coal in the world, producing about 400 million tonnes annually. Jharkhand has 39480 million tonnes of proved coal reserve and ranks first in the country. Coal produces 40% of the world’s electricity and around 70% of the world’s steel. Coal is used in cement, paper, chemical, pharmaceutical industries and also used as liquid fuel in transportation and electricity. Coal is mined in over 50 countries and 7 million people are employed in coal mining sector. In developing countries the coal industry is export oriented and is a major source of foreign currency. Thus, coal makes a significant contribution to global economic development. Beside above facts mining of coal and its uses in different industries have a number of adverse environmental impacts. Use of coal causes emissions of oxides of nitrogen and sulphur, ash, trace elements and carbon dioxide. Ash from coal combustion can effect people’s respiratory systems and it also impacts local visibility. This ash also causes environmental pollution. Emissions of trace elements like selenium and arsenic can be harmful to human health and the environment. During the combustion process NO2 and SO2 gas formed and it can increase ground level ozone, acid rain, green house effect, smog and acidic aerosols. Similarly, coal mining, particularly surface mining, also raises a number of environmental challenges like soil erosion, dust, noise and water pollution etc. which has an impact on local biodiversity

Immunologic glomerulopathies-diagnostic role of immunofluorescence study of renal biopsies

Background: The kidney is a structurally complex organ that has evolved to subserve a number of important functions: excretion of the waste products of metabolism, regulation of body water and salt, maintenance of appropriate acid balance, and secretion of a variety of hormones and autacoids. Some clinical disorders affect more than one structure. In addition, the anatomic interdependence of structures in the kidney implies that damage to one almost always secondarily affects the others. Thus, severe glomerular damage impairs the flow through the peritubular vascular system, conversely, tubular destruction, by increasing interglomerular pressure, may induce glomerular atrophy. Thus, whatever the origin, there is a tendency for all forms of chronic renal disease ultimately to destroy all four components of the kidney, culminating in chronic renal failure and what has been called end-stage contracted kidneys. The functional reserve of the kidney is large, and much damage may occur before functional impairment is evident. The circulating immune complexes play a very major role in various types of glomerular nephropathies.Methods: The present study was conducted on renal biopsies referred to Pathology Department of G.S.V.M. Medical College, Kanpur and Regency Hospital Ltd., Kanpur. Frozen section of renal biopsy was taken for IF studies. Renal biopsy tissue was received in IF fluid containing Ammonium sulphate, N-ethyl malcimide, Magnesium sulphate.Results: The lgG class of immunoglobulins was found to be most fatal to the G13M, the 1gM and IgA were also found to cause glomerular damage. This mechanism was seen responsible for most cases of ICGN. In the present study, fluorescent study of renal biopsy tissue was also done using Hollande’s fixative and it was observed that a better diagnosis could be done when used with routine H & E and immunofluorescent studies.Conclusions: The immunofluorescence microscopy proved to be very useful and essential, for proper diagnosis and therapy of a renal disease. IFM comes out to be a very good indicator of the deposition site and class of immunoglobulin involved in the Immune-complex deposit

Acute kidney injury in severe dengue

Background: Several forms of renal involvement have been identified in patients with dengue, including proteinuria, glomerulonephritis, and IgA nephropathy to acute kidney injury (AKI). Objective: The objective of the study was to know the type of AKI and the outcome of patients with AKI. Materials and Methods: All serologically proven dengue patients admitted in our wards/pediatric intensive care unit (PICU) were included in the study. A detailed history was done and a thorough clinical examination was performed on all the included patients. They were monitored for pulse pressure, urine output, hemoglobin, packed cell volume, and platelet counts regularly. On admission, renal function tests were done and assessed for pre-renal or renal AKI. Patients were managed as per the WHO protocol for dengue. Results: Based on the pediatric risk, injury, failure, loss, and end-stage renal disease criteria, we encountered an incidence of 61.3% of AKI, of which 45% were at risk of developing AKI and 15.9% had developed kidney injury. All the patients had pre-renal type of AKI. There were no deaths seen, but the length of stay was prolonged in patients with AKI. Conclusion: It is possible to detect renal involvement at an early phase, and by strict monitoring of fluid status, timely management can reduce the morbidity and mortality

Study of Longitudinal palmar flexion crease among Lodhis’ of Sagar district, (Madhya Pradesh), India.

Creases like other dermatoglyphic features are controlled by polygenic factor and stand a chance to be used in the study of ethnic, bimanual and bisexual variations. The the present investigation is to study the bimanual and bisexual variation of longitudinal palmar flexion creases among Lodhis’ of Sagar district (MP), India. The basis of the study was 103 males and 102 female unrelated individuals of Lodhis’. For taking palm prints cummins and Midlo(1859) method were fully adopted. The analysis of longitudinal palmar creases was done in accordance with the method of Eswaraiha (1977). The values in this study are of a qualitative in nature so the statistical interpretation of the data has been made by means of the chi-square test. The result shows significant bisexual and noticeable bimanual variation of longitudinal creases among Lodhis’

Effect of portulaca olearecea and its interaction with vecuronium on neuromuscular junction in experimental animals

Background: The extracts from the plant Portulaca oleracrea have been mentioned to have muscle relaxant properties in traditional medicine literatures and used as a food supplement. The site of therapeutic action is directly on muscle fibres rather than neuromuscular transmission.The muscle relaxant property is found to be similar with dantrolene in frog rectus abdominis .So objectives of our study to analyze the effect of Portulaca oleracea and its interaction with vecuronium on the neuromuscular junction in experimental animal.Methods: The study was conducted in two parts i.e. study 1 and study 2. In study 1:2 ml and 4 ml Portulaca oleracea fresh aqueous leave juice was given orally to 12 number rabbits and vecuronium 5 microgram/ml was given intravenously to all 6 rats through marginal ear vein with the help of scalp vein attached with 10 ml syringe. The head drop time is recorded and reversal of neuromuscular blockade was done with neostigmine (0.25 mg/kg) along with atropine (2 mg). Study 2: 2 ml and 4 ml of Portulaca oleracea fresh aqueous leave juice was tested on frog's isolated rectus abdominis muscle in Dales’s isolated organ bath and its interaction with vecuronium (1 mmole-32 mmole) was recorded.Results: Portulaca oleracea has muscle relaxant properties, which was recorded which was indicated by decreasing the time of head drop and complete block in study 1. In study 2, it also decreased the Ach induced contraction in presence of vecuronium.Conclusions: The results indicate the muscle relaxant properties fresh juice of Portulac Oleracea probably due to high content of potassium

A Case Study on Small Town Big Player – Enjay IT Solutions Ltd., Bhilad

Adequately trained Manpower is a problem that affects the IT industry as a whole, but it is particularly acute for Enjay IT Solution. Enjay's location in a semi-urban or rural area makes it even more difficult to find a talented employee with the right skills. As the competition for skilled workers grows, it becomes more difficult to attract and keep those workers who have the requisite training and experience

Internal pressure and optical properties of binary mixture of formamide with dimethylaminoethanol and diethylaminoethanol at different temperatures

The density (ρ) and refractive indices (n) of binary mixtures of formamide (FA) with dimethylethanolamine (DMEA) and diethylethanolamine (DEEA) have been recorded at different temperatures for the whole composition ranges. The experimental values of density data and refractive index are used to estimate the molar refraction (Rm), reduced molar free volume (Vm/Rm), molecular radii (r) and internal pressure (Pint). The deviations of refractive index (ΔnD), molar refractions (ΔRm), reduced molar free volumes Δ (Vm/Rm) and internal pressures (ΔPint) have been also calculated. The variations of these parameters with composition and temperature of the mixtures are discussed in terms of molecular interactions due to physical, chemical and structural effects between the unlike molecules. The applicability of different refractive index mixing rules is tested against the experimentally measured values and good agreement has been obtained

Spontaneous unscarred fundal rupture after normal vaginal delivery

Uterine rupture is one of the most dangerous obstetric situation carrying an increased risk of maternal and perinatal morbidity and mortality, associated with poorly managed labour. The incidence of spontaneous rupture of unscarred uterus is around 1 in 8000 to 1 in 15000 deliveries. We report this unusual case of spontaneous unscarred fundal rupture after normal vaginal delivery. This case under reference developed shock soon after delivery and was explored due to suspected intraperitoneal hemorrhage. This case is being reported to emphasis the need for proper post-delivery monitoring not only to diagnose post-partum hemorrhage but also to suspect uterine rupture as a cause of unexplained shock developing after delivery inspite of all resuscitative measures. Although unexpected in a woman with an unscarred uterus, rupture should be considered as a possible cause of unusual pain or hypotension in the mother. The most effective way to reduce the number of morbidity and mortality would be to prevent unwanted pregnancies by informed and effective use of contraception