Effectiveness of sustained maximal inspiration along with transcutaneous electrical nerve stimulation in patients with malignant pleural effusion with intercostal drainage tube: a randomized controlled trial

Background: Malignant pleural effusion (MPE) is one of the most common causes of an exudative pleural effusion. It is the most common cause of a unilateral massive pleural effusion. Most MPE s are secondary to metastases to the pleura, most often from lung or breast cancer.  Medical management includes aspiration of fluid with the insertion of a chest tube, which may be necessary to relieve dyspnea. Hypoventilation does occur in certain areas of the lungs because of pain and muscle guarding after intercostal drainage tube (ICD) tube placements in pleural effusion. Therefore, it is important to emphasize pain management and expansion of affected areas of the lungs and chest wall. SMI is the basic maneuver of incentive spirometry and is mainly given to prevent atelectasis and lung collapse in postoperative patients. TENS is a method of producing an electro-analgesic effect and is effective in providing post-operative pain control. Methods: The study design of the study was a randomized controlled trial. A total of 44 participants with a diagnosis of MPE with an intercostal drainage tube were included in this study. The study duration was 5 years with an intervention period of 2 weeks and the outcome measures were pulmonary functions and intercostal pain severity using the NRS Scale. Results: There was a significant improvement in pulmonary functions in the control group and a highly significant improvement in pulmonary functions in the experimental group after 2 weeks of interventions and pain severity (NRS) was significantly reduced in the experimental group only (p<0.001) Conclusions: This study concluded that sustained maximal inspiration (SMI) along with TENS significantly improves pulmonary functions and reduces pain at the site of ICD in patients with MPE

Evaluation of micronucleus frequency in oral exfoliated buccal mucosa cells of smokers and tobacco chewers: a comparative study

Background: Oral cancer is one of the tenth most common cancers in the world and constitutes the third most important group of malignancies in India. Majority of these cancers are diagnosed at an advanced stage resulting in poor prognosis and survival rates among patients. Hence early diagnosis of oral cancers seems to be the need of the hour. Analysis of exfoliated buccal cell micronuclei (MN) is a sensitive method of monitoring genetic damage. The present study aims to compare the frequency of micronucleus in tobacco chewers and smokers and thus evaluate the genotoxic potential of these habits.Methods: The study was conducted on 60 subjects, divided into 3 groups each of 20 subjects. Group 1: with history of chewing tobacco, group 2: with history of chewing tobacco and smoking, group 3: healthy subjects without any habits as controls. Oral exfoliated cells were obtained from buccal mucosa of the subjects, 2 slides were prepared from each subject stained with Giemsa and H&E stain respectively. Atleast 1000 cells were examined for each subject and micronuclei frequency was scored according to criteria of Tolbert et al.Results: The mean number of micronuclei was 18.5±9.5 in tobacco chewers, 19.1±9.2 in chewers with smoking habit and 8.2±5.6 in controls. Bonferroni multiple comparisons amongst these three groups showed the mean difference of micronuclei to be highly significant when chewers and chewers with smoking habit were compared to controls. Similarly based on the duration of addiction, a highly significant difference was noted in no. of micronucleated cells in subjects addicted to tobacco for more than 15 years.Conclusions: Tobacco can cause and increase the rate of nuclear anomalies in both smoking and smokeless forms. Thus oral mucosal micronuclei frequency can be used as a marker of epithelial carcinogenic progression.

ANTI-INFLAMMATORY PROPERTIES OF UNEXPLORED PLANTS – CUSCUTA REFLEXA AND COCCULUS HIRSUTUS – AN EXPERIMENTAL STUDY

Objective: The study aimed to document the rarely explored plants, namely, Cuscuta reflexa (CRA) and Cocculus hirsutus (CHP) used by the ethnic people of a specific region. The anti-inflammatory (AI) property of kwath of CRA (KCRA), kwath of CHP (KCHP), and their blend (kwath blend [KB]) was also assessed. Methods: The KCRA and KCHP were prepared following standard Ayurvedic procedures. The AI property was determined by carrageenan-induced paw edema at doses; 250, 125, and 62.5 mg/kg. The KB (500 mg/kg) was prepared using equal parts of KCRA and KCHP in view of the potential AI property as compared to the individual plants. Ibuprofen (100 mg/kg) was used as the standard AI drug standard drug (SD). Results: The carrageenan-induced paw inflammation was highest and doubled at 3 h. The oral administration of SD (100 mg/kg) produced a high reduction of edema (78.47%) at 3 h. Both KCRA and KCHP had reduced edema and were equally potent (EC50; 139.8 and 147.3 mg/kg, respectively) at the early phase. However, the efficacy of KCRA was greater than KCHP at the second phase of inflammation (EC50=313.6 and 2760 mg/kg, respectively). KCRA was efficacious and potent as an AI agent. Unlike SD, KB had effectively inhibited paw edema from the 6th h onward. The AI activity of KB was superior compared to individual plant groups. Conclusions: The study demonstrated that the traditional formulation – kwath of rarely explored plants, namely, CRA, CHP, and KB has AI property and can be explored to develop them as AI agents

The Spectral Energy Distribution and Infrared Luminosities of z ≈ 2 Dust-obscured Galaxies from Herschel and Spitzer

Dust-obscured galaxies (DOGs) are a subset of high-redshift (z ≈ 2) optically-faint ultra-luminous infrared galaxies (ULIRGs, e.g., L_(IR) > 10^(12) L_☉). We present new far-infrared photometry, at 250, 350, and 500 μm (observed-frame), from the Herschel Space Telescope for a large sample of 113 DOGs with spectroscopically measured redshifts. Approximately 60% of the sample are detected in the far-IR. The Herschel photometry allows the first robust determinations of the total infrared luminosities of a large sample of DOGs, confirming their high IR luminosities, which range from 10^(11.6) L_☉ 10^(13) L_☉. The rest-frame near-IR (1-3 μm) spectral energy distributions (SEDs) of the Herschel-detected DOGs are predictors of their SEDs at longer wavelengths. DOGs with "power-law" SEDs in the rest-frame near-IR show observed-frame 250/24 μm flux density ratios similar to the QSO-like local ULIRG, Mrk 231. DOGs with a stellar "bump" in their rest-frame near-IR show observed-frame 250/24 μm flux density ratios similar to local star-bursting ULIRGs like NGC 6240. None show 250/24 μm flux density ratios similar to extreme local ULIRG, Arp 220; though three show 350/24 μm flux density ratios similar to Arp 220. For the Herschel-detected DOGs, accurate estimates (within ~25%) of total IR luminosity can be predicted from their rest-frame mid-IR data alone (e.g., from Spitzer observed-frame 24 μm luminosities). Herschel-detected DOGs tend to have a high ratio of infrared luminosity to rest-frame 8 μm luminosity (the IR8 = L_(IR)(8-1000 μm)/νL_ν(8 μm) parameter of Elbaz et al.). Instead of lying on the z = 1-2 "infrared main sequence" of star-forming galaxies (like typical LIRGs and ULIRGs at those epochs) the DOGs, especially large fractions of the bump sources, tend to lie in the starburst sequence. While, Herschel-detected DOGs are similar to scaled up versions of local ULIRGs in terms of 250/24 μm flux density ratio, and IR8, they tend to have cooler far-IR dust temperatures (20-40 K for DOGs versus 40-50 K for local ULIRGs) as measured by the rest-frame 80/115 μm flux density ratios (e.g., observed-frame 250/350 μm ratios at z = 2). DOGs that are not detected by Herschel appear to have lower observed-frame 250/24 μm ratios than the detected sample, either because of warmer dust temperatures, lower IR luminosities, or both

A comparative study of two doses of magnesium sulphate in attenuating haemodynamic responses to laryngoscopy and intubation

Background: Laryngoscopy and intubation evoke a presser response in the human body by causing catecholamine release due to sympatho-adrenal stimulation. Various drugs have been tried to attenuate haemodynamic response to laryngoscopy and intubation during general endotracheal anaesthesia. In the last few years there has been an explosion of interest in both the physiological and pharmacological properties of magnesium and its clinical use. We planned this comparative, prospective dose response study compare the efficacy of two doses (30 mg/kg and               40 mg/kg) of intravenous magnesium sulphate in attenuating the cardiovascular response to laryngoscopy and intubation.Methods: Seventy five patients aged 15-50 years, scheduled for elective surgery under general anaesthesia, were randomly assigned to one of the three pre-treatment groups of 25 each, group C- control group, group T (MgSO4       30 mg/kg) and group F (MgSO4 40 mg/kg). Study drug was given 90-120 seconds before tracheal intubation. Heart rate, systolic blood pressure and rate pressure product were recorded at different intervals (baseline values, after study drug, after induction, at laryngoscopy, after intubation, 2 and 3 minutes after intubation).Results: Mean heart rate and systolic blood pressure was significantly high (P <0.0001) after laryngoscopy and intubation, in group C (46.87% and 40.81% from baseline) than in group T (22.78% and 7.25% from baseline) and group F (24.55% and 5.83 from baseline)  respectively.Conclusions: Intravenous MgSO4 successfully attenuates the haemodynamic changes during laryngoscopy and intubation. 30 mg/kg gives adequate cardiovascular control without any complications. Transient tachycardia is more with higher doses.

Obstetric outcome in primigravida with unengaged versus engaged fetal head at term

Background: Labour although a physiological process can present challenges to clinician and patient. Primigravida and nulliparae are obstetric high-risk group, especially the very young and the elderly, where pregnancy and labour must be supervised. The study was done to compare the maternal and fetal outcome in primigravida with unengaged and engaged head at term.Methods: A prospective study was done for a period of 18 months from June 2018 to December 2019 in Department of Obstetrics and Gynaecology Adichunchanagiri Institute of Medical Sciences and Research Center. 100 women with unengaged head at term (group A) and 100 women with engaged head at term (group B) as controls were selected.  All the relevant data was filled in the partogram. Following observations were made, station of fetal head at the onset of labour, course of labour, duration of labour, any medical or surgical interventions or caesarean delivery. Data was analysed by SPSS 20.0 software and p value&lt;0.05 was taken as statistically significant.Results: in group A 49% and 63% in group B had vaginal delivery. 17% of group A and 14% of group B had instrumental vaginal delivery. Caesarean delivery was 34% in group A and 23% in group B. The mean total duration of labour was 13.53 hours in group A and 9.73 hours in group B. P value was 0.000.Conclusions: Duration of labour was more in group A than group B.  Proper supervision and timely intervention in cases with an unengaged head can have vaginal delivery

Role of hysterolaparoscopy in management of infertility a retrospective clinical analysis

Background: Diagnosis and treatment of infertility is an elaborate process. The goal of treating clinician is to decide upon the plan of management best suited to the couple by selecting relevant investigations and procedures from available options. Objective was to determine the role of hysterolaparoscopy in the management of infertility.  Methods: This retrospective study was conducted at a tertiary canter (Department of reproductive medicine and surgery) over a period of 12 months-January 2019 to December 2019. Women aged 20-40 years with primary or secondary infertility, except male factor infertility, undergoing hysterolaparoscopy were included. Results: Out of 41 cases, 71.84% patients had primary infertility. Common laparoscopic abnormalities were adhesions (36.5%) and endometriosis (17.07%) Hysteroscopy revealed polyps (9.7%) and intrauterine synechia (4.8%) as common pathologies. The diagnosed pathologies were dealt surgically in the same sitting. Plan of infertility treatment could be outlined in all patients based on intraoperative findings. Conclusion: Hysterolaparoscopy serves both diagnostic and therapeutic purpose. Various pelvic, peritoneal, tubal, endometrial and uterine factors can be diagnosed and treated at the same time. The clinician has to be well versed and skilled in selecting and performing the appropriate surgery. Clinical information gained from hysterolaparoscopy helps in decision making and designing individualized, evidence-based treatment plan can for the patients

Utilization of Agro-Industrial Byproducts for Bacteriocin Production Using Newly Isolated Enterococcus faecium BS13

Microbial production of antimicrobials as biopreservatives is the major area of focus nowadays due to increased interest of consumers towards natural and safe preservation of ready to eat food products. The agro-industrial byproduct based medium and optimized process conditions can contribute in economical production of bacteriocins. Keeping this in view, the present investigation was carried out on agro-industrial byproducts utilization for the production of bacteriocin using Enterococcus faecium BS13 isolated from local fermented food. Different agro-industrial byproduct based carbon sources (whey, potato starch liquor, kinnow peel, deoiledrice bran and molasses), nitrogen sources (soya okra, pea pod and corn steep liquor), metal ions and surfactants were tested for optimal bacteriocin production. The effect of various process parameters such as pH, temperature, inoculum level, agitation and time were also tested on bacteriocin production. The optimized medium containing whey, supplemented with 4%corn steep liquor and polysorbate-80 displayed maximum bacteriocin activity with 2% inoculum, at pH 6.5, temperature 40oC under shaking conditions (100 rpm)