A clinical study of phenomenology in subjects with pervasive developmental disorders

Background: Pervasive Developmental Disorders (PDD) are group of developmental disorder with impairments in interaction, communication and behaviour. The study aims to explore the phenomenological aspects of subjects with PDD.Methods: Patients in Psychiatry outpatient department (OPD), presented with impairment in social- interaction, language, communication and mental retardation were assessed for features of PDD by applying Developmental Behaviour Check List (DBCL), ICD-10 Diagnostic Criteria for Research and Multi-Axial version of ICD-10. The subjects were assessed for severity of PDD on Childhood Autism Rating Scale (CARS).Results: Total number of screened positive cases were 20, in which males were over-represented (90%). Majority belonged to urban locality (65%) and nuclear family (75%). Cases of childhood autism were found in all age groups, while childhood disintegrative disorder, Rett’s disorder and atypical autism were found in younger subjects. No family history of PDD was found in 1st degree relatives of PDD subjects. Five subjects (25%) had birth and perinatal complication.Conclusions: The mean age at presentation of the children with PDD was 8.12 years. Eighty percent (80%) of the subjects had severe autism on CARS.  Hyperactivity, inattention and impulsivity were present in 90%, 80% and 45% of subjects respectively

IN-VITRO IN-VIVO STUDIES OF LAMOTRIGINE TABLETS PREPARED BY HOT MELT EXTRUSION TECHNIQUE

Objective: Present study deals with improvement in dissolution and bioavailability of poorly water soluble Lamotrigine (Lamo), an antiepileptic drug (AED) of phenyltriazine class. Formulation of poorly water soluble drug for oral delivery is one of the biggest challenge. Amongst all the approaches, the novel solid dispersion (SD) technique known as hot melt extrusion (HME) has found to be the most widely used method in improving dissolution and bioavailability.Methods: Dissolution enhancement of Lamo were done by HME technology where crystalline form of API is converted to amorphous form using hydrophilic polymer Kollidon VA64. Plasticizers like Polyethylene glycol (PEG 4000), polyoxyl 35 castor oil (Cremophor EL) and Sorbiton monolaurate (Montane 20PHA) were used. Physical blends of drug, polymer and plasticizer were prepared in the ratio of 1:1:0.1. These physical mixtures were subjected to melt and the resultant formulations were subjected to physical characterization, dissolution, permeability and in vivo testing. Pharmacokinetics of Lamo was studied in rats. Drug efflux pump like P-glycoprotein (P-gp) was recognized to posses' functional role in determining the pharmacokinetics of drugs.Results: Drug release showed the similar profile for all the HME formulations while the permeability studies showed improved permeability of formulations containing Montane 20PHA. In comparison to Non HME, HME formulations showed a significant enhancement in permeability. SD prepared by Cremophor EL resulted in 765.22% enhancement in extent of absorption.Conclusion: HME technology could be a promising formulation approach to enhance the dissolution and bioavailability of Lamo

Occurrence of psychiatric disorders in the patients of multi drug resistant tuberculosis under treatment

Background: Tuberculosis (TB) is considered as one of the leading causes of mortality worldwide. Even though fatality of TB is well known, treatment non-adherence is major barrier related to management of TB. Studies have shown that there is strong association between psychiatric disorders and treatment nonadherence to TB. Psychiatric issues present a challenge in the treatment of patients with multi drug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs require aggressive management for better management of TB. The objective of the present endeavour was to study the occurrence of psychiatric complications in patients of MDR-TB during treatmentMethods: Patients of MDR-TB registered at PMDT centre situated at a tertiary level hospital were screened for psychiatric disorder by using GHQ-12 and assessment was done using structured clinical interview for DSM-IV-TR (SCID-1) research version. Diagnosis of psychiatric disorder was made on the basis of DSM-IV-TR.Results: Psychiatric disorders were already present in 8 (6.15%) patients before the start of MDR-TB treatment and development of psychiatric disorder in 12 (9.23%) patients after initiation of the treatment. Depressive disorder (n=9; 6.9%), anxiety disorder (n=5; 3.8%) and psychosis (n=4; 3.1%) were most frequent psychiatric disorders.Conclusions: GHQ-12 was found to be very useful screening instrument for detection of psychiatric disorders. The regimen IV anti tubercular drugs used for the treatment of MDR-TB drug resistant tuberculosis, significantly increases the risk of development of psychiatric disorders.

Effect of Sertraline on biomarker alterations in patients of multidrug resistant tuberculosis with depression: a prospective clinical trial

Background: Lipid profile parameters may be used as biomarker for depression. Sertraline belongs to selective serotonin reuptake inhibitors (SSRIs), the most commonly used group to treat the depression in multidrug resistant tuberculosis patients.Methods: A prospective clinical trial was carried out in department of Psychiatry and department of Tuberculosis and Respiratory disease G.S.V.M. Medical College, Kanpur. Diagnosed MDR TB patients were screened for depression applying Hamilton Depression Rating Scale (HDRS) and these patients were referred to Psychiatrist for diagnosis of depression. Total 25 diagnosed patients of MDR TB with mild to moderate depression were selected. HDRS Score and morning blood sample of 5ml were collected to analyze biomarker for depression before intervention. Same test was repeated in 18 patients who completed the study at day 30 and 120 after administering Sertraline (50mg). Data were compiled and analyzed using SPSS 20.0 and paired t - test.Results: The mean decrease in HDRS score from base line at day 30 and 120 of administering Sertraline were 6.22 (±1.26) and 2.72 (±0.67) which were significant (p˂0.001). The mean increase in serum cholesterol at day 30 was 153.94 (±19.31) and at day 120 was 157.83 (±19.36) which were significant (p˂0.001). Rest of Tg, HDLc, LDLc and VLDL cholesterole levels were not increased significantly.Conclusions: As the depression symptoms improved by sertraline. The biomarkers of depression were also increased (within the normal range) from baseline but significant increase was observed in serum cholesterol only

Structural Stress Analysis for Cornering Fatigue Test of Wheel Rim as per AIS 073 using Finite Element Method

All vehicle components are undergone with the physical testing to certify the safety standard and to designvalidation. Experimental testing is taking too much time and sothe overall design process is getting slow. Now a days to minimize the design cycle time most of suppliers and OEM are perform the FE simulation. FE simulation is commonly used for the full vehicle analysis and component level. FEA simulation can be able to provide the results with minimum % error. In this project I have perform the finite element analysis of the cornering fatigue test for the E vehicle automobile wheelrim as per the automotive industry standard AIS 073. The objective of this analysis is to find out the critical and high stress concentration region for the CFT loading for further design modification and to minimize the design cycle time

FE Analysis of Cornering Fatigue Test for Wheel Rim of Light Commercial Vehicle

Automobile wheels are an essential and important part of any automobile from their invention to today they have taken on various designs changes, structures, and styles. Main function of automobile wheels is to carry the overall weight of vehicle, resist the forces & stresses created during driving and transmit the driving torque to achieve the required speed & torque while driving. Wheels must have well strength stiffness and having durable design to withstand running at high speeds. Also they are capable to absorb various shocks and vibration on various road load condition like braking, bump, cornering. Automobile wheel assembly consist of various parts like tire, wheel rim, disc, and bearing. Wheel is mounted on axle hub to provide vehicle motion through bearing. Tires reduce shock and provide traction & cushioning. They can be considered part of the suspension system. They transmit engine power, as well as braking and cornering efforts, to the road. Tires prevent wheel rim from various force which are directly comes from roads while driving

Analysis and Examination of Heart distress from ECG signal using Artificial Intelligence.

Health data analysis is usually based on a comparison of derived health measures to predefined thresholds. Symptoms can be observed if a value is above or below a threshold. Early detection of signs of heart failure allows the prediction of strokes of heart failure and can therefore prevent these. So identifying “accurate” criteria is the most important task. The accuracy of an experiment depends strongly on the accuracy of the criteria used. Congestive heart failure (CHF) occurs when the heart can not pump sufficient blood for a stable physiological condition. CHF usually occurs when the coronary artery blockage causes the heart tissue to become acidic. The data used to analyze data such as Linear Regression, Missing Enrollment Data, Search Signal, Clinical Data Protection Programs, and Early Adaptive Alarm. The proposed system involves models including server and data warehouse processing, pre-processing, extraction classification characterization in this paper. Classification of heart defects and prediction of heart failure by using applied classifier for hybridization, guideline for treating patients as a gym, level of stress management. In this article, the program tracks the heart disease patients, predicts atrial fibrillation and ventricular fibrillation, and alerts patients when the critical condition occurs

Amisulpiride induced tardive dyskinesia: a case report

Amisulpride is a bezamide group of antipsychotic, and like other antipsychotics, it acts by reducing signalling via the dopamine D2 receptor. It is associated with a high risk, of developing increased blood levels of the lactation hormone, prolactin and low risk, as compared with typical antipsychotics, of causing movement disorders. Tardive dyskinesia is a type of movement disorder, which is more common with typical antipsychotics but development of tardive dyskinesia is not rare with the use of atypical antipsychotics. Newer molecules are being developed to reduce the incidence of various dyskinesias, but side effects are evident even with relatively newer molecules. Amisupride is also classed with newer generation of atypical antipsychotic, used to treat schizophrenia and dysthymia. We are reporting a case of middle aged female patient suffering from schizophrenia who developed tardive dyskinesia with the use of amisulpride

Links demystified: Periodontitis and cancer

Cancer is marked by the uncontrolled growth of cells, tissue invasion and metastasis to various organs via the circulatory and lymphatic systems. Recent data have expanded the concept that inflammation is a critical component of tumor progression. Many cancers arise from sites of infection, chronic irritation, and inflammation. The tumor microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival, and migration. Periodontal disease, a chronic inflammatory condition is characterized by an oral bacterial infection leading to inflammation within the supporting tissues of the teeth, which often leads to the destruction of the periodontal tissues and alveolar bone that support the teeth. This oral inflammation often has systemic effects leading to an increased concentration of circulating inflammatory markers with the severity of disease being correlated directly with levels of serum inflammatory markers. Periodontal infection has been linked to organ and systemic diseases. There is documented evidence of significant associations between cancer of the lung, kidney, pancreas, hematological and oral cancers, and periodontal disease. This articles reviews and summarizes the possible biological mechanisms involved between periodontal infection and cancer

Evaluation of 8-Hydroxy deoxyguanosine levels, as a marker of oxidative stress in chronic gingivitis and chronic periodontitis individuals during the course of phase 1 periodontal therapy in comparison with periodontally healthy individuals

Aim: The aim was to evaluate the levels of 8-Hydroxy deoxyguanosine levels, as a marker of oxidative stress in Chronic Gingivitis and Chronic Periodontitis individuals during the course of Phase 1 periodontal therapy in comparison with Periodontally healthy Individuals. Materials and Method:  All the individuals were divided into 3 groups each including 16 subjects. Group 1 included healthy subjects and group 3 and 4 included subjects with chronic gingivitis and chronic periodontitis respectively. Saliva samples were collected and the 8-OHdG levels were assessed. Results: The levels reduced to 1.59±0.50 in chronic periodontitis group one month after scaling and root planing. A statistically non-significant value of 0.09 was recorded. The levels in chronic gingivitis group were 1.20±0.89. Conclusion: From the above study it can be concluded that 8-OHdG is an important biomarker of oxidative stress and is increased in patients with chronic gingivitis and chronic periodontitis