Balance and gait adaptations in patients with early knee osteoarthritis

AbstractGait adaptations in people with severe knee osteoarthritis (OA) have been well documented, with increased knee adduction moments (KAM) the most commonly reported parameter. Neuromuscular adaptations have also been reported, including reduced postural control. However these adaptations may be the result of morphological changes in the joint, rather than the cause. This study aimed to determine if people with early OA have altered gait parameters and neuromuscular adaptations. Gait and postural tasks were performed by 18 people with early medial knee OA and 18 age and gender-matched control subjects. Parameters measured were kinematics and kinetics during gait and postural tasks, and centre of pressure and electromyographic activity during postural tasks. OA subjects showed no differences in the gait parameters measured, however they demonstrated postural deficits during one-leg standing on both their affected and unaffected sides and altered hip adduction moments compared with controls. Increased activity of the gluteus medius of both sides (p<0.05), and quadriceps and hamstrings of the affected side (p<0.05) during one-leg standing compared with controls were also noted. This study has demonstrated that gait adaptations commonly associated with OA do not occur in the early stages, while neuromuscular adaptations are evident. These results may be relevant for early interventions to delay or prevent osteoarthritis in its early stages

Innovations in irrigation financing

"Financing for water projects, especially for irrigation, has been moving towards collapse in recent years due to declining donor and government funding. Some Indian states have undertaken innovative institutional reforms by setting up financially autonomous corporations to mobilise required funds from the domestic bond market. This analysis of the performance of one such corporation, Karnataka's Krishna Bhagya Jal Nigam Limited, indicates that although adequate funds were mobilised, and physical works are on schedule, the new institution did not attempt to enhance overall irrigation performance and to move towards financial sustainability of the irrigation project. This paper describes the background of this institution, its achievements, inadequacies and potential of the innovative efforts made in irrigation financing reforms." Authors' AbstractIrrigation India ,Irrigation projects India ,Finance ,Government spending policy ,

Gossip Codes for Fingerprinting: Construction, Erasure Analysis and Pirate Tracing

This work presents two new construction techniques for q-ary Gossip codes from tdesigns and Traceability schemes. These Gossip codes achieve the shortest code length specified in terms of code parameters and can withstand erasures in digital fingerprinting applications. This work presents the construction of embedded Gossip codes for extending an existing Gossip code into a bigger code. It discusses the construction of concatenated codes and realisation of erasure model through concatenated codes.Comment: 28 page

Correlative study of diabetic retinopathy in type 2 diabetes mellitus with haemoglobin A1c, duration of diabetes and modifiable risk factors: smoking, alcohol and BMI in adult population attending a tertiary care hospital

Background: Diabetes is a disease, which if not controlled, affects every cell of the body from head to toe. No wonder it is often referred to as the “SILENT KILLER”. So through our study, we aim to study the correlation between (haemoglobin A1c) HbA1c levels, duration of diabetes and modifiable risk factors with diabetic retinopathy (DR) in patients of type 2 diabetes mellitus.Methods: This study was conducted in 100 patients (200 eyes) who were diagnosed cases of type 2 diabetes mellitus. A detailed history of the duration of diabetes, alcohol intake and smoking and HbA1c levels was taken. Complete ocular examination was done. BMI was also calculated.Results: 2/3rd of the eyes with grade 3 DR were of>10 years duration while 2/3rd of the eyes with grade 2 DR were of 5-10 years duration. Of the eyes with grade 3 DR, all the patients had HbA1c of more than 8. Significant p value shows strong correlation between DR and obesity. No significant correlation of DR was found with alcohol and smoking.Conclusions: The findings in our study endorse the view that duration and HbA1c are important risk factors for occurrence and severity of DR and therefore a regular follow up and good glycemic control is highly essential for the prevention of occurrence and progression of DR. Strong correlation between BMI and DR suggest that lifestyle changes play a pivotal role

Correlations of record events as a test for heavy-tailed distributions

A record is an entry in a time series that is larger or smaller than all previous entries. If the time series consists of independent, identically distributed random variables with a superimposed linear trend, record events are positively (negatively) correlated when the tail of the distribution is heavier (lighter) than exponential. Here we use these correlations to detect heavy-tailed behavior in small sets of independent random variables. The method consists of converting random subsets of the data into time series with a tunable linear drift and computing the resulting record correlations.Comment: Revised version, to appear in Physical Review Letter

A study to assess the knowledge and attitude of parents of children with epilepsy

Objective: The objective was to evaluate the knowledge and attitude of parents of children with epilepsy toward the disease. Methods: Inthis cross-sectional, descriptive study, parents of 60 children with epilepsy from pediatric neurology clinic of All India Institute ofMedical Sciences were enrolled. Data on epilepsy were collected using pre-tested and validated self-developed knowledge, belief, andattitude questionnaire (α=0.85, 0.89). Results: The mean knowledge and attitude scores of parents of the children with epilepsy were9.82±3.9 (2-22) and 31.25±9.27 (0-40), respectively. Parents of the children with epilepsy had poor 50 (83.3%, scores &lt;60%) to fairknowledge scores (60-70%). Majority of the parents 33 (55%) had excellent attitude (≥80%), while 11 (18.3%), 6 (10%), and 10 (16.7%)parents had good, fair, and poor attitude, respectively. Correlation between knowledge and attitude was found to be very weak andnegative (r=−0. 039, p=0.77) with few misconception related to disease and clear idea about the activities to be performed with/withoutcaution. Conclusion: There is a need for developing informational booklet and conducting educational sessions on epilepsy for theparents in particular and public in general

Evaluation of AgNORs in gallbladder lesions

Background: Quantification of argyrophillic nucleolar organizer regions (AgNORs) is a good indicator of cellular proliferation activity and is useful diagnostic tool to estimate the malignant potential of lesions in gallbladder. The aim of the present study was to study the AgNORs and assess their correlation with various lesions of the gallbladder.Methods: This study was conducted in the department of pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. One hundred specimens of gall bladder lesions (50 cases chronic cholecystitis,30 cases epithelial hyperplasia and 20 cases of carcinoma) were study subjects. AgNOR staining was done on three micron thin sections of paraffin embedded tissue, as per the method of Crocker and Smith with safranin counterstain. The number of AgNORs, stained as black dots was counted in one hundred adjacent cells in different lesions.Results: Mean AgNOR count in chronic cholecystitis, epithelial hyperplasia and carcinoma was 2.44±0.31, 3.88±0.39 and 7.90±0.76 respectively. AgNOR counts in various lesions gradually increased from chronic cholecystitis to carcinoma and the increase was statistically significant (p<0.05).Conclusions: Despite inter-laboratory variations and lack of standardization of counts for a particular lesion, AgNOR technique is easy to perform, economical and reliable indicator of malignant potential of the gall bladder lesions, hence can be used in resource poor set up as an adjunct to histopathology.

Morphological spectrum of gall bladder lesions and their correlation with cholelithiasis

Background: Gall stones are known to produce diversified histological changes in the gallbladder such as inflammation, metaplasia, hyperplasia, dysplasia and even precursor lesions of malignancy. The aim of our study was to correlate the various histological changes in the gallbladder with the different types of gallstones (cholesterol, pigmented and mixed).Methods: This prospective study was conducted in the department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh from July 2014 to June 2015. The age, sex distribution and the incidence of different types of gallstones was studied. The histological changes in the gallbladders were examined and its correlation with the type of gallstones was evaluated.Results: In all 1371 specimens of gall bladder were received during this period. The mean age of the patients was 44 years (age range 13-86 years) with Male: Female ratio of 1: 8.3. Out of the total 1371 cholecystectomy specimens, 1259 (91.8 %) had calculi and 112 (8.2%) were acalculus. Of the 1259 cases of calculus disease, mixed stones were observed in 840 (66.7%) patients, cholesterol stones in 289 (22.9%) and pigmented stones in 130 (10.4%) patients. Overall 1291 (94%) cases had chronic cholecystitis followed by acute cholecystitis and chronic active cholecystitis in 2% each, dysplasia in 1.5% and carcinoma cases 0.5%.Conclusions: Routine cholecystectomy performed for a common condition like gallstone disease can result in detection of diverse and wide spectrum of histopathological lesions ranging from chronic cholecystitis to carcinoma

Diarrhea, CD4 counts and enteric infections in a hospital - based cohort of HIV-infected patients around Varanasi, India

Background: As most of the studies in HIV patients with diarrhea were cross sectional, focusing on the etiological agents, we are reporting data on the rate of diarrhea, associations between diarrhea and CD4 counts and variation in frequency of identifying a pathogen with consistency of diarrhea and duration in a prospective hospital based study. Methods: Stool specimens were obtained between Jan 2001 and April 2003 from HIV infected adults with diarrhea presenting to Infectious Disease clinic, Banaras Hindu University, Varanasi. In all patients with diarrhea, specimens were examined by microscopy and cultures to identify pathogens. Results: During the study, 630 person years of observations with diarrhea were analyzed. 140 stool samples were collected representing 43% of episodes of reported diarrhea. Positivity of finding a pathogen from watery stools and formed stools were 40%&amp;24% respectively (p &lt; 0.01) probably due to associated inflammation is more in watery diarrhea. Patients having chronic diarrhea are 2.25 (95%CI 1.52-2.81) times at more risk of developing other opportunistic infections compared to those who don't have. However this is not true with the acute diarrhea where risk of harboring the opportunistic infections remain same. Conclusion: Diarrhea was most strongly associated with low CD4 counts. Over two-thirds of diarrheal episodes were undiagnosed, suggesting that unidentified agents or primary HIV enteropathy are important causes of diarrhea in this population. There is a strong negative association between duration of diarrhea and CD4 levels