Gender based differences in lipid profile and other novel atherogenic risk factors in type-2 diabetes mellitus patients

Background: Utilization of lipids and lipoproteins gets altered in diabetes mellitus (DM) leading to atherogenic dyslipidemia. This study evaluates cardiovascular risk profile of diabetic men and women, including conventional lipid profile and novel risk factors namely lipid ratios, atherogenic coefficient and atherogenic index.Methods: In all 200 diabetic patients (100 males and 100 females) aged 18-65 years who were under treatment were randomly sampled for the study. Socio-demographic data were collected. Glycated hemoglobin levels, lipid profile, fasting blood sugar, were estimated using standard procedures. Anthropometric variables such body mass index (BMI) was measured, systolic and diastolic blood pressures were also taken. There was no difference between men and women with respect to duration of DM and type of treatment.Results: Lipid profile estimates showed that diabetic females had higher level of total cholesterol (TC) (198.07 vs 169.5 mg/dl) and higher level of high-density lipoprotein (HDL)-C (43.99 vs. 41 mg/dl) as compared to males. All the parameters that are raised total cholesterol, triglyceride levels and low-density lipoprotein (LDL) levels were observed in significantly higher proportion of females as compared to males. The values of atherogenic indices [CR1, CR2, AC and atherogenic index of plasma (AIP)] for both genders were higher than the baseline value. In this study females had higher mean non-HDL 154 mg/dl as compared to males mean non-HDL 129 mg/dl and this study showed that female participants held on in high-risk AIP category and so they were at a higher risk of developing coronary heart condition.Conclusions: Dyslipidemia was observed in a greater proportion of female diabetic patients than male diabetic patients

Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India

Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features were observed and documented. Results: Median age of the deceased (71) was 29 years, and 57.7% were females. Median time observed was 5 days from onset of illness to diagnosis of influenza A (H1N1), and 57.7% were referred from general practitioner (OR=0.42, CI=0.24-0.74). Median hospital stay reported was 3 days. All admitted patients received oseltamivir, but only 16.9% received it within 2 days of onset of illness. The most common symptoms were cough (97.2%), fever (93%), sore throat and shortness of breath. Co-morbid conditions were present in almost half of the patients who ultimately died, the most common of which was pregnancy (OR=0.15, CI=0.04-0.52). Radiological pneumonia was reported in 98% patients. Conclusion: Residing in urban area, delayed referral from general practitioner, presence of co-existing condition, especially pregnancy was responsible for mortality among influenza A (H1N1) infected positive

Full Moon Days and Crime: Is there any association?

It is been reported that full moon is associated with increase in crimes. Aim of this study was to see whether there is any connection between full moon and crimes reported in medico legal register of tertiary health care centre?  All the crime related events were noted from central medico-legal register from the record section of hospital in a predesigned proforma. Crime events were compared between full moon days and non full moon days. Crimes were also compared after stratification on the basis of days of week. Events reported as frequencies. Frequencies of full moon days and non full moon days were compared by Chi-Square test.  There was no significant difference of crimes events on full moon days and non full moon days (p = 0.07). On stratification there was no difference between full moon day of week and same non full moon day of week except on Wednesday.  It was concluded that crimes events are not related with full moon days.

A RETROSPECTIVE STUDY OF CLINICAL PROFILE AND DRUG PRESCRIBING PATTERN IN OSTEOPOROSIS IN A TERTIARY CARE HOSPITAL

Objective: To study the clinical profile and prescription pattern of drugs in the treatment of osteoporosis in a tertiary care centre in Karnataka, India.Methods: This was a retrospective study carried out in a multi-speciality tertiary care hospital in Karnataka. Information was collected from case record forms of 100 patients of osteoporosis during a 12 mo tenure regarding various signs and symptoms they presented with and treatment provided.Results: Majority of the subjects were females (90%). Low back ache was the most common presenting symptom. There was an increase in mean calcium (8.84±8.32 mg/dL) and phosphorus levels (2.45±1.83 mg/dL) as compared to baseline at the follow up visit. Vitamin D and calcium supplementation were the most commonly prescribed medications followed by analgesics, calcitonin and bisphosphonates. A total of 77 adverse reactions were reported, gastritis being the commonest one.Conclusion: Vitamin D and Calcium supplements were more commonly prescribed than specific anti osteoporotic medications.Â

Text Extraction from Natural Images of Different Languages Using ISEF Edge Detection

In this paper, we proposed the algorithm text extraction of different images of languages. In computer vision research area, text is very important in images. Here, we use edge based extraction of text using ISEF (infinite symmetrical edge filter). ISEF is optimal edge detector which gives accurate results for text in images. Text extraction involves detection, localization, tracking and enhancement. Large numbers of technique have been proposed for the text extraction. Our aim is to present robust technique for text extraction of different languages images

A study of minimally invasive percutaneous plate osteosynthesis for tibial plateau fractures

Background: Fractures of proximal tibia involve a major weight-bearing joint and are serious injuries, which, if not treated well, result in functional impairment. To preserve normal knee function one must strive to maintain joint congruity, preserve the normal mechanical axis, ensure joint stability and restore a full range of motion. This is a formidable task to accomplish, especially in the face of associated medical conditions of the patients.Methods: In our study, 30 cases were selected. Selection of cases were done on the basis of X-rays. Schatzker type I, II, III, IV, V & VI included in study. Criteria for acceptable reduction 1) <5 mm of articular step; 2) <5 mm of articular depression. Each case is referred to one set of tibial plateau fracture, showing distribution of tibia plateau fractures that we treated with MIPPO. Clinical follow-up examination was performed at 4, 6, 10, 12 weeks and 3, 6 months. Clinico-radiological assessment was done at 3 month and grading was done. Patients were evaluated according to grading minimum 3 months after injury.Results: Our study of 30 tibial plateau fractures confirms that the MIPPO technique is an excellent treatment modality in case of tibial plateau fractures. We observed these fractures mainly in age group of 30-40 years, which were involved in road traffic accident. Tibial plateau fractures seen in elder age group were mainly due to abnormal loading patterns on the leg. We have found oblique views very much informative especially for posterolateral or posteromedial displacement, articular depression which helps to plan the position and direction of screws to be used for fixation. Conclusions: In view of the excellent results obtained with this technique, we advocate MIPPO over conventional open reduction and internal fixation technique for tibial plateau fracture fixation

Bacteriological analysis of bile in cholecystectomy patients

Background: Cholecystectomy is currently a frequently performed operation. The presence of gallstones within either the gallbladder or biliary tree is associated with the bacterial colonization of the bile. Acute cholangitis spans a continuous clinical spectrum and can progress from a local biliary infection to advanced disease with sepsis and multiple organ dysfunction syndrome. Therefore, it is important to know the microbiological flora of the gallbladder before prophylactic antibiotics are given. Aims & objectives: To evaluate the microbiological profile of bile from gall bladder in patients undergoing cholecystectomy. To determine the appropriate antibiotic for preoperative prophylaxis in cholecystectomy patients based on the microbiological profile of bile.Methods: The study was a prospective study carried out in SSG Hospital. A total of 78 patients undergone cholecystectomy who met the inclusion criteria were included in the study. 3cc bile was aspirated from all patients, this collected bile from gallbladder before cholecystectomy was transported to the laboratory in sterile test-tube. The specimen was evaluated to find out whether it is sterile or has any bacteria present. The types of bacteria are determined and whether the amount of isolate is significant or not. And sensitivity to antibacterial agents against antibiotics was determined.Results: 19 patients showed positive bile culture in which Escherichia coli was the most common isolated bacteria (63.16% among positive bile culture and 15.38% among all patients) and bile was sterile in 59 patients (75.64%). Other organisms isolated were Pseudomonas (3.85%), Klebsiella (2.56%), coagulase negative Staphylococcus and Staphylococcus viridans (1.28%). Positive bile culture was a more common finding (50% of patients were bile culture positive) in patients with acute cholecystitis in this study. Post-operative wound infection is more common (15.79%) in group of patients with isolated organism from bile. There is a strong correlation between bile culture and wound culture (75%).  Conclusions: It was found that sensitivity to third- and fourth-generation cephalosporins was higher as compared to aminoglycoside in acute as well as chronic cholecystitis. In this study levofloxacin also shows good sensitivity against isolated organism from bile. Piperacilin and tazobactum also shows good sensitivity against isolated organism from bile and they are more effective against pseudomonas. The resistance to second-generation cephalosporins and aminoglycoside has increased. For preoperative prophylaxis third and fourth-generation cephalosporins and levofloxacin show better promise and may be used as the first line of preoperative prophylaxis in operations for acute and chronic cholecystitis undergoing cholecystectomy.

A Retrospective Audit of Widal Testing For Enteric Fever in the City Of Ahmedabad

Introduction: Widal test has been used extensively for the sero-diagnosis of Enteric fever in India, however, its accuracy and reliability are debatable. We studied widal testing and widal positivity rates in the entire city of Ahmedabad for the diagnosis of Enteric Fever. Methods We screened all 1700 possible diagnostic laboratory facilities, in Ahmedabad, in the public and private sector. We performed telephonic surveys for the initial filtering of facilities that could be conducting widal testing. It was followed by physical visits to probable facilities to confirm testing methods and preservation of reports of widal testing. We followed a systematic process for screening and selection of 23 laboratories, which conducted widal tests and had reliable data. While 14 laboratories refused to share data, data provided by three of them were inappropriate and couldn’t be used.  We finally analyzed data from four large public hospitals, one private trust hospital and one corporate laboratory for variable periods in a span of 15 years (2000 – 2015). Result: The Widal testing rate was found to be 8.7% and widal positivity as 12.5% in a sample of 1.2 million clinically suspected in-patients. In 15 years, the private hospital had admitted 1/10th as many cases as all the public hospitals together. However, the widal testing and positivity rates were similar in both. We observed a lower proportion of widal positivity among children below 12 years and a disproportionate, but insignificant, gender distribution of widal positivity. Conclusion: This study indicates that the widal test, which is meant to be an initial screening test, is widely used in the city. We propose linkage of testing and reporting of widal with other more reliable and accurate tests such as Typhidot and blood culture in order to strengthen our knowledge of enteric fever epidemiology in India

clinical homogeneity and allelic heterogeneity in seven patients

Background Larsen syndrome is an autosomal dominant skeletal dysplasia characterized by large joint dislocations and craniofacial dysmorphism. It is caused by missense or small in-frame deletions in the FLNB gene. To further characterize the phenotype and the mutation spectrum of this condition, we investigated seven probands, five sporadic individuals and a mother-son-duo with Larsen syndrome. Methods The seven patients from six unrelated families were clinically and radiologically evaluated. All patients were screened for mutations in selected exons and exon-intron boundaries of the FLNB gene by Sanger sequencing. FLNB transcript analysis was carried out in one patient to analyse the effect of the sequence variant on pre-mRNA splicing. Results All patients exhibited typical facial features and joint dislocations. Contrary to the widely described advanced carpal ossification, we noted delay in two patients. We identified the five novel mutations c.4927G > A/p.(Gly1643Ser), c.4876G > T / p.(Gly1626Trp), c.4664G > A / p.(Gly1555Asp), c.2055G > C / p.Gln685delins10 and c.5021C > T / p.(Ala1674Val) as well as a frequently observed mutation in Larsen syndrome [c.5164G > A/p.(Gly1722Ser)] in the hotspot regions. FLNB transcript analysis of the c.2055G > C variant revealed insertion of 27 bp intronic sequence between exon 13 and 14 which gives rise to in-frame deletion of glutamine 685 and insertion of ten novel amino acid residues (p.Gln685delins10). Conclusions All seven individuals with Larsen syndrome had a uniform clinical phenotype except for delayed carpal ossification in two of them. Our study reveals five novel FLNB mutations and confirms immunoglobulin-like (Ig) repeats 14 and 15 as major hotspot regions. The p.Gln685delins10 mutation is the first Larsen syndrome-associated alteration located in Ig repeat 5. All mutations reported so far leave the filamin B protein intact in accordance with a gain-of-function effect. Our findings underscore the characteristic clinical picture of FLNB-associated Larsen syndrome and add Ig repeat 5 to the filamin B domains affected by the clustered mutations