Influence of Advancing Age on Heart Rate Variability in Beta Thalassemia Major Patients Receiving Blood Transfusions

ABSTRACT The purpose of this study was to evaluate the effect of advancing age on heart rate variability(HRV) in beta(β) thalassemia major(TM) patients receiving regular blood transfusion in a hospital based comparative observational study. Day care center of S.M.S.Medical College and Hospital, Jaipur. A total of 51 confirmed beta thalassemia major patients in the age range 5-19 years were examined and the grouping was done on the basis of age. They had no symptoms and signs of cardiovascular disease as assessed clinically and by chest radiograph, routine laboratory profile and echocardiography. All patients underwent recording of impedance peripheral pulse in the right forearm for five minutes. All frequency domain HRV parameters were found to be reduced as age advanced in thalassemia patients who received regular blood transfusion. Regular iron chelation therapy along with regular blood transfusion may help/ delay iron overload which may influence cardiac autonomic balance affecting Heart rate variability

Heart Rate Variability Analysis in Beta Thalassemia Major Patients Receiving Different Therapeutic Aids

ABSTRACT The purpose of this study was to evaluate heart rate variability(HRV) in beta(β) thalassemia major(TM) patients receiving different therapeutic aids in a hospital based comparative observational study. A total of 56 confirmed beta thalassemia major patients in the age range 5-20 years ,taken from the day care center of S.M.S.Medical College,Hospital,Jaipur were examined and the grouping was done on the basis of receiving of regular/irregular blood transfusion along with regular/irregular or no iron chelation therapy.They had no symptoms and signs of cardiovascular disease as assessed clinically ,routine laboratory profile and echocardiography. All patients underwent recording of impedance peripheral pulse in the right forearm for five minutes. All frequency and time domain HRV parameters were found to be significantly reduced in patients receiving irregular/no iron chelation therapy along with regular/irregular blood transfusion. Therefore TM patients should receive regular iron chelation therapy along with regular blood transfusion so as to prevent/delay iron overload which may influence cardiac autonomic balance

Evidence-based decision making and covid-19: what a posteriori probability distributions speak

Background: In the absence of any pharmaceutical interventions, the management of the COVID-19 pandemic is based on public health measures. The present study fosters evidence-based decision making by estimating various “a posteriori probability distributions" from COVID-19 patients.  Methods: In this retrospective observational study, 987 RT-PCR positive COVID-19 patients from SMS Medical College, Jaipur, India, were enrolled after approval of the institutional ethics committee. The data regarding age, gender, and outcome were collected. The univariate and bivariate distributions of COVID-19 cases with respect to age, gender, and outcome were estimated. The age distribution of COVID-19 cases was compared with the general population's age distribution using the goodness of fit c2 test. The independence of attributes in bivariate distributions was evaluated using the chi-square test for independence. Results: The age group ‘25-29’ has shown highest probability of COVID-19 cases (P [25-29] = 0.14, 95% CI: 0.12- 0.16). The men (P [Male] = 0.62, 95%CI: 0.59-0.65) were dominant sufferers. The most common outcome was recovery (P [Recovered] = 0.79, 95%CI: 0.76-0.81) followed by admitted cases (P [Active]= 0.13, 95%CI: 0.11-0.15) and death (P [Death] = 0.08, 95%CI: 0.06-0.10). The age distribution of COVID-19 cases differs significantly from the age distribution of the general population (c2  =399.04, P < 0.001). The bivariate distribution of COVID-19 across age and outcome was not independent (c2 =106.21, df = 32, P < 0.001). Conclusion: The knowledge of disease frequency patterns helps in the optimum allocation of limited resources and manpower. The study provides information to various epidemiological models for further analysis

Evidence-based decision making and covid-19: what a posteriori probability distributions speak

Background: In the absence of any pharmaceutical interventions, the management of the COVID-19 pandemic is based on public health measures. The present study fosters evidence-based decision making by estimating various “a posteriori probability distributions" from COVID-19 patients.  Methods: In this retrospective observational study, 987 RT-PCR positive COVID-19 patients from SMS Medical College, Jaipur, India, were enrolled after approval of the institutional ethics committee. The data regarding age, gender, and outcome were collected. The univariate and bivariate distributions of COVID-19 cases with respect to age, gender, and outcome were estimated. The age distribution of COVID-19 cases was compared with the general population's age distribution using the goodness of fit c2 test. The independence of attributes in bivariate distributions was evaluated using the chi-square test for independence. Results: The age group ‘25-29’ has shown highest probability of COVID-19 cases (P [25-29] = 0.14, 95% CI: 0.12- 0.16). The men (P [Male] = 0.62, 95%CI: 0.59-0.65) were dominant sufferers. The most common outcome was recovery (P [Recovered] = 0.79, 95%CI: 0.76-0.81) followed by admitted cases (P [Active]= 0.13, 95%CI: 0.11-0.15) and death (P [Death] = 0.08, 95%CI: 0.06-0.10). The age distribution of COVID-19 cases differs significantly from the age distribution of the general population (c2  =399.04, P < 0.001). The bivariate distribution of COVID-19 across age and outcome was not independent (c2 =106.21, df = 32, P < 0.001). Conclusion: The knowledge of disease frequency patterns helps in the optimum allocation of limited resources and manpower. The study provides information to various epidemiological models for further analysis

Evaluating interactions between hyperglycemia and clotting factors in patients suffering with SARS-CoV-2 infection

Background. With coronavirus disease-19 (COVID-19), patients with diabetes mellitus are dealing with two pandemics and are at a higher risk of mortality. The present study was undertaken to evaluate interactions between hyperglycemia and clotting factors in COVID-19 patients. Methods. In this retrospective observational study,  53 real-time RT-PCR SARS-CoV-2 positive cases in 40 to 70 years of age, representing both sexes, were enrolled in the study from SMS Medical College, Jaipur (Rajasthan, India). Based on their history of diabetes mellitus and exclusion criterion, patients were divided into diabetics (N = 11) and non-diabetics (N = 17) groups. The data on clinical profile and coagulation profile was recorded along with the markers of inflammation and infection. The two groups were compared using the Mann-Whitney test and the Fisher’s exact test. Correlation coefficients between clotting factors were compared between two groups using Student t test. Results. There was no significant difference in age  (p = 0.25) or gender (p = 0.12) between the two groups.The coagulation indicators FDP (p = 0.79), D-dimer  (p = 0.30), APPT (p = 0.96), PT (p = 0.79), INR (p = 1.00)  PLT (p = 0.17) and the markers of inflammation and infection did not differ significantly between the two groups. There was no significant difference in correlation coefficients among coagulation indicators between the two groups (p > 0.05). Conclusion. The study concludes that pathogenesis in clotting system is not significantly different in stud-ied groups. Further research is needed to explain the higher mortality in diabetic patients suffering from COVID-19.

A new voltammetric method for corrosion rate determination

44-48A new voltammetric method has been proposed to determine the corrosion rates of mild steel in 2N HCI with and without diethylenetriamine pentamethylene phosphonic acid (DTPMP) inhibitor at short time intervals. Significantly, it has also been possible to determine simultaneously the corrosion rates with respect to Fe(ll) and Fe(III). These results have been compared with the average corrosion rates obtained using gravimetric (planned interval test method)

Role of bio-metal Fe(III) in anticancer behaviour of tamoxifen

429-433Physicochemical, microbial and pharmacological studies on Fe (III) - Tamoxifen complex have been carried out in solid and aqueous phases. On the basis of elemental analysis, polarographic studies, amperometric titrations and IR spectral studies the probable formula for the complex has been worked out to be 1:1, Fe(III) - Tamoxifen. A tentative structure has been suggested to the complex. The metal ligand interaction has been studied using polarographic method at 27° ± 1°C and at ionic strength of μ = 1.0 (KCl). Microbial studies on the complex was carried out against various pathogenic bacteria and fungi using Raper's method. Mouse sarcoma cell line 180 and Balb/C mice were used for the anticancer screening of solid compex, in vitro and in vivo, respectively. The results of microbial and pharmacological studies with the M:Drug complex revealed that the complex is more potent as compared to the pure drug as regards to its anticancer activity. As such Fe (III) Tamoxifen complex may be recommended to the therapeutic experts for its possible use as more potent anticancer drug

Corrosion rate determination at short time intervals: A new voltammetric method

398-401The variation of metal corrodibility, solution corrosiveness and corrosion rates for mild steel in 1 N H2SO4 acid, as a function of time have been studied using gravimetric (planned interval test) and electochemical methods. A new voltammetric method has been developed to determine the corrosion rates at short time intervals. The results of the corrosion of mild steel in 1 N H2SO4 with and without polyvinyl glycol (PVG) inhibitor at short time intervals have been reported. The corrosion inhibition efficiency of PVG is 91 % after 24 h. Significantly, it has also been possible to determine simultaneously the corrosion rates with respect to Fe(II) and Fe(III).</span

Corrosion and inhibition kinetics of PVA polymer on carbon steel in sulfuric acid solution

2270-2273A new voltammetric method to determine the corrosion rates at short time intervals has been developed. Variation of metal corrodibility, solution corrosiveness and corrosion rates have been reported as a function of time. The corrosion inhibition efficiency of PVA (polyvinyl acetate) is 91 % after 24 hours. Using the proposed method it is also possible to determine simultaneously, the corrosion rates with respect to Fe(II) and Fe(III)

Two stages repair of proximal hypospadias: Review of 700 cases

Objective: Surgical repair of hypospadias is challenging and problematic even for the most experienced specialists, and this is especially true when severe and complicated case is confronted. Many operations had been described for the management of this deformity. Materials and Methods: During the period from May 2004 to December 2015, we performed 700 cases with proximal hypospadias, at our institute in the Department of Pediatric Surgery by a single surgeon. Data were collected retrospectively and included patient's age at operation, degree of the hypospadias, degree of associated chordee, complications, and cosmetic outcome. All patients underwent 2 two-stage procedures with 9–12 months interval in between. Results: Seven hundred patients with proximal hypospadias were operated upon in a period of 11 years. Byars's 2 two-stage operation was used in all 700 cases. Neither complete disruption nor urethral diverticula occurred 2 two-stage procedures in the 700 patients. 677 (96.7%) patients had no complication. Fistula was present in 21 (3%) patients. There was no case of meatal stenosis in our study. Conclusion: Two stages procedure using the principles of Byar's technique is a versatile operation that can be used for 2 two-stage procedures the proximal hypospadias. It decreases the rate of fistula formation, disruption, and stenosis and gives a satisfactory cosmetic appearance