Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study

Abstract Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum  C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004). Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD. Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal

Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study

Abstract Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum  C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004). Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD. Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal

Bone mineral density and its correlation with Vitamin D status in healthy adults of Manipur – A cross-sectional study

The levels of vitamin D have an important effect on bone mass in young and old. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling, and hence bone density. Objective: The present study was conducted to determine the status of serum 25(OH)D and BMD of healthy adult men in Manipur and also to find out the relationship of 25(OH)D level with BMD. Methods: A cross-sectional study was conducted in Department of Physiology in collaboration with the Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal from October 2014 to September 2016. 100 Healthy adult males in Manipur in the age group 18-35years and ≥50years were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. The serum 25-OH vitamin D level was estimated by using an enzyme immunoassay (EIA) kit (IDS immunodiagnostic systems, United Kingdom). The BMD of lumbar spine was determined using enCORE – based X-ray bone densitometer (Lunar Prodigy advance, GE Medical Systems, USA) which is based on DEXA scan. Results: The present study revealed that the majority of subjects with insufficiency of 25(OH)D had low bone mass, whereas all the subjects with 25(OH)D deficiency had BMD readings consistent with osteopenia or osteoporosis in both the age groups. This study also showed a positive correlation between BMD and 25(OH)D in most subjects, particularly in the groups with insufficiency or deficiency of 25(OH)D.Conclusion: In conclusion, the study shows a positive relationship between the serum 25 (OH) D concentrations and BMD. Keywords: Serum 25(OH)D; Bone mineral density (BMD); Enzyme immunoassay (EIA)

Validation of an integrated patient positioning system: Exactrac and iViewGT on Synergy Platform

Purpose: Evaluation of the newly integrated system for its validation and designing a quality assurance frame work to assess its geometrical, radiological and mechanical accuracy.Methods: Isocentric accuracy of two independent imaging modalities, kV based ExacTrac and MV based iViewGT was evaluated using Winston-Lutz test. A pelvic humanoid phantom was used for the radiological end-to-end test for its clinical utilization. Image quality for the systems was evaluated using Las Vegas Phantom and ETR-1 plate. The kV system was also assessed for kVp accuracy, kVp - dose linearity, mAs-dose linearity and timer linearity and its accuracy. The system was tested for total filtration and output consistency. Tests for uniformity and noise measurement of kVp accuracy and its reproducibility, linearity test between applied kVp and the x-ray dose, linearity Test between applied mAs and the x-ray dose were also done. Results: Winston-Lutz test gave the isocentric deviation of 0.058 ± 0.015 mm with the average lateral deviation as 0.028 ± 0.021 mm, average longitudinal deviation as 0.032 ± 0.015 mm and average vertical deviation as 0.030 ± 0.016 mm. With the phantom test, the minimum measured displacement of Exactrac positioning was 0.2 ± 0.3 mm, 0.0 ± 0.2 mm and 0.1 ± 0.3 mm in longitudinal, lateral and vertical directions respectively. In image quality test, visible smallest visible hole size seen by both Exactrac and EPID imaging system was 5 mm and can resolve 1.5 lp/mm or better. The image uniformity was found to be 132.9 ± 3.06 pixels for MV images and 139 ± 4.41 pixels for kV images with the associated noise of ≤1% both for 120 kV-20 mAs and 4 MV beam energy of ExacTrac and iViewGT respectively. The uniformity and noise test, measured pixel intensity values for various points on MV and kV images separately were found to agree within ± 1% with respect to the central axis pixel value. The kVp accuracy and its reproducibility were tested for kV imager only. The deviation of kVp was found to be than ± 1% and its precision was seen to be even lesser than ± 0.1%. Linearity test between applied kVp and the x-ray dose and applied mAs and x-ray dose were tested only for the ExacTrac. Both the coefficient of linearity for kVp as well as mAs was found to be < 0.1. Conclusion: It is feasible to install ExacTrac imaging system with an Elekta linear accelerator. Both the imaging systems were found to be compatible in terms of image quality test and isocentric accuracy and can be used for the patient imaging in the same Linear accelerator.-----------------------------Cite this article as: Jassal K, Munshi A, Sarkar B, Paul S, Sharma A, Mohanti BK, Ganesh T, Chougule A, Sachdev K. Validation of an integrated patient positioning system: Exactrac and iViewGT on Synergy Platform. Int J Cancer Ther Oncol 2014; 2(2):020212. DOI: 10.14319/ijcto.0202.1

Using Evolutionary Conserved Modules in Gene Networks as a Strategy to Leverage High Throughput Gene Expression Queries

Background: Large-scale gene expression studies have not yielded the expected insight into genetic networks that control complex processes. These anticipated discoveries have been limited not by technology, but by a lack of effective strategies to investigate the data in a manageable and meaningful way. Previous work suggests that using a pre-determined seednetwork of gene relationships to query large-scale expression datasets is an effective way to generate candidate genes for further study and network expansion or enrichment. Based on the evolutionary conservation of gene relationships, we test the hypothesis that a seed network derived from studies of retinal cell determination in the fly, Drosophila melanogaster, will be an effective way to identify novel candidate genes for their role in mouse retinal development. Methodology/Principal Findings: Our results demonstrate that a number of gene relationships regulating retinal cell differentiation in the fly are identifiable as pairwise correlations between genes from developing mouse retina. In addition, we demonstrate that our extracted seed-network of correlated mouse genes is an effective tool for querying datasets and provides a context to generate hypotheses. Our query identified 46 genes correlated with our extracted seed-network members. Approximately 54% of these candidates had been previously linked to the developing brain and 33% had been previously linked to the developing retina. Five of six candidate genes investigated further were validated by experiments examining spatial and temporal protein expression in the developing retina. Conclusions/Significance: We present an effective strategy for pursuing a systems biology approach that utilizes an evolutionary comparative framework between two model organisms, fly and mouse. Future implementation of this strategy will be useful to determine the extent of network conservation, not just gene conservation, between species and will facilitate the use of prior biological knowledge to develop rational systems-based hypotheses

Forecasting the Requirement for Nonelective Hospital Beds in the National Health Service of the United Kingdom: Model Development Study

BackgroundOver the last decade, increasing numbers of emergency department attendances and an even greater increase in emergency admissions have placed severe strain on the bed capacity of the National Health Service (NHS) of the United Kingdom. The result has been overcrowded emergency departments with patients experiencing long wait times for admission to an appropriate hospital bed. Nevertheless, scheduling issues can still result in significant underutilization of bed capacity. Bed occupancy rates may not correlate well with bed availability. More accurate and reliable long-term prediction of bed requirements will help anticipate the future needs of a hospital’s catchment population, thus resulting in greater efficiencies and better patient care. ObjectiveThis study aimed to evaluate widely used automated time-series forecasting techniques to predict short-term daily nonelective bed occupancy at all trusts in the NHS. These techniques were used to develop a simple yet accurate national health system–level forecasting framework that can be utilized at a low cost and by health care administrators who do not have statistical modeling expertise. MethodsBed occupancy models that accounted for patterns in occupancy were created for each trust in the NHS. Daily nonelective midnight trust occupancy data from April 2011 to March 2017 for 121 NHS trusts were utilized to generate these models. Forecasts were generated using the three most widely used automated forecasting techniques: exponential smoothing; Seasonal Autoregressive Integrated Moving Average; and Trigonometric, Box-Cox transform, autoregressive moving average errors, and Trend and Seasonal components. The NHS Modernisation Agency’s recommended forecasting method prior to 2020 was also replicated. ResultsThe accuracy of the models varied on the basis of the season during which occupancy was forecasted. For the summer season, percent root-mean-square error values for each model remained relatively stable across the 6 forecasted weeks. However, only the trend and seasonal components model (median error=2.45% for 6 weeks) outperformed the NHS Modernisation Agency’s recommended method (median error=2.63% for 6 weeks). In contrast, during the winter season, the percent root-mean-square error values increased as we forecasted further into the future. Exponential smoothing generated the most accurate forecasts (median error=4.91% over 4 weeks), but all models outperformed the NHS Modernisation Agency’s recommended method prior to 2020 (median error=8.5% over 4 weeks). ConclusionsIt is possible to create automated models, similar to those recently published by the NHS, which can be used at a hospital level for a large national health care system to predict nonelective bed admissions and thus schedule elective procedures

Thermal conductivity and thermal diffusivity of palm fiber reinforced binary phenolformaldehyde composites

865-869<span style="font-size:13.0pt;mso-bidi-font-size: 12.0pt;font-family:" times="" new="" roman";mso-fareast-font-family:"times="" roman";="" color:black;mso-ansi-language:en-in;mso-fareast-language:en-in;mso-bidi-language:="" ar-sa"="" lang="EN-IN">Thermal conductivity and thermal diffusivity of binary dispersed composites prepared by reinforcing varying volume fractions or palm fiber in phenolformaldehyde (PF) matrix have been measured at room temperature and normal pressure employing the transient plane source technique (TPS). Composites obtained by reinforcing 20, 30, 40, 50 weight percentage or fibers in the phenolformaldehyde matrix have been studied. It has been round that thermal conductivity as well as thermal diffusivity or the composites decreases, from that or the matrix, as the fraction or the fiber increases in the composites. Further, the experimental results, are used to evaluate the thermal conductivity of the fiber employing Y Agari model. Results obtained by Y Agari model are compared with that obtained from two models and by extrapolation. Using thermal conductivity value or the matrix and thermal conductivity or the fiber, effective thermal conductivity of the composites have been evaluated employing different models and compared with the experimental results. Quite good agreement between experimental and theoretical results has been round.</span

Thermal conduction and diffusion through polyester composites

746-750Using Transient Plane Source technique, thermal properties like thermal conductivity, thermal diffusivity and specific heat of polyester composites of banana fibers (treated and untreated) are measured simultaneously at room temperature and normal pressure. The increase in thermal conductivity is observed in some treatments. The performance of the composite depends to a large extent on the adhesion between polymer matrix and the reinforcement. This is often achieved by surface modification of the matrix or the filler. Banana fiber was modified chemically to achieve improved interfacial interaction between the fiber and the polyester matrix. Various silanes and alkali were used to modify the fiber surface. Chemical modification was found to have a profound effect on the fiber/matrix interaction which is evident from the enhanced thermal conductivity values. Of the various chemical treatments, simple alkali treatment with 1% NaOH was found to be the most effective

Validation of an integrated patient positioning system: Exactrac and iViewGT on Synergy Platform

Purpose: Evaluation of the newly integrated system for its validation and designing a quality assurance frame work to assess its geometrical, radiological and mechanical accuracy.Methods: Isocentric accuracy of two independent imaging modalities, kV based ExacTrac and MV based iViewGT was evaluated using Winston-Lutz test. A pelvic humanoid phantom was used for the radiological end-to-end test for its clinical utilization. Image quality for the systems was evaluated using Las Vegas Phantom and ETR-1 plate. The kV system was also assessed for kVp accuracy, kVp - dose linearity, mAs-dose linearity and timer linearity and its accuracy. The system was tested for total filtration and output consistency. Tests for uniformity and noise measurement of kVp accuracy and its reproducibility, linearity test between applied kVp and the x-ray dose, linearity Test between applied mAs and the x-ray dose were also done. Results: Winston-Lutz test gave the isocentric deviation of 0.058 ± 0.015 mm with the average lateral deviation as 0.028 ± 0.021 mm, average longitudinal deviation as 0.032 ± 0.015 mm and average vertical deviation as 0.030 ± 0.016 mm. With the phantom test, the minimum measured displacement of Exactrac positioning was 0.2 ± 0.3 mm, 0.0 ± 0.2 mm and 0.1 ± 0.3 mm in longitudinal, lateral and vertical directions respectively. In image quality test, visible smallest visible hole size seen by both Exactrac and EPID imaging system was 5 mm and can resolve 1.5 lp/mm or better. The image uniformity was found to be 132.9 ± 3.06 pixels for MV images and 139 ± 4.41 pixels for kV images with the associated noise of ≤1% both for 120 kV-20 mAs and 4 MV beam energy of ExacTrac and iViewGT respectively. The uniformity and noise test, measured pixel intensity values for various points on MV and kV images separately were found to agree within ± 1% with respect to the central axis pixel value. The kVp accuracy and its reproducibility were tested for kV imager only. The deviation of kVp was found to be than ± 1% and its precision was seen to be even lesser than ± 0.1%. Linearity test between applied kVp and the x-ray dose and applied mAs and x-ray dose were tested only for the ExacTrac. Both the coefficient of linearity for kVp as well as mAs was found to be &lt; 0.1. Conclusion: It is feasible to install ExacTrac imaging system with an Elekta linear accelerator. Both the imaging systems were found to be compatible in terms of image quality test and isocentric accuracy and can be used for the patient imaging in the same Linear accelerator.-----------------------------Cite this article as: Jassal K, Munshi A, Sarkar B, Paul S, Sharma A, Mohanti BK, Ganesh T, Chougule A, Sachdev K. Validation of an integrated patient positioning system: Exactrac and iViewGT on Synergy Platform. Int J Cancer Ther Oncol 2014; 2(2):020212. DOI: 10.14319/ijcto.0202.12</p