Role of Angiotensin Converting Enzymes Ace and Ace2 in Diabetes Induced Cardiovascular Dysfunction

Cardiovascular disease is a long term complication of diabetes, which remains a leading cause of mortality and morbidity. There is recent evidence for activation of the Renin angiotensin system (RAS) in diabetic animals and humans. Emerging evidence shows that the vasoconstrictor actions of Ang II may be opposed by formation of the vasodilator, Ang (1-7). There is limited data on blood pressure in murine models of type 2 diabetes. The aim is to study the role of angiotensin converting enzymes ACE and ACE2 in diabetes induced cardiovascular dysfunction using type 2 diabetic murine mouse models (db/db mice). Both db/db mice and their controls were implanted with carotid telemetric probes for chronic monitoring of MAP (Mean Arterial pressure), heart rate and activity. At 8-9 weeks age, mice showed hyperinsulinemia, hyperglycemia and increase in body weight compared to their lean controls while MAP was not altered. At an older age (14-15 weeks) there was a significantly increased BP in the db/db mice compared to controls. In young (8 weeks) normotensive mice there was a highly significant increase in plasma ACE activity in db/db mice compared to controls. In contrast there was increased ACE2 activity and decreased ACE activity in kidney in 8 weeks old db/db mice compared to controls. No significant difference between ACE and ACE2 activity was observed in lungs and brain. In addition western blot analysis for ACE/ACE2 protein expression also revealed that there was a significant increase in kidney ACE2 and decrease in kidney ACE protein expression in 8 weeks old db/db mice compared to their lean controls. In addition no difference was observed between lung ACE and ACE2 protein expression. Increased plasma and kidney ACE activity and a decreased kidney ACE2 activity were observed in 24 weeks old db/db mice. In conclusion: 1. Eight weeks\u27 db/db mice were normotensive despite an increase in plasma ACE activity. 2. There was an age dependent increase in the BP but no change in heart rate (HR) in both young and old mice. 3. ACE2 may play a compensatory mechanism against development of hypertension in db/db mice in the early stage of type2 diabetes. 4. The up regulation of ACE coupled with a down regulation of ACE2 might be the cause for hypertension at a later stage in this murine model of type2 diabetes

Virtual Kung fu Sifu with Kinect

In this computer world almost everything is made available online. All possible systems are making use of the Internet and so does the learning systems. People willing to learn any kind of arts, but have no time would look for a tutor who would be available at his/her ease. An attempt to satisfy the same is the project that I’ve implemented. My focus is mainly on Kung fu an ancient form of Chinese Martial arts. Learning Kung fu needs a lot of practice and therefore demands having a professional kung fu master monitoring all the time, which is very expensive. Therefore, I have developed a new way of learning experience by creating a virtual Kung fu master normally called as Sifu. In this application, players can learn and perfect different styles and techniques with the help of virtual Sifu. All these styles have be pre recorded by a professional Sifu using a motion sensing input device called Kinect. This Virtual Trainer is designed to help users learn and improve their martial arts by comparing the user’s movements against those of a pre-recorded motion profile of Sifu by giving an immediate feedback to the user. Although many comparision algorithms exist I have chosen Dynamic Time Warping algorithm, which uses the Euclidean Distance formula. One of the main advantages of Dynamic Time Warping algorithm is, it overcomes the problems of motion analysis in speed and time

Evans Syndrome in Pregnancy: A Case Report

Evans syndrome is a chronic autoimmune disease characterized by autoimmune hemolytic anemia (AIHA) along with immune thrombocytopenic purpura (ITP), caused by autoantibodies against red blood cells and platelets. The prevalence of ITP alone is 12/100,000 in U.S. adults, and Evans syndrome has been diagnosed in 1.8-10% of patients with ITP. Few case reports of Evans syndrome in pregnancy have been published, and guidelines for treatment are not well-defined due to the lack of information available in literature. We present a case of Evans syndrome in pregnancy, her clinical course, treatment, and complications postpartum. Evans syndrome is known to be a chronic condition with remissions and relapses. There is some evidence that Evans syndrome may have a more favorable course in pregnancy. More studies are needed to understand the clinical course, treatment options, and neonatal outcome of Evans syndrome in pregnancy.https://scholarlycommons.henryford.com/merf2020caserpt/1127/thumbnail.jp

Evans Syndrome Associated with Pregnancy and COVID-19 Infection

Background: Evans syndrome (ES) is a chronic autoimmune disease characterized by autoimmune hemolytic anemia along with immune thrombocytopenic purpura. Few case reports of ES in pregnancy have been published, and ES may be difficult to distinguish from other diagnoses more common in pregnancy. Guidelines for treatment of ES are not well-defined. Case: A 23-year-old multigravid woman in active labor was found to have severe anemia and thrombocytopenia. She was diagnosed with ES and started on immunosuppressive treatments for persistent immune thrombocytopenic purpura. In the postpartum period, she was found to have coronavirus (COVID-19) infection and acute pulmonary embolism. Conclusion: Evans syndrome is a challenge to diagnose in pregnancy and poses important considerations for intrapartum and postpartum management

Removal of Heavy Metals Using Modified Limestone Media: Zinc and Cadmium

Heavy metal contamination is a serious concern throughout the world. Increased concentrations in drinking water have many negative impacts on human health. Limestone is an inexpensive and simple media for removing high concentrations of heavy metals from drinking water supplies. Ferric based media is commonly used to remove zinc, cadmium, lead, arsenic and other heavy metals. The drinking water standards set by the US EPA for cadmium, zinc and arsenic are 0.005 mg/L, 5 mg/L and 0.010 mg/L respectively. Bangladesh, parts of India, China and the United States have high concentrations of arsenic in drinking water. Although many technologies exist for heavy metal removal, most of these are complicated and are associated with high costs making them ineffective and unfavorable to be used in impoverished areas. We propose a novel method that combines the benefits of limestone with the capacity of ferric media in an iron-coated limestone based material. Samples of water with various concentrations of zinc and cadmium were prepared and batch tests were performed using both uncoated and iron coated limestone and are compared in removal efficiency. Kinetics studies showed that zinc is removed to a maximum level after 24 hours, while cadmium takes only 15 minutes. The effect of pH on removal of heavy metals was also studied. Metals are analyzed using Inductively Coupled Plasma Emission Spectroscopy (ICP-ES). Limestone is readily available and is also easy to coat with iron, making this material a cost effective and affordable method to be used by developing countries

A clinical study to evaluate the efficacy of Murivenna application on Episiotomy Wound

A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labor is called episiotomy (Perineotomy). It is in fact an inflicted second-degree perineal injury. It is the most common obstetric operation performed. This is done to enlarge the vaginal introitus to facilitate easy and safe delivery of the fetus and to minimize overstretching and rupture of the perineal muscles and fascia thus to reduce the stress and strain on the fetal head. This wound of episiotomy is associated with a delicate area of the female with immense pain and discomfort and seeks appropriate medical care and attention. If ignored, it may lead to puerperal wound infections and delayed healing that can interfere mother-infant interaction, lactation and prolonged hospital stay. Episiotomy wound care should be start immediately after suturing the wound in order to reduce pain and inflammation. The surgical wound of episiotomy can be considered as Sadyo Vrana. Different treatment modalities have been told in Ayurveda for Vrana Chikitsa. Drugs having Shodhana and Ropana qualities are essential for healing. In this research study total 30 patients were registered and treated in two groups, group A with application of Jatyadi Taila on episiotomy wound after Ushna Jala Parisheka as a standard control group and Group B with application of Murivenna after Ushna Jala Parisheka as a trial group. Encouraging results were observed in Murivenna. Study emerges that Murivenna possess better pain relieving and tenderness diminishing properties

Overcoming the Inhibitor Problem in PCR Detection of Salmonella in Recreational Waters: A Volume Based Approach

Fecal contamination of environmental or recreational waters is a world wide health concern. Methods currently endorsed by the U.S. EPA for monitoring fecal contamination are based on plate counts of fecal surrogates such as E. coli or Enterococci spp. Due to the sensitivity and specificity of PCR, there is growing interest in using PCR-based methods to detect and quantitate pathogens directly. However, a major impediment to more widespread use of PCR-based methods is the presence of inhibitors that frequently contaminate DNA isolated from environmental sources, especially water rich in organic matter. The major objectives of the present project are to ascertain the extent of this inhibitor problem and to develop alternative approaches. Using Salmonella as a model, real-time PCR and an Amplification Control (AC), we demonstrate that PCR inhibition occurs to varying degrees with all environmental water samples. Inhibition can be ameliorated by using less template DNA but the level of dilution required to permit amplification of the AC is often too severe to permit detection of the pathogen. Our results show that because the severity of the inhibitor problem is stochastic and there is not a reliable method to correct for the effect of the inhibitor, it is not feasible to convert real-time PCR data to bacterial counts. Instead, we propose a volume based approach to quantitate pathogens in recreational waters. The method is based on realtime PCR detection of bacteria, Salmonella in this case, in a specific volume of water. It includes a short enrichment step in a non-selective medium prior to DNA isolation and PCR. The enrichment step increases the amount of template DNA isolated without a concomitant increase in inhibitor level and solves the inhibitor problem because the ratio of inhibitors to template DNA used in PCR is greatly reduced. The detection limit of the method was 10 CFU/dL using a 6 hr enrichment period. Because the risk of exposure to a particular waterborne pathogen is directly related to its concentration, we believe this volume based approach provides a useful method to assess exposure risk in the future

Detection of Salmonella spp. in Coastal Waters

The U.S. Environmental Protection Agency published guidelines in 1986 on recommended water quality criteria for bacteria to protect bathers from gastrointestinal illness in recreational waters. The criteria, based on Escherichia coli and enterococci counts as indicators of the presence of fecal pollution, are still in use today. With the availability of PCR-based methods for the detection and quantification of specific pathogens, it might be possible in the future to base recreational water quality standards on the level of specific pathogens instead of indicator counts. Because most pathogen detection methods were developed for clinical samples, research is needed to adopt such methods to environmental samples where the presence of PCR-inhibitors is a common problem. The purpose of the current project was to determine the best method to process beach water samples for the detection and quantification of Salmonella spp. by qPCR. Although Salmonella is considered a low-grade pathogen that does not persist in the environment, it is one of the most common causes of enteric diseases and several PCR-based methods for its detection have already been developed. Our findings are that filtration through a coarse filter to remove debris followed by centrifugation (5 min at 5,000 x g) was an efficient method to concentrate samples. Detection limit can be lowered to 10 cfu/dL using sample enrichment in either a nonselective medium such as Brain Heart Infusion or a selective medium such as Rappaport Vassiliadis Soya Peptone. DNA purification prior to PCR increases the frequency of false negatives probably as a result of co-precipitation of PCR inhibitors with bacterial DNA. A simple boiling lysis procedure was found to be the most efficient method to prepare samples for PCR. Our conclusion is that it is now feasible to use a PCR-based method to detect and semi-quantitate Salmonella in environmental water samples

Comparative study on the analysis of functional outcome in distal radius articular fractures treated by closed reduction through bridging external fixator augmented with K-wires and Volar-locking plating

PURPOSE: The purpose of this study was to compare the functional outcome in distal radius articular fractures treated by closed reduction through bridging external fixator augmented with k-wires and volar-locking plating. METHODS: This study included patients with comminuted unstable intra-articular distal radius fractures treated at Rajiv Gandhi Govt. General Hospital. 27 patients treated with either modality of treatment were analysed, who had been followed up for an average of was 8.9 months, ( range : 3 months to 24 months). Prospective and retrospective data were gathered on patients, of which 15 were treated with external fixator augmented with k-wire and 12 were treated with 2- column fixed- angle volar LCP . The 2 groups were compared for range of motion (ROM), strength, and functional outcome as measured by the Mayo wrist score. Fracture reduction was evaluated from radiographs taken at the last follow-up visit and compared between groups. Sarmiento’s modification of Lindstorm’s criteria was used to compare the radiological outcome in both the groups. RESULTS: The mean passive wrist ROM at the final follow-up evaluation in ext fixation patients was 55 degrees extension and 67 degrees flexion, compared with 69 degrees extension and 77 degrees flexion in patients treated with volar LCP group. Whereas mean passive wrist ROM at the final follow-up evaluation in ext fixation patients was 58 degrees supination and 46 degrees pronation, compared with 76 degrees supination and 64 degrees pronation in patients treated with volar LCP group. Final radiographic measurements for the Ext fixation group averaged 2.9 degrees volar tilt and 14.2 mm degrees radial inclination, with 5mm radial length. The Volar LCP group averaged 7.3 degrees volar tilt, 16.9 degrees radial inclination, with 9.75mm radial length. Radial length and volar tilt were significantly greater for the ORIF group when compared with the radial length. There was significant difference in the radiological and functional outcome of AO Muller type C fractures treated by volar LCP with respect to the external fixator group ( p value 0.009 and 0.026 respectively ). There was no significant difference in the radiological and functional outcome of AO Muller type B fractures treated by volar LCP with respect to the external fixator group ( p value 0.706 and 0.707 respectively ). CONCLUSION: The use of ORIF with a volar fixed-angle implant resulted in stable fixation of the unstable (dorsally or volarly displaced intraarticular) distal articular fragments, allowing early postsurgical wrist motion (functional outcome) and having excellent to good radiological outcome. The fracture fixation with volar plate and screw system in the management of distal radius articular fractures, especially in type C ( Complete intraarticular fractures ) is a superior method to maintain the reduction till union and prevent the collapse of the fracture fragments, even in grossly comminuted , unstable and osteoporotic bones ; as compared with external fixator augmented with K – wires. However in type B ( partial intraarticular fractures ) fractures, Volar LCP and K- wire augmented External fixator provide equivocal results and none is proved superior. Ligamentotaxis by external fixation provided favourable results in younger age group and in partial intra- articular type of distal radius fractures and requires atleast 4 cortical purchases on each side for effective stability. However long term follow-up is required to confirm our findings