A cross-sectional study on pain management during vaso-occlusive crisis in sickle cell disease

Background: Sickle cell disease is an inherited hematological disorder characterized by hard and sticky red blood cells that appears like a C-shaped “sickle” in contrast to the healthy, round red blood cells which tend to stick and clog the blood vessels during blood flow leading to pain or vaso-occlusive crisis. Methods: A cross-sectional study was conducted at Yashoda hospital in Hyderabad, India. Data regarding the management of acute pain during VOC in SCD patients was gathered from the hematology department on a daily basis during the duration of the study. The data was recorded in an online questionnaire form and a subsequent DUE was conducted. Results: Among all the patients that were enrolled in the study, acute pain as VOC was presented in 72%, whereas 28% did not experience pain. Pain was manifested as acute chest syndrome, generalized body pain, headache. Crizanlizumab, a monoclonal antibody was administered to patients who were ≥16 years to decrease the frequency of VOC. Upon DUE, per prescription distribution of crizanlizumab was 11.2%, while 88.8% constituted of anti-metabolites, antibiotics, analgesics, opiate antagonist, etc. Frequency of use of crizanlizumab among SCD patients was 69.23% Conclusions: Management of VOC cannot be described as one size fits all. Interindividual variability must be considered at all times during planning and implementing a treatment regimen. Assessment of pain on pain scale to ensure targeted treatment at maximum effective concentration followed by titration of dose to reduce the occurrence of tolerance, withdrawal, dependence and addiction should be basis of management

Ca2+ Regulated Antibiotic Resistance in Pseudomonas aeruginosa

Pseudomonas aeruginosa, an opportunistic pathogen, causes life threatening infections in cystic fibrosis (CF) patients. Due to increased abundance of Ca2+ in CF lung, P. aeruginosa is surrounded with elevated Ca2+ that could be recognized by the bacterium as a cue for adaptation in this environment. Previous research by our group and others identified Ca2+ responsive regulators and defined their role in Ca2+-dependent virulence factor production. In addition, tightly maintained intracellular Ca2+ ([Ca2+]in) homeostasis suggests the signaling role of Ca2+ in P. aeruginosa. Our current study report that growth at 5 mM/ 10 mM Ca2+ increases the antibiotic resistance of PAO1 more than 10 fold. Here, our main goal was to elucidate the regulatory role of Ca2+ in adaptive antimicrobial resistance and virulence of PAO1. We identified several of the RND superfamily efflux pumps involved in Ca2+-regulated tobramycin resistance, plant infectivity and [Ca2+]in homeostasis maintenance. We have established that Ca2+ transcriptionally regulates five of the six efflux pumps involved in Ca2+-induced tobramycin resistance in a growth phase dependent manner. Ca2+ reliant tobramycin resistance and increase transcription of mexAB-oprM, one of the efflux pumps involved in Ca2+-induced tobramycin resistance, requires intact Ca2+ homeostasis. We have also identified a putative calcium channel in PAO1, homologous to the pH-sensitive Ca2+ leak channel, BsYetJ in Bacillus subtilis. This channel is essential for PAO1 to generate transient changes in [Ca2+]in. Disruption of this gene affects the Ca2+ regulated global transcription of many virulence and adaptation associated genes in PAO1. The lack of intact [Ca2+]in transients also resulted into reduction in Ca2+ regulated virulence of this organism. Previously our lab identified calmodulin-like EF hand protein (EfhP), Ca2+-regulated two-component system (CarSR), Ca2+ binding protein (CarP), and Ca2+-regulated OB-fold protein, which contribute to Ca2+-regulated virulence in PAO1. Here, we established that Ca2+ regulated transcription of calC is dependent on CarSR, CarP and EfhP. Finally, we also identified three hypothetical proteins involved in Ca2+-induced polymyxin B resistance of PAO1. Overall, the findings of this research identifies the genes involved in Ca2+ regulatory cascade of P. aeruginosa and how they contribute to Ca2+ regulated antibiotic resistance and virulence of this pathogenMicrobiology, Cell, & Molecular Biolog

Anatomical Changes in the Skin of Rattus Norvegicus After Artificial UV Exposure

Acute and subacute artificial UV exposure to albino rats exhibit morphological and histo-anatomical changes in the skin of albino rat. The anatomical changes include hyperplasia, hyperkeratosis, hypergranulosis and acanthosis beside numerical changes in keratinocytes, Langerhans, melanocytes and fibroblast seen after acute and subacute artificial UVB exposure

Parental supply of alcohol in childhood and risky drinking in adolescence: Systematic review and meta-analysis

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment

ACTIVE POWER ENHANCEMENT OF HVDC SYSTEM BY MMC

Modular Multilevel Converter (MMC) is becoming increasingly popular with the development of HVDC connections and, in the future, with the integration of Multi Terminal DC grids. A lot of publications have been published about this topology these last years since it was first proposed. Few of them are addressing explicitly the two different roles that are held by this converter in an HVDC link: power control or DC voltage level control. Moreover, for a given function, different ways of controlling this converter may be considered. This paper proposes an overview of the different solutions for controlling the MMC and proposes a methodology to synthesize the control architecture

Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites

This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towards depression with increasing age amongst British Bangladeshis. Older British Bangladeshis believed depression was an illness that brought a sense of shame and loss of dignity to the individual and his or her family, and they also favoured a lay referral system for sufferers. They also had more superstitious beliefs about depression than both younger British Bangladeshis and British Whites. A pattern of increasing negativity with increasing age was not evident amongst the British Whites, but older individuals in both groups tended to believe that depression was not helped by psychological intervention. The attitudes towards depression in the young was similar (and generally positive) in both ethnic groups. These findings highlight the necessity to provide more culturally sensitive and accessible services for migrant communities - particularly amongst older individuals. © 2014 © 2014 Taylor & Francis

Prospective study on quality of newborn care

Background: Quality of services provided by health care provider, the closest health functionary to the community has impact on neonatal mortality. Aims: Study on quality of newborn care in rural areas.  Settings and Design: This is a prospective study in the field practice areas of J.N. Medical College and areas under primary health centre of public health care system in Wardha district.  Methods and Material: Modified quality check list on the basis of PHC MAP module guidelines for assessing the quality of service-module 6-user’s guide was prepared. Face to face interview with 205 (group-A/104 nos + group-B/101 nos) mother of newborn was method to collected information in three postnatal visits.  Statistical analysis: Quality (verbal response) of each service was quantified as acceptable, average and worst.  Quality of both the groups was compared by calculating P-value after utilizing Z-test.  Results: Over all acceptable quality of medical history was 30.03%, physical examination was 21.73%, preventive service was 91.17% and counseling was 24.83%. Significant difference between two groups were found on history taking for (cry, breathing and body movement of baby), recording weight and counseling regarding exclusive breast feeding for first 6 month of life. Worst quality in this study were observed in history for anything applying to eyes, umbilical cord stump and complication of baby for which appropriate management was taken. Except for weight recording and examination of head and fontanels all other variables under physical examination were not acceptable. Counseling regarding high risk condition of baby was only 13.66%. Conclusion: Existing newborn services except immunization is inadequate and needs to be strengthened especially physical examination and counseling services

Local dispersal of land snail Zootecus insularis (Ehrenberg, 1831) (Gastropoda: Subulinidae) shells in mangroves of Karachi

1869-1872The present study of the gastropod Zootecus insularis found in mangroves of Karachi, Pakistan is the first report of this species from coastal habitat. Although, the species is a land snail, widely distributed in arid and semiarid lands of many countries including Pakistan, and other nearby countries like Afghanistan and India, its presence in marine wetland habitat is reported from Pakistan in the present study. While studying the benthic fauna of the mangrove swamps of Avicennia marina, fifteen empty shells of the species were found in intertidal muddy region of Korangi Creek and Sand Spit backwaters, Karachi. It is distributed mostly along intertidal zones, more commonly in high and low tidal zones during an average tidal height of 0.5 m. The presence of empty shells of Zootecus insularis in the mangroves sediments is probably, a consequence of a passive transport by external sources

Conservation Status of the Indian Peafowl Pavo cristatus (Aves: Galliformes: Phasianidae) in Bangalore University Campus, Bengaluru, Karnataka, India

The Indian Peafowl, Pavo cristatus was abundant in Bangalore University Campus (BUC) during 1970-80. However, the peafowl population declined alarmingly in the BUC region after 1990. The present paper deals with the abundance, sex ratio of peafowls and their conservation methods in the Biodiversity Park (Bio-Park) of BUC, which had been established in 2006. A total of 117 peafowls was recorded in the BUC region in which the females outnumbered the males. The increased abundance of the peafowl population in the campus could be mainly due to the availability of suitable roosting, foraging and nesting sites. The peafowls have used 18 species of plants and trees for perching and roosting in BUC. The peafowl population increased in the BUC region due to habitat rejuvenation and protection, availability of food sources and breeding/nesting sites. The results of the present investigation constitute the baseline data for the further understanding of the ecological community of national bird in the protected habitats as hotspots for biodiversity of urban ecosystem. Conservation of microhabitats through the proper restoration of ponds, streams and water check-dams including vegetation in the BUC is responsible for the existence of peafowl population

Conservation Status of the Indian Peafowl Pavo cristatus (Aves: Galliformes: Phasianidae) in Bangalore University Campus, Bengaluru, Karnataka, India

The Indian Peafowl, Pavo cristatus was abundant in Bangalore University Campus (BUC) during 1970-80. However, the peafowl population declined alarmingly in the BUC region after 1990. The present paper deals with the abundance, sex ratio of peafowls and their conservation methods in the Biodiversity Park (Bio-Park) of BUC, which had been established in 2006. A total of 117 peafowls was recorded in the BUC region in which the females outnumbered the males. The increased abundance of the peafowl population in the campus could be mainly due to the availability of suitable roosting, foraging and nesting sites. The peafowls have used 18 species of plants and trees for perching and roosting in BUC. The peafowl population increased in the BUC region due to habitat rejuvenation and protection, availability of food sources and breeding/nesting sites. The results of the present investigation constitute the baseline data for the further understanding of the ecological community of national bird in the protected habitats as hotspots for biodiversity of urban ecosystem. Conservation of microhabitats through the proper restoration of ponds, streams and water check-dams including vegetation in the BUC is responsible for the existence of peafowl population