ADVERSE DRUG REACTIONS ASSOCIATED WITH FIRST-LINE ANTI TUBERCULAR DRUGS IN A TERTIARY CARE HOSPITAL OF CENTRAL INDIA: A STUDY OF CLINICAL PRESENTATIONS, CAUSALITY, AND SEVERITY

  Objective: The objective was to study the adverse drug reactions (ADRs) associated with first-line anti-tubercular drugs for clinical presentations, causality, and severity.Methods: A retrospective study was undertaken in a 750 bedded tertiary care teaching hospital of central India for the duration of 1 year (May 2013‑May 2014). Patients diagnosed with tuberculosis and under treatment with the first-line anti-tubercular drugs were study subjects. Causality, preventability, and severity were analyzed and other parameters such as male to female ratio, most affected system, most common class of drug, and common types of ADRs, were studied.Results: Nearly 118 patients were started on anti-tubercular treatment of first-line drugs in the study duration. Out of these 45 patients suffered one or more ADRs with a total number of reported ADRs being 91. 57.77% were males. Maximum patients belonged to the age group of 31-40 years (26.66%). The most commonly involved system was hepatic and biliary system (53.33%) followed by gastrointestinal system (51.11%), the most common ADR observed was disturbed liver transaminases (33.33%) followed by nausea and vomiting (28.88%). Causality assessment by Naranjo's scale showed 58.2% ADRs scoring probable, 31.86% were of possible score, whereas 9.8% definite score category. Severity assessment shows 68.88% cases of mild grading, 31.11% of moderate and no case of severe grading was reported in the study duration.Conclusions: Vigilance regarding these ADRs occurrences can result in early diagnosis and thus, proper management can be instituted earliest. This will build confidence of patients and will decrease the dropouts which in turn can result in decrease chances of developing drug-resistant strains.Keywords: Adverse drug reactions, Multidrug resistant tuberculosis, Extensively drug-resistant tuberculosis, Causality, Naranjo's algorith

A Case Study on effect of Vamana Karma in Lupus Induced Hypothyroidism

Introduction- Auto-immune thyroid disease is most common in lupus.  Anti-Nuclear-Anti-body is related to both. Primary hypothyroidism occurs in about 15%-19% in patient of Lupus. Hypothyroid Signs and symptoms include low metabolic rate, tendency to weight gain, somnolence, lethargy, menstrual disturbance, aches, muscle stiffness, hair loss, infertility and sometimes myxedema. The above symptoms closely resemble the symptoms of Vikruta Kapha Dosha which are Gaurava, Shaithya, Slatangatwa, Tamah, Klaibya. The location of thyroid gland is In Urdwajatrugata Pradesha i.e., Greeva. Adoption of Vamana karma is best shodhana for Kapha Dosha and also for Urdwa Shareerasthitha Roga making an ideal Panchakarma for hypothyroidism. Aim- To evaluate the efficacy of Vamana Karma in Lupus induced Hypothyroidism. Methodology- Single subject was treated with Deepana-Pachana followed by Shodhananga Snehapana and was subjected to Vamana. As per the Shuddhi the subject was advised Samsarjana Krama. Assessment was done with thyroid profile before and after treatment. Result- Significant changes were noted in thyroid profile.  Discussion- Vamana Karma which is ideal for Kapha Dosha has a positive effect over the disease Hypothyroidism in managing and also maintaining health for longer duration

Comparison of aerosol products retrieved from AERONET, MICROTOPS and MODIS over a tropical urban city, Pune, India

Aerosol Optical Depth (AOD) measurements from Aerosol Robotic NETwork (AERONET; level 2.0), Microtops - II sun-photometer and MODerate Resolution Imaging Spectroradiometer (MODIS) (Terra and Aqua; level 2, collection 5, dark target) were compared and used to characterize aerosols over Pune, India. AODs from Microtops and MODIS were compared with those measured by AERONET to evaluate the measurement quality. To the best of our knowledge, this is the first systematic comparison of MODIS aerosol products over Pune, India. The results of the analysis show that during 2008-10, 68 to 84 of the MODIS AODs fell within an expected error, as defined by the MODIS science team, and thus the retrievals from this system are validated and accepted. In addition, during pre-monsoon periods MODIS retrievals are better-matched with ground-based measurements. On the seasonal scale, MODIS retrievals corroborate well with ground-based measurements, with correlation coefficients ranging from 0.62 to 0.93. Despite an overall satellite-ground agreement, MODIS tends to under-estimate AOD during winter, and this may be due to improper assumptions of surface reflectance and the incorrect selection of aerosol types. AERONET retrieved single scattering albedo (SSA) values in winter (0.82-0.86), suggesting the dominance of absorbing aerosols, slightly increased (0.87-0.89) in pre-monsoon season, indicating more scattering type of aerosols. These values are about 8.9-1.1 lower than those of the assumed SSA values in the MODIS algorithm

Preliminary Antiplaque Efficacy of Aloe Vera Mouthwash on 4 Day Plaque Re -Growth Model: Randomized Control Trial

Background: Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo (saline water).Material and Methods: A total of 300 systemically healthy subjects were randomly allocated into 3 groups: Aloe vera mouthwash group (n=100), control group (=100)–chlorhexidene group and saline water-Placebo (n=100). To begin with, Gingival index (GI) and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After randomization of the participants into three groups they were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash (Aloe vera mouthwash, 0.2% chlorhexidine gluconate mouthwash, or normal saline) as per therapeutic  dose for 4 days.Results: The results showed that Aloe vera mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days. There was a significant reduction on plaque in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them (p>0.05). Aloe vera mouthwash showed no side effects.Conclusion: The results of the present study indicated that Aloe vera may prove an effective mouthwash due to its ability in reducing dental plaque.Keywords: Mouthwash, plaque, chlorhexidin

Calibration of Traffic Simulation Models using SPSA

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Γεωπληροφορική

Morphology, ontogenetic, and molecular phylogenetic studies on species of the genera Sterkiella and Fragmospina

We investigated a poorly known species of the genus Sterkiella based on two populations collected from an agricultural field in Marche Region, Italy and from soil samples collected from the Silent Valley National Park, India. This study represents an example where data on the ontogenesis clarifies the polyphyletic behavior of the genus Sterkiella. Both populations showed a rather similar morphology and ontogenetic pattern and thus supported the polyphyletic behavior of the genus Sterkiella in molecular phylogenetic analyses. In addition, description of a species of the genus Fragmospina has been presented based on the detailed investigations on morphology, ontogenesis, and molecular phylogenetic methods

Common variants of the TCF7L2 gene are associated with increased risk of type 2 diabetes mellitus in a UK-resident South Asian population

Background Recent studies have implicated variants of the transcription factor 7-like 2 (TCF7L2) gene in genetic susceptibility to type 2 diabetes mellitus in several different populations. The aim of this study was to determine whether variants of this gene are also risk factors for type 2 diabetes development in a UK-resident South Asian cohort of Punjabi ancestry. Methods We genotyped four single nucleotide polymorphisms (SNPs) of TCF7L2 (rs7901695, rs7903146, rs11196205 and rs12255372) in 831 subjects with diabetes and 437 control subjects. Results The minor allele of each variant was significantly associated with type 2 diabetes; the greatest risk of developing the disease was conferred by rs7903146, with an allelic odds ratio (OR) of 1.31 (95% CI: 1.11 – 1.56, p = 1.96 × 10-3). For each variant, disease risk associated with homozygosity for the minor allele was greater than that for heterozygotes, with the exception of rs12255372. To determine the effect on the observed associations of including young control subjects in our data set, we reanalysed the data using subsets of the control group defined by different minimum age thresholds. Increasing the minimum age of our control subjects resulted in a corresponding increase in OR for all variants of the gene (p ≤ 1.04 × 10-7). Conclusion Our results support recent findings that TCF7L2 is an important genetic risk factor for the development of type 2 diabetes in multiple ethnic groups

Variability of lightning, convective rain and solar activity study over South/Southeast Asia during ENSO episode for the period of 1998-2010

Abstract Analysis of monthly mean data of lightning and convective rain for the region 8° N - 35° N, 60° E - 120° E and for the period 1998-2010 show that lightning and convective rain are not significantly influenced by solar parameters such as sunspot number, total solar irradiance (TSI) and solar radio flux whereas CAPE anomaly and temperature anomaly have significant impact on the total lightning flash rate and convective rain during ENSO periods. Further no significant relation between cosmic ray flux and total lightning flash rate during La Niña period is obtained. On the other hand, for the El Niño period and for the total period, we get statistically some significant negative correlation between cosmic ray flux and total lightning flash rate. However, it is not possible to make any comment on the general relation between cosmic ray flux and total lightning flash rate due to contaminating global effects, regional effects and cloud microphysics. In the monthly variation of the parameters, temperature anomaly can be used as a proxy for the total lightning flash rate for the region under consideration. Most of the variation in ozone during the ENSO period is due to lightning. In the region considered here, role of aerosols in producing lightning and rainfall is quite comparable during La Niña period. On the other hand, aerosols contribute more towards production of lightning than producing rain during El Niño due to changes in cloud microphysics and cloud electrification

Structural basis for hemoglobin capture by Staphylococcus aureus cell-surface protein, IsdH

Pathogens must steal iron from their hosts to establish infection. In mammals, hemoglobin (Hb) represents the largest reservoir of iron, and pathogens express Hb-binding proteins to access this source. Here, we show how one of the commonest and most significant human pathogens, Staphylococcus aureus, captures Hb as the first step of an iron-scavenging pathway. The x-ray crystal structure of Hb bound to a domain from the Isd (iron-regulated surface determinant) protein, IsdH, is the first structure of a Hb capture complex to be determined. Surface mutations in Hb that reduce binding to the Hb-receptor limit the capacity of S. aureus to utilize Hb as an iron source, suggesting that Hb sequence is a factor in host susceptibility to infection. The demonstration that pathogens make highly specific recognition complexes with Hb raises the possibility of developing inhibitors of Hb binding as antibacterial agents. © 2011 by The American Society for Biochemistry and Molecular Biology, Inc