Epidemiological and laboratory investigations of outbreaks of diarrhoea in rural South India: implications for control of disease

Two epidemics of acute, watery diarrhoea in villages in North Arcot district, India, were investigated. The attack rates were 10.03 and 15.53 per 100 population, the median duration was 5 days and enteric pathogens were present in 56.8% and 60.3% of specimens from the two villages, but no predominant pathogen was identified. Examination of stools from a 20% age-stratified random sample of the population of one of the villages after the epidemic found 22.9% of asymptomatic subjects excreted bacterial enteric pathogens. Despite the high background of enteric pathogen carriage, the isolation rates for shigellae, enteropathogenic Escherichia coli and Shiga-toxin producing E. coli were significantly higher (P < 0.001, P < 0.02, P < 0.05) during the epidemic. The epidemics may have been caused by faecal contamination of well water following rain. Point-of-use techniques for water disinfection may be most effective for preventing such outbreaks, but further research into the development of appropriate technology is required

Study of Pulmonary Function Tests in Cardiac patients

INTRODUCTION: Coronary artery heart disease and rheumatic heart disease are among the most common causes of morbidity and mortality in India. These two diseases are the most common causes of cardiac failure. Patients with these diseases should have regular follow-up with doctors. Impaired pulmonary function is common in cardiac patients. Respiratory muscle wasting has been well documented in Rheumatic Heart Disease patients. But Pulmonary Function Test is the least common test that is undergone by the patients. This current study is aimed to assess the Pulmonary Function of cardiac patients with coronary artery heart disease and rheumatic heart disease who have recovered from cardiac failure. AIMS AND OBJECTIVES: 1. To study the Pulmonary Function Test patterns in patients with coronary artery heart disease and Rheumatic Heart Disease who have revived from Cardiac Failure. 2. To diagnose any underlying undiagnosed respiratory problem coexisting with cardiac failure. MATERIALS AND METHODS: This study is a observational study conducted in Department of Medicine, Tirunelveli Medical College Hospital. Seventy five patients admitted in TVMCH from MAY 2014 to MAY 2015 will participate in the study. The volunteer patients who met the inclusion criteria, signed a consent form after they got a clear explanation of the spirometry evaluation procedures. Inclusion Criteria: 1. Adult patients with Rheumatic Heart Disease (Male and Female). 2. Coronary artery heart disease patients less than 60 years of age (Male and Female). Exclusion Criteria: 1. Pediatric patients less than 12 years of age and Adult patients more than 60 years of age. 2. Rheumatic Heart disease patients with known respiratory disease (COPD, Bronchial Asthma, Pulmonary Tuberculosis) 3. CAHD patients with known respiratory disease (COPD, Bronchial Asthma, Pulmonary Tuberculosis) Morbid and sick patients. 4. Severe Left Ventricular Dysfunction patients as per ECHO report. Data Collection: 1. Detailed medical history and physical examination is done. 2. Basic Laboratory investigations such as complete blood count, RFT and Urine analysis done. 3. ECG, 4. X-Ray Chest PA view, 5. Echocardiogram, 6. Spirometry test. SPIROMETER: The spirometry is performed using a device called a spirometer, which comes in several different varieties. Most spirometers display the following graphs, called spirograms: 1. A volume-time curve, showing volume (liters) along the Y-axis and time (seconds) along the X-axis 2. A flow-volume loop, which graphically depicts the rate of airflow on the Y-axis and the total volume inspired or expired on the X-axis PROCEDURE: The basic forced volume vital capacity (FVC) test varies slighty depending on the equipment used. Generally, the patient is asked to take the deepest breath they can, and then exhale into the sensors hard as possible, for as long as possible, preferably at least 6 seconds. It is sometimes directly followed by a rapid inhalation (inspiration), in particular when assessing possible upper airway obstruction. Sometimes, the test will be preceded by a period of quiet breathing in and out from the sensor (tidal volume) or the rapid breath in (forced inspiratory part) will come before the forced exhalation. During the test, soft nose clips may be used to prevent air escaping through the nose. Filter mouthpieces may be used to prevent the spread of microorganisms. DISCUSSION: This study “study of pulmonary function tests in cardiac patients” is an observational study done on 75 patients revived from cardiac failure. The parameters studied were forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and ratio of FEV1/FEV. Among the studied patients, 52% had normal pattern of pulmonary function test, 32% had restrictive pattern and 16% had obstructive pattern. Both males and females had similar type of distribution of pulmonary function test pattern. Compared to cardiac failure patients with coronary artery disease, patients with rheumatic heart disease had lower proportion of patients with normal pulmonary function test pattern. The prevalence of restrictive pattern of pulmonary function test was more in those with rheumatic heart disease than those with coronary artery heart disease. The prevalence of obstructive pattern was more in patients with left ventricular ejection fraction of less than 50% CONCLUSION: The presence of impaired pulmonary function tests in cardiac failure patients has been already demonstrated in various studies. This study concludes that more than half of the cardiac failure patients had normal pulmonary function pattern. In those who had abnormal pulmonary function pattern, incidence of restrictive pattern was more than that of obstrictive pattern. The prevalence of restrictive pattern of pulmonary function test was more in patients with rheumatic heart disease than coronary artery disease patients. As LV ejection fraction of patients with cardiac failure decreased there is a higher incidence of obstructive pattern of pulmonary function test

Effect of plasma lysozyme on live Mycobacterium tuberculosis

The role of plasma lysozyme of normal healthy subjects (NHS, n = 12) and active pulmonary tuberculosis (ATB) patients (n = 15) on the innate immune mechanism was studied by the binding activity of lysozyme on live Mycobacterium tuberculosis. Plasma samples of NHS and ATB patients treated with live M. tuberculosis for 4 h and 24 h time points showed a significant decrease in the plasma lysozyme level when compared to the untreated samples (4 h, P < 0.001; 24 h, P < 0.001). Pretreatment of live M. tuberculosis with plasma of NHS and ATB patients showed a trend in the reduction of viability of live M. tuberculosis. Moreover, M. tuberculosis pretreated plasma of NHS showed a trend towards an increased spontaneous as well as antigen-induced lymphocyte response when compared to ATB plasma. The enzymatic action of the lysozyme and other enzymes on the cell wall may induce M. tuberculosis to release some antigenic components which may be immunogenic and induce lymphocyte proliferation. The present study suggests that lysozyme and other enzymes may play an important role in the first line defence, i.e. the innate immunity, against M. tuberculosis infection

Stability improvement of an efficient graphene nanoribbon field-effect transistor-based sram design

The development of the nanoelectronics semiconductor devices leads to the shrinking of transistors channel into nanometer dimension. However, there are obstacles that appear with downscaling of the transistors primarily various short-channel effects. Graphene nanoribbon field-effect transistor (GNRFET) is an emerging technology that can potentially solve the issues of the conventional planar MOSFET imposed by quantum mechanical (QM) effects. GNRFET can also be used as static random-access memory (SRAM) circuit design due to its remarkable electronic properties. For high-speed operation, SRAM cells are more reliable and faster to be effectively utilized as memory cache. The transistor sizing constraint affects conventional 6T SRAM in a trade-off in access and write stability. This paper investigates on the stability performance in retention, access, and write mode of 15 nm GNRFET-based 6T and 8T SRAM cells with that of 16 nm FinFET and 16 nm MOSFET. The design and simulation of the SRAM model are simulated in synopsys HSPICE. GNRFET, FinFET, and MOSFET 8T SRAM cells give better performance in static noise margin (SNM) and power consumption than 6T SRAM cells. The simulation results reveal that the GNRFET, FinFET, and MOSFET-based 8T SRAM cells improved access static noise margin considerably by 58.1%, 28%, and 20.5%, respectively, as well as average power consumption significantly by 97.27%, 99.05%, and 83.3%, respectively, to the GNRFET, FinFET, and MOSFET-based 6T SRAM design. © 2020 Mathan Natarajamoorthy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

HLA-DR phenotypes and lymphocyte response to M. tuberculosis antigens and in cured spinal tuberculosis patients and their contacts

Background: Our earlier studies on Human Leucocyte Antigens (HLA) in pulmonary tuberculosis patients revealed the association of HLA-DR2 antigen with susceptibility to pulmonary TB and DR2 antigen has been shown to influence the immunity to tuberculosis. Objectives: The present study was carried out to find out whether HLA-DR antigens are associated with susceptibility to spinal tuberculosis. Moreover, the role of HLA-DR antigens on lymphoproliferative response to Mycobacterium tuberculosis culture filtrate antigens was studied using Lymphocyte Transformation Test (LTT). Material and Methods: HLA-DR genotyping and lymphoproliferative response was carried out in 63 cured spinal TB patients and 63 control subjects (spouses of pulmonary and spinal TB patients). Results: A trend towards an increased frequency of HLA-DR9 antigen was observed in spinal TB patients compared to controls. A significantly decreased lymphocyte response to M. tuberculosis antigens was observed in HLA-DR9 antigen positive control subjects compared to HLA- DR9 antigen negative subjects (P=0.0009) whereas increased response was observed with DR9 positive cured spinal TB patients compared to HLA-DR9 antigen negative patients. Further, HLADR3 antigen positive patients showed a decreased lymphocyte response compared to HLA-DR3 antigen negative patients (P<0.05). Conclusion: The study suggests that HLA-DR9 antigen either alone or in combination with other HLA antigen as lhplotype and non-HLA genes may be associated with susceptibility to spinal TB and play a regulatory role on the immune response to M. tuberculosis in spinal tuberculosis patients

Association of vitamin D receptor gene variants of BsmI, ApaI and FokI polymorphisms with susceptibility or resistance to pulmonary tuberculosis

Vitamin D receptor (VDR) gene polymorphism was studied to find out whether the variants of this gene are associated with susceptibility or resistance to pulmonary tuberculosis (PTB) and bacteriological relapse of tuberculosis. BsmI, ApaI and FokI polymorphisms of VDR gene were studied in PTB patients (n = 120), patient contacts (spouses of the patients; n = 80), bacteriological relapse patients (n = 48) and quiescent patients (n = 48). Significant increase of Bb genotype (heterozygote carrier) of BsmI polymorphism (P = 0.028) and FF genotype (homozygotes of common allele F) of FokI polymorphism (P = 0.034) were observed in male PTB patients than male contacts. The BB genotype (homozygote of common allele B) of BsmI polymorphism and AA genotype (homozygote of common allele A) of ApaI polymorphism were increased in male contacts than male PTB patients (BB: P = 0.018; AA: P = 0.04). No significant differences were found among female patients and female contacts. In bacteriological relapse cases of PTB, a decreased frequency of AA genotype (P = 0.015) and an increased frequency of Aa genotype (P = 0.024) were observed in bacteriological relapse patients than quiescent patients of PTB. The present study suggests that Bb genotype of BsmI polymorphism and FF genotype of FokI polymorphism of VDR gene may be associated with the susceptibility to tuberculosis in males. The BB and AA genotypes may be associated with resistance to PTB in males. The genotype Aa may be associated with bacteriological relapse and AA may be associated with protection against bacteriological relapse

Cytoskeletal changes during poliovirus infection in an intestinal cell line

Background and Objectives: Although polioviral replication has been extensively studied, cytoskeletal changes in the host cell during poliovirus replication have not been extensively investigated. We studied the ultrastructural and cytoskeletal changes in host cells during poliovirus infection. Methods: Fluorescence staining of filamentous actin with a fluorescein-isothiocynate labelled mycotoxin, in the absence and presence of microfilament inhibitors cytochalasins B and D, and electron microscopy were used to investigate the role and fate of actin microfilaments during poliovirus infection, morphogenesis and release in an intestinal cell line, HRT-18. Results: At 10 h post-infection, fluorescence staining of actin showed focal areas of fluorescence in the cytoplasm. By 16 h, these became more prominent and increased in number, and by 18-22 h they coalesced to enclose areas of the cytoplasm. These changes in the actin profile were confirmed by electron microscopy, where small actin bundles appeared in association with vesicles, increased in size, number and thickness, enclosed areas of cytoplasm with numerous vesicles and were finally seen in association with crystalline arrays of virus near the periphery of the cells. The addition of microfilament inhibitors cytochalasins B and D, after the initial period of adsorption resulted in complete inhibition of changes in the actin profile and of viral release, indicating that microfilament inhibitors prevented both polymerization of actin and movement of the virus within the cell. Interpretation and Conclusion: In poliovirus infection, both intracellular movement and release of virus appear to be related to cytoskeletal changes, particularly involving actin microfilaments

Immune response to Mycobacterium tuberculosis culture filtrate antigen in cured spinal tuberculosis patients and their spouses

Humoral and cell mediated immune responses were studied in cured spinal tuberculosis patients and their spouses to understand immunit to tuberculosis in cured patients. Antibody litre and immune complex levels were measured and lymphocyte response to Mycobaclerinm tuberculosis culture filtrate antigen was observed in cured spinal tuberculosis patients ( n = 3 0 ) and their spouses (n =27). A trend towards increased antibody litre was seen in cured patients as compared to their spouses. Significantly increased circulating immune complex levels, as measured by PEG OD280 (polyethylene glycol optical density 280) were seen in the contacts compared to cured patients. And a trend towards increased lymphocyte response to Mtuberculosis culture filtrate antigen was seen with different antigen concentrations (0.1,1 and 10 μg /ml). Moreover, the effect of active-pulmonary-Tuberculosis (AT B) plasma taken from 1ILA-DR2 positive and DR2 negative patients on lymphocyte response of the cured patients showed no dramatic immunomodulatory effect in the lymphocyte response when treated with DR2 positive or DR2 negative plasma. The study suggests that the memory response lo Mtuberculosis is well maintained even after 10-15 years of treatment

Rigidity and Non-recurrence along Sequences

Two properties of a dynamical system, rigidity and non-recurrence, are examined in detail. The ultimate aim is to characterize the sequences along which these properties do or do not occur for different classes of transformations. The main focus in this article is to characterize explicitly the structural properties of sequences which can be rigidity sequences or non-recurrent sequences for some weakly mixing dynamical system. For ergodic transformations generally and for weakly mixing transformations in particular there are both parallels and distinctions between the class of rigid sequences and the class of non-recurrent sequences. A variety of classes of sequences with various properties are considered showing the complicated and rich structure of rigid and non-recurrent sequences

The repeatability and reproducibility of four techniques for measuring horizontal heterophoria: Implications for clinical practice

PURPOSE: Convergence insufficiency, the most common binocular vision anomaly, is characterised by a receded near point of convergence and an exophoria which is at least 4 prism dioptres (Δ) larger at near than at distance. However, the repeatability of standard heterophoria measures are poorly understood. This study assessed the ability of four common heterophoria tests to detect differences of 4Δ by evaluating the inter- and intra-examiner variability of the selected techniques. METHODS: Distance and near horizontal heterophorias of 20 visually-normal adults were measured with the alternating prism cover test, von Graefe prism dissociation, Howell Card and Maddox Rod by two examiners at two separate visits using standardised instructions and techniques. We investigated inter- and intra-examiner variability using repeatability and reproducibility indices, as well as Bland-Altman analysis with acceptable limits of agreement defined as ±2Δ. RESULTS: The Howell card test had the lowest intra-examiner variability at both distance and near, as well as the best 95% limits of agreement (±1.6Δ for distance and ±3.7Δ for near). Inter-examiner reproducibility results were similar, although at near the alternating prism cover test had better repeatability (1.1Δ, 95% confidence intervals −1.1Δ to 4.0Δ) than the Howell card (1.4Δ, 95% confidence intervals −1.9Δ to 5.9Δ). CONCLUSION: The low repeatability of many standard clinical heterophoria tests limits the ability to reliably detect a 4Δ difference. The Howell Card provided the most repeatable and reproducible results indicating that this technique should be used to detect small changes in heterophoria magnitude and direction