DEXTEROUS MANIPULATION CAPABILITIES ARE ASSOCIATED WITH CHANGE IN DISCHARGE RATE PROPERTIES OF MOTOR NEURONS WITH AGE

Aging is accompanied by declines in manual dexterity and fine motor control. The purpose of this research was to compare hand motor control in young and older adults and examine the neuromuscular mechanisms responsible for enabling these interactions. We test force variability during isometric and dynamic contractions, manual dexterity and track motor unit activity to identify the neuromuscular mechanisms responsible for changes in dexterity with age. 26 older adults (66-86 years) and 28 young adults (19 – 38 years) participated in the study. Research participants performed force matching tasks during index finger abduction, precision pinch, static pressing and hybrid force/ motion tasks. The coefficient of variation (CV) during the force-matching task computed. Multichannel high-density EMG was measured from the First Dorsal Interosseus (FDI) and extensor Digitorum Communis (EDC). The EMG signals were decomposed to obtain motor unit discharge rate parameters such as discharge rate and discharge rate variability of the motor neurons was computed. Low-frequency common oscillatory drive to the motor neurons was computed using Principal Component Analysis (PCA) on the motor unit discharge rates. Associations between the force variability, dexterity scores and motor unit parameters were analyzed for group differences and associations. A higher CV of force was observed in older and younger adults was associated with reduced mean discharge rates, increased discharge rate variabilities and an increase in the low-frequency common oscillatory signal to the motor units. Additionally, the motor unit parameters were associated with performance on tests of manual dexterity such as the box and block test and grooved pegboard test

Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from pus samples at tertiary care cancer hospital

Background: Pseudomonas aeruginosa is one of the most frequent opportunistic microorganisms causing infections in cancer patients. The aim of the study was to determine the antibiotic susceptibility of Pseudomonas aeruginosa and multidrug-resistant (MDR) isolates in cancer patients. Methods: A retrospective study was conducted from January 2022 to December 2022 at Government Cancer Hospital, Aurangabad. A total of 143 pus samples were collected from both IPD and OPD patients. Pus samples were collected as per standard procedure and were inoculated on blood and MacConkey agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute (CLSI) guidelines 2022 using Kirby-Bauer's disc diffusion method and VITEK 2 Automation. Data analysis was done by statical method with statistical software SPSS version 22. Results: Out of 143 clinical samples 33 samples (23%) were positive for Pseudomonas aeruginosa growth. mean age of patients was 50 years old out of 33 isolates 12 (36%) isolates were multidrug-resistant, 11 (33%) isolates were extensively drug-resistant and 1 (3%) were pan-drug-resistant. The majority of isolates were responsive to polymyxin B 32 (96%) and colistin 32 (96%); However, the resistance to gentamycin, ceftazidime, and amikacin was higher, at 66%, 60%, and 57%, respectively.   Conclusions: This hospital-based retrospective study will help to implement better infection control strategies and improve the knowledge of antibiotic resistance patterns among clinicians. Thus, there is a need for an antibiotic stewardship program to monitor the resistant pattern in a tertiary care   cancer hospital

Correlation of awareness of the disease with glycaemic control and diabetic complications among patients attending a tertiary care hospital

Introduction. The awareness level among diabetic patients varies across patient population based on many factors such as differences in the literacy of the study population, socioeconomic status, availability of diabetes education. Hence, it is important to study the same in our set-up to plan appropriate preven- tive strategies. The present research work attempted to assess the awareness level about diabetes and its complications among diabetic patients attending a tertiary care teaching hospital.  Materials and methods. This is a hospital based, cross- sectional study, done in diabetic patients attending a tertiary care teaching hospital in South India. The awareness level of the patient was assessed using a pretested questionnaire. The questionnaire had 25 questions (knowledge — 18, attitude — 4 and prac- tice — 3) and each correct answer was given a score of ‘one’ and each wrong answer was given a score of ‘zero’. Patients were assessed clinically for the presence of micro and macrovascular complications and basic investigations were carried out. Metabolic control is assessed by HbA1c level.  Results. A total of 150 patients were included in the study. Approx. 52.6% of patients scored between 14 and 18 (sufficient awareness), 6.6% of patients had satisfactory awareness (KAP score 19–20) and 4% of patients had highly satisfactory awareness (KAP score > 20). Only eight patients had a score less than 10 (highly insufficient awareness) and 31.3% had insufficient awareness (KAP score 10–13). A positive correlation between educational qualification and awareness level was observed (r = 0.495, p < 0.001). Mean awareness score of patients who received diabetes education from physician and dietitian was significantly high when compared to other sources of patient education. Mean awareness scores were lower for those with various diabetic complications. There is a statistically signifi- cant negative correlation observed between awareness and HbA1c values (r = 0.527, p < 0.001).  Conclusion. Majority of the patients had sufficient awareness about the disease and about one-third of the patients had insufficient awareness about diabetes. The awareness level of the patients about the disease had a strong influence on the metabolic control, diabetic complications and also correlated with their educational status.

Rotational analysis of 2620 &#197; and 2760 &#197; bands of <SUP>32</SUP>S<SUP>34</SUP>S

Rotational analysis of bands of 32S34S at 2620 &#197; and 2760 &#197; has been made, which confirms the earlier vibrational assignment of these bands

IS DOSE TITRATION REQUIRED FOR ANTIHYPERTENSIVE AGENTS IN GERIATRIC DIABETIC PATIENTS?

Objective: The objective of this study is to evaluate the antihypertensive drug usage and dosage differences between geriatric and non-geriatric diabetics with reference to the duration of hypertension and creatinine clearance (Crcl).Methods: In this observational study, patients with type 2 diabetes mellitus were grouped into geriatric (age ≥60 years) and non-geriatric (age &lt;60 years). Patients' demographic data, duration of hypertension, drugs prescribed, and serum creatinine were recorded after the patients had a stabilized antihypertensive dose for 6 months. Crcl was calculated using Cockcroft–Gault formula. The dosages of antihypertensives were converted into equivalent doses for easy comparison within a group. For angiotensin-converting enzyme inhibitors (ACEIs), enalapril was considered as prototype, and for angiotensin receptor blockers (ARBs) losartan, beta-blocker atenolol, and calcium channel blockers (CCBs), amlodipine was considered as prototype. Univariate analysis was done for comparison of drug doses between groups.Results: A total of 336 diabetics with hypertension were included, of which 252 were geriatric and 84 non-geriatric. Duration of hypertension was expectedly longer in the geriatric group (8.40±7.26 vs. 5.46±5.67; p=0.001). Systolic blood pressure was higher in geriatrics (137.14±13.51 vs. 133.38±12.49; p=0.01). When adjusted for the duration of hypertension and Crcl, there were no significant differences in the mean converted equivalent doses of beta-blockers, CCBs, ARBs, and hydrochlorothiazide between geriatrics and non-geriatrics. However, statistically significant lower converted equivalent doses of all ACEIs were needed in geriatrics compared to non-geriatrics, when adjusted for duration of hypertension and Crcl. Enalapril required 20.57% and ramipril required 18.36% dose reduction in geriatrics compared to non-geriatrics.Conclusion: A 20% dosage reduction is needed for ACEIs in the elderly

Evaluation of appropriateness of prescription and polypharmacy in the geriatric population: a cross sectional study at a comprehensive geriatric clinic in a tertiary care hospital

Objective: To assess the prescription quality in a comprehensive geriatric clinic and to determine the frequency of inappropriate prescription and polypharmacy.Methods: Both males and female patients above the age of 60 y attending a comprehensive geriatric clinic of a tertiary care hospital were included in the study. Medications taken by the patients, excluding vitamins, minerals and herbal medications were counted in each patient and analyzed by considering their medical history and using universally accepted tools like medication appropriateness index, START, STOPP &amp; Beer's criteria. In this study, polypharmacy was considered as having 6 or more medications per prescription. Results: A total of 120 patients were included in the study. Around 82 (68.33%) patients had less than 6 prescribed medications and 38 patients (31.66%) were on 6 or more than 6 medications. The number of medications used by the patients is 4.37±2.33. Around 21 (17.5%) were on medications that are not indicated, 25 patients (20.83%) were receiving medications which are to be avoided in elderly as per the Beer's and STOPP criteria. Medication was underused in 24 patients (20%) as per START criteria. When both overused drugs and drugs to be avoided were considered for assessment of inappropriateness, 39 patients (32.5%) were found to be receiving inappropriate medication. Among the drugs to be avoided in elderly, amitriptyline was the most common drug and was used in 15 (12.5%) patients. Antihypertensives were the most common potential prescribing omissions in geriatric patients.Conclusion: Polypharmacy is seen in a significant proportion of geriatric patients. Inappropriate prescription and potential prescribing omissions were observed in a significant proportion of geriatric patients.Keywords: Polypharmacy, Geriatrics, Beer's criteria, STOPP criteri

218 Sinhgad Institute of Management and Computer Application (SIMCA)

Abstract: The idea is to develop a table-inbuilt console based interactive system for manual ordering system. This interactive system can be used in coffee shops, clubs, public restaurants or bars. The aim is to provide every table with a touch screen based console that can be used by customers as an interactive interface between the customers as well as restaurant manager or administrator. Our system will allow the user to view menu items and order them accordingly. The consoles shall be centrally connected to a central server where actual centralized order processing of all clients can be done. A single administrator can view / monitor all the orders from this centralized server. The system also saves time for both customers as well as hotel owner for order placement

Sociobiological Control of Plasmid copy number

Background:&#xd;&#xa;All known mechanisms and genes responsible for the regulation of plasmid replication lie with the plasmid rather than the chromosome. It is possible therefore that there can be copy-up mutants. Copy-up mutants will have within host selective advantage. This would eventually result into instability of bacteria-plasmid association. In spite of this possibility low copy number plasmids appear to exist stably in host populations. We examined this paradox using a computer simulation model.&#xd;&#xa;&#xd;&#xa;Model:&#xd;&#xa;Our multilevel selection model assumes a wild type with tightly regulated replication to ensure low copy number. A mutant with slightly relaxed replication regulation can act as a &#x201c;cheater&#x201d; or &#x201c;selfish&#x201d; plasmid and can enjoy a greater within-host-fitness. However the host of a cheater plasmid has to pay a greater cost. As a result, in host level competition, host cell with low copy number plasmid has a greater fitness. Furthermore, another mutant that has lost the genes required for conjugation was introduced in the model. The non-conjugal mutant was assumed to undergo conjugal transfer in the presence of another conjugal plasmid in the host cell.&#xd;&#xa;&#xd;&#xa;Results:&#xd;&#xa;The simulatons showed that if the cost of carrying a plasmid was low, the copy-up mutant could drive the wild type to extinction or very low frequencies. Consequently, another mutant with a higher copy number could invade the first invader. This process could result into an increasing copy number. However above a certain copy number within-host selection was overcompensated by host level selection leading to a rock-paper-scissor (RPS) like situation. The RPS situation allowed the coexistence of high and low copy number plasmids. The non-conjugal &#x201c;hypercheaters&#x201d; could further arrest the copy numbers to a substantially lower level.&#xd;&#xa;&#xd;&#xa;Conclusions:&#xd;&#xa;These sociobiological interactions might explain the stability of copy numbers better than molecular mechanisms of replication regulation alone

GRFS and CRFS in alternative donor hematopoietic cell transplantation for pediatric patients with acute leukemia.

We report graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) (a composite end point of survival without grade III-IV acute GVHD [aGVHD], systemic therapy-requiring chronic GVHD [cGVHD], or relapse) and cGVHD-free relapse-free survival (CRFS) among pediatric patients with acute leukemia (n = 1613) who underwent transplantation with 1 antigen-mismatched (7/8) bone marrow (BM; n = 172) or umbilical cord blood (UCB; n = 1441). Multivariate analysis was performed using Cox proportional hazards models. To account for multiple testing, P \u3c .01 for the donor/graft variable was considered statistically significant. Clinical characteristics were similar between UCB and 7/8 BM recipients, because most had acute lymphoblastic leukemia (62%), 64% received total body irradiation-based conditioning, and 60% received anti-thymocyte globulin or alemtuzumab. Methotrexate-based GVHD prophylaxis was more common with 7/8 BM (79%) than with UCB (15%), in which mycophenolate mofetil was commonly used. The univariate estimates of GRFS and CRFS were 22% (95% confidence interval [CI], 16-29) and 27% (95% CI, 20-34), respectively, with 7/8 BM and 33% (95% CI, 31-36) and 38% (95% CI, 35-40), respectively, with UCB (P \u3c .001). In multivariate analysis, 7/8 BM vs UCB had similar GRFS (hazard ratio [HR], 1.12; 95% CI, 0.87-1.45; P = .39), CRFS (HR, 1.06; 95% CI, 0.82-1.38; P = .66), overall survival (HR, 1.07; 95% CI, 0.80-1.44; P = .66), and relapse (HR, 1.44; 95% CI, 1.03-2.02; P = .03). However, the 7/8 BM group had a significantly higher risk for grade III-IV aGVHD (HR, 1.70; 95% CI, 1.16-2.48; P = .006) compared with the UCB group. UCB and 7/8 BM groups had similar outcomes, as measured by GRFS and CRFS. However, given the higher risk for grade III-IV aGVHD, UCB might be preferred for patients lacking matched donors. © 2019 American Society of Hematology. All rights reserved

Increased frequency and nocturia in a middle aged male may not always be due to Benign Prostatic Hypertrophy (BPH): a case report

Primary signet ring cell carcinoma of urinary bladder is a rare type of bladder tumor and carries a very high mortality rate. It may have a clinical presentation similar to common diseases like Benign Prostatic Hypertrophy (BPH) and the management options are extremely limited. We report a case of 58 year old Caucasian male who presented with a 5 month history of increased frequency of urination, nocturia and weight loss without any fever or hematuria. He was found to have an increased creatinine of 2.8 mg/dl and a prostate specific antigen level of 0.18 ng/ml. His azotemia was thought to be secondary to BPH. A foley catheter was initially placed with a plan for outpatient follow up. On removal of the catheter his problems persisted and he returned to the hospital. Diagnostic work up including abdominal ultrasonography, computed tomography (CT) scan, retrograde pyelogram, cystography and cystoscopic biopsies revealed the diagnosis of primary signet ring cell carcinoma of urinary bladder. Although cystectomy was planned, our patient passed away before this could be done