A Study on Glycosylation pattern of Serum Transferrin in patients with clinically suspected Congenital Glycosylation disorders

INTRODUCTION: Congenital disorder of glycosylation (CDG) is an inborn error of metabolism due to defective glycosylation of glycoproteins/glycolipids. It is a multisystem disorder with wide range of clinical presentations. Glycosylation pattern of a glycoprotein should be evaluated to diagnose this disorder. Transferrin is a glycoprotein whose glycosylation pattern does not changes with age. Therefore isoelectric focussing of serum transferrin is the gold standard technique to diagnose this disorder. CDG prevalence is undoubtedly underestimated in our population due to lack of awareness & availability of automated, quick access diagnostic techniques. MATERIALS AND METHODS: This study consists of two groups. Control group with 30 samples of apparently healthy individuals and cases group with 30 patients who were clinically suspected to have congenital disorders of glycosylation. Other differential diagnosis of their symptoms such as disorders of aminoacid metabolism, fatty acid oxidation defects, organic acidemias and structural anomalies of brain were excluded using possible investigations such as Urine metabolic screening, Tandem mass spectrometry, CT-Brain, ophthalmological and ENT evaluation. The cases were then screened for congenital disorders of glycosylation using capillary zone electrophoresis (CZE) of serum transferrin. RESULTS: Statistical analysis was done using SPSS software version 20.0 by Independent sample T test and Chisquare test. • Out of 30 cases three patients had abnormal transferrin pattern i.e. Carbohydrate deficient transferrin (CDT) - 7.5%, 66.4%, 56.4 %. (The reference interval of CDT is <1.3%). • No statistical significant difference in the distribution of transferrin isoforms between different age groups and sexes in the control group. • Statistically significant increase in the distribution of asialotransferrin was found in the group with history of consanguinous marriage in parents and in the group with cerebral atrophy as a radiological finding. DISCUSSION: Out of 30 cases three cases showed increased Carbohydrate deficient. This observational study concludes that the prevalence of CDG is about 10% among the 30 cases which is a statistically significant finding. This finding inferes CZE of serum transferrin can be used as a simple technique to screen this disorder. There is no statistical significant difference in the distribution of transferrin isoforms between different age group and sexes in the control group. Therefore age and gender specific reference interval for transferrin isoforms may not be important in the diagnosis of CDG There is statistically significant increase in the aisialotransferrin isoform is present in the group with H/O of consanguinous marriage and in the group with positive radiological findings (cerebral atrophy). Since asialo transferrin contributes to the CDT measure, this finding infers that consanguinous marriage is a significant risk factor for congenital disorder of glycosylation and presence of radiological features adds as a supportive evidence for the diagnosis of CDG. CONCLUSION: From this study we have first reported the presence of congenital disorders of glycosylation in our country. The prevalence of congenital disorders of glycosylation is high in the study population. Capillary zone electrophoresis of serum transferrin can be used as a reliable screening technique to screen this disorder in our population. Transferrin isoform levels do not vary between ages or sexes. Therefore age or gender specific reference interval for transferrin isoforms is not mandatory for the diagnosis of congenital disorders of glycosylation. Consangineous marriage is a significant risk factor for congenital disorders of glycosylation. Radiological finding of cerebral atrophy serves as a supportive evidence for the diagnosis of congenital disorders of glycosylation

A meta-analysis of analgesic efficacy of opioids in the treatment of neuropathic pain

Background: Neuropathic pain is the most common form of chronic pain often associated with impaired quality of life due to its poor management. Tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors and calcium channel alpha 2 ligand agonist are preferred as first line therapy for neuropathic pain. Lignocaine patches and transdermal patches of capsaicin are used as second line agents. Moderate efficacy opioids like tramadol and strong opioids are recommended as second line and third line therapy for neuropathic pain respectively. Previous meta-analysis and systematic review shows inconsistent data and lacks reliability in getting conclusive results in opioids use in neuropathic pain. So, author conducted a meta-analysis to reanalyse the analgesic efficacy of opioid agonist for the treatment of neuropathic pain.Methods: Author searched Oxford pain relief data base, Google web, Embase, Medline and Cochrane library from February 2001 to November 2017 for articles related to analgesic efficacy of opioid agonist in neuropathic pain based on author’s selection criteria. Reference list of reviews were retrieved using Prisma Algorithm and analysed using REVIEW MANAGER 5 software.Results: Among 1108 publications searched, only 5 trials met the inclusion criteria. Primary outcome measure was proportion of participants reporting 50% of pain relief or better. In five trials, 305 patients treated with opioids and placebo/standard treatment for neuropathic pain, the number per treatment group ranges from 31 to 170 (median 50±5). The overall point estimate of risk difference was 0.17 (95% CI 0.02 to 0.33, P=0.026) translating to number needed to treat (Benefit) of 5.9 (3.0 to 50.0).Conclusions: In this meta-analysis, opioid agonist efficacy trials shown consistent analgesic efficacy and benefit over placebo/standard treatment in reducing neuropathic pain

Rights And Interest of Indigenous People: In Post Independent India From The Perspective Of Human Rights

People who inhabited a land before it was conquered by colonial societies and who consider themselves distinct from the societies currently governing those territories are called Indigenous peoples. Large areas of the earth’s surface are inhabited by substantial number of Indigenous Peoples. According to rough estimates, globally they account for about one sixth of the population; there are some 370 million indigenous people around the world, the rights of who are often ignored, yet, due to their geographical spread across continents and countries, Indigenous Peoples. They live in nearly all the countries on all the continents of the world and form a spectrum of humanity, ranging from traditional hunter gatherers and subsistence farmers to legal scholars. Despite the extensive diversity in indigenous communities throughout the world, all indigenous peoples have one thing in common- they all share a history of injustice. The nations of the world refuse to recognize that indigenous peoples have human rights. They have been denied the right to participate in governing process of the current state systems. Conquest and Colonization have attempted to steal their dignity and identity as indigenous peoples, as well as the fundamental right of selfdetermination

Seamless Heterogeneous Handoff Based on SAP

Contemporarily there has been a number of techniques being suggested and used for heterogeneous handoff hitch. Different types of decision making methods are being implemented for handoff impediment. Mobile terminals progressing in neighbourhood will incur a handoff when its link capacity decreases below the threshold level. Various types of Multiple Attribute Decision Making methods have been exploited for handoff decision making. Here we have used a novel Reliable Seamless Handoff such as Simple Analytical Process method which uses Analytical Hierarchy Process for predicting the criterion weights and employed Simple Additive Weighting method for handoff decision making. Alternatives such as GSM, CDMA and EDGE networks are used. Data Rate, Packet Loss, Velocity, Bandwidth, Dwell time and Jitter are the parameters applied

Prospective Evaluation of Ridge Augmentation in the Posterior Maxilla by Hydraulic Pressure Indirect Sinus Lift Method

PURPOSE: To prospectively evaluate the ridge augmentation in the posterior maxilla following hydraulic pressure indirect sinus lift in combination with sticky bone graft and immediate placement of endosseous implants with the help of Cone Beam Computed Tomography. MATERIALS AND METHODS: 5 patients requiring maxillary sinus lift surgery for implant placement because of reduced residual alveolar height were chosen. The average residual bone height of the patients was about 5.8mm. A minimally invasive technique of sinus lift in which hydraulic pressure was used to elevate the schneiderian membrane through the crestal osteotomy was performed. Sticky bone was used to fill the increased subsinosal space. Pre operative and 6 months post operative radiographic investigations were done using CBCT, having OPG and RVG as adjuncts to measure the subsinosal bone height and bone density. RESULTS: The preoperative bone height had a mean value of 5.8 ± 1.3 mm with a mean difference of -7mm and it is statistically significant compared to the postoperative average bone height of 12.8 ± 1.9 mm (P 0.05). CONCLUSIONS: Hydraulic pressure indirect sinus lift is a more reliable technique with predictable outcomes for the elevation of schneiderian membrane for implant placement. It is a fast and simple technique that enables elevation of the sinus floor with much lesser morbidity compared to the other sinus lift techniques. The incidence of perforation of schneiderian membrane is less and it also enables simultaneous implant placement

A Comparative study of Efficacy and Safety of Topical mometasone furoate 0.1% with Topical placental extract Versus Topical mometasone furoate 0.1% with Topical tacrolimus 0.1% in vitiligo

BACKGROUND: Vitiligo is an idiopathic, acquired, depigmentation disorder of the skin and hair. Vitiligo is one of the commonest skin disorder affecting about 1 to 2 % of world population. Typical vitiligo lesions are characterised by milky white, non-scaly macules with clearly defined margins. For stable vitiligo, where the involvement of depigmented macules is less than 20 % of Body surface area, the main modality of treatment is topical steroids with adjunctive treatment. Topical tacrolimus, an immunomodulator, calcineurin inhibitor added to the newer armemantarium in treatment of vitiligo. In this study Efficacy and Safety of topical tacrolimus in combination with topical mometasone was well studied and compared with standard treatment, topical mometasone with topical placental extract. AIM AND OBJECTIVE: To determine and compare the efficacy and safety of topical mometasone 0.1% with topical placental extract versus topical mometasone 0.1% with topical tacrolimus 0.1% in terms of repigmentation in vitiligo patients. METHODS: Single centered, openlabel, randomized, comparative, interventional parallel arm study. This study was conducted in dermatology OPD, Govt. Stanley Medical College, Chennai for a duration of 28 weeks. Among 80 patients included in the study, 41 patients in group A received standard treatment of topical mometasone 0.1% with topical placental extract and 39 patients in group B received topical mometasone 0.1% with topical tacrolimus 0.1%. Efficacy was determined in terms difference in mean VASI score between two groups and percentage repigmentation rate between two groups from baseline and at the end of 2nd, 4th, 8th, 12th, 24th weeks. Adverse events were closely monitored. RESULTS: In our study, totally 124 patients were screened, 44 patients were excluded, 80 patients participated in the study. 41 patients in group A received standard treatment and 39 patients in the study group received topical mometasone with topical tacrolimus for 24 weeks. Mean VASI score at baseline was 10.58 in group A and 10.82 in group B (P=0.7170) which was comparable. At the end of 24 weeks mean VASI score , mean VASI score in group A was 5.66 and group B was 3.56 where there is significant difference in the reduction of mean VASI score between two groups (P = 0.0027) . Percentage repigmentation rate were higher in the group B, in which 19 patients (48.71%) in group B had excellent repigmentation(grade IV) whereas only 2 patients (4.87%) had grade IV repigmentation in group A. From the results, it was clear that combination therapy of topical mometasone with topical tacrolimus were having significantly beneficial effects than standard treatment CONCLUSION: In this study, topical tacrolimus 0.1% used with topical mometasone 0.1% is a better combination therapy in producing repigmentation and clinical improvement in stable vitiligo patients. Topical Tacrolimus 0.1% is a well-tolerated and effective adjunctive therapy with topical mometasone for stable vitiligo

A retrospective analysis of adverse drug reactions reported at a tertiary care hospital in South India

Background: Adverse drug reactions (ADRs) have a major impact on public health. Pharmacovigilance has become an integral part of pharmacotherapy. This study has been undertaken to retrospectively analyze the various adverse drug reactions and to promote the reporting of ADRs among the healthcare providers.Methods: A retrospective analysis of the reported ADRs over a period of 3 years at a tertiary care hospital, in Chennai was done. Data related to the number of adverse drug reactions, the demographic particulars, details on the drugs administered, type of ADRs, serious events and prevention strategies undertaken was analyzed. ADRs were assessed for their causality, severity, and preventability as per the standard criteria.Results: A total of 128 suspected ADRs were found to be reported over a period of 3 years. 81.25% ADRs were found to be of mild severity using the Hartwigs scale of assessment, 71.09% were classified as possible using the Naranjo’s causality assessment, the outcome of 63.28% were found to be recovering from the ADR and 41.40 % were under the probably preventable category. The most common ADRs were the skin reactions. The antimicrobial agents were found to have caused the highest number (58.59%) of ADRs followed by NSAIDs (14.84%) and the antihypertensive drugs (14.06%).Conclusions: The antimicrobial agents were associated with ADRs in majority of the patients. The commonly reported ADR s were the skin reactions

Expression of Matrix Metalloproteinase- 9 (Gelatinase- B) in Gingival Tissues of Chronic Periodontitis patients With and Without Diabetes Mellitus: An Immunohistochemical study

INTRODUCTION: Periodontitis is a chronic inflammatory disease which leads to destruction of the periodontal tissues and alveolar bone. Among the various host factors which are involved in destruction of periodontal tissues, one of the most important factor ismatrix metalloproteinases. Matrix metalloproteinases (MMPs) are a large family of calcium-dependent zinc containing endopeptidases which are responsible for tissue remodeling and degradation of ECM including collagens, elastins, gelatin and proteoglycans. They are divided into six groups, one among them consists of gelatinases MMP-2 (gelatinase A) and MMP-9 (gelatinase B). MMP-8, MMP-13 and MMP-9 are the main proteases involved in periodontal tissue destruction. Among these MMP-8 and MMP-9 are the most abundant MMPs which reflect the periodontal disease severity, progression and treatment response. AIM AND OBJECTIVE: To evaluate and to compare the immunohistochemical expression of MMP-9 in gingival tissues of patients with gingivitis, systemically healthy patients with chronic periodontitis and diabetic patients with chronic periodontitis. MATERIALS AND METHODS: A total of 45 subjects were divided into 3 groups: Group A- 15 Patients with gingivitis, Group B- 15 Systemically healthy patients with chronic periodontitis, Group C- 15 Chronic periodontitis patients with diabetes based on inclusion and exclusion criteria. Clinical parameters like gingival index, plaque index, probing depth and clinical attachment level were taken. Gingival tissue samples were collected from the subjects during surgical procedures like crown lengthening, flap surgery and impaction. Samples were analysed for immunohistochemical expression of MMP-9 in the epithelium and connective tissue. After immunostaining, the expression of MMP-9 was evaluated using compound microscope. RESULTS: When compared to Group A, Group B and Group C showed a statistically significant higher expression of MMP-9. But no significant difference was found between Group B and Group C. CONCLUSION: Therefore, both chronic periodontitis and diabetes are found to be associated with the elevated levels of MMP-9 in gingival tissues and bidirectional relationship between chronic periodontitis and diabetes mellitus was observed

MAIL SORTER USING LABVIEW

The Indian postal system is the largest networks in the world. Being the 7th largest country in the world, major population of the country is rural based, where the basic amenities of life is a sweet dream. In such a scenario, having an efficient mail delivery system is essential. Hence, to eliminate the drawbacks in other processes, we propose to fully automate the sorting process. Unlike the code generation technique, it neither requires any human intervention to generate a code based on the pin code nor will be a problem in case of absence of the pin code. The principle used for sorting is the Optical Character Recognition using LabVIEW software. Camera, placed over the slide unit captures the image of the address. The pin code or the state (in the absence of the pin code) is selected and compared with a set of trained characters in the data base. On finding a positive match, based on the first two digits of the pin code or the first four letters of the state, the mail is segregated by the LabVIEW program involving OCR technique. The processed data is sent to the real time application by the DAQ card, which activates the actuating arm(servo motor) to allow the letters to move to the respective stack(zone) and thus sorting the mails automatically, reducing the human effort and errors