Risk factors of occupation related back pain and neck pain among patients attending tertiary care hospital, Ahmedabad, India

Introduction: Neck/back pain is one of the common health problems associated with significant impact on health resulting in sickness absenteeism. Neck/back pain is one of important causes of disability adjusted life years worldwide. The Objectives of study were: To identify various occupations related risk factors and their possible role in occurrence of back pain/neck pain and Visual analogue scale(VAS) assessment of their perceived pain. Methods: The study was conducted at one of the tertiary care hospital at Ahmedabad city, India. All patients above age of 18 years attending physiotherapy department for treatment of back pain/neck pain and gave consent were taken as study participants. Information about certain body postures in their lifestyle or at workplace which can have effects on back pain/neck pain were asked. VAS for perceived pain was anchored by “no pain” (score 0) and “pain as bad as it could be” (score 100). Data were entered in MS Excel and analyzed by frequency, contingency coefficient and Goodman & Kruskal’s Gamma test. Result and Conclusion: Total of 512 participants were included in study, among which 53 & 392 participants had Neck pain and Back pain alone, respectively, while 67 participants had both Neck and Back pain. Age, Marital status, socioeconomic class, BMI and type of occupation revealed statistically significant association with severity of pain. Various body postures like prolonged sitting/ standing, frequent bending at waist/knee, Pulling/Pushing heavy objects, frequent weight lifting > 10 kg. and repetitive movement of back/neck revealed as statistically significant risk factors for back/neck pain

Discovery of a Non-Peptidic Inhibitor of West Nile Virus NS3 Protease by High-Throughput Docking

An estimated 2.5 billion people are at risk of diseases caused by dengue and West Nile virus. As of today, there are neither vaccines to prevent nor drugs to cure the severe infections caused by these viruses. The NS3 protease is one of the most promising targets for drug development against West Nile virus because it is an essential enzyme for viral replication and because success has been demonstrated with the closely related hepatitis C virus protease. We have discovered a small molecule that inhibits the NS3 protease of West Nile virus by computer-aided high-throughput docking, and validated it using three experimental techniques. The inhibitor has potential to be developed to a drug candidate to combat West Nile virus infections

Cognitive mediated eye movements during the SDMT reveal the challenges with processing speed faced by people with MS

Abstract Background The Symbol Digit Modalities Test (SDMT) is regarded as the cognitive test of choice for people with MS (pwMS). While deficits are linked to impaired processing speed, the mechanisms by which they arise are unclear. Cognitive-mediated eye movements offer one putative explanation. The objective of this study was to determine the association between eye movements and performance on the SDMT. Methods Thirty-three people with confirmed MS and 25 matched healthy control subjects (HC) were administered the oral SDMT while eye movements were recorded. Results Mean SDMT scores were significantly lower in pwMS (p < 0.038). Shorter mean saccade distance in the key area (p = 0.007), more visits to the key area per response (p = 0.014), and more total number of fixations in the test area (p = 0.045) differentiated pwMS from HCs. A hierarchical regression analysis revealed that the number of visits to the key area per response (p < 0.001; ΔR2 = 0.549) and total number of fixations in the test area (p < 0.001; ΔR2 = 0.782) were the most robust predictors of SDMT scores. Conclusion Cognitive-mediated eye movements help elucidate the processing speed challenges confronted by people with MS. Mechanistic insights such as these can potentially help inform new cognitive rehabilitation strategies

Revisiting cognitive reserve and cognition in multiple sclerosis: A closer look at depression

Background: The protective effect of cognitive reserve (CR) on cognition in people with multiple sclerosis (PwMS) has been well described. Objective: To explore the relationship between aspects of CR, namely, leisure pursuits and depression. Methods: In a cross-sectional study, a sample of 155 PwMS and 115 healthy controls (HC) underwent cognitive testing with the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery. Leisure activity was retrospectively recorded using the Leisure Activity Scale (LAS). Depression was assessed using the Hospital Anxiety and Depression Scale. Results: PwMS demonstrated greater decreases in leisure activity over time compared to the HC group, particularly in the past year (p < 0.001). Here, depression accounted for 17% of the variance in determining the level of leisure activity (p < 0.001). Premorbid IQ and leisure activity within the past year emerged as significant predictors of information processing speed, learning, memory and executive function. After controlling for depression, the influence of leisure activity on cognition was insignificant. Conclusion: Depression can cause significant changes in behaviour which can influence indices of CR, such as leisure pursuits. Successfully treating depression may lead to a more active lifestyle thereby offsetting in part the cognitive burden of disease

Deconstructing the symbol digit modalities test in multiple sclerosis: The role of memory

Background The Symbol Digit Modalities Test (SDMT) is a sensitive measure of impaired cognition in people with MS. While the SDMT is primarily considered a test of information processing speed, other components such as visual scanning and oral-motor ability have also been linked to performance. The objective of this study was to determine the role of memory in the performance of the SDMT. Methods Two version of a modified computerized SDMT (c-SDMT) were employed, a fixed and a variable. For each group 50 MS and 33 healthy control (HC) participants were recruited. In the fixed c-SDMT, the symbol-digit code is kept constant for the entire test whereas in the variable version, it changes eight times. Unlike the traditional SDMT which records the correct number of responses, the c-SDMT presented here measures the mean response time (in seconds) for the eight trials. Results MS participants were slower than HC on the fixed (p < 0.001) and variable (p = 0.005) c-SDMT. Trend analysis showed performance improvement on the fixed, but not on the variable c-SDMT in both MS and HC groups. Furthermore, immediate visual memory recall was associated with the fixed (β = −0.299, p = 0.017), but not variable (B = −0.057, p = 0.260) c-SDMT. Immediate verbal memory was not associated with either versions of the c-SDMT. Conclusions Given that the fixed and variable c-SDMTs are identical in every way apart from the fixity of the code, the ability of participants to speed up responses over the course of the fixed version only points to the contribution of incidental visual memory in test performance

Assessment of the relation between obesity, serum lipids, and dietary intake of vegetable oils

Introduction: The study was conducted to assess the association between consumption of particular variety of cooking oil and its effect on serum lipid profile and also on body mass index (BMI). Material and Methods: The study was conducted at one of the tertiary care hospitals, Ahmedabad city, India. Patients with ≥18 years age who were undergoing “lipid profile” test at central laboratory department of selected hospital and giving consent were the study participants. Details of serum lipid profile were taken from report along with which anthropometric measurements were done and details of diet were taken. Data were entered into MS Excel and were analyzed by frequency, contingency coefficient, and Fisher's exact test. Results: Total 1000 participants were included in the study, among which 274 (27.4%) had raised lipid levels and 729 (72.9%) were preobese or obese. Association between variety of cooking oil used and cholesterol-high-density lipoprotein ratio revealed contingency coefficient value of 0.042 with P value of 0.416. Association between BMI and variety of cooking oil used revealed Fisher's exact value as 83.015 with P < 0.001. Conclusion: Statistical association was not found between serum lipid profile and type of oil used for cooking. Obesity indices revealed significant statistical association with both variety of cooking oil used and serum lipid profile. Dyslipidemia was found to have statistical significant association with raised blood pressure and raised blood glucose

Distraction adds to the cognitive burden in multiple sclerosis

Background: Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living. Objectives: To develop an improved method of cognitive assessment in people with MS using novel real-world distracters. Methods: A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without. Results: The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter (p = 0.001) and non-distracter (p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment. Conclusions: The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of

The rationale and design of Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT): a prospective cohort study of childhood nephrotic syndrome

Abstract Background Nephrotic syndrome is one of the most commonly diagnosed kidney diseases in childhood and its progressive forms can lead to chronic kidney disease (CKD) and/or end-stage renal disease (ESRD). There have been few longitudinal studies among a multi-ethnic cohort to determine potential risk factors influencing disease susceptibility, treatment response, and progression of nephrotic syndrome. Temporal relationships cannot be studied through cross-sectional study design. Understanding the interaction between various factors is critical to developing new strategies for treating children with kidney disease. We present the rationale and the study design of a longitudinal cohort study of children with nephrotic syndrome, the Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT) study. The specific aims are to determine: 1) socio-demographic, environmental, and genetic factors that influence disease susceptibility; 2) rates of steroid treatment resistance and steroid treatment dependence, and identify factors that may modify treatment response; 3) clinical and genetic factors that influence disease susceptibility and progression to CKD and ESRD; and 4) the interaction between the course of illness and socio-demographic, environmental, and clinical risk factors. Methods/design INSIGHT is a disease-based observational longitudinal cohort study of children with nephrotic syndrome. At baseline, participants complete questionnaires and provide biological specimen samples (blood, urine, and toenail clippings). Follow-up questionnaires and repeat biological specimen collections are performed annually for up to five years. Discussion The proposed cohort will provide the structure to test various risk factors predicting or influencing disease susceptibility, treatment response, and progression to CKD among children with nephrotic syndrome. Trial registration ClinicalTrials.gov Identifier NCT01605266

Higher pulmonary vein index on computed angiography and optimum surgical resection ensures smooth postoperative recovery in Fallot's tetralogy: Special emphasis on indices of evaluation and Monocusp preparation

Abstract Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. Its surgical correction requires ventricular septal defect (VSD) closure and right ventricular outflow tract obstruction (RVOTO) relief, with transannular patch enlargement (TAPE) of the pulmonary valve. The first successful repair of TOF was reported in 1954 and consisted of closure of the VSD through a large right ventriculotomy, and RVOTO relief with TAPE of the pulmonary valve. To predict the intraoperative requirements and postoperative course of patients with this condition, various evaluation indices are available that can provide a good indication of patient prognosis. We performed this study in a male child (age, 1 year, 9 months; weight 8.5 kgs.) who underwent intracardiac repair for TOF as a primary procedure. We calculated the pulmonary vein index (PVI), McGoon ratio, and Nakata index. The McGoon ratio was 1.97, Nakata index was 539.22 mm2/m2, and PVI was 368.12 mm2/m2. The child had an uneventful post‐operative course with no symptoms of low cardiac output syndrome. He was ventilated for 122 h. The length of intensive care unit and hospital stays were 11 and 14 days, respectively. The PVI is a novel indicator offering prognostic indications for pediatric cardiac patients who have undergone surgical correction of TOF