A study to compare the diagnostic accuracy of GeneXpert MTB/RIF/assay and its comparison with liquid culture in clinically suspected cases of genital tuberculosis attending outpatient department of tertiary center

Background: Tuberculosis is a major health issue globally despite a declining trend in mortality with effective diagnosis and treatment, an estimated 10.4 million persons developing active TB each year with 1.33 million deaths. Objective of this study was to evaluate role of GeneXpert MTB/RIF/assay in diagnosis of female genital tuberculosis in suspected cases of tuberculosis.Methods: It was a cross sectional study done in department of obstetrics and gynecology in S. N. Medical college Agra for a period of 2 year (July 2017 to October 2019). 70 cases were selected from OPD of department of obstetrics and gynecology, S. N. Medical College Agra who met the inclusion and exclusion criteria after taking proper consent. In all selected cases endometrial biopsy sample was taken using endometrial biopsy curette in premenstrual period. All samples of endometrial biopsy were taken under all aseptic precaution from both corneal ends, anterior and posterior wall and lower part of uterus using endometrial biopsy curette and sample was collected in two separate sterile vials having normal saline and was sent for GeneXpert MTB/RIF/assay and liquid culture simultaneously.Results: Out of total 70 clinically suspected cases of female genital tuberculosis in between 20-45 years of age cough with expectoration 94% was the most common respiratory symptom followed by fever 81%, weight loss 56% and anorexia 54%. Prevalence of genital tuberculosis in active pulmonary tuberculosis patients was 30%. Irregular menstruation, vaginal discharge and pelvic pain were present in 69%, 60% and 52% patients respectively.Conclusions: The overall sensitivity of CBNAAT was 22% and specificity was 77%. The overall sensitivity of liquid culture was 28% and specificity was 71%

Causes of Sudden Cardiac Death on Autopsy Findings; a Four-Year Report

Introduction: Incidence of sudden cardiac death (SCD) has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127), followed closely by the age group 60-69 (28.43%; n-58). Male to female ratio was around 10:1. The maximum number of deaths (n=78) was within few hours (6 hours) after the onset of signs and symptoms. In 24 (11.8%) cases major narrowing was noted in both the main coronaries, in 87 (42.6%) cases in the left anterior descending coronary artery (LAD), and in 18 (51.5%) cases in the right coronary artery (RCA). The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86%) and myocardial infarction (n-104; 50.9%). most of the SCDs occurred in the place of residence (n-80; 39.2%) followed closely by death in hospital (n-49; 24.01%). Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1.

Intramuscular oxytocin 10 units versus intravenous methylergometrine 0.2 mg in active management of third stage of labour for prevention of postpartum haemorrhage: a comparative study

Background: To compare the effectiveness of 10 IU of oxytocin IM with 0.2 mg methyl ergometrine IV in the prevention of post-partum hemorrhage when used as a part of active management of third stage of labour. This study aims to compare their influence on duration of the third stage of labour, the amount of blood loss during the third stage of labour and the immediate post-partum period and side effects of the drugs if any.Methods: The study was conducted in a tertiary care teaching hospital. 200 women, who underwent normal delivery with or without episiotomy, were enrolled and were randomly distributed into two groups. 100 women received 10 IU of intramuscular Oxytocin and 100 women received intravenous 0.2 mg of methyl ergometrine. Women of both the groups were given the medication after delivery of anterior shoulder of the baby. Comparison done between percentages fall in Hb from before delivery to 24 hours after delivery, need for additional uterotonic agents, need for blood transfusion, duration of third stage of labour and any side effects including retained placenta and need for manual removal of placenta.Results: Intravenous methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage. There was no difference in the duration of third stage of labour, amount of blood loss, need for additional uterotonic agents, and need for blood transfusion in both the groups. There was no significant side effect in both the groups.Conclusions: Intramuscular oxytocin is as efficacious as Intravenous methylergometrine in the prevention of postpartum hemorrhage with no side effects

Lysis of tubercle bacilli in fresh and stored sputum specimens: implications for diagnosing tuberculosis in stored and paucibacillary specimens by PCR

<p>Abstract</p> <p>Background</p> <p>Nucleic acid amplification techniques are being used increasingly in diagnosing tuberculosis. In developing countries clinical samples are often stored for subsequent analysis since molecular tests are conducted at only a limited number of laboratories. This study was conducted to assess the speed at which mycobacteria undergo autolysis and free DNA is detected in the supernatant during low-temperature storage.</p> <p>Results</p> <p>Eighty-seven smear positive sputa from tuberculosis patients were analysed immediately and after storage at -20°C. Timelines of 1 and 2 months were selected to assess the maximum extent of DNA loss that occurred during storage. All samples remained PCR- and smear-positive at 1 month and only 1 sample turned negative after 2 months. Bacterial lysis in the specimens was demonstrated by PCR analysis of supernatant fractions; 53% of the freshly analysed samples contained mycobacterial DNA in supernatants. PCR positivity increased significantly during storage (to 69% and 77% after 1 and 2 months of storage, respectively, P < 0.0001). Storage-associated bacterial lysis was accompanied by a decrease in smear grade status in 28 of 87 samples (P < 0.0001 after 2 months of storage) and a significant storage-associated reduction in bacterial numbers in the remaining samples.</p> <p>Conclusion</p> <p>We conclude that (i) freshly isolated sputum contains both intact and lysed mycobacteria, (ii) lysis increased during storage and (iii) supernatant fractions routinely discarded during sample processing contain mycobacterial DNA. We propose that supernatant is a valuable sample for PCR for both fresh and stored specimens, particularly those with a low bacterial load in addition to conventional sediment.</p

Effectiveness of Honey and Aloe Vera on the Post Extraction Healing Among Young Adults: A Randomized Clinical Trial

INTRODUCTION: "Dry socket" was first described by Crawford in literature in 1896. When people are recognizing that current medicine is not the soul cure for diseases, we look back to the past for potential remedies with the least possible side-effectiveness. So the objective of this study was to evaluate the effectiveness of honey and aloevera on healing of post extraction wounds. MATERIAL AND METHODS: Honey and aloe-vera were prepared by mixing with sterilized cotton. The socket involved was separated by dry autoclaved cotton rolls from the rest of the oral cavity, then honey/aloe-vera was inserted into the respective groups. All patients were advised to avoid solid and liquid diets for 30 minutes after the treatment. Dressings were changed on 3rd day and on 7th day and sockets were evaluated. RESULTS: When the intra-group comparison of honey (p-value=0.003) and aloe-vera (p-value=0.000) was done, both were found to be statistically significant in the healing of dry socket. When the inter-group comparison was done between honey and aloe-vera, Aloe-vera had high healing capacity and was found to be highly statistically significant (p-value=0.001). DISCUSSION: When the intra-group comparison of honey and aloe-vera was done, both were found to be statistically significant in the reduction of dry socket. When the inter-group comparison was done between honey and aloe-vera, Aloe-vera had high healing capacity and was found to be highly statistically significant (p-value=0.00). CONCLUSION: From the analysis, it can be inferred that aloe vera and honey are healthy, natural and user-friendly substitute adjuncts that might be feasible to promote healing of extraction sockets

Soil Structure Interaction Effect on High Rise and Low Rise Buildings

Effect of supporting soil on the response of structure has been analyzed in the present study. A low rise (G+ 5 storey) and a high rise (G+12 storey) building has been taken for the analysis. For both type of buildings, the response of building with and without consideration of soil structure interaction effect has been compared.Without interaction case is the case in which ends of the structure are assumed to be fixed while in interaction case, structure is assumed to be resting on soil strata (ends are not fix). Type of supporting soil has been also changed based on modulus of elasticity of soil (soft, medium and hard soil). STAAD Pro. 2006 software has been used for analysis. It has been observed that response of G+12 storey building is affected more by soil structure interaction effect as compared to G+5 storey building. In case of soft soil the response of both type of buildings are changed very drastically compared to without interaction case. While in case of hard soil there is not much difference in response of buildings compared to without interaction case. Medium soil is showing intermediate effects

Knowledge, Attitude and Practice Regarding Tobacco Cessation Methods among the Dental Professionals of Bareilly International University: A Cross-sectional Study

INTRODUCTION: In India, the percentage of deaths caused by tobacco smoking is anticipated to rise from 1.4 percent in 1990 to 13.3 percent by 2020.Health care experts have done their best to persuade and counsel users to quit the habit through their collaborative efforts. AIM AND OBJECTIVES: Assessment of dentistry students' attitudes and practices concerning tobacco cessation strategies, as well as the role of information in their promotion. MATERIALS AND METHODS: This cross-sectional survey was carried out at the Institute of Dental Sciences, Bareilly among the dental professionals, i.e. final year, interns, postgraduates students. The questionnaire was designed to test the knowledge, attitude, and practice of dental students regarding tobacco use. The self-administered survey included a set of questions. Descriptive statistics and Chi-square test had been used to test associations between their responses among age, qualification, and academic year using statistical package for social sciences (SPSS) version 22. RESULTS: A total of 300 surveys were sent out, with a 96.39 percent response rate. There were 54 percent females and 46 percent males among the 250 participants. Approximately 68 percent of people were between the ages of 20 and 23. In the current study, 32.4 percent were seeking MDS and 67.6 percent were pursuing BDS. Nearly half of those prefer to prescribe nicotine replacement therapy (NRT) as a cigarette cessation recommendation to patients, followed by self-quitting at 48% and pharmaceutical approaches at 1.2 percent. DISCUSSION: More than half of the respondents had an average level of awareness of smoking cessation therapies, and the majority of them had a favorable attitude toward their provision. As a result, it is important to persuade students to develop an interest in learning about tobacco quitting strategies

AN EXPEDIENT APPROACH TO TREAT ASTHMA THROUGH NON-STEROIDAL, NATURAL TRANSFEROSOMES AEROSOL SYSTEM

Asthma is the most common respiratory disease, affecting an estimated 262 million people and resulting in 461,000 fatalities in 2019. The treatment is available on the market, but it is quite expensive, and it also has serious adverse effects due to the high concentration of steroids in the medicine. If given effectively, curcumin, formononetin, and matrine’s anti-inflammatory properties can play a significant role in treatment. To improve the chemical stability and therapeutic potential of these active pharmaceutical ingredients (APIs) in the respiratory tract, a transferosomes system was designed, which encapsulates the APIs inside its vesicular structure and delivers them selectively to the inflamed cells. The DPPC layer will allow for efficient penetration, whereas Tween-80 will aid in deformability and lower interfacial tension, resulting in a small Z-average diameter, allowing for efficient penetration between layers of cells. The APIs’ stability at alkaline pH (7.6) is ensured by the nano-vesicular structure, which significantly increases cellular antioxidant activity and ferric reducing antioxidant power values. On the RAW264.7 cell line, the formulation will be tested for anti-inflammatory activity. Nuclear factor kappa B, tumor necrosis factor, interleukin (IL)-1, IL-2, IL-6, IL-8, IL-12, nitric oxide, and cyclooxygenase-2 are all reduced by curcumin, formononetin, and matrine. They also have an inhibitory effect on the MAPK signaling pathway, preventing extracellular signal-regulated kinase, c-Jun N-terminal kinase, and p38 from causing inflammation. This formulation can effectively treat asthma without the use of steroids, has no adverse effects, and is inexpensive

Coarse race data conceals disparities in clinical risk score performance

Healthcare data in the United States often records only a patient's coarse race group: for example, both Indian and Chinese patients are typically coded as ``Asian.'' It is unknown, however, whether this coarse coding conceals meaningful disparities in the performance of clinical risk scores across granular race groups. Here we show that it does. Using data from 418K emergency department visits, we assess clinical risk score performance disparities across granular race groups for three outcomes, five risk scores, and four performance metrics. Across outcomes and metrics, we show that there are significant granular disparities in performance within coarse race categories. In fact, variation in performance metrics within coarse groups often exceeds the variation between coarse groups. We explore why these disparities arise, finding that outcome rates, feature distributions, and the relationships between features and outcomes all vary significantly across granular race categories. Our results suggest that healthcare providers, hospital systems, and machine learning researchers should strive to collect, release, and use granular race data in place of coarse race data, and that existing analyses may significantly underestimate racial disparities in performance.Comment: The first two authors contributed equally. Under revie

Loss of α-Synuclein Does Not Affect Mitochondrial Bioenergetics in Rodent Neurons.

Increased α-synuclein (αsyn) and mitochondrial dysfunction play central roles in the pathogenesis of Parkinson's disease (PD), and lowering αsyn is under intensive investigation as a therapeutic strategy for PD. Increased αsyn levels disrupt mitochondria and impair respiration, while reduced αsyn protects against mitochondrial toxins, suggesting that interactions between αsyn and mitochondria influences the pathologic and physiologic functions of αsyn. However, we do not know if αsyn affects normal mitochondrial function or if lowering αsyn levels impacts bioenergetic function, especially at the nerve terminal where αsyn is enriched. To determine if αsyn is required for normal mitochondrial function in neurons, we comprehensively evaluated how lowering αsyn affects mitochondrial function. We found that αsyn knockout (KO) does not affect the respiration of cultured hippocampal neurons or cortical and dopaminergic synaptosomes, and that neither loss of αsyn nor all three (α, β and γ) syn isoforms decreased mitochondria-derived ATP levels at the synapse. Similarly, neither αsyn KO nor knockdown altered the capacity of synaptic mitochondria to meet the energy requirements of synaptic vesicle cycling or influenced the localization of mitochondria to dopamine (DA) synapses in vivo. Finally, αsyn KO did not affect overall energy metabolism in mice assessed with a Comprehensive Lab Animal Monitoring System. These studies suggest either that αsyn has little or no significant physiological effect on mitochondrial bioenergetic function, or that any such functions are fully compensated for when lost. These results implicate that αsyn levels can be reduced in neurons without impairing (or improving) mitochondrial bioenergetics or distribution