Fluid mechanics study of the mitral valve complex

Issued as Report, Project no. E-19-56

GENE EXPRESSION DURING IMIDACLOPRID-INDUCED HORMESIS IN GREEN PEACH APHID

Imidacloprid-induced hormesis in the form of stimulated reproduction has previously been reported in green peach aphid, Myzus persicae. Changes in gene expression accompanying this hormetic response have not been previously investigated. In this study, expression of stress response (Hsp60), dispersal (OSD, TOL and ANT), and developmental (FPPS I) genes were examined for two generations during imidacloprid-induced reproductive stimulation in M. persicae. Global DNA methylation was also measured to test the hypothesis that changes in gene expression are heritable. At hormetic concentrations, down-regulation of Hsp60 was followed by up-regulation of this gene in the subsequent generation. Likewise, expression of dispersal-related genes and FPPS I varied with concentration, life stage, and generation. These results indicate that reproductive hormesis in M. persicae is accompanied by a complex transgenerational pattern of up- and down-regulation of genes that likely reflects trade-offs in gene expression and related physiological processes during the phenotypic dose-response. Moreover, DNA methylation in second generation M. persicae occurred at higher doses than in first-generation aphids, suggesting that heritable adaptability to low doses of the stressor might have occurred

A Comparative Study on Low Dose Intrathecal Ropivacaine alone with Ropivacaine and Sufentanil in Labor Analgesia

INTRODUCTION: “For all the happiness Mankind can gain is not in pleasure but in rest from pain" - JOHN DRYDEN. Pain derived from the Latin word “poena” which means punishment. In ancient times, Pain was considered as punishment from god. Labor is an extremely painful process. Being a natural process, women have accepted labor pain as a normal one. Traditionally a number of techniques have been employed to provide labor analgesia. Epidural analgesia, either continuous or intermittent boluses, is considered to be the gold standard in labor analgesia due to the long duration of labor. Traditionally only high doses of local anaesthetics were used. Though they provide excellent pain relief, they produce an unacceptable high level of motor blockade which impairs the parturient’s ability to bear down during labor, resulting in prolonged labor. Lower doses of local anaesthetics by themselves are inadequate. The technique of spinal analgesia in labor pain relief was a setback due to the shorter duration of analgesia. The newer technique of combined spinal-epidural analgesia is a major breakthrough in labor analgesia. Current obstetric practice aiming to provide effective pain relief, led Collins and colleagues to popularize the combined spinal-epidural technique for labor analgesia. These techniques involved an initial intrathecal injection of a local anaesthetic with an opioid (Fentanyl) to establish analgesia and subsequent epidural injections to maintain analgesia. The doses of drugs involved were such that ambulation was possible. The discovery of opioid receptors in spinal analgesia provides an interesting option. Opioid agonists selectively block pain impulses but leave the motor system unaffected. The doses for central neuraxial blockade are also very little when compared to parenteral routes and does not result in significant respiratory depression both to the mother and the fetus. Since opioids and local anaesthetics act at different sites, their combination provides a synergistic effect permitting to use lesser concentration of both. When used in such low doses the individual side effects are minimized while maximizing the desired effects. Ropivacaine, a newer local anaesthetics which has been shown to cause less intense motor blockade and less cardiotoxic is rapidly evolving as local anaesthetic of choice in labor analgesia as well as in post operative analgesia. The aim of this study was to compare the analgesic and the motor sparing effect of low dose intrathecal Ropivacaine 3mg with or without sufentanil 10μg as a part of CSE labor analgesia. Efficacy, Duration of analgesia, sensory blockade and fetal effects were studied in detail. AIM: To compare the effect of low dose intrathecal Ropivacaine alone with Ropivacaine and Sufentanil in providing labor analgesia. The parameters that were analysed include: 1. The analgesic and the motor sparing effect of low dose intrathecal Ropivacaine alone and with sufentanil in labor analgesia. 2. Maternal and fetal outcomes. 3. Safety and patient comfort. MATERIALS AND METHODOLOGY: This is a prospective randomized controlled study. Prior approval was obtained from the ethics committee of Stanley Medical College and Hospital & RSRM Lying in Hospital for the study. Forty parturients who were admitted to the labor ward andwho requested pain relief during labor were selected for the study. The procedure was explained to them in detail and written consent was obtained from them. Inclusion Criteria: 1. Patients in early active labor (Cervical dilatation 3-5 cms) 9 2. Patients belonging to ASA I. 3. Only primigravida patients with singleton pregnancy were included in the study. 4. Vertex presentation. Exclusion Criteria: 1. Patients with medical or systemic disorders. 2. Patients with obstetric complications (PIH, GDM, Eclampsia, etc.) 3. Presentation other than vertex 4. Any contraindications for Central Neuraxial Blockade. 5. Patients who have already received parenteral opioids or systemic analgesics. 6. Patients with known allergy to local anaesthetics. RESULTS: The study was conducted in Government RSRM Lying-in Hospital during 2006. Forty patients in active labour (Cervical dilatation 3-5 cms)9 who requested analgesia were chosen and randomly assigned to either of the two groups : R-Group (Ropivacaine) : Recieved intrathecal Ropivacaine 3mg as part of CSE, followed by epidural top-ups with bupivacaine 0.0625% and fentanyl 1.5μg/ml. RS-Group (Ropivacaine with Sufentanil) : Recieved intrathecal Ropivacaine 3mg with Sufentanil 10 μg as part of CSE, followed by epidural top-ups with bupivacaine 0.0625% and fentanyl 1.5μg/ml for standardization. The study commenced at the intrathecal injection and completed with the patients first request for analgesia. The above stated period alone was taken for statistical analysis, using students t-test, Chi-Square tests, fischer tests. Since some of the cases end earlier, the datas were taken for analysis upto 45 mins duration, though all the parameters were monitored till the delivery of the baby. SUMMARY: In my study, parturients in both the groups had effective pain relief and gave more satisfaction because of the earlier onset of analgesia thus Ropivacaine, a useful local anaesthetic in labor analgesia. Motor blockade was nil in both the groups, making Ropivacaine, an effective drug in central neuraxial analgesia, especially in settings where ambulation should be retained, such as analgesia during labor or outpatient anaesthesia. The duration of analgesia was prolonged(mean 93.25 mins in RS-group vs mean 47.6 mins in R-group) when sufentanil is added intrathecally as an additive providing better pain relief, although no statistical difference between the groups in patients satisfaction. Maternal and fetal outcomes were also favourable. Complications were only few, minor and easily manageable with just reassurance. The technique doesnot pose any additional difficulty. CONCLUSION: In my study, I conclude low dose intrathecal Ropivacaine(3 mg as 0.2% solution) provides effective and rapid pain relief ,and doesnot impair the motor function. Thus ambulation is made easy in CSE labour analgesia, without imposing any significant impact on the hemodynamics, mode of delivery, duration of labor or fetal outcome. Hence low dose intrathecal Ropivacaine is a safe drug in CSE labor analgesia. And when combined with sufentanil the quality and duration of intrathecal analgesia is much better (almost twice the duration) with minimal side effects. Low dose intrathecal Ropivacaine with Sufentanil provides safe and satisfactory labor analgesia and can be used in all parturients who request labor pain relief. Providing pain relief to laboring parturients will surely be a gratifying experience for the anaesthesiologists

Prediction of outcome in patients with sepsis using C-reactive protein and apache II scoring system

The word sepsis originated from the old Greek word meaning “PUTREFACTION”.Nowadays this term is used to describe the host systemic response to infectious stimuli that is characterized by clinical, hemodynamic,biochical and inflammatory responses.Increasing understanding of various inflammatory cascade mechanisms has given new insights and provided several markers that,in conjunction with other manifestation of sepsis can be useful as indicators of infection.C-Reactive protein is one such marker. Many biochemical markers and clinical scoring systems are used to assess the severity and outcome of sepsis.CRP levels are widely used as a relative non-specific marker of inflammation.The level of CRP will be correlated with the prognosis of a patient with sepsis.Prognostic indexes have been developed for estimating hospital mortality rates for patients hospitalized in ICU,based on demographic, physiological and clinical data.The most frequently used indices is APACHE II Scoring system.Both scoring systems and CRP levels were significantly higher in the nonsurvivors when compared with the survivors.Nonsurvivors had significantly higher CRP levels.The relationship between the CRP levels and APACHE II score indicates that both these parameters are useful indicators of severity and prognosis. AIMS AND OBJECTIVES: To study the prognostic outcome of patients with sepsis by using both the scoring system(APACHE II) and Acute phase reactant(CRP) MATERIALS AND METHODS: In our study 50 patients with sepsis who met the inclusion and exclusion criteria were selected from the medical wards and ICU in the institute of internal medicine. Serum CRP and APACHE II score were checked at the time of admission and 48 hours after admission by using immunoturbidometric method and score calculator. OBSERVATION AND RESULTS: In our study, it was observed that CRP and APACHE II were compared at admission.The correlation is statistically significant with the P value of 0.01 with correlation coefficient of 0.63.After 48-72 hours also it is statistically significant with Pvalue of 0.01 and the correlation coefficient of 0.61.Comparision of CRP with smoking, hypertension,diabetes,alcohol are not statistically comparison of CRP with SOFA score also not statistically significant. CONCLUSION: In conclusion, the present study showed a statistically significant correlation between the CRP and APACHE II score on admission and after 48 hours.CRP estimation is an economically,consistent and reproducible test and available in almost every hospital.It is elevates significantly in patient with sepsis and increase according to the severity of the sepsis which could lead to increased predisposition to morbidity and mortality.Mortality of the sepsis is increase with the age of the patient.When using both the scoring system and CRP the prediction of outcome in patients with sepsis is increased.So this study is useful in a way that in future if a patient is admitted with sepsis and having high APACHE II score and CRP levels means the prognosis and outcome of the patient is poor and he/she should be treated with aggressive and appropriate therapy

Analysis of kinetics parameters on T cell recognition to viral infection

T cell plays an important role in clearance of viral infections and development of memory population for a rapid immune response in the case of secondary infections. T cells utilize T cell receptor (TCR) to recognize viral antigens in the form of peptide major histocompatibility complex (pMHC) as its ligand. When viral mutations occur, TCR recognition is impaired for its ligand and in result, lowers immune cell lytic response. Conventionally, TCR binding kinetics to its ligands is linked to TCR binding propensity stemming from 3D assays, providing numerical values in relation to its strength. However, characterizing the interaction of viral variant peptides to TCR is poorly understood and providing a unique perspective in understanding the interaction provides potential solutions to vaccine development, especially for chronic viral infections. In this study, we characterize Cytomegalovirus (CMV)-specific T cell 2D effective binding affinity to both WT and viral variants. Additionally, we characterized to elucidate the importance of specific amino acids found on the peptide influences recognition, thereby potentially bridging gap to understand the mechanics of how specific recognition motifs influence functionality. As T cell gets activated following peptide recognition, multiple signaling pathways take place in order to invoke an effective functional output. To invoke such a response, T cells first translate from naïve to activated state and then returning to homeostasis over the course of an immune response. Although the entire process takes several days, how recognition dynamics is influenced in the context of viral clearance and how that leads into developing memory population has not been fully elucidated. To understand these phenomenon, we primarily evaluated a single transgenic T cell population over the course of an acute lymphocytic choriomeningitis virus (LCMV) viral infection to characterize and understand the dynamics of the T cell function and development that is influenced by organ compartmentalization. Our results highlight an important aspect on how TCR propensity is influenced by the microenvironments during viral clearance and in the occurrence of viral mutation, how characterizing TCR recognition provides new insights on impaired binding kinetic and functional profile.Ph.D

Orthodontic apps: An assessment of content accuracy and validity

Objective: To assess the content accuracy of orthodontic treatment information in patient-focused apps. Design: A cross-sectional review study. Setting: Orthodontic apps available on the UK Android and Apple App Stores. Methods: Apps identified in a previous research study and those identified via a questionnaire of specialist orthodontists were assessed for accuracy of content utilising an evidence-based checklist. The checklist covered five main orthodontically relevant themes and 32 codes with respective items. Results: The accuracy of information content for 16 patient-focused apps was assessed. Eight apps provided information related to orthodontic treatment and handling emergencies. Five apps were reminder apps and a small number (n = 3) contained games and timers for toothbrushing and aligners. With regard to the accuracy of information content, only two apps contained information across all five themes of the evidence-based checklist. Only one app received a score of ‘fair - excellent’ under the oral hygiene theme; interestingly, this app was the most commonly used patient-focused app. Eight apps containing orthodontic treatment information scored poorly as they had inaccurate information on handling emergency situations. None of the apps were deemed excellent with regard to accuracy of information content. Conclusion: The orthodontic mobile apps assessed in this study mostly contained information of poor accuracy. Therefore, there is a need for high-quality apps with credible information supported by evidence to be developed

The Sixth Rhino: A Taxonomic Re-Assessment of the Critically Endangered Northern White Rhinoceros

BACKGROUND: The two forms of white rhinoceros; northern and southern, have had contrasting conservation histories. The Northern form, once fairly numerous is now critically endangered, while the southern form has recovered from a few individuals to a population of a few thousand. Since their last taxonomic assessment over three decades ago, new material and analytical techniques have become available, necessitating a review of available information and re-assessment of the taxonomy. RESULTS: Dental morphology and cranial anatomy clearly diagnosed the southern and northern forms. The differentiation was well supported by dental metrics, cranial growth and craniometry, and corresponded with differences in post-cranial skeleton, external measurements and external features. No distinctive differences were found in the limited descriptions of their behavior and ecology. Fossil history indicated the antiquity of the genus, dating back at least to early Pliocene and evolution into a number of diagnosable forms. The fossil skulls examined fell outside the two extant forms in the craniometric analysis. Genetic divergence between the two forms was consistent across both nuclear and mitochondrial genomes, and indicated a separation of over a million years. CONCLUSIONS: On re-assessing the taxonomy of the two forms we find them to be morphologically and genetically distinct, warranting the recognition of the taxa formerly designated as subspecies; Ceratotherium simum simum the southern form and Ceratotherium simum cottoni the northern form, as two distinct species Ceratotherium simum and Ceratotherium cottoni respectively. The recognition of the northern form as a distinct species has profound implications for its conservation

Continuing professional development and quality of teaching: a case study in state secondary schools in Mauritius

This research has investigated how Continuing Professional Development and Learning (CPDL) could help teachers to become better teachers by acquiring new skills and improving their competencies. The aim was to find out to what extent the present system of CPDL in Mauritius is able to fulfill that important role of providing CPDL which influences positively on the quality of teaching. The skills teachers wanted to develop in order to become better classroom practitioners were also explored. The research comprised a survey made of all the principals of the State Secondary Schools (SSSs) in Mauritius followed by semi-structured interviews with nine teachers, three Heads of Departments (HoDs) and principals of three schools studied and two directors of the Ministry of Education (MOE). Data were also obtained from a World Bank consultant during his visit to Mauritius advising the government on education reforms and three inspectors. Evidence suggests that in the Mauritian secondary schools studied there are shortcomings in the provision of CPDL but there are also possibilities for improvement. The findings of the research make it possible to make recommendations which might be useful for policy makers to bring changes to improve the provision of CPDL at the level of the teachers, the school and the MOE. The main findings of the research were that the main model of CPDL, that is workshops, does not provide educators with the necessary skills to improve their quality of teaching; HoDs and senior educators who were supposed to lead CPDL were not fulfilling that role to its fullest; principals were not in general supporting HoDs to provide CPDL; and the inspectors seemed unable to do much in terms of improving the quality of teaching. Nevertheless, there is a place for CPDL with teachers in the SSSs provided it is dispensed by experts in their fields; teachers learn from them; there is follow up and what is learnt is applied in the classroom. Key words: CPDL, teaching skills, competencies, coaching, collaboration and one-day workshops