Evidence for endotoxin as a causative factor for leptospiral uveitis in humans

Purpose: To understand the pathogenic mechanism of leptospiral uveitis by determining the profile of infiltrating cells, the levels of cytokines, and the causative factor in aqueous humor (AH). Methods: AH and blood samples were collected from 22 patients with leptospiral uveitis that was confirmed by microscopic agglutination test (MAT). Nine patients with Behçet's uveitis, 10 with phacolytic uveitis, and 13 with age-related cataract were included as control subjects. A cytometric bead array was used to estimate human inflammatory and Th1/Th2 cytokines. The level of endotoxin in AH was estimated by limulus amebocyte lysate (LAL) test and by dot blot analysis using a leptospiral serovar lipopolysaccharide (LPS)-specific monoclonal antibody. Results: Except for one patient with leptospiral uveitis, AH from all other patients and control subjects was negative for Gram-negative bacterial endotoxin by LAL test. However, a significant level of serovar Copenhageni LPS was observed in AH of patients with leptospiral uveitis seropositive for the same serovar by MAT, in contrast to its absence in all control subjects. A selective infiltration of neutrophils as well as a significant increase in the levels of protein and cytokines IL-12p70, TNF, IL-6, IL-8, and IL-10 was observed in AH of patients with leptospiral uveitis. Phacolytic uveitis was associated with a high proportion of activated macrophages and increased levels of IL-6 and IL-8, whereas Behçet's uveitis was associated with a predominant infiltration of neutrophils and increased levels of IFN-γ. Conclusions: The results demonstrate the presence of serovar-specific LPS in AH, and thus it is likely that endotoxin is a causative factor in leptospiral uveitis

Primal-Dual 2-Approximation Algorithm for the Monotonic Multiple Depot Heterogeneous Traveling Salesman Problem

We study a Multiple Depot Heterogeneous Traveling Salesman Problem (MDHTSP) where the cost of the traveling between any two targets depends on the type of the vehicle. The travel costs are assumed to be symmetric, satisfy the triangle inequality, and are monotonic, i.e., the travel costs between any two targets monotonically increases with the index of the vehicles. Exploiting the monotonic structure of the travel costs, we present a 2-approximation algorithm based on the primal-dual method

Differential flatness and absolute equivalence

In this paper we give a formulation of differential flatness-a concept originally introduced by Fliess, Levine, Martin, and Rouchon (1992)-in terms of absolute equivalence between exterior differential systems. Systems which are differentially flat have several useful properties which can be exploited to generate effective control strategies for nonlinear systems. The original definition of flatness was given in the context of differential algebra, and required that all mappings be meromorphic functions. Our formulation of flatness does not require any algebraic structure and allows one to use tools from exterior differential systems to help characterize differentially flat systems. In particular, we show that in the case of single input control systems (i.e., codimension 2 Pfaffian systems), a system is differentially flat if and only if it is feedback linearizable via static state feedback. However, in higher codimensions feedback linearizability and flatness are not equivalent: one must be careful with the role of time as well the use of prolongations which may not be realizable as dynamic feedbacks in a control setting. Applications of differential flatness to nonlinear control systems and open questions are also discussed

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

Seasonal hand line fishery for yellowfin tuna at Colachel

In Tamil Nadu, the oceanic tunas like skipjack and yellowfin tuna are exploited mainly by multiday drift gill netters. However, in Colachel, Kanyakumari, there is a seasonal fishery targeting yellowfin tuna of medium size weighing around 30 kg, with hand lines that are operated from multiday trawlers. This is an additional income for both the fishermen and the trawl boat owners

Early investigation on cryopreservation of Dendrobium sonia-28 using encapsulation-dehydration with modified Evan blue assay

This study was conducted to determine the potential of cryostoring and regenerating Dendrobium sonia-28 protocorm-like bodies (PLBs) using the encapsulation-dehydration technique. The parameters tested for this study included the PLB size range (1 to 2 and 3 to 4 mm), preculture using six different sucrose concentrations (0.0, 0.2, 0.4, 0.6, 0.8 and 1.0 M) and encapsulation using three different sodium alginate concentrations (2.5, 3.0 and 3.5%). Based on initial trials, 1 to 2 mm PLBs that were precultured in 1.0 M sucrose were selected for further studies as they produced the best viability as indicated by the Evans blue (EB) staining method. Subsequently, the PLBs were subjected to a 30 min encapsulation experiment involving the three sodium alginate concentrations. Finally, the chlorophyll content and total soluble protein of cryopreserved, non-cryopreserved and untreated PLBs were determined.Key words: Orchid, protocorm-like bodies, cryopreservation

A comparative assessment of the impact of computer assisted learning of knowledge and skill based competencies among undergraduate students in a medical college in South India

Background: Pharmacology has always been one subject ultimatum and a cornerstone in building up competency, based on applied therapeutics among medical graduates in prescribing and practicing skills. A focus on an integrated strategical approach towards teaching pharmacology for better proficiency in achieving clinical skills is mandatory. Thus, this study has been done to assess the impact and retainment of overall knowledge gained on various domains, based on a revised method of teaching in pharmacology.Methods: An observational, questionnaire based comparative study was done in a medical college, in Chennai. The study included two group of students, one who have completed their pharmacology course based on the revised pattern of teaching with a comparative group of students who have not been exposed to the revised pattern of teaching. A feedback survey was also done.Results: The study results indicated that the average scoring based on the questionnaire was 84% with the students who have been exposed to revised pattern of teaching in comparison to the average scoring of 70% with the students who have not been exposed to the new pattern of teaching. The average scoring of the students who were found to agree to several questions on the new method of teaching was 74% and 22% of the students were found to disagree. 4% of students were non responders.Conclusions: The ultimate improvement in the outcome of health care education can be achieved through appropriate skill building through a simple strategical modification of the regular teaching pattern with an integrated approach involving pharmacologists and clinicians. A refresher course in pharmacology in the final year curriculum and CRRI involving pharmacologists is mandatory

A shared HLA-DRB1 epitope in the DR beta first domain is associated with Vogt-Koyanagi-Harada syndrome in Indian patients

PURPOSE: Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia (SO) are two distinct entities that share common clinical and histopathological features; however, it remains unknown whether they have a common genetic susceptibility. Several studies have shown an association of human leukocyte antigen (HLA)-DR4 with VKH disease in patients of different ethnic backgrounds. We present in this paper the HLA-DRB1 genotyping analysis of a large cohort of VKH patients from southern India and compare these patients to patients with SO and to healthy individuals from the same geographic area. METHODS: VKH patients were diagnosed according to the revised criteria of the International Committee on VKH disease. Patients with granulomatous uveitis after ocular trauma or multiple eye surgeries were diagnosed as having SO. Genomic DNA was extracted from all patients and controls. Samples were analyzed for HLA-DRB1 alleles by reverse polymerase chain reaction (PCR) sequence-specific oligonucleotide (SSO) hybridization on microbeads, using the Luminex technology, and by PCR sequence-specific primers (SSP) typing for DRB1*04 allele determination. Strength of associations was estimated by odds ratios (OR) and 95% confidence intervals (CI) and frequencies were compared using the Fisher's exact test. RESULTS: HLA-DRB1 alleles were determined in 94 VKH patients, 39 SO patients, and 112 healthy controls. HLA-DRB1*04 frequency was higher in VKH patients (20.2% versus 10.3% in controls; OR=2.2, p=0.005, pc=0.067). This association was lower than the association of HLA-DRB1*04 frequency in cohorts of patients from different origins. No significant DR4 association with SO was detected. HLA-DRB1*0405 and HLA-DRB1*0410 alleles were significantly increased in VKH patients (8.5% versus 0.9% in controls; OR=10.3, 95% CI=2.34-45.5, p<0.001). These two alleles share the epitope S57-LLEQRRAA (67-74) in the third hypervariable region of the HLA-DR molecule. None of the DRB1 alleles was significantly associated with SO. CONCLUSIONS: Based on the association of HLA-DRB1*0405 and HLA-DRB1*0410 alleles with VKH disease, we propose that the epitope S57-LLEQRRAA (67-74) in the third hypervariable region of the HLA-DRbeta1 molecule is the relevant susceptibility epitope. This genetic component seems specific to VKH disease since no correlation could be identified in SO patients. The weaker association with HLA-DR4 in this VKH patient cohort compared to VKH patients from northern India is probably related to the lower frequency of HLA-DRB1*0405 in our study group. The HLA-DRB1 association with susceptibility to VKH syndrome seems weaker in Indian patients compared to Japanese or Hispanic patients, suggesting a different non-HLA immunogenetic background in Indian VKH patients

Phocomelia: is it time to retrospect, regulate and rescue? a case report

Phocomelia is an extremely rare congenital anomaly which presents as, the proximal part of the limb (humerus or femur, radius or tibia, ulna or fibula) being absent or markedly hypoplastic, with normal or near normal hand or foot. True phocomelia presents as the total absence of the intermediate segments of the limb, with the hand or foot directly attached to the trunk. Presented here is a case of phocomelia in an aborted foetus, with no maternal history of thalidomide exposure in her pregnancy and for whom evaluation of other family members/ siblings failed to reveal any substantial abnormality. The differential diagnosis and the significance of reporting of serious adverse drug reactions are discussed