A RETROSPECTIVE STUDY ON THALASSEMIA IN SOUTH INDIAN TERTIARY CARE TEACHING HOSPITAL

Thalassemia syndromes are a heterogeneous group of disorders caused by inherited mutations that decrease the synthesis of adult haemoglobin, Hb-A [alpha2 beta2]. Depending on whether the genetic defect or deletion lies in transmission of alpha or beta globin chain genes, thalassemia are classified in to Alpha and Beta Thalassemia. Materials and methods: A Retrospective study was carried out in RIMS Kadapa for two months. Patient demographic details, type of thalassemia, prevalence of thalassemia, Hb levels, known & new cases were collected. Results: A total of 139 cases were diagnosed as having thalassemia in between February 2017 – March 2017. Among which 55 cases were seen in between 11-15 years followed by 6-10 years [38cases] later 0-5 years [38 cases] , 16-20 years [2 cases] 31-35 years[1case]. Highest number of cases was observed in males [91 cases] than females [48]. In our study we couldn't identify type of thalassemia in 122 cases as it was not written in the case sheets. Conclusion: There is a urgent need for making the people aware of this threatening disease Thalassemia, as this disease increasing day by day in the population silently. Health education programmers in the society may reduce the burden of the disease. Moreover, the complications of Thalassemia are one of the major problem on which one has to focus. Diagnosis of Thalassemia, treatment in the early phase may reduce the economic burden and complications in the society. Key words: Alpha thalassemia, Beta thalassemia, RBC destruction, Anemia

Work-related musculoskeletal disorders among dentists and their prevention through ergonomic interventions - A systematic review

Introduction: Occupational or work-related musculoskeletal disorders (WMSDs) vastly prevail among dental professionals. This review aims to summarize the prevalence of WMSDs and ergonomic interventions for the prevention of WMSDs among dental professionals. Methods: Thorough literature search was done using scientific databases. The terms musculoskeletal disorders among dentists/dental professionals/ hygienists in dentistry, occupational or work-related MSDs, ergonomics, ergonomic interventions, and several combinations were used as keywords. Articles published in the English language only were included. Abstracts, thesis work, and other languages were excluded. Results: Our findings revealed several studies showing the prevalence of WMSD among dental professionals and ergonomic interventions to prevent MSDs among dental professionals. Conclusion: Dental practice is highly challenging both in terms of physical and mental status there is a need for continuing efforts to discover innovative preventive strategies, to reduce the prevalence of WMSDs. This article guides dental professionals to incorporate the proper ergonomic methods in their early stages of day-to-day work, for long-term and healthy dental practice.

Cerebral salt wasting following traumatic brain injury

Hyponatraemia is the most commonly encountered electrolyte disturbance in neurological high dependency and intensive care units. Cerebral salt wasting (CSW) is the most elusive and challenging of the causes of hyponatraemia, and it is vital to distinguish it from the more familiar syndrome of inappropriate antidiuretic hormone (SIADH). Managing CSW requires correction of the intravascular volume depletion and hyponatraemia, as well as mitigation of on-going substantial sodium losses. Herein we describe a challenging case of CSW requiring large doses of hypertonic saline and the subsequent substantial benefit with the addition of fludrocortisone

Computational reprogramming of homing endonuclease specificity at multiple adjacent base pairs

Site-specific homing endonucleases are capable of inducing gene conversion via homologous recombination. Reprogramming their cleavage specificities allows the targeting of specific biological sites for gene correction or conversion. We used computational protein design to alter the cleavage specificity of I-MsoI for three contiguous base pair substitutions, resulting in an endonuclease whose activity and specificity for its new site rival that of wild-type I-MsoI for the original site. Concerted design for all simultaneous substitutions was more successful than a modular approach against individual substitutions, highlighting the importance of context-dependent redesign and optimization of protein–DNA interactions. We then used computational design based on the crystal structure of the designed complex, which revealed significant unanticipated shifts in DNA conformation, to create an endonuclease that specifically cleaves a site with four contiguous base pair substitutions. Our results demonstrate that specificity switches for multiple concerted base pair substitutions can be computationally designed, and that iteration between design and structure determination provides a route to large scale reprogramming of specificity

A Randomized Community-based Intervention Trial Comparing Faith Community Nurse Referrals to Telephone-Assisted Physician Appointments for Health Fair Participants with Elevated Blood Pressure

To measure the effect of faith community nurse referrals versus telephone-assisted physician appointments on blood pressure control among persons with elevated blood pressure at health fairs. Randomized community-based intervention trial conducted from October 2006 to October 2007 of 100 adults who had an average blood pressure reading equal to or above a systolic of 140 mm Hg or a diastolic of 90 mm Hg obtained at a faith community nurse-led church health event. Participants were randomized to either referral to a faith community nurse or to a telephone-assisted physician appointment. The average enrollment systolic blood pressure (SBP) was 149 ± 14 mm Hg, diastolic blood pressure (DBP) was 87 ± 11 mm Hg, 57% were uninsured and 25% were undiagnosed at the time of enrollment. The follow-up rate was 85% at 4 months. Patients in the faith community nurse referral arm had a 7 ± 15 mm Hg drop in SBP versus a 14 ± 15 mm Hg drop in the telephone-assisted physician appointment arm (p = 0.04). Twenty-seven percent of the patients in the faith community nurse referral arm had medication intensification compared to 32% in the telephone-assisted physician appointment arm (p = 0.98). Church health fairs conducted in low-income, multiethnic communities can identify many people with elevated blood pressure. Facilitating physician appointments for people with elevated blood pressure identified at health fairs confers a greater decrease in SBP than referral to a faith community nurse at four months

Maturation in serum thyroid function parameters over childhood and puberty:results of a longitudinal study

Context: Serum thyroid hormone levels differ between children and adults, but have not been studied longitudinally through childhood. Objective: To assess changes in thyroid-stimulating hormone (TSH) and thyroid hormone levels over childhood and their interrelationships. Design: Cohort study. Setting: The Avon Longitudinal Study of Parents and Children, a population-based birth cohort. Participants: A total of 4442 children who had thyroid function measured at age 7, and 1263 children who had thyroid function measured at age 15. Eight hundred eighty-four children had measurements at both ages. Main Outcome Measures: Reference ranges for TSH, free tri-iodothyronine (FT3), free thyroxine (FT4), their longitudinal stability, and interrelationships. Results: Children at age 7 years had a higher FT3 [6.17 pmol/L, standard deviation (SD) 0.62] than children at age 15 (5.83 pmol/L, SD 0.74); P , 0.0001 with 23.2% of children at age 7 having FT3 above the adult reference range. Higher FT3 levels at age 7 in boys (P = 0.0001) and girls (P = 0.04) were associated with attainment of a more advanced pubertal stage at age 13. TSH was positively associated with FT3 at age 7 and age 15 even after adjusting for confounders. In contrast, TSH was negatively associated with FT

A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement

Background: Low intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation (tACS or tDCS), applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional magnetic resonance imaging (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both brain function and tES effects. Methodological aspects of tES-fMRI studies underpin the results, and reporting them in appropriate detail is required for reproducibility and interpretability. Despite the growing number of published reports, there are no consensus-based checklists for disclosing methodological details of concurrent tES-fMRI studies. Objective: To develop a consensus-based checklist of reporting standards for concurrent tES-fMRI studies to support methodological rigor, transparency, and reproducibility (ContES Checklist). Methods: A two-phase Delphi consensus process was conducted by a steering committee (SC) of 13 members and 49 expert panelists (EP) through the International Network of the tES-fMRI (INTF) Consortium. The process began with a circulation of a preliminary checklist of essential items and additional recommendations, developed by the SC based on a systematic review of 57 concurrent tES-fMRI studies. Contributors were then invited to suggest revisions or additions to the initial checklist. After the revision phase, contributors rated the importance of the 17 essential items and 42 additional recommendations in the final checklist. The state of methodological transparency within the 57 reviewed concurrent tES-fMRI studies was then assessed using the checklist. Results: Experts refined the checklist through the revision and rating phases, leading to a checklist with three categories of essential items and additional recommendations: (1) technological factors, (2) safety and noise tests, and (3) methodological factors. The level of reporting of checklist items varied among the 57 concurrent tES-fMRI papers, ranging from 24% to 76%. On average, 53% of checklist items were reported in a given article. Conclusions: Use of the ContES checklist is expected to enhance the methodological reporting quality of future concurrent tES-fMRI studies, and increase methodological transparency and reproducibility

Urdu keyboards for creating bibliographic records:An assessment

Input Method Editors (IMEs) – keyboard layouts - are the applications essential for converting keystrokes to character in another language. The study examined four different Urdu IMEs (keyboard layouts) to compare them for the creation of bibliographic records in libraries. It was found that there is no significant difference between the keyboards. The implication of the study is that the cataloguers can choose any one of the IMEs of their choice as there is no distinct advantage of any one IME over others