Association of the pre-monsoon thermal field over north India and the western Tibetan Plateau with summer monsoon rainfall over India

In this paper, interannual variability of tropospheric air temperatures over the Asian summer monsoon region during the pre-monsoon months is examined in relation to Indian summer monsoon rainfall (ISMR; June to September total rainfall). For this purpose, monthly grid-point temperatures in the entire troposphere over the Asian summer monsoon region and ISMR data for the period 1949–2012 have been used. Spatial correlation patterns are investigated between the temperature field in the lower tropospheric levels during May over the Asian summer monsoon region and ISMR. The results indicate a strong and significant northwest–southeast dipole structure in the spatial correlations over the Indian region, with highly significant positive (negative) correlations over the regions of north India and the western Tibetan Plateau region – region R1 (north Bay of Bengal: region R2). The observed dipole is seen significantly up to a level of 850 hPa and eventually disappears at 700 hPa. Thermal indices evaluated at 850 hPa level, based on average air temperatures over the north India and western Tibetan Plateau region (TI1) and the north Bay of Bengal region (TI2) during May, show a strong, significant relationship with the ISMR. The results are found to be consistent and robust, especially in the case of TI1 during the period of analysis. A physical mechanism for the relationship between these indices and ISMR is proposed. Finally the composite annual cycle of tropospheric air temperature over R1 during flood/drought years of ISMR is examined. The study brings out the importance of the TI1 in the prediction of flood/drought conditions over the Indian subcontinent

Specific detection of Aspergillus fumigatus in sputum sample of pulmonary tuberculosis patients by two-step PCR

The incidence of life-threatening systemic fungal infections has been increasing in recent years, and the increasing incidence has been correlated with increasing numbers of immunocompromisedpatients. We developed a two-step PCR assay that specifically amplifies a region of the 18S rRNA gene that is highly conserved in Aspergillus fumigatus. This assay allows direct and rapid detection of down to 10 fg of Aspergillus fumigatus DNA corresponding to 1 to 5 colony forming unit (CFU) per ml of sputum sample of pulmonary tuberculosis patients. The two primer pairs that produced PCR productswith the highest sensitivity and species specificity were the Aspergillus fumigatus primers AFU7S and AFU7AS, which amplified a fragment of 405 bp, followed by AFU5S and AFU5AS, which produced aninternal fragment of 236 bp. PCR has been shown to be a highly sensitive diagnostic tool for the detection of infectious fungi specimens. Our point to the considerable potential clinical value of thissimple, specific, rapid, and inexpensive PCR assay is for improving the means of early diagnosis of systemic aspergillosis tuberculosis patients

Prescription pattern and rationality of antihypertensive drugs in patients of type 2 diabetes with hypertension: a pilot study

Background: As presence of hypertension (HTN) in type 2 diabetes significantly increases risk of morbidity and mortality, its control with rational use of antihypertensives is essential. Authors performed this study to understand the current prescribing pattern of antihypertensives in patients of type 2 diabetes and their assess the rationality to recommendations of JNC-8 guidelines.Methods: Authors performed a cross sectional survey of prescription of diagnosed patients of diabetes with HTN at a tertiary care hospital. Prescription of patients attending medicine OPD were scanned. Data was collected over 2 month and analyzed with descriptive statistics.Results: In 76 patients analysed, mean age was 54.9±9.3 years and 51.3% were females. Insulin and oral antidiabetic agents were prescribed in 16 (21.1%) and 73 (96.1%) patients respectively. One, two, three and four antihypertensive drugs were prescribed in 44 (57.9%), 28 (36.8%), 3 (3.9%) and 1 (1.3%) patients respectively and 24 (31.6%) of them were fixed dose combinations. Among antihypertensives, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), thiazide diuretics, beta blockers (BBs) and calcium channel blockers (CCBs) were present in 29 (38.2%), 26 (34.2%), 22 (28.9%), 21 (27.6%) and 14 (18.4%) respectively. In individual drugs, ramipril (28.9%) was most common followed by telmisartan (26.3%), hydrochlorothiazide (26.3%), atenolol (16, 21.1%) and amlodipine (17.1%) were frequently prescribed. In adjuvant drugs, antiplatelet (52.6%) and statins (56.6%) were common. This pattern of prescription was as per the recommendations of recent JNC-8 guidelines for treatment of hypertension.Conclusions: ACEIs/ARB are the most preferred for HTN treatment in type 2 diabetes mellitus. Prescription of antihypertensives in our set up was rational as per JNC-8 recommendations

Development of a photometric system for continuous flow analysis

Most chemical analyses carried out in a clinical laboratory are colorimetric. An improved photometric system is described where a tungsten lamp is the light source, a photo-diode is the detector and a microcontroller 8051 is used for processing and displaying absorbances. The performance characteristics of the instrument are reported. The parameters investigated are photometric linearity, precision and instrumental drift

Free-flap reconstitutions of head and neck defects after oncologic ablation

Background: Head and neck cancers are the sixth most common cancers worldwide. The primary treatment modality for most head and neck cancers is surgery with reconstruction of resultant defects. Reconstruction of these defects is a unique challenge as it has to not only restore integrity but also function and often cosmesis. The objective of this study was to assess the utility of free flaps in the reconstruction of these defects, done in a tertiary care centre in a three-tier city in India. Methodology: We analyzed the computerized medical records of the last 3 years in this retrospective study carried out in the department of head and neck oncology at the cancer centre. The study included cases that had undergone surgery for head and neck cancer and underwent free flap reconstruction. Results: Out of the 1061 cases requiring reconstruction after an oncologic ablation, 201 cases underwent free flap reconstruction. For defects requiring Facio cutaneous reconstruction, the radial forearm was the preferred donor free flap site, while the fibula was the preferred donor site for mandibular reconstructions survival rate was 94.5%, with factors like age and comorbidities like diabetes and hypertension or habits like cigarette smoking or tobacco chewing not affecting survival rates. Twenty cases of minor flap complications were observed. Conclusions: Free flap reconstructions for head and neck defects after oncologic ablation have been a boon with good survival rates and immense flexibility of use, giving good cosmetic and functional outcomes. Our study shows that a significant number of free flap reconstructions can be done in a tertiary care centre in a three-tier city in India with an internationally comparable survival rate

Free-flap reconstitutions of head and neck defects after oncologic ablation

Background: Head and neck cancers are the sixth most common cancers worldwide. The primary treatment modality for most head and neck cancers is surgery with reconstruction of resultant defects. Reconstruction of these defects is a unique challenge as it has to not only restore integrity but also function and often cosmesis. The objective of this study was to assess the utility of free flaps in the reconstruction of these defects, done in a tertiary care centre in a three-tier city in India. Methodology: We analyzed the computerized medical records of the last 3 years in this retrospective study carried out in the department of head and neck oncology at the cancer centre. The study included cases that had undergone surgery for head and neck cancer and underwent free flap reconstruction. Results: Out of the 1061 cases requiring reconstruction after an oncologic ablation, 201 cases underwent free flap reconstruction. For defects requiring Facio cutaneous reconstruction, the radial forearm was the preferred donor free flap site, while the fibula was the preferred donor site for mandibular reconstructions survival rate was 94.5%, with factors like age and comorbidities like diabetes and hypertension or habits like cigarette smoking or tobacco chewing not affecting survival rates. Twenty cases of minor flap complications were observed. Conclusions: Free flap reconstructions for head and neck defects after oncologic ablation have been a boon with good survival rates and immense flexibility of use, giving good cosmetic and functional outcomes. Our study shows that a significant number of free flap reconstructions can be done in a tertiary care centre in a three-tier city in India with an internationally comparable survival rate

Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures: the suture “bridge” pull out technique and evaluation of results

Background: Tibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. Operative treatment is indicated for type 2, 3 and 4 fractures. Arthroscopic fixation is the preferred method and numerous fixation options are described. The purpose of this study is to evaluate the results of a new technique of arthroscopic fixation.Methods: A retrospective study was done involving twelve patients having displaced ACL tibial avulsion fractures. The arthroscopic suture “bridge” pull out technique was used to fix these fractures. Patient symptoms like knee pain, locking, clicking, sensation of giving way and clinical signs like tenderness, range of motion, Mc Murray’s test, stability test and Lysholm knee scores were evaluated pre operatively and post operatively at 3 months and 6 months. Patient satisfaction was noted at latest follow up.Results: One patient had type 2, 7 patients had type 3 and 4 patients had type 4 tibial ACL avulsion fractures. All the fractures united and all patients achieved full knee range of motion by 2 months post-operative. The clinical symptoms and signs improved post operatively. The mean Lysholm knee score at 3 months follow up was 88.8 and at 6 months follow up were 98.8. At latest follow up, all the patients were satisfied with their knee function. Conclusions: The arthroscopic suture “bridge” pull out technique is an effective method for fixation of ACL tibial avulsion fractures with respect to knee stability, range of motion and resumption of pre injury activity level

Studies on electrical properties of wheat as a function of moisture content

Abstract Introduction Moisture content of cereal grains is one of the most important characteristics for determining quality of grains. Objectives The electrical properties of Indian wheat with moisture content range of 14.3% to 29.38% were characterized to develop a moisture prediction model. Methods A specially designed coaxial cylindrical cell was used for the purpose and electrical properties characterization system was used to carry out measurements of these properties. The studies were conducted for frequency range of 100 kH

Impact of a centralized osteoporosis coordinator on post-fracture osteoporosis management: a cluster randomized trial

SUMMARY: We conducted a cluster randomized trial evaluating the effect of a centralized coordinator who identifies and follows up with fracture patients and their primary care physicians about osteoporosis. Compared with controls, intervention patients were five times more likely to receive BMD testing and two times more likely to receive appropriate management. INTRODUCTION: To determine if a centralized coordinator who follows up with fracture patients and their primary care physicians by telephone and mail (intervention) will increase the proportion of patients who receive appropriate post-fracture osteoporosis management, compared to simple fall prevention advice (attention control). METHODS: A cluster randomized controlled trial was conducted in small community hospitals in the province of Ontario, Canada. Hospitals that treated between 60 and 340 fracture patients per year were eligible. Patients 40 years and older presenting with a low trauma fracture were identified from Emergency Department records and enrolled in the trial. The primary outcome was ‘appropriate’ management, defined as a normal bone mineral density (BMD) test or taking osteoporosis medications. RESULTS: Thirty-six hospitals were randomized to either intervention or control and 130 intervention and 137 control subjects completed the study. The mean age of participants was 65 ± 12 years and 69% were female. The intervention increased the proportion of patients who received appropriate management within 6 months of fracture; 45% in the intervention group compared with 26% in the control group (absolute difference of 19%; adjusted OR, 2.3; 95% CI, 1.3–4.1). The proportion who had a BMD test scheduled or performed was much higher with 57% of intervention patients compared with 21% of controls (absolute difference of 36%; adjusted OR, 4.8; 95% CI, 3.0–7.0). CONCLUSIONS: A centralized osteoporosis coordinator is effective in improving the quality of osteoporosis care in smaller communities that do not have on-site coordinators or direct access to osteoporosis specialists