Pulmonary functions in type 2 diabetes mellitus patients: an observational study at a tertiary level hospital in Mumbai, Maharashtra, India

Background: Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. A reduction in lung capacity has been reported previously in diabetics. We undertook a study to check the association between pulmonary function tests in type 2 DM. Also to determine their correlations with body mass index (BMI), glycemic control and other clinically evident complications like peripheral neuropathy.Methods: The study was conducted at tertiary care BYL Nair hospital, Mumbai where diabetic patients without any hypertension, cardiovascular disease, primary respiratory abnormalities and without any microangiopathic complications were enrolled. They were clinically evaluated for pulse, blood pressure, skin changes, BMI and various biochemical investigations. Blood sugar- fasting and post prandial, serum cholesterol, serum triglyceride, urinary proteins, electrocardiograph, X- ray chest were noted. Pulmonary function test was performed by spirometry. Peripheral neuropathy was looked for an association with pulmonary function tests (PFT).Results: Out of 200 patients 68% (136) patients had normal PFT, mild obstruction 10.0% (20), mild restriction 10% (20) moderate obstruction 2% (4), moderate restriction 4% (8) and mixed 6% (12) were noted. FEV1, FVC values were statistically significantly reduced in patients with peripheral neuropathy and FEV1/FVC % significantly decreased with increasing duration of diabetes.Conclusions: The present study shows that there is a statistically significant association between PFTs and type 2 DM in Indian patients. Pathologically it may be attributed to microangiopathic complications.

Dengue and HEV co-infection in a case of hepatitis

A 35 years old male presented in the casualty of D.Y. Patil hospital with chief complaints of fever with chills since 10 days. Due to high endemicity of malaria in the Navi Mumbai region an initial diagnosis of malaria was made. Patient was admitted and started on anti-malarials. Initial reports were positive for dengue NS1 antigen. As the patient had severe jaundice a possibility of another co-infection was considered. On further investigation hepatitis E (HEV) Ig M was positive. This case illustrates the importance of considering co-infections in endemic areas that can pose diagnostic dilemmas

Scleroderma: a case report

Scleroderma is systemic multi organ autoimmune disorder characterized by hardening of skin. Also known as systemic sclerosis. Estimated annual incidences of approximately 19 cases per million persons. The limited skin disease has a 10-year survival rate of 71%, whereas those with diffuse skin disease have a 10-year survival rate of just 21%. Risk is higher in women than men and peak in individuals aged 30-50 years. It has no definitive treatment. It may be limited or diffuse depending upon manifestations of symptoms or signs affecting internal organs especially lungs, heart, or kidney. We report a case of scleroderma with pulmonary hypertension and interstitial lung disease in our hospital who presented with tightening of skin, joint pain, dysphagia, and breathlessness. On examination skin appeared dark, shiny, and tight, with loss of hair, paraesthesia and digital ulceration. Patient also has history of Raynaud's phenomenon. On investigation, Scl-70 and ANA (antinuclear antibodies) by enzyme immunoassay came positive. HRCT thorax was suggestive of interstitial fibrosis and PFT revealed moderate restriction. On 2D echocardiography, mild pulmonary hypertension was present while barium swallow showed motility disorder involving oesophagus. On view of extensive systemic involvement like skin, respiratory system, gastrointestinal system and heart, we would like to present this rare disorder

Accelerated oxidation of cotton cellulose in presence of reducing substances-I

(1) The measurement of oxidation potential of dilute solutions of sodium hypochlorite has been carried out at 30°C. by a method used successfully by various investigators. (2) The values of the oxidation potential at 30°C. are higher than those at 20°C. The differences in the potentials become more and more marked with reduction in the pH of the hypochlorite solution. (3) A correction of pH×0.06 volts to the measured potentials at 30°C. does not show any maximum value over the pH region examined. A sharp change in the direction of pH-corrected oxidation potential curve, however, occurs at about the same pH at which a maximum is obtained at 20°C. (4) There exists no similarity between the corrected oxidation potential-pH curve at 30°C. and a curve showing relation between oxygen uptake or fluidity and pH at 30°C. Nabar, Scholefield and Turner had shown a striking resemblance between these curves at 20°C

Percutaneous tricuspid valvotomy for pacemaker lead-induced tricuspid stenosis

AbstractPermanent pacemaker lead-induced tricuspid regurgitation is extremely uncommon. We report a patient with severe tricuspid stenosis detected 10 years after permanent single chamber pacemaker implantation in surgically corrected congenital heart disease. The loop at the level of the tricuspid valve may have caused endothelial injury and eventually led to stenosis. Percutaneous balloon valvotomy for such stenosis has not been reported from India

Gliopathy of Demyelinating and Non-Demyelinating Strains of Mouse Hepatitis Virus.

Demyelination in the central nervous system induced by neurovirulent strains of Mouse Hepatitis Virus (MHV) is mediated by the viral spike glycoprotein, but it is not clear whether the mechanism of this disease pathology involves direct viral infection of oligodendrocytes. Detailed studies of glial cell tropism of MHV are presented, demonstrating that direct MHV infection of oligodendrocytes differs between demyelinating (RSA59) and non-demyelinating (RSMHV2) viral strains both in vitro and in vivo. Our results indicate that direct injury of mature oligodendrocytes is an important mechanism of virus-induced demyelination. In vivo, RSA59 infection was identified in spinal cord gray and white matter, but infected oligodendrocytes were restricted to white matter. In contrast, RSMHV2 infection was restricted to gray matter neurons and was not localized to oligodendrocytes. In vitro, RSA59 can infect both oligodendrocyte precursors and differentiated oligodendrocytes, whereas RSMHV2 can infect oligodendrocyte precursors but not differentiated oligodendrocytes. Viral spreading through axonal means to white matter and release of the demyelinating strain MHV at the nerve end is critical for oligodendrocytes infection and subsequent demyelination. Understanding the mechanisms by which known viruses effect demyelination in this animal model has important therapeutic implications in the treatment of human demyelinating disease

End-to-End Joint Antenna Selection Strategy and Distributed Compress and Forward Strategy for Relay Channels

Multi-hop relay channels use multiple relay stages, each with multiple relay nodes, to facilitate communication between a source and destination. Previously, distributed space-time codes were proposed to maximize the achievable diversity-multiplexing tradeoff, however, they fail to achieve all the points of the optimal diversity-multiplexing tradeoff. In the presence of a low-rate feedback link from the destination to each relay stage and the source, this paper proposes an end-to-end antenna selection (EEAS) strategy as an alternative to distributed space-time codes. The EEAS strategy uses a subset of antennas of each relay stage for transmission of the source signal to the destination with amplify and forwarding at each relay stage. The subsets are chosen such that they maximize the end-to-end mutual information at the destination. The EEAS strategy achieves the corner points of the optimal diversity-multiplexing tradeoff (corresponding to maximum diversity gain and maximum multiplexing gain) and achieves better diversity gain at intermediate values of multiplexing gain, versus the best known distributed space-time coding strategies. A distributed compress and forward (CF) strategy is also proposed to achieve all points of the optimal diversity-multiplexing tradeoff for a two-hop relay channel with multiple relay nodes.Comment: Accepted for publication in the special issue on cooperative communication in the Eurasip Journal on Wireless Communication and Networkin

Clobetasol propionate 0.025%: a topical therapeutic for skin diseases

The most widely recommended drugs for the treatment of a variety of dermatoses are topical corticosteroids (TC). These medications are approved for the treatment of inflammatory and pruritic manifestations of dermatologic disorders due to their powerful, symptom-relieving impact. Clobetasol propionate (CP) is the most popular TC used to relieve itching, redness, and edema caused by skin disorders. Topical corticosteroids exhibit anti-inflammatory, anti-pruritic, and vasoconstrictive activities. Clobetasol propionate binds to cytoplasmic glucocorticoid receptors and activates glucocorticoid receptor-mediated gene expression, resulting in the production of anti-inflammatory proteins and suppression of the production of inflammatory mediators. The effectiveness, safety, and clinical experience of utilizing CP 0.025% topical therapy for the treatment of various dermatologic disorders are discussed in this case series