A Study on Inflammatory markers level in elderly with Comorbid illness, without Comorbid illness and with Frailty attending Government General Hospital, Chennai: A Clinical and Biochemical profile

INTRODUCTION: Chronic inflammation has been implicated as predictor and contributor of aging and age associated diseases. Inflammation involves elevation of serum inflammatory markers such as C-Reactive protein, interleukin-6. Association of cardiovascular diseases and elevated level of inflammatory markers is well known. Many studies have demonstrated the association of elevated level of inflammatory markers in cardiovascular diseases. Absence of vascular disease has been established as a major determinant of longevity. Recent studies have shown elevated level of serum inflammatory markers such as Interleukin-6, C-reactive protein in diseases primarily associated with aging like Coronary heart disease, diabetes mellitus, systemic hypertension, stroke, Dementia, Frailty, Osteoarthritis, Osteoporosis, Cancer, Rheumatoid Arthritis. AIM OF THE STUDY: 1. To Compare the level of inflammatory markers Interleukin-6, High-sensitivity C-Reactive protein in elderly patients: i) Healthy elders (without comorbid elders), ii) Frail elders, iii) With comorbid illness. 2. To correlate the role of Infammatory markers in Aging. 3. To analyse whether elevated level of inflammatory markers could be used in predicting the risk of aging in elders, with a view of primary prevention. MATERIALS AND METHODS: Setting: Outpatient and Inpatient setting of the Department of Geriatric Medicine, Madras Medical College & Government General Hospital, Chennai. Study Design: Single Center, Cross Sectional, clinical and analytical study. Period of study: August 2008 to September 2010. Sample size: 90. Selection of patients: Inclusion criteria: 90 elderly patients age more than 75years from Geriatric outpatient and inpatient Department are included in the study. Exclusion criteria: 1. Acutely toxic patients, 2. Rheumatoid arthritis, chronic liver disease, Multiple myeloma, Proliferative diseases like psoriasis, mesangial proliferative glomerulonephritis. DISCUSSION: In this study inflammatory markers C-Reactive protein and Interleukin-6 of 90 elderly patients were analysed, under the three groups namely healthy elders, frail elders and elders with comorbid illness. Among them 63% are males and 37% are females. In healthy elders 19 are male and 11 are female. In frailty group 17 are male and 13 are female. In elders with comorbid illness 21 are male and 9 are female. T he age distribution was 89% in age group of 75 to 80 years. 10% in age group of 81 to 90 years. Remaining 1% in age group of >90 years. More number of patients were found in age group of 75 to 80 years. In the study group 28.9% were smokers and 71.1% were non smokers. C-Reactive protein levels are elevated in smokers as well as non smokers in all the three groups. Hence it is not a significant association. Where as Interleukin-6 levels are more elevated in smokers in healthy elders and elders with comorbid illness, than non smokers of the same groups. In the comorbid group, diabetes was detected in 14, systemic hypertension in 20, Coronary heart disease in 8, stroke in 6 and dementia in 5 patients. CRP level are elevated in all the patients. Interleukin-6 level are elevated more in diabetic and coronary heart disease patients. In the frailty group 6 were Pre frail and 24 were frail. CRP are elevated in both Pre frail and frail group. Interleukin-6 was elevated, more in frail group than in Pre frail group. 83% of patients in Pre frail group, and 96% of patients in frail group had elevated level of interleukin-6. CRP levels are elevated in all the 3 groups. The mean CRP level was 63.7 in healthy elders, 89 in Frail elders, 99.3 in elders with comorbid illness. CRP is 10 fold increased in healthy elders, 15 fold increased in frail elders, 16.5 folds increased in elders with comorbid illness. Thus the patients with comorbid illness have higher CRP level. In healthy elders 21(70%) have elevated level of interleukin-6. In frail elders 28(93%) have elevated level of interleukin-6. In comorbid illness 27 (90%) have elevated level of interleukin-6. The mean interleukin-6 level was 6.6 in healthy elders, 11.4 in frail group, 5.5 in comorbid illness. Interleukin-6 is 3 fold increased in healthy elders, 6 fold in frail elders and 2.75 fold increased in elders with comorbid illness. Thus in frail elders interleukin-6 is more elevated. In summary CRP level are elevated in all the three groups. In patients with comorbid illness CRP levels are higher compared with other two groups. Interleukin-6 level are elevated more in diabetes and coronary heart disease patients. Interleukin-6 is more elevated in frail elders. CONCLUSION: 1. CRP levels are elevated in all patients age more than 75 years. 2. Elders with comorbid illness have higher CRP level, compared to healthy groups. 3. Interleukin-6 levels are elevated in smokers, both in healthy group and in comorbid group. 4. Interleukin-6 level are elevated more in diabetic and coronary heart disease patients. 5. Interleukin-6 was elevated more in frail group than in Pre frailgroup

Multi Response Optimization of process parameters of friction stir welded AA6061 T6 and AA 7075 T651 Using Response Surface Methodology

232-234In this work friction stir welding of AAA 6061 T6 with 7075-T651 of 6mm thickness was carried out. A 31 run Central composite design was adopted to run the experiments. The process parameter ranges were identified based on trial runs. The optimization of the process parameters was done based on the results and plots obtained from Design Expert 10.0 software and the mathematical model was developed for the same. The microhardness tests were also studied. The advancing side was 6061 T6 due to its formability properties. Interference of each process parameters on the Tensile strength was obtained from the contour plots. The fitness was justified by Anova

Linguistic Choices for Literary Dialectics: A Coming Together of Divergent Entities

Literature involves the manipulation of language for creative purposes and the discipline which fosters this synergic relationship between literature and language is termed stylistics. The purpose of this article is to show how it is possible to bridge the divide between language and literature by using the analytical techniques available within this sub-discipline of language study. Stylistics aims to interconnect linguistic form and literary effect, and also account for what it is that readers respond to when they praise the quality of a particular piece of writing. This article attempts to depict how the knowledge of linguistic intricacies can affect the reader’s interpretation. It also discusses how linguistic form relates to literary effect by analysing “Domination of Black”, by the renowned American poet Wallace Stevens. We aim to show that a linguistic approach to the analysis of a literary text does not have to mean that interpretation is disregarded. On the contrary, stylistic analysis can often illuminate why a particular literary text is regarded so highly

A Study to assess the knowledge and practice of temporary contraceptive methods among primi mothers at Kovilpalayam, Coimbatore

OBJECTIVES: 1. To assess the knowledge and practice of temporary contraceptive methods among primi Mothers. 2. To deliver the structured teaching programme on temporary contraceptive methods among primi Mothers. 3. To evaluate the structured teaching programme on temporary contraceptive methods among primi Mothers. 4. To correlate the relationship between knowledge and practice of temporary contraceptive methods among primi Mothers. 5. To find out significant association between knowledge and practice with selected demographic variables. The conceptual frame work of the study was based on Von Bertalanffy, 1968 the general system theory. Non equivalent control group pre-test, post-test design as quasi experimental design used to asses the knowledge of temporary contraceptive method among primi mothers. Non probability purposive sampling technique was used to select 40 sample. The knowledge and practice was assessed by pre test questionnaire. Teaching on temporary contraceptive methods was given with the help of audio visual aids, pamphlet, booklet, flash card, samples. Descriptive and inferential statistics were used to analyse the data. The Findings of the Study Revealed that : Post test mean score of knowledge and practice was significantly higher than the pre test. It shows significant improvement in the Temporary contraceptive method knowledge and practice. There is an significant association between knowledge with demographic variable such as education. Based on the Findings Several Recommendations were made : A similar study can be conducted for a larger group on a long term basis. A similar study can be done in urban settings This study is done with primi mothers further studies can be conducted with permanent method. Structured Questionnaire Schedule on Temporary Contraceptive Method : Description of Tool: Questionnaire was structured into three sections Section – I : Deals with demographic data which include variables like age, religion, type of family, mother’s education, monthly income, occupation, residence, husband and family idea etc., Section – II : This section consists of questionnaire assessing the knowledge of temporary contraceptive method of primi mothers. This section has 25 multiple choice questions. Interpretation of Questionnaire : Each correct answer carries one mark. Wrong answer carries zero mark. Total score allotted for this section is 25 marks. Section – III : This section consists of checklist regarding temporary contraceptive method practice. Total score allotted for this section is 15 marks. Instruction to Participants : Dear participants, there are three section in the questionnaire. You are requested to answer all items. This information will be treated as confidential. Kindly put a Right mark to the answer. You feel correct in the specific columns mentioned to the right side of the questionnaire. CONCLUSION: Knowledge of the primi mother regarding temporary contraceptive method significantly improved after structured teaching programme. This study revealed that there was no association between the age, family type, source of information, occupation of the primi mother with the pre test knowledge score. This study showed that there was an association between the education of the mother with the post test knowledge score

Total synthesis of (+) Artemisinin

(+) Artemisinin is a sesquiterpene endoperoxide lactone with an unprecedented structure is a natural medicine for the treatment of malaria in particular drug against drug resistant malaria and cerebral malaria. The total synthesis of this novel sesquiterpene is described using an inter-molecular radical reaction on important intermediate iodolactone starting from terpene (+) isolimonene

Effect of pilates and breathing exercise on quality of life and sleep quality among medical students with premenstrual syndrome

Background: Quality of life and sleep quality have been documented as a challenge for college students, with reports indicating impacts on daytime functioning and academic achievement. The present study evaluates the effect of Pilates and breathing exercise on quality of life and sleep quality among medical college students. Methods: This pre-test and post-test quasi experimental study involving 132 participants consists of one experimental group (assigned Pilates and breathing exercise) and control group (breathing exercise). After the first supervised session, participants were instructed to perform the exercise protocol three times a week for eight weeks. Quality of life and sleep quality were measured by short form 36 quality of life questionnaire and Pittsburgh sleep quality index, respectively. The variables were assessed at baseline and after eight weeks of the study. Results: After eight weeks, findings showed an improvement in the quality of life and sleep quality in experimental group (p<0.05) compared to the control group. The subjects in the experimental group who followed the Pilates and breathing exercise improved quality of life after the intervention. Especially the role limitation in their activities of daily living due to health problem and emotional problem and the social functioning improved significantly comparing to the pre-test evaluation done prior to the intervention.  When comparing the different PSQI components in both pre and post-test of experimental group, the strongest difference was observed in component 3 (sleep duration, p<0.05) and component 7 (daytime dysfunction, p<0.05). Conclusions: Eight week of Pilates and breathing exercise have significant improvement in quality of life and sleep quality in medical college students

Impact of Seed-born Colletotrichum lindemuthianum on French Bean Seed Quality

French bean seed samples were collected from different parts of Tamil Nadu including both tropical and temperate region including four cultivars viz.,Arkakomal,Premier,Rajmash DPU 88-4 and Watex.The variety Watex was found to maximum per cent seed infection of C.lindemuthianum with more discolorations.Among the various techniques adopted for detection,agar plate method was found to be best and yielded maximum per cent seed infection.Direct correlation was obtained between seed discoloration and per cent seed infection.The pathogen was found to be present mostly in seed coat and cotyledon and rarely in embryonic axis.The artificial inoculation of 45-day-old plants resulted in maximum disease incidence,resultant seed infection and minimum seed yield /plant and 100 grain weight

The effects of epidural analgesia in normal labour

Background: Epidural analgesia is considered to be gold standard technique for labour analgesia but is claimed to prolong labour. Previous studies have evaluated epidural analgesia versus systemic opioids to no analgesia. The present study evaluated the effect of epidural analgesia on duration of labour compared to no analgesia.Methods: Sixty primigravida with full term-singleton, vertex presentation in spontaneous labour were included in the study. Parturient willing for epidural analgesia were allocated as epidural group (n=30), rest served as control. The intervention in active stage of labour included 10 ml of Inj. Bupivacaine 0.125% and Inj. Fentanyl 100μg and maintenance with infusion of Inj. Bupivacaine 0.125% and Inj. Fentanyl 2μg/ml added at a rate of 6-8 ml/hr. Duration of the first two stages of labour, patient satisfaction, side effects, number of instrumental vaginal/ vacuum-assisted deliveries, and neonatal APGAR score were recorded.Results: The mean duration of first stage of labour was shorter in epidural group (250.17±106.33 minutes) compared with control (302.00±111.99 minutes), (p= 0.071). The mean duration of second stage in epidural group was (18.73±6.82 minutes) compared with control (18.33±14.53 minutes) was not significant (p= 0.892). Although instrumental vaginal delivery rate was greater in the epidural group (6.7%) as compared to control (3.3%), (p=1.000). Pain score (VAPS) varied between1-3 and 4-10 in epidural group and control respectively (p< 0.001). The APGAR scores at 5 min and neonatal ICU admissions were statistically comparable.Conclusions: Epidural analgesia with Bupivacaine and Fentanyl results in good pain relief with undue prolongation of labour

Effect of curcumin on the contraction of isolated goat uterus

Background: The aim of the study was to investigate the effect and mechanism of action of curcumin on potassium chloride (KCl) induced contraction of isolated goat uterine tissue.Methods: KCl induced contraction in the presence and absence of log doses of curcumin were obtained with the help of force transducer and student physiograph. Also, the effect of glibenclamide (K+ATP channel blocker) and methylene blue v (nitric oxide blocker) on the contractility of uterus tissue in presence of curcumin was recorded. Wilcoxon Signed Rank test was used for statistical analysis. The percentage inhibition of height and area under curve were calculated.Results: There was decrease in the height of KCl induced contraction in the presence of curcumin 4 µM (p value 0.046) 40 µM (p value=0.028) and 400 µM (p value=0.028). There was reduction in area under curve of KCl induced contraction in presence of curcumin 4 µM (p value=0.463) 40µM (p value=0.027) and 400 µM (p value=0.028). There was decrease in the height (p value=0.046) and significant decrease in area (p value=0.046) of KCl induced contraction in the presence of curcumin 100 µM and glibenclamide. There was decrease in height (p value=0.027) and area (p value=0.028) of KCl induced contraction in the presence of curcumin 100 µM and methylene blue.Conclusions: Curcumin causes relaxation of goat uterus. Since methylene blue and glibenclamide were not able to reverse the inhibition produced by curcumin it implies curcumin may not act via the nitric oxide pathway nor does it interact with K+ATP channels to relax the uterus

Multi Response Optimization of process parameters of friction stir welded AA6061 T6 and AA 7075 T651 Using Response Surface Methodology

In this work friction stir welding of AAA 6061 T6 with 7075-T651 of 6mm thickness was carried out. A 31 run Central composite design was adopted to run the experiments. The process parameter ranges were identified based on trial runs. The optimization of the process parameters was done based on the results and plots obtained from Design Expert 10.0 software and the mathematical model was developed for the same. The microhardness tests were also studied. The advancing side was 6061 T6 due to its formability properties. Interference of each process parameters on the Tensile strength was obtained from the contour plots. The fitness was justified by Anova