Isoniazid induced acute generalised exanthematous pustulosis

Tuberculosis (TB) poses major health problem in developing countries including India. According to WHO in 2010 survey, there were about 9.4 million active pulmonary TB Patients worldwide, out of that 2.3 million case were found in India. Isoniazid is known to be the least toxic among the first line antitubercular drugs.  Hypersensitivity reactions due to Isoniazid may present in the form of fever and skin rash. We hereby report a case of acute generalised exanthematous pustulosis due to isoniazid in a patient on anti-tubercular treatment. We also established the causality, severity, and preventability of the suspected adverse drug reactions (ADRs).

Correlation between glycemic control and dyslipidemia in Type 2 Diabetes Mellitus patient

Background: India is one of the countries with highest number of diabetes patients. Patients of type 2 diabetes mellitus are usually dyslipidemic. The objective of the research was to study the pattern of dyslipidemia and to study the correlation of glycemic control with dyslipidemia in type 2 diabetes mellitus patients.Methods: A cross sectional observational study was performed on patients of type 2 diabetes mellitus over 6 months period. The study included 200 patients and the variables recorded were demographic profile, FBS, PPBS, HbA1C and lipid profile parameters. The patients were divided into 3 groups according to HbA1C level i.e. Group I (Good glycemic control HbA1C 6-7 gm%), group II (Fair glycemic control HbA1C 7.1-8.2 gm%) and group III (poor glycemic control, HbA1C >8.2 gm%).Results: The data showed that TG level was maximum in group III and was minimum in group I. Comparison between the group shows a significant difference between all the groups (P <0.001). A significant positive correlation (Correlation coefficient 0.67, P <0.001) was also observed between level of TG and HbA1C. Similarly, LDL level was also highest in group III with a significant difference with other two groups (P <0.05). Also, a positive correlation (Correlation coefficient 0.64, P <0.05) was observed between LDL and HbA1C. On the other hand, HDL was lowest in group III as compared to groups I and II (P <0.001) and a negative correlation (Correlation coefficient -0.716, P <0.001) was seen between HDL and HbA1C.Conclusions: Dyslipidemia is less prevalent in diabetics who have better glycemic control

Evolutionary Perspective of Fungal Pathogenic Genes

Fungal pathogenesis has been vastly investigated in recent years and the phylogenic studies of fungal genome reveal that unique genes are responsible for pathogenesis. It has been found that the pathogenesis is caused by genes responsible for DNA repair, vegetative growth and sporulation. In the recent past, studies on filamentous pathogenic fungi playing an important role in establishing a pathogenic relationship with the host was well described

PROMISING AYURVEDIC HERBS IN THE MANAGEMENT OF KITIBHA (PSORIASIS)- A REVIEW

Psoriasis is one of the commonest skin disorders seen in routine clinical scenario, in entire world around 80 million people suffering from psoriasis. Psoriasis is differentiated by patches of abnormal skin. These skin patches are typically red, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete body coverage. It typically presents as red patches with white scales on top. Areas of the body most commonly affected are the back of the forearms, chin, navel area, and scalp. Diagnosis is typically based on the signs and symptoms. Men and women are affected with equal frequency. The disease may begin at any age, but typically starts in adulthood. Psoriasis is associated with an increased risk of psoriatic arthritis, lymphomas, cardiovascular disease and depression. Psoriatic arthritis affects up to 30 percent of individuals with Psoriasis. It is noted that around 2% of population are touching with Psoriasis. In present study review on Herbs frequently used in treating psoriasis were compiled. The Herbs Nimba, Stri Kutaja, Guduchi, Daruharidra, Bhallataka Haritaki, Aragvadha, Amalaki, Karveera, Saptaparna, Khadira, Vasa, Guggulu, Chitraka &amp; Katuki are reviewed to be having Vata or Kapha balancing properties. The pharmacological studies showing that Nimbidin of Neem having anti psoriatic property, The Methanolic and ethanolic extracts of Stri Kutaja and Guduchi are having anti oxidant and anti psychotic properties which are helpful in reducing the symptoms of psoriasis.

Multifractal Behaviour of n-Simplex Lattice

We study the asymptotic behaviour of resistance scaling and fluctuation of resistance that give rise to flicker noise in an {\em n}-simplex lattice. We propose a simple method to calculate the resistance scaling and give a closed-form formula to calculate the exponent, $\beta_L$, associated with resistance scaling, for any n. Using current cumulant method we calculate the exact noise exponent for n-simplex lattices.Comment: Latex, 9 pages including one figur

Dependence of reaction center-type energy-dependent quenching on photosystem II antenna size

AbstractThe effects of photosystem II antenna size on reaction center-type energy-dependent quenching (qE) were examined in rice plants grown under two different light intensities using both wild type and qE-less (OsPsbS knockout) mutant plants. Reaction center-type qE was detected by measuring non-photochemical quenching at 50 μmol photons m−2 s−1 white light intensity. We observed that in low light-grown rice plants, reaction center-type qE was higher than in high light-grown plants, and the amount of reaction center-type qE did not depend on zeaxanthin accumulation. This was confirmed in Arabidopsis npq1–2 mutant plants that lack zeaxanthin due to a mutation in the violaxanthin de-epoxidase enzyme. Although the electron transport rate measured at a light intensity of 50 μmol photons m−2 s−1 was the same in high light- and low light-grown wild type and mutant plants lacking PsbS protein, the generation of energy-dependent quenching was completely impaired only in mutant plants. Analyses of the pigment content, Lhcb proteins and D1 protein of PSII showed that the antenna size was larger in low light-grown plants, and this correlated with the amount of reaction center-type qE. Our results mark the first time that the reaction center-type qE has been shown to depend on photosystem II antenna size and, although it depends on the existence of PsbS protein, the extent of reaction center-type qE does not correlate with the transcript levels of PsbS protein. The presence of reaction center-type energy-dependent quenching, in addition to antenna-type quenching, in higher plants for dissipation of excess light energy demonstrates the complexity and flexibility of the photosynthetic apparatus of higher plants to respond to different environmental conditions

Detection of anti-Mycobacterium avium subspecies paratuberculosis antibodies in thyroid and type-1 diabetes patients

49-52Mycobacterium avium subspecies paratuberculosis (MAP) causes granulomatous intestinal disease in animals (Johne’s diseases). MAP has also been associated with several autoimmune disorders. In this study, we screened serum samples from confirmed patients of thyroid and type 1 diabetes for the presence of antibody against MAP. We used newly developed 'cocktail ELISA' (based on recombinant secretary proteins) and extensively validated 'indigenous ELISA' (based on whole cell protoplasmic antigen) and both the tests were also compared for their diagnostic potential. A total of 90 serums samples were included of which anti-MAP antibodies was detected in 28.8% and 26.6% of samples by indigenous ELISA (iELISA) and cocktail ELISA (cELISA), respectively. There was almost perfect agreement between the two tests in detecting the anti-MAP antibodies. Study raises concern on high detection of anti-MAP antibodies in human, thus warranting necessary control measure to minimize MAP exposure in human beings

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention