A Study on Surgical Conditions among HIV/AIDS Cases

AIM OF STUDY: 1. To define the prevalence of all surgical conditions among HIV infected patients ttending the surgical/surgical superspeciality Outpatient/In patient/surgical casualty/ART OPD of TMCH, Thanjavur. 2. To study about various Acute surgical emergencies in HIV/AIDS patients. 3. To study age and sex incidence in these patients. 4. To study the outcome and management. 5. To study the clinical presentation of these HIV patients with surgical disease. MATERIALS AND METHODS: A prospective and observational study was done with 60 patients who presented to Department of general surgery, Thanjavur Medical College, Thanjavur from July 2015 to August 2016. INCLUSION CRITERIA: All patients presenting to the surgical/surgical speciality OPDs/In patients/surgical casualty/ART OPD with surgical illness were included. EXCLUSION CRITERIA: Medical/medical speciality patients, Patients less than 12 years of age, Withdrawal/Refusal of consent. RESULTS: In this study of 60 patients, most patients were males (68%), commonly between the age group 41-50 years (37%), predominant comorbid factor was diabetes (20%),most of them were labourers (27%). Most of them were in ART between 5-8 years (24%), though 38% of them were in ART since 0-4 years. Though patients presented with various clinical presentation most common was infectious non tuberculous, among which non abscess infections were more common. The predominant organ system involved was gastrointestinal tract. About 52% were operated, among which 55% were operated in emergency and 45% in elective theatres. CONCLUSION: Among all patients with surgical illness 52% were operated, majority in emergency, about 55% of the total operated, commonest elective surgery is Hernia, commonest emergency being Appendicular perforation. Predominant system involved is gastrointestinal system.most of them were males, commonly between 41-50 years, most of them were labourers by occupation

Study on postprandial hypertriglyceridemia as an independent risk factor for ischemic heart disease

INTRODUCTION : Coronary heart disease is the leading cause of death in Western countries and it is now an increasing problem in developing countries too, due to changes in life style and dietary habits. Heart Disease is responsible for more deaths and disability among Western Population, both male and female, than any other killer disease, and it is quickly establishing itself as the leading cause of death and disability among Indians as well. This sudden increase in incidence of Heart disease is seen in our people, as they have adopted a more sedentary westernized life style, together with the intake of high-fat, high-salt diet and processed foods that have come to be associated with technological affluence. Researchers are noticing that Diseases prevalent in western hemisphere are now becoming more and more the prevalent causes of death in Asia. AIMS AND OBJECTIVES : 1. To study relation between risk factors for atherosclerosis and fasting and postprandial triglyceride levels in patients of unstable angina. 2. To establish that post-prandial triglycerides level is a better indicator as a ‘risk factor’ for atherosclerosis. 3. To study risk factors for atherosclerosis in diabetic and nondiabetic patients having normal fasting triglyceride. MATERIALS AND METHODS MATERIALS: This study was carried out in reference to 100 patients, diagnosed to have ischemic heart disease who were admitted at Govt. Mohan Kumramangalam Medical College Hospital, Salem for unstable angina. The study was approved by the Department of medicine. This study was conducted on patients between January 2007 and June 2008. INCLUSION CRITERIA: 1. Unstable angina diagnosed on classical anginal chest pain or anginal chest pain equivalent With ECG showing ST segment depression in two consecutive chest leads or Limb leads and Normal S.CPK-MB levels. 2. Fasting S. Triglycerides <150 mg% 3. Fasting S. Cholesterol < 180 mg% EXCLUSION CRITERIA: 1. Patient on treatment with Tablet Rosiglitazone in past one month. 2. On treatment with lipid lowering drugs. 3. Suspected cases of Prinzmetal’s angina 4. Rheumatic heart disease 5. Oral contraceptive pills or other hormone therapy 6. Abnormal liver and Renal function test. METHODS: A complete and detailed history of patient with address, occupation, past history of diabetes, hypertension, family history, habits of smoking and alcohol was noted. CLINICAL ASSESSMENT : • A complete physical and cardiovascular system examination performed. • Blood pressure measurements were performed with mercury sphygmomanometer in a standardized fashion. • Height measured in standing position without shoes with a standard tape meter. • Body mass index was calculated with formula of B.M.I = wt(kg) /Ht (m2) SUMMARY : In the study entitled “Postprandial Hypertriglyceridemia as a Independent Risk Factor for Ischemic Heart Disease” conducted at Govt. Mohan Kumaramangalm Medical College Hospital, Salem from July 2007 to June 2008, a total of 100 patients of ischemic Heart disease were included as per defined criteria. Postprandial Hypertriglyceridemia was found in 64%, 52% had high BMI, 73% patients had High Waist Hip ratio and 64% patients had Diabetes Mellitus. Increased triglyceride level is a risk factor for cardiovascular disease independent of HDL cholesterol level. Our study showed patients of ischemic Heart disease have high postprandial triglyceride levels inspite of normal fasting triglyceride level. There is a positive correlation between high waist-hip ratio, diabetes mellitus and postprandial hypertriglyceridemia in ischemic heart disease patients. 63 Non fasting triglyceride levels indicate the presence of remnant lipoproteins, which may promote atherosclerosis. Postprandial Hypertriglyceridemia may be an independent risk factor for Atherosclerosis in Ischemic Heart Disease patients. Evaluation of postprandial triglyceride levels is important during assessment of ischemic heart disease patients. CONCLUSION : In our study with reference to patient of ischemic heart disease, postprandial Hypertriglyceridemia was found in 64% patients, having normal fasting triglyceride level. There is statistically a significant correlation between postprandial triglyceride and ischemic heart disease, even in patients having normal fasting triglyceride level. It means that patients having high postprandial triglyceride levels have higher risk of Ischemic heart disease. The relative risk is 1.44. There is statistically a significant correlation found between postprandial Hypertriglyceridemia and high waist-hip ratio and Diabetes Mellitus

Quantum chaos in the spectrum of operators used in Shor's algorithm

We provide compelling evidence for the presence of quantum chaos in the unitary part of Shor's factoring algorithm. In particular we analyze the spectrum of this part after proper desymmetrization and show that the fluctuations of the eigenangles as well as the distribution of the eigenvector components follow the CUE ensemble of random matrices, of relevance to quantized chaotic systems that violate time-reversal symmetry. However, as the algorithm tracks the evolution of a single state, it is possible to employ other operators, in particular it is possible that the generic quantum chaos found above becomes of a nongeneric kind such as is found in the quantum cat maps, and in toy models of the quantum bakers map.Comment: Title and paper modified to include interesting additional possibilities. Principal results unaffected. Accepted for publication in Phys. Rev. E as Rapid Com

Modeling Basal Ganglia for understanding Parkinsonian Reaching Movements

We present a computational model that highlights the role of basal ganglia (BG) in generating simple reaching movements. The model is cast within the reinforcement learning (RL) framework with the correspondence between RL components and neuroanatomy as follows: dopamine signal of substantia nigra pars compacta as the Temporal Difference error, striatum as the substrate for the Critic, and the motor cortex as the Actor. A key feature of this neurobiological interpretation is our hypothesis that the indirect pathway is the Explorer. Chaotic activity, originating from the indirect pathway part of the model, drives the wandering, exploratory movements of the arm. Thus the direct pathway subserves exploitation while the indirect pathway subserves exploration. The motor cortex becomes more and more independent of the corrective influence of BG, as training progresses. Reaching trajectories show diminishing variability with training. Reaching movements associated with Parkinson's disease (PD) are simulated by (a) reducing dopamine and (b) degrading the complexity of indirect pathway dynamics by switching it from chaotic to periodic behavior. Under the simulated PD conditions, the arm exhibits PD motor symptoms like tremor, bradykinesia and undershoot. The model echoes the notion that PD is a dynamical disease.Comment: Neural Computation, In Pres

Benzenesulfonamide Analogs : Synthesis, Anti-GBM Activity and Pharmacoprofiling

The tropomyosin receptor kinase A (TrkA) family of receptor tyrosine kinases (RTKs) emerge as a potential target for glioblastoma (GBM) treatment. Benzenesulfonamide analogs were identified as kinase inhibitors possessing promising anticancer properties. In the present work, four known and two novel benzenesulfonamide derivatives were synthesized, and their inhibitory activities in TrkA overexpressing cells, U87 and MEF cells were investigated. The cytotoxic effect of benzenesulfonamide derivatives and cisplatin was determined using trypan blue exclusion assays. The mode of interaction of benzenesulfonamides with TrkA was predicted by docking and structural analysis. ADMET profiling was also performed for all compounds to calculate the drug likeness property. Appropriate QSAR models were developed for studying structure–activity relationships. Compound 4-[2-(4,4-dimethyl-2,6-dioxocyclohexylidene)hydrazinyl]-N-(5-methyl-1,3,4-thiadiazol-2-yl)benzenesulfon-amide (AL106) and 4-[2-(1,3-dioxo-1,3-dihydro-2H-inden-2-ylidene)hydrazinyl]-N-(5-methyl-1,3,4-thiadiazol-2-yl)benzenesulfonamide (AL107) showed acceptable binding energies with the active sites for human nerve growth factor receptor, TrkA. Here, AL106 was identified as a potential anti-GBM compound, with an IC50 value of 58.6 µM with a less toxic effect in non-cancerous cells than the known chemotherapeutic agent, cisplatin. In silico analysis indicated that AL106 formed prominent stabilizing hydrophobic interactions with Tyr359, Ser371, Ile374 and charged interactions with Gln369 of TrkA. Furthermore, in silico analysis of all benzenesulfonamide derivatives revealed that AL106 has good pharmacokinetics properties, drug likeness and toxicity profiles, suggesting the compound may be suitable for clinical trial. Thus, benzenesulfonamide analog, AL106 could potentially induce GBM cell death through its interaction with TrkA and might be an attractive strategy for developing a drug targeted therapy to treat glioblastoma.Peer reviewe

Distribution of resonances for open quantum maps

We analyze simple models of classical chaotic open systems and of their quantizations (open quantum maps on the torus). Our models are similar to models recently studied in atomic and mesoscopic physics. They provide a numerical confirmation of the fractal Weyl law for the density of quantum resonances of such systems. The exponent in that law is related to the dimension of the classical repeller (or trapped set) of the system. In a simplified model, a rigorous argument gives the full resonance spectrum, which satisfies the fractal Weyl law. For this model, we can also compute a quantity characterizing the fluctuations of conductance through the system, namely the shot noise power: the value we obtain is close to the prediction of random matrix theory.Comment: 60 pages, no figures (numerical results are shown in other references

Design, synthesis and anticancer evaluation of novel arylhydrazones of active methylene compounds

Nerve growth factor (NGF) and its receptor, tropomyosin kinase receptor kinase type A (TrkA) is emerging as an important target for Glioblastoma (GBM) treatment. TrkA is the cancer biomarker majorly involved in tumor invasion and migration into nearby normal tissue. However, currently, available Trk inhibitors exhibit many adverse effects in cancer patients, thus demanding a novel class of ligands to regulate Trk signaling. Here, we exploited the role of TrkA (NTRK1) expression from the 651 datasets of brain tumors. RNA sequence analysis identified overexpression of NTRK1 in GBM, recurrent GBM as well in Oligoastrocytoma patients. Also, TrkA expression tends to increase over the higher grades of GBM. TrkA protein targeting hydrazone derivatives, R48, R142, and R234, were designed and their mode of interaction was studied using molecular docking and dynamic simulation studies. Ligands' stability and binding assessment reveals R48, 2 2-(2-(2-hydroxy-4-nitrophenyl) hydrazineylidene)-1-phenylbutane-1,3-dione, as a potent ligand that interacts well with TrkA's hydrophobic residues, Ile, Phe, Leu, Ala, and Val. R48- TrkA exhibits stable binding potentials with an average RMSD value <0.8 nm. R48 obeyed Lipinski's rule of five and possessed the best oral bioavailability, suggesting R48 as a potential compound with drug-likeness properties. In-vitro analysis also revealed that R48 exhibited a higher cytotoxicity effect for U87 GBM cells than TMZ with the IC50 value of 68.99 μM. It showed the lowest percentage of cytotoxicity to the non-cancerous TrkA expressing MEF cells. However, further SiRNA analysis validates the non-specific binding of R48, necessitating structural alteration for the development of R48-based TrkA inhibitor for GBM therapeutics.Peer reviewe

Risk factors for myocardial infarction among low socioeconomic status South Indian population

<p>Abstract</p> <p>Background</p> <p>As longevity increases, cases of myocardial infarction (MI) are likely to be more. Cardiovascular disease (CVD) is a major global health problem reaching epidemic proportions in the Indian subcontinent, also among low socio-economic status (SES) and thin individuals.</p> <p>Objectives</p> <p>The present study was undertaken to elicit risk factors for MI among low SES Southern Indians and to find out its association with body mass index (BMI).</p> <p>Materials and methods</p> <p>A case-control study of patients with MI matched against healthy control subjects was carried out in a tertiary care teaching hospital. Standard methods were followed to elicit risk factors and BMI. Chi-square and Fishers exact test for categorical versus categorical, to show relationship with risk factors were analyzed.</p> <p>Results</p> <p>A total of 949 patients (male (M) = 692 and post menopausal female (F) = 257) and 611 age and sex matched healthy controls were included. In our study, BMI was below 23 in 48.2% of patients and below 21 in 22.5%. The risk of developing MI was significantly more in males (odds ratio (OR) = 3.3, 95% confidence interval (C.I.) = 2.69-4.13), among females with post-menopausal duration (PMD) of more than or equal to 3 years (OR = 9.27, 95% C.I. = 6.36-13.50) and in those with BMI less than 23 with one or other risk factors (P = 0.002, OR = 1.38, 95% C.I. = 1.13-1.70).</p> <p>Conclusion</p> <p>BMI cannot be considered as a lone independent risk factor, as the study population had low BMI but had one or more modifiable risk factors. It would be advisable to keep BMI at least 21 kg/m²for screening program. Health education on life style modification and programs to diagnose and control diabetes and hypertension have to be initiated at community level in order to reduce the occurrence.</p

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001). Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice