Study of thyroid function in patients admitted in intensive care unit

Background: The thyroid gland produces two related hormones, tetraiodothyronine (T4) and triiodothyronine (T3) play a critical role in cell differentiation during development and maintain thermogenic and metabolic homeostasis in the adult. Critically ill patients have been defined as those that by dysfunction or failure of one or more organ system depend on survival from advanced instruments monitoring and therapy. The objective was to study the thyroid dysfunction in critically ill patients admitted in intensive care units and its relation to the mortality and severity of disease.Methods: This is a cross sectional study carried out in Dr. Pinnamaneni Siddhartha institute of medical sciences and research foundation, Chinoutpalli, Andhra Pradesh from 1st January 2022 to 30th September 2022 involving 100 patients. Patients of age above 18 years, both sexes, admitted to intensive care units with critical illness were analyzed and approved by institutional ethics committee of Dr. PSIMS and RF data were entered in MS-excel and analyzed in SPSS V22 software. Descriptive statistics, Mann-Whitney U test, logistic regression, ROC curves were applied. P values were reported for all statistical tests and a value of<0.05 was considered to be significant.Results: Out of 100 critically ill patients out of which 17 patients had sepsis, 18 had acute renal failure, 19 patients had acute respiratory failure, 19 patients had diabetic ketoacidosis, 16 patients had congestive cardiac failure, and 11 patients had stroke and their correlation with t3 hormone decrement showed positive correlation.Conclusions: Thyroid profile can be used in predicting the mortality in ICU patients

Human Immunodeficiency Virus Infection among Tuberculosis Patients with Special Reference to Cd4 Count

ABSTRACT Tuberculosis (TB) has been and continues to be one of the most significant infections causing human disease. HIV infection has contributed to a significant increase in the world wide incidence of TB. The dual epidemic of HIV and TB is a concern for India where both these diseases are prevalent in epidemic proportions. In India TB is the indicator disease for HIV infection and most often the first AIDS defining disease. The objectives of the study are to determine the seroprevalence of HIV infection among TB patients and to compare the clinical profile of TB in HIV positive patients with special reference to CD4 counts. Seroprevalence of HIV among TB patients was 6.7%. Among them 32.2% were in the age group of 31-40 years. 62.5% patients had extrapulmonary TB, 32.5% were pulmonary TB. 10%were sputum positive pulmonary TB. Chest xray lesions were varied with more of infiltrative lesions (84.6%). There were 38.46% patients with upper lobe infiltrates and 61.53% patients with middle and lower zone infiltrates. Mean CD4 counts in this study was 192.10±118.42 cells/μl. Most of the patients with extrapulmonary TB and disseminated TB had CD4 counts <200 cells/μl. Sputum positivity and upper zone lesions in chest x ray were seen more in patients with CD4 >200 cells/μl. Mortality was as high as 20% in patients who were both seropositive and TB positive. HIV seroprevalence is quite high among TB patients in Tumkur.. Extrapulmonary TB and disseminated TB were common when CD4 is <200 cells/μl and chest x ray findings were atypical when CD4 <200 cells/μl

Bain type of X‐linked syndromic mental retardation in a male with a pathogenic variant in HNRNPH2

Heterogeneous nuclear ribonucleoproteins (hnRNPs) are RNA binding proteins, which aid in maturation, stabilization, and transport of mRNA. They have a significant role in cellular nucleic acid metabolism. The hnRNPs alter gene expression and are linked to various neurodegenerative disorders and cancers. Previously, six unrelated girls with developmental delay, intellectual disability, and hypotonia were found to have de novo heterozygous pathogenic missense variants in HNRNPH2, located on the X chromosome. A gain‐of‐function effect was proposed for the variant and it was thought to be lethal in males as no surviving males were identified. We describe a family with two affected siblings, one male and one female, with a known pathogenic variant in HNRNPH2, possibly due to maternal germline mosaicism.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152580/1/ajmga61388.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152580/2/ajmga61388_am.pd

Formulation, development and evaluation of Microsponge loaded Topical Gel of Nystatin

Nystatin containing microsponge as active constituent (API) in different formulations by changing the proportions of drug (Nystatin), polymer (ethyl cellulose), emulsifier (Poly vinyl alcohol) were obtained successfully using quasi-emulsion solvent diffusion method. These formulations were studied for particle size and physical characterization. Scanning electron microscopy (SEM) images showed the microsponges porous and spherical in shape. The physical characterization showed that microsponge formulation coded by P6 showed a better loading efficiency and production yield. This microsponge formulation was prepared as gel in carbopol and studied for pH, viscosity, spreadability, drug content, in-vitro release. The microsponge formulation gel, F3 showed viscosity3465.84cps,spreadability of 26.22g cm/s and drug content of 89.65%. The nystatin microsponge gel formulations showed an appropriate drug release profile. F3 released 81.03% of drug at 12 hours. Keywords: Microsponge, Solvent diffusion method, Scanning electron microscope, Nystatin microsponge gel

Genetic landscape of congenital insensitivity to pain and hereditary sensory and autonomic neuropathies

Congenital insensitivity to pain (CIP) and hereditary sensory and autonomic neuropathies (HSAN) are clinically and genetically heterogeneous disorders exclusively or predominantly affecting the sensory and autonomic neurons. Due to the rarity of the diseases and findings based mainly on single case reports or small case series, knowledge about these disorders is limited. Here, we describe the molecular workup of a large international cohort of CIP/HSAN patients including patients from normally under-represented countries. We identify 80 previously unreported pathogenic or likely pathogenic variants in a total of 73 families in the >20 known CIP/HSAN-associated genes. The data expand the spectrum of disease-relevant alterations in CIP/HSAN, including novel variants in previously rarely recognized entities such as ATL3-, FLVCR1- and NGF-associated neuropathies and previously under-recognized mutation types such as larger deletions. In silico predictions, heterologous expression studies, segregation analyses and metabolic tests helped to overcome limitations of current variant classification schemes that often fail to categorize a variant as disease-related or benign. The study sheds light on the genetic causes and disease-relevant changes within individual genes in CIP/HSAN. This is becoming increasingly important with emerging clinical trials investigating subtype or gene-specific treatment strategies

Protocol Insecurity with Assertions

In the study of symbolic verification of cryptographic protocols, a central result due to Rusinowitch and Turuani [2003] is that the insecurity problem (deciding whether a protocol admits an execution which leaks a designated secret to the intruder) for security protocols with finitely many sessions is NP-complete. Central to their proof strategy is the observation that any execution of a protocol can be simulated by one where the intruder only communicates terms of bounded size. They prove this by analyzing how variables used in the protocol can be instantiated in different contexts by the intruder. However, when we consider protocols where, in addition to terms, some logical statements or "assertions" about the terms (as presented by Ramanujam, Sundararajan, and Suresh [2017]) are also communicated, the analysis of the insecurity problem becomes tricky. In this paper we consider the insecurity problem for protocols with a class of assertions that includes equality on terms and existential quantification. The intruder can potentially exploit the fact that witnesses for existential quantifiers may be unbounded, and obtaining small witness terms while maintaining equality proofs complicates the analysis considerably. We use a notion of well-typed equality proofs that helps in bounding the sizes of the terms involved, and show that the insecurity problem for assertions is in NP