Trend of fatal poisoning in Kanpur: a two year autopsy based study

Background: Kanpur is not only the biggest city of the Uttar Pradesh but also 9th most populated city of the India and is the main centre of commercial and industrial activities. Kanpur is situated at the bank of holy river Ganga. It is very crowded city and facing the problems of population influx from neighboring towns and villages. Apart from fame for industry, Kanpur lies between two rivers Ganga and Pandu. The land of Kanpur district is plain and fertile with Cultivable Barren Land 185480 Hectare. Kanpur is an only notified metropolitan area by UP Government under Code of Criminal Procedure 1973, and therefore has a Chief Metropolitan Magistrate. Poisoning is an important public health issue in India and worldwide. The present study is aimed to assess the epidemiological variables of fatal poisonings in Kanpur.Methods: All medico legal autopsies of the city were conducted in the GSVM Medical College mortuary, Kanpur. During the study period, 582 cases of fatal poisoning were autopsied. Only autopsies with confirmed diagnosis of poisoning were included in this prospective study.Results: A total of 7648 medico legal autopsies were performed at the aforementioned centre. Poisoning deaths comprised 582 cases (7.6%) of the total autopsies conducted during the study period.Conclusions: Suicidal poisoning is accountable for majority of poisoning deaths in India. Societies at large owe a collective responsibility to this manner of death and mere condemnation or sympathy is not sufficient to curb these avoidable deaths

Ligamentum Flavum Cyst - A Rare Cause of Lumbar Canal Stenosis: A Case Report with Review of Literature

Lumbar spinal stenosis is most common entity coming to spine out-patient department which may present with complaint of back pain with lower limbs neurogenic claudication, caused by degenerative disc conditions or to facet joint hypertrophy or ligamentum flavum thickening. We represent a case report of a patient suffering from low back pain with worsening neurogenic claudication. Imaging showing a cystic lesion at L3-4 spinal level with no lysthesis pinching the traversing nerve root who undervent minimal invasive tubular transforaminal lumbar interbody fusion. Intraoperatively, a cystic mass originating from ligament flavum with yellow jelly fluid adherent to dura and no communication with subarachnoid space or facet joint was found. Histologically, these cysts represent a distinct entity different from synovial cysts in terms of devoid of epethelial lining. To differentiate in cyst outlines and origin is very helpful in preoperative planning as even complete removal of ligamentum flavum cyst does not damage the facet joint and no fixation is required in these cases as compared to facetal cyst which represents instability and fixation is mandatory

Particulate number emissions during cold-start with diesel and biofuels: A special focus on particle size distribution

The share of biofuels in the transportation sector is increasing. Previous studies revealed that the use of biofuels decreases the size of particles (which is linked to an increase in particulate toxicity). Current emission regulations do not consider small particles (sub-23 nm); however, there is a focus in future emissions regulations on small particles. These and the fact that within cold-start emissions are higher than during the warmed-up operation highlight the importance of a research that studies particulate matter emissions during cold-start. This research investigates the influence of biofuel on PN and PM concentration, size distribution, median diameter and cumulative share at different size ranges (including sub-23 nm and nucleation mode) during cold-start and warm-up operations using diesel and 10, 15 and 20% mixture (coconut biofuel blended with diesel). During cold-start, between 19 and 29% of total PN and less than 0.8% of total PM were related to the nucleation mode (sub-50 nm). Out of that, the share of sub-23 nm was up to 9% for PN while less than 0.02% for PM. By using biofuel, PN increased between 27 and 57% at cold-start; while, the increase was between 4 and 19% during hot-operation. The median diameter also decreased at cold-start and the nucleation mode particles (including sub-23 nm particles) significantly increased. This is an important observation because using biofuel can have a more adverse impact within cold-start period which is inevitable in most vehicles’ daily driving schedules.<br/

A Prospective Study To Evaluate Medical Management Vs Surgical Intervention In Pain Relief And Healing Of Anal Fissure

Introduction: Anal fissure is a commonly encountered problem for surgeons. It is a longitudinal tear in distal anal canal with or without an ulcer. It causes significant changes in quality of life. This study was done to compare the efficacy of medical management and surgical intervention in cases of anal fissures. Methods: 50 patients were divided into two groups of 25 each. Group A patients were treated with topical application of 2% diltiazem gel and Group B patients were treated with Lateral sphincterotomy. Both groups were examined weekly for 4 weeks for pain using VAS score and at 12 weeks for healing. Results: 21(84%) patients were pain free after 4 weeks under Group A, 24 (96%) patients were pain free after 4 weeks under Group B. 22(88%) patients were completely healed at 12 weeks under Group A, 25(100%) patients were completely healed at 12 weeks under Group B. Conclusion: Lateral sphincterotomy can be advocated as treatment of choice for anal fissures. It has better pain relief and healing rates compared to topical application of 2% diltiazem gel. Medical Management can be used in patients refusing surgery or unfit for surger

Effects of Age, Sex, Body Weight, and Quantity of Alcohol Consumption on Occurrence and Severity of Alcoholic Hepatitis

Only a minority of heavy drinking individuals develop alcoholic hepatitis (AH), for unclear reasons. We analyzed data from the Translational Research and Evolving Alcoholic Hepatitis Treatment cohort: subjects who drink heavily with normal results from liver tests (controls) and patients with AH. We examined risk factors for the development of AH including body mass index (BMI), drinking pattern and quantity, and sex

Nephrin Regulates Lamellipodia Formation by Assembling a Protein Complex That Includes Ship2, Filamin and Lamellipodin

Actin dynamics has emerged at the forefront of podocyte biology. Slit diaphragm junctional adhesion protein Nephrin is necessary for development of the podocyte morphology and transduces phosphorylation-dependent signals that regulate cytoskeletal dynamics. The present study extends our understanding of Nephrin function by showing in cultured podocytes that Nephrin activation induced actin dynamics is necessary for lamellipodia formation. Upon activation Nephrin recruits and regulates a protein complex that includes Ship2 (SH2 domain containing 5′ inositol phosphatase), Filamin and Lamellipodin, proteins important in regulation of actin and focal adhesion dynamics, as well as lamellipodia formation. Using the previously described CD16-Nephrin clustering system, Nephrin ligation or activation resulted in phosphorylation of the actin crosslinking protein Filamin in a p21 activated kinase dependent manner. Nephrin activation in cell culture results in formation of lamellipodia, a process that requires specialized actin dynamics at the leading edge of the cell along with focal adhesion turnover. In the CD16-Nephrin clustering model, Nephrin ligation resulted in abnormal morphology of actin tails in human podocytes when Ship2, Filamin or Lamellipodin were individually knocked down. We also observed decreased lamellipodia formation and cell migration in these knock down cells. These data provide evidence that Nephrin not only initiates actin polymerization but also assembles a protein complex that is necessary to regulate the architecture of the generated actin filament network and focal adhesion dynamics

Risk of secondhand smoke exposure and severity of COVID-19 infection: multicenter case–control study

IntroductionExposure to secondhand smoke (SHS) is an established causal risk factor for cardiovascular disease (CVD) and chronic lung disease. Numerous studies have evaluated the role of tobacco in COVID-19 infection, severity, and mortality but missed the opportunity to assess the role of SHS. Therefore, this study was conducted to determine whether SHS is an independent risk factor for COVID-19 infection, severity, mortality, and other co-morbidities.MethodologyMulticentric case–control study was conducted across six states in India. Severe COVID-19 patients were chosen as our study cases, and mild and moderate COVID-19 as control were evaluated for exposure to SHS. The sample size was calculated using Epi-info version 7. A neighborhood-matching technique was utilized to address ecological variability and enhance comparability between cases and controls, considering age and sex as additional matching criteria. The binary logistic regression model was used to measure the association, and the results were presented using an adjusted odds ratio. The data were analyzed using SPSS version 24 (SPSS Inc., Chicago, IL, USA).ResultsA total of 672 cases of severe COVID-19 and 681 controls of mild and moderate COVID-19 were recruited in this study. The adjusted odds ratio (AOR) for SHS exposure at home was 3.03 (CI 95%: 2.29–4.02) compared to mild/moderate COVID-19, while SHS exposure at the workplace had odds of 2.19 (CI 95%: 1.43–3.35). Other factors significantly related to the severity of COVID-19 were a history of COVID-19 vaccination before illness, body mass index (BMI), and attached kitchen at home.DiscussionThe results of this study suggest that cumulative exposure to secondhand cigarette smoke is an independent risk factor for severe COVID-19 illness. More studies with the use of biomarkers and quantification of SHS exposure in the future are needed