Evaluation of co-relation between hip fractures and vitamin D level

Background: Hip fractures are devastating injuries that most often affect the elderly and have a tremendous impact on both the health care system and society in general. Approximately 97% occur in patients over 50 years of age. It has been a general belief that rickets and vitamin D deficiency are uncommon problems in India because of abundant sunshine. Hence the aim was to identify patients with hip fractures and to attain the vitamin D levels in these patients.Methods: The study was a descriptive type of study. Patients who fulfilled the inclusion criteria were included in the study. A total of 154 patients were included in the study. Patients were assessed clinically, with a thorough history and physical examination. The symptoms and signs elicited were recorded in a performa.Results: Neck of femur (NOF) was more common in female patients and intertrochanteric (IT) fracture was common in male patients. These fractures were mainly seen in the age group between 61 to 70 years of age for hip fractures. It was also noted that anaemia was prevalent in both male and female patients and the overall vitamin D deficiency was 76% of the total number of patients with more predominant (84.6%) in female patients.Conclusions: Treatment of the vitamin D deficiency reduces the chances of fall, morbidity and financial burden on the patient when fractures occur. The treatment of vitamin D deficiency will improve the quality of life overall. Hence the need for food fortification and supplementation in elderly Indian population

Dynamic Analysis of Vehicle Performance for Changes to Rear Axle Housing

This paper explores the performance improvements of a 2013 Ford Mustang Shelby GT500 resulting from changes to the rear axle housing. In previous work, described in [1, 2], the rear axle housing was optimized in order to minimize its weight. It was expected that the decrease in weight would lead to improved fuel economy; in this work, the vehicle was simulated for the EPA highway drive cycle (HWFET) both before and after the optimization of the housing, in order to quantify the changes in fuel economy. It was found that the optimization of the housing did produce a modest improvement in the chassis energy demand and in the fuel energy demand

Myocardial fibrosis in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is characterised by myocardial hypertrophy, fibrosis and abnormal vascular pathology and is usually caused by mutations in sarcomeric protein genes. Histological studies and in vivo imaging with cardiac magnetic resonance imaging (CMRI) have shown that myocardial fibrosis is an important entity that contributes to disease progression. However, little is known about the regulation of genes involved in collagen synthesis and metabolism, the pathways that contribute to the development of myocardial fibrosis and whether this is an early pathological process which ultimately leads to the development of the overt phenotype in genetic mutation carriers. Furthermore, the contribution of fibrosis on myocardial function has been poorly defined. In this thesis, I identified that myocardial genetic expression of collagen is upregulated in patients with HCM and this is paralleled by elevated levels of procollagen in plasma. The genetic expression of transforming growth factor beta (TGF-β) and its downstream mediator connective tissue growth factor was also enhanced in HCM and correlated with collagen I and III RNA levels, suggesting a central role of TGF-β in mediating fibrosis. Plasma markers of collagen synthesis and metabolism were also increased in sarcomeric mutation carriers without hypertrophy, suggesting that fibrosis may be an early process that contributes to the development of the overt phenotype. Plasma levels of procollagen I were higher in patients with non-sustained ventricular tachycardia and focal fibrosis identified by CMRI was associated with impaired systolic deformation. Diffuse fibrosis beyond that seen in healthy controls also correlated with a reduction in systolic function. Together, the findings of this thesis support the hypothesis that myocardial fibrosis is an active process in HCM that precedes clinical phenotype. Myocardial fibrosis is at least in part mediated by the TGF- β pathway and associated with impaired systolic performance and may contribute to arrhythmic risk in HCM

What’s the harm in waiting? Patient harms in the referral waiting gap

Background Patient safety research seeks to improve the delivery of care, and ensure that patients’ risk of injury from healthcare itself is minimised. Referral between primary healthcare, specialist diagnostic agencies (such as community medical laboratories and radiological centres), and hospital based healthcare is common and important in primary care, yet patients have highly variable waiting times before receiving their care. However, there is almost no research exploring what happens to patients while they wait. Aims This study aims to investigate patient’s waiting periods between referral from their General Practitioner (GP) and receiving specialist healthcare. Specifically, this study aims to determine if patients come to any harm in this waiting gap, and if so, which patients are harmed and what types of harm happen. Methods I reviewed 5 years (2003-2007) of healthcare records of 201 general practice patient’s notes. Each consultation record was examined to identify the types of referral that were made and to find evidence of harms while the patient was waiting for referred healthcare. A subset of 101 of these patients also had the records reviewed for investigation types and evidence of harm while waiting for investigation. A broad definition of harm was used to capture a greater number of harms. Harms were categorised as related to referral for investigation, referral to medical specialty or referral to other non-medical specialty. Harms were also graded in severity (mild, moderate and severe) and were described under the following: ‘continued symptoms’, ‘delay in subsequent management’, ‘deterioration of condition’, ‘financial cost to patient’, ‘anxiety/mental harm’ or ‘other’. Comparisons were made between patients whose referrals had evidence of harm in the waiting gap with patients who did not. Comparisons included length of waiting gap, age, gender and specialty referred to and used t-tests or non-parametric tests, as appropriate. Results 5003 Consultation records were reviewed. A referral rate of 0.21 per person per year for medical and non-medical specialties was found, and a referral rate of 1.00 per person per year for investigations was found. 45 of 183 (25.5%) of referrals to medical or non-medical specialties had evidence of harm in the waiting gap, whereas 9 of 105 (1.8%) of referrals for investigation had harm in the waiting gap. Of the 58 total harms, 43 (74.1%) of harms were minor, 12 (20.5%) were moderate and 3 (5.2%) were severe. The largest broad classification of harm was “continued symptoms” with 38 harms (65.5%), followed by “delay in subsequent management” with 14 harms (24.1%) and “deterioration in condition” with 14 harms (24.1%). There were no statistically significant relationships between the age of patient nor sex of patient nor length of waiting time and the incidence of harm in the waiting gap. Conclusion This is the first study of harm in the referral waiting gap. The findings indicate that harm does happen while patients wait for referred care, and more research is needed to explore these harms. While the relatively small number of patients in this study limits the ability to draw robust implications for changed clinical practice, it is a strong starting point for larger, future research

Susceptibility to ATP depletion of primary proximal tubular cell cultures derived from mice lacking either the alpha1 or the alpha2 isoform of the catalytic domain of AMPK.

International audienceBACKGROUND: The purpose of this study was to determine whether AMPK influences the survival of primary cultures of mouse proximal tubular (MPT) cells subjected to metabolic stress. Previous studies, using an immortalized MPT cell line, suggest that AMPK is activated during metabolic stress, and ameliorates stress-induced apoptosis of these cells. METHODS: Primary MPT cells were cultured from AMPK knockout (KO) mice lacking either the alpha1 or the alpha2 isoform of the catalytic domain of AMPK. MPT cells were subjected to ATP depletion using antimycin A. RESULTS: Surprisingly, there was no difference in the amount of death induced by metabolic stress of MPT cells from either type of AMPK KO mice compared to its WT control. Moreover, inhibition of the activity of the alpha1 isoform in primary MPT cells from alpha2-/- mice (pharmacologically, via compound C) or inhibition of the alpha2 isoform in primary MPT cells from alpha1-/- mice (molecularly, via knockdown) both decreased cell viability equivalently in response to metabolic stress. The explanation for this unexpected result appears to be an adaptive increase in expression of the non-deleted alphaisoform. As a consequence, total As a consequence-domain expression (i.e. alpha1 + alpha2), is comparable in kidney cortex and in cultured MPT cells derived from either type of KO mouse versus its WT control. Importantly, each alphaisoform appears able to compensate fully for the absence of the other, with respect to both the phosphorylation of downstream targets of AMPK and the amelioration of stress-induced cell death. CONCLUSIONS: These findings not only confirm the importance of AMPK as a pro-survival kinase in MPT cells during metabolic stress, but also show, for the first time, that each of the two alpha-isoforms can substitute for the other in MPT cells from AMPK KO mice with regard to amelioration of stress-induced loss of cell viability

Modeling and Optimization of Ultrasonic Welding Process for Low Density Polymer: A Review

The purpose of this research is to determine the effect of various weld and machine parameters on ultrasonic weld strength. In this we are going to use thermosetting material named epoxy which is one of the low density polymers. By considering three main parameters that is amplitude, pressure and weld time we are going to conduct the experiment. After doing the welding, we will check the tensile strength of the welded pieces by using UTM. (Universal testing machine).Further with the help of MINITAB software we will optimize the number of experiments

Abdominal and pelvic radiographs of medical devices and materials- part 2: neurologic and genitourinary devices and materials

Radiographs of the abdomen and pelvis are routinely obtained as a standard part of clinical care for the abdomen and pelvis. Brisk advances in technology over the last few decades have resulted in a multitude of medical devices and materials. Recognizing and evaluating these devices on abdominal and pelvic radiographs are critical, yet increasingly a difficult endeavor. In addition, multiple devices serving different purposes may have a similar radiographic appearance and position causing confusion for the interpreting radiologist. The role of the radiologist is to not only identify accurately these medical objects, but also to confirm for their accurate placement and to recognize any complications that could affect patient care, management or even be potentially life threatening. An extensive online search of literature showed our review article to be the most comprehensive work on medical devices and materials of the abdomen and pelvis, and in this second part of our two-part series, we discuss in depth about the neurologic and genitourinary devices seen on abdominal and pelvic radiographs