Study of Spirometry in Interstitial Lung Disease Patients and its Correlation with Clinical and Radiological Profile.

Interstitial Lung Disease are heterogeneous group of disorders of the lower respiratory tract. For their smoldering evolution and non specificity of symptoms they may remain undiagnosed and not treated for long time. Spirometry is rarely diagnostic, reduction of lung function help to characterize the extent of disease. Spirometry may provide an estimated prognosis in Interstitial Lung Disease. MATERIAL: The present study was conducted in department of General Medicine at Dr D Y Patil medical college and hospital, Kolhapur on 32 patients over a period of one year. All those patients who were suspected as case of interstitial Lung Disease on clinical and radiological ground were included. A detailed history along with occupational history was obtained and noted. All patients were examined clinically and underwent Basic investigations and performed spirometry. Correlation between spirometry findings and clinical and radiological profile done. OBSERVATION: The study group of 32 patients with ILD, Idiopathic Pulmonary Fibrosis was the most comman cause of ILD consists of 22 patients performing 68% of the study group. Average duration of symptoms in ILD patients in this study was 6-8 months. The mean age of patients was 59 year with 12(38%) female and 20(62%) male. Cough and dyspnoea were the most comman features at presentation in our study group, present in all patients of this study. Crepitations on auscaltation were present in 25(78%) patients. Most comman chest Xray feature was reticular opacities which was present in 11(34%) patients. Fibrosis and GGO in HRCT chest were seen in 11(34%) and 25(78%) patients respactively. Most comman spirometric pattern seen in our study was Restrictive pattern which was present in 23(72%) patients. CONCLUSION: The major spirometric pattern seen in various types of Interstitial Lung Disease is restrictive pattern. Though spirometry show restrictive pattern it is not diagnostic in between various types of Interstitial Lung Disease.

Appraisal of groundwater from lithological diversity of the western coastal part, Maharashtra, India: An integrated hydrogeochemical, geospatial and statistical approaches.

The present study attempts to decipher the seasonal variations in hydro-geochemistry of groundwater in the Terekhol River Basin, western coastal region, Maharashtra, India. A total of 65 groundwater samples of post-monsoon (POMS) and pre-monsoon (PRMS) seasons were collected and analyzed for major ion composition using standard analytical procedures of APHA. Piper and Gibbs plots is used to elucidate the controlling factors which altering the groundwater composition. Scatter plots of ions indicate that major ions from lithologies exposed in the study area and anthropogenic activities are altering the groundwater chemistry. Statistical analysis includes correlation, factor analysis and cluster analysis used to interpret the hydrochemical data. As compared to the WHO drinking standards, all the groundwater samples are fit for drinking. Irrigation water suitability was ascertained based on SAR, %Na and KR indices. Overall, the groundwater chemistry in study area is reflects changes in natural processes rather than anthropogenic inputs.

Day-Case Admission for External Dacryocystorhinostomy in Preschool Children.

PURPOSE: Epistaxis during or after dacryocystorhinostomy may present a risk of circulatory compromise, particularly in young children. In view of this concern, we reviewed the outcome and complications of external dacryocystorhinostomy in preschool children, aged less than 4½ years. DESIGN: Retrospective noncomparative series. PATIENTS AND METHODS: A case-note review for a series of preschool children undergoing external dacryocystorhinostomy as a day-case admission at Moorfields Eye Hospital between 1992 and 2018; all surgery was consultant-led. Details were taken of the type of surgery, any intraoperative or postoperative complications (surgical or anesthetic), any unplanned admissions after surgery, and the functional outcome. To assess the veracity of the medical records, the parents for a sample of 67 children were contacted to check whether there had been any unrecorded events or concerns. OUTCOME MEASURES: Anesthetic or surgical complications, unplanned admissions, and postoperative events. RESULTS: One-hundred and eighty-seven children (117 boys; 63%) underwent 228 external dacryocystorhinostomies during 201 admissions, the average admission age being 36.8 months (median, 37.5; range, 5.5-53.5 months). Forty-one children (20%) underwent bilateral dacryocystorhinostomy: the 27 having simultaneous bilateral surgery dacryocystorhinostomy were operated at a mean age of 38.2 months (median, 37.5; range, 15.5-53.5 months), this being significantly different from the average age at first operation in 14 children undergoing sequential admission for bilateral dacryocystorhinostomy (mean, 24.9 months; median, 27.0; range, 5.5-42.5) (p = 0.0023). No adverse anesthetic events were recorded, 2 children (2 dacryocystorhinostomies) required temporary nasal packing at the end of surgery for epistaxis, and one further child was admitted for overnight observation because of persistent mild epistaxis after bilateral dacryocystorhinostomy. Three children (3 dacryocystorhinostomies) had a mild, self-limiting secondary epistaxis, and there were no unplanned emergency admissions. The telephone survey did not reveal any disparity in the medical records. CONCLUSION: With experienced surgeons and anesthetists in a suitable specialist hospital, external dacryocystorhinostomy in preschool children would appear to be a safe and effective procedure, with few and minor complications. Although facilities for overnight observation should be available, the surgery can typically be planned as a day-case admission, and simultaneous bilateral surgery is also possible in this age-group.

Signal conditioning using logarithmic amplifier for biomedical applications of electrical impedance tomography.

OBJECTIVE: The aim of this study was to explore the use of a logarithmic amplifier to improve the spatial resolution (RES) of a low-cost electrical impedance tomography (EIT) system. In an EIT system, the measured signal has a large dynamic range from µV to mV, which requires high-RES (analog to digital conversion) cards. The logarithmic amplifier reduces the dynamic range by expanding lower values and compressing higher values, thereby improving the sensitivity and at the same time preventing the signal from saturation. In addition, a low-RES analog to digital conversion (ADC) cards can be used, making the system cost effective. This work evaluates the performance of a logarithmic amplifier and a linear amplifier used for signal conditioning in a low-cost EIT system. APPROACH: Two EIT systems based on a linear amplifier and logarithmic amplifier were designed. Phantom experiments were carried out with very small amounts of current injection. The signal-to-noise ratio (SNR), image quality, minimum detectable size and minimum detectable conductivity change were obtained. MAIN RESULTS: The logarithmic amplifier-based EIT system increased the average SNR by 4 dB. It also showed improvement in the RES and contrast-to-noise ratio of the images. The minimum size detectable by the logarithmic amplifier-based system was of radius 0.25 cm in a tank of radius 11 cm and the minimum change in conductivity detectable was 11%. SIGNIFICANCE: Logarithmic amplifier-based signal conditioning is a promising technique for improving the spatial RES of a low-cost EIT system that has a low-RES ADC.

Neuronal developmental gene and miRNA signatures induced by histone deacetylase inhibitors in human embryonic stem cells.

Human embryonic stem cells (hESCs) may be applied to develop human-relevant sensitive in vitro test systems for monitoring developmental toxicants. The aim of this study was to identify potential developmental toxicity mechanisms of the histone deacetylase inhibitors (HDAC) valproic acid (VPA), suberoylanilide hydroxamic acid (SAHA) and trichostatin A (TSA) relevant to the in vivo condition using a hESC model in combination with specific differentiation protocols and genome-wide gene expression and microRNA profiling. Analysis of the gene expression data showed that VPA repressed neural tube and dorsal forebrain (OTX2, ISL1, EMX2 and SOX10)-related transcripts. In addition, VPA upregulates axonogenesis and ventral forebrain-associated genes, such as SLIT1, SEMA3A, DLX2/4 and GAD2. HDACi-induced expression of miR-378 and knockdown of miR-378 increases the expression of OTX2 and EMX2, which supports our hypothesis that HDACi targets forebrain markers through miR-378. In conclusion, multilineage differentiation in vitro test system is very sensitive for monitoring molecular activities relevant to in vivo neuronal developmental toxicity. Moreover, miR-378 seems to repress the expression of the OTX2 and EMX2 and therefore could be a regulator of the development of neural tube and dorsal forebrain neurons.

Association of Mycobacterium tuberculosis in the causation of Eales' disease: an institutional experience.

BACKGROUND: Eales' disease is an idiopathic retinal vasculitis characterized by retinal inflammation, ischemia, and neo-vascularisation. It frequently causes massive vitreous haemorrhage and retinal detachment leading to blindness. Although the exact etiology is unknown, this condition is considered to be a consequence of hypersensitivity reaction to tubercular protein due to previous Mycobacterium tuberculosis (M. tuberculosis) infection. This study is aimed at the detection of association of M. tuberculosis in patients with Eales' disease. MATERIALS AND METHODS: A prospective case-control study was undertaken in 65 clinically diagnosed cases of Eales' disease. Patients with proliferative diabetic retinopathy, neo-vascular proliferation, macular oedema, premacular fibrosis and tractional retinal detachment were taken as controls. M. tuberculosis DNA was detected (MPT64 gene by polymerase chain reaction, PCR) in patients with Eales' disease. Clinical symptoms along with tuberculin skin test (TST) and erythrocyte sedimentation rate (ESR) were used as gold standard for comparing results of PCR. RESULT: PCR positivity was found in 12 (38.7%) patients with Eales' disease. The PCR positivity was significantly associated with the patients with high TST reading and high ESR values. CONCLUSION: Patients with a high TST reading and ESR value and a positive PCR in vitreous samples have a high likelihood of having M. tuberculosis as an etiology.

Fam40b is required for lineage commitment of murine embryonic stem cells.

FAM40B (STRIP2) is a member of the striatin-interacting phosphatase and kinase (STRIPAK) complex that is involved in the regulation of various processes such as cell proliferation and differentiation. Its role for differentiation processes in embryonic stem cells (ESCs) is till now completely unknown. Short hairpin RNA (shRNA)-mediated silencing of Fam40b expression in ESCs and differentiating embryoid bodies (EBs) led to perturbed differentiation to embryonic germ layers and their derivatives including a complete abrogation of cardiomyogenesis. Pluripotency factors such as Nanog, Oct4 and Sox2 as well as epigenetic factors such as histone acetyltransferase type B (HAT1) and DNA (cytosine-5)-methyltransferase 3-ß (Dnmt3b) were highly upregulated in Fam40b knockdown EBs as compared with control and scrambled EBs. To examine the relevance of Fam40b for development in vivo, Fam40b was knocked down in developing zebrafish. Morpholino-mediated knockdown of Fam40b led to severe abnormalities of the cardiovascular system, including an impaired expression of ventricular myosin heavy chain (vmhc) and of cardiac myosin light chain 2 (cmlc2) in the heart. We identified the gene product of Fam40b in ESCs as a perinuclear and nucleolar protein with a molecular weight of 96 kDa. We conclude that the expression of Fam40b is essential for the lineage commitment of murine embryonic stem cells (mESCs) into differentiated somatic cells via mechanisms involving pluripotency and epigenetic networks.

Forskolin: upcoming antiglaucoma molecule.

Forskolin is the first pharmaceutical drug and product derived from a plant to be approved in India by the DCGI in 2006. Forskolin (7beta-acetoxy-8, 13-epoxy-1a, 6ß, 9a-trihydroxy-labd-14-en-11-one) is a diterpenoid isolated from plant Coleus forskohlii (Lamiaceae). It is a lipid-soluble compound that can penetrate cell membranes and stimulates the enzyme adenylate cyclase which, in turn, stimulates ciliary epithelium to activate cyclic adenosine monophosphate, which decreases intraocular pressure (IOP) by reducing aqueous humor inflow. The topical application of forskolin is capable of reducing IOP in rabbits, monkeys, and humans. In its drug interactions, forskolin may act synergistically with epinephrine, ephedrine and pseudoephedrine. Whereas the effects of anti-clotting medications like warfarin, clopidogre, aspirin, anoxaparin, etc., may be enhanced by forskolin. Forskolin is contraindicated in the medications for people with ulcers as forskolin may increase acid level. Forskolin has a very good shelf-life of five years. Recently, its Ophthalmic inserts and in situ gels for sustained and delayed-release drug delivery systems were tested in New Zealand Albino Rabbits for its antiglaucoma efficacy. This drug review explains Forskolin as a drug, its antiglaucoma potential and recent findings of forskolin as an antiglaucoma agent. The literature search method used for this review was different databases and search engines like PubMed, International Pharmaceutical Abstracts, Google, Medicinal and Aromatic Plants (MAPA).

Cytosine arabinoside induces ectoderm and inhibits mesoderm expression in human embryonic stem cells during multilineage differentiation.

BACKGROUND AND PURPOSE: Teratogenic substances induce adverse effects during the development of the embryo. Multilineage differentiation of human embryonic stem cells (hESCs) mimics the development of the embryo in vitro. Here, we propose a transcriptomic approach in hESCs for monitoring specific toxic effects of compounds as an alternative to traditional time-consuming and cost-intensive in vivo tests requiring large numbers of animals. This study was undertaken to explore the adverse effects of cytosine arabinoside (Ara-C) on randomly differentiated hESCs. EXPERIMENTAL APPROACH: Human embryonic stem cells were used to investigate the effects of a developmental toxicant Ara-C. Sublethal concentrations of Ara-C were given for two time points, day 7 and day 14 during the differentiation. Gene expression was assessed with microarrays to determine the dysregulated transcripts in presence of Ara-C. KEY RESULTS: Randomly differentiated hESCs were able to generate the multilineage markers. The low concentration of Ara-C (1 nM) induced the ectoderm and inhibited the mesoderm at day 14. The induction of ectodermal markers such as MAP2, TUBB III, PAX6, TH and NESTIN was observed with an inhibition of mesodermal markers such as HAND2, PITX2, GATA5, MYL4, TNNT2, COL1A1 and COL1A2. In addition, no induction of apoptosis was observed. Gene ontology revealed unique dysregulated biological process related to neuronal differentiation and mesoderm development. Pathway analysis showed the axon guidance pathway to be dysregulated. CONCLUSIONS AND IMPLICATIONS: Our results suggest that hESCs in combination with toxicogenomics offer a sensitive in vitro developmental toxicity model as an alternative to traditional animal experiments.

Hirayama's disease: the importance of flexion magnetic resonance imaging.

Hirayama's disease is a form of juvenile muscular atrophy affecting young individulas in their second to third decade. The underlying pathogenetic mechanism is believed to be an imbalanced growth between the individuals' vertebral column and the spinal canal contents, which causes abutment of the anterior spinal cord against the vertebral column and detachment of the posterior dura, leading to microcirculatory disturbances and ischemic changes in the cord. This mechanism is exiquisitely demonstrated on magnetic resonance imaging (MRI), but requires additional imaging, with the neck in the flexed position. Neurphysiological imaging studies have provided supporting evidence by demonstrating changes in the N13 potential, with neck flexion. Nonetheless, few studies have also reported contradictory findings with MRI and somatosensory evoked potentials, in Hirayamas Disease. This condition is underdiagnosed because most clinicians are not familiar with this disorder and do not request a flexion MRI. Early recognition of this entity and differentiation from other causes of focal cord atrophy is important, because limitation of neck flexion by using a simple neck collar can prevent its further progression. We report the classical MRI findings in a young patient with Hirayama's disease with neutral and flexion MRI.

Occupational stress among police personnel of Wardha city, India.

BACKGROUND: Police work tends to impose a high degree of stress and a multiplicity of stressful situations which can affect the physical, mental and interpersonal relationships of police personnel. The objective of the present study was to assess the level of stress among police personnel and to find the association of various factors with the level of stress among police personnel. METHOD: A cross-sectional study was conducted among 102 police personnel in Wardha city. A structured questionnaire based on The Professional Life Stress Test by Fontana was given to all participants. A grading scale was used to link participant's verbal descriptions of perceived stress to a numerical scoring system being given scores between zero and five. The total score obtained for each respondent was considered as a measure of stress level. RESULTS: Different stressors that were identified among the police personnel included criticism by superiors, excess work, no rewards, inadequate value given to abilities and commitments and no satisfaction from work. Seventy participants scored >15 which indicated that stress in the workplace was a problem, while 32 participants scored ≤15, indicating stress in the workplace was not a problem. A significant association was found with between age group, marital status, education and working hours and the level of stress among police personnel. CONCLUSION: The majority of police personnel studied were under stress at their workplace due to a variety of stressors. This indicates the necessity to modify the organizational environment within the police force.

Obesity: as rural females perceive it.

Out of 318 rural females studied, 17.3% were found to be obese. Most of them are aware of their obese status except for 10.9% who were unaware. Majority of the females considered eating more, childbirth and reduced activity as the possible cause of their obesity and also obesity in other persons. Though 48.1% and 33.6% of the females mentioned dieting and exercise/walking respectively as the method of prevention still 52.5% mentioned that medicine is the only method for prevention of obesity. Regarding remedy of obesity again 48.4% females mentioned medicine as the method.