Norms Of Prone Plank Testing For Isometric Endurance Assessment In Indian Healthy College Aged Individuals - An Observational Cross Sectional Study

Background:Assessment of Musculoskeletal performance is crucial to analyze for development and improvement of required goals and reducing risk of injuries. Isometric endurance assessment of core, as a part of this analysis is often done with techniques that are valid. Objective: To develop normative percentile separated by genderof hold time of prone plank in Indian college aged individuals, investigate effect of habitual physical activity along with reason for test termination and effect of BMI with hold time of testing. Material And Methods:206 individuals meeting the inclusion criteria performed the prone plank test as long as they can and time was noted. Result:Males produced significantly longer test duration than females and BMI is inversely proportional to hold time. Conclusion:These normative percentiles for abdominal endurance suggest that the abdominal plank test can now be used as an alternative to other abdominal assessments in Indian college students.

Xylanase production with xylan rich lignocellulosic wastes by a local soil isolate of Trichoderma viride / Produção de xilanase com resíduos lignocelulósicos ricos em xilana por uma cepa local de Trichoderma viride isolada de solo

In the present study, cultural and nutritional conditions for enhanced production of xylanase by a local soil isolate of Trichoderma viride, using various lignocellulosic substrates in submerged culture fermentation have been optimized. Of the lignocellulosics used, maize straw was the best inducer followed by jowar straw for xylanase production. The highest activity achieved was between 14 to 17 days of fermentation. A continuous increase in xylanase production was observed with increasing level of lignocellulosics in the medium and highest activity was observed with maize straw at 5 percent level. Xylanase production with higher levels of lignocellulosics (3 to 5 percent) of maize, jowar and barseem was found to be higher as compared to that with commercial xylan as carbon source. Sodium nitrate was the best nitrogen source among the six sources used. Maximum xylanase production was achieved with initial medium pH of 3.5-4.0 and incubation temperature of 25ºC.The enzyme preparation was effective in bringing about saccharification of different lignocellulosics. The xylanase production could be further improved by using alkali treated straw as carbon source.

Neste estudo, otimizou-se as condições culturais e nutricionais para produção aumentada de xilanase por uma cepa local de Trichoderma viride isolada de solo, empregando-se vários substratos lignocelulósicos, em fermentação submersa. Entre os substratos utilizados, o melhor indutor de produção de xilanase foi palha de milho, seguido de palha de sorgo. A atividade mais alta foi obtida entre 14 e 17 dias de fermentação. Com palha de milho observou-se um aumento contínuo na produção de xilanase com o aumento da concentração dos substratos lignocelulósicos no meio, sendo que a melhor atividade foi obtida com 5 por cento de palha de milho. A produção de xilanase com níveis mais altos de (3 a 5 por cento) de milho, sorgo e forragem verde (barseem) foi mais levada do que com xilana comercial como fonte de carbono. Entre as fontes de nitrogênio testadas, a melhor foi nitrato de sódio. Produção máxima de xilanase foi obtida quando o pH inicial do meio foi 3,5 4,0 e a temperatura de incubação 25ºC. A enzima foi eficiente na sacarificação de diferentes substratos lignocelulósicos. A produção de xilanase poderia ser aumentada empregando-se álcali ao invés de palha tratada como fonte de carbono.

Gastrooesophageal reflux in infants and children in north India.

OBJECTIVES: To assess the prevalence of gastrooesophageal reflux disease (GERD) as suggested by the symptom profile in babies ranging in age from 1 month to 2 years. METHODS: Six hundred and two babies were recruited from the well baby clinic for hospital delivered babies and from the childrens OPD of a tertiary care hospital. Children with acute severe illness needing hospitalization were excluded from the study. The primary care taker of each baby was interviewed using a questionnaire (IGERQ) designed by Orenstein et al and the I-GERD score obtained was used to assess for likelyhood of GERD. Upper gastrointestinal (GI) endoscopy was carried out and an oesophageal biopsy was taken in clinically suspected cases of GERD (IGERD > 5). RESULTS: Sixty one (10%) of the 602 subjects had an I-GERD score of > 5 suggestive of GERD. Regurgitation was present in 56 of these 61 subjects and also in 106 of the 541 normal subjects. 112 of 205 infants aged 1-6 months had regurgitation and 25 (22.2%) of these regurgitant infants had a score suggestive of GERD. Only 30 of the 202 infants aged 6-12 months and 20 of the 195 babies aged 12-24 months had regurgitation, however 14 of the 30 (46.5%) and 17 of the 20 (85%) regurgitant babies had an I-GERD score suggestive of GERD. Upper GI endoscopy was carried out in 31 babies with a score > 5 and endoscopic oesophagitis was detected in 16 (51.6%). Oesophageal biopsies were taken in 25 of these cases and showed histological evidence of reflux oesophagitis in 23 (92%). CONCLUSION: GERD is fairly common under 2 years of age as observed by symptom evaluation using the I-GERD score. Regurgitation when present beyond 6 months of age with no other identifiable cause needs evaluation. Upper GI endoscopy and oesophageal biopsy is a useful means of demonstrating reflux oesophagitis in babies with a symptom profile suggestive of GERD.

Management of celiac disease.

Celiac disease (CD), perceived as a rare cause of chronic diarrhea three decades ago, was diagnosed as a cause of diarrhea in 60 (7.5%) post weaned children among 800 cases of chronic diarrhea. The diagnosis was established on the basis of a detailed clinical history, histopathological studies on small bowel mucosa and a complete recovery on gluten free diets. Thirty four children were followed up for a period of 0.3 to 8.2 years (mean 3.45 +/- 2.28). Catch up growth was seen in all. A rapid gain in height and weight was observed in first year following exclusion of gluten from the diet. However, on subsequent follow up, flattening of growth curve was seen in 9 subjects which was attributed to non-compliance of gluten free diets and dietary inadequacies. Strict dietary compliance is difficult to adhere to with wheat being a staple cereal in India. Other factors affecting compliance include lack of awareness and non availability of gluten free diets as well as contamination of other items with wheat at grocery shops. A few cases may present as celiac crisis which is a medical emergency requiring aggressive management including use of corticosteroids to improve survival in this otherwise life threatening situation. Effective management of CD requires intense family cooperation as well as concerted national efforts to provide these patients easy access to gluten free diets. The evolution of Celiac Societies, and widespread dissemination of knowledge through all available media will greatly help in management of patients with this chronic disease.

Aetiology of chronic diarrhoea in tropical children.

AIM: We studied the causes and presentations of chronic diarrhoea in post-weaned children. METHODS: Forty seven children (6 months to 12 years) with diarrhoea of more than 2 weeks duration were recruited and subjected to detailed clinical examination and investigations. RESULTS: Primarily on the basis of history, clinical examination and duodenal biopsy, children could be classified into 5 groups namely tropical enteropathy (46.8%), irritable bowel syndrome (10.6%), giardiasis (14.8%), celiac disease (6.8%) and non specific diarrhoea (21.8%). Children with tropical enteropathy improved with broad spectrum antimicrobial therapy, those with irritable bowel syndrome and non specific chronic diarrhoea with dietary interventions while children with celiac disease required definite withdrawal of gluten from diet.

Peripheral odontogenic fibroma with chondroid differentiation.

An unusual case of peripheral odontogenic fibroma, presenting as a swelling on gingiva involving hard palate in a 3-year-old female child, is described. Even with cellular stroma and unencapsulation these tumors behave in a benign fashion. To the best of our knowledge, cartilagenous differentiation of stroma as observed in this case has not been reported in English literature so far.

Determinants of symptomatic giardiasis in childhood.

Giardia has been frequently implicated as a causative agent for acute as well as chronic diarrheal diseases in children. The present study was aimed at exploring the determinants of manifestations of Giardiasis in childhood, in relation to various host and parasite related factors. A total of 200 children with acute (100), chronic (50) or without (50) diarrhea in last 15 days were recruited for the study and evaluated with regards to nutritional status, serum immunoglobulins, secretory IgA levels, presence of Giardia in stool/duodenal aspirate/duodenal biopsy specimen and for associated infections. Lysates from acute giardiasis cases were further studied for zymodeme (banding) pattern. After correlation of all investigations, humoral immune defect in the host was found to be the major determinant of whether the Giardial infestation would be symptomatic or not, while associated bacterial infections and zymodeme patterns were not found to be important in determining the pathogenicity or presentation of giardiasis.

Diagnostic value of gene probes and its correlation with clinical profile of leprosy in children.

Clinico-bacteriological profile of 73 leprosy patients below 16 years of age was studied. Majority of the patients were males and fell in 11-16 years age group (p < 0.05). Skin lesions were present in all cases on both exposed as well as unexposed areas and their number increased with advancing age. Cutaneous sensations were affected in most of the patients while nerve thickening was observed in 41. As age increased, the disease moved from the tuberculoid end of spectrum towards the lepromatous end (p < 0.05) and the positivity of the skin smears increased (p < 0.05). Majority of the paucibacillary cases were lepromin positive while most multibacillary cases were lepromin negative (p < 0.01). Two M. leprae specific gene probes were applied in 42 cases to assess their diagnostic value. Eighty one per cent cases were picked up by the probes indicating presence of active bacilli. These included all lepromin positive cases, all smear positive cases, and most of smear negative cases (p < 0.05). Seven children with inconclusive histology were also positive. Drug treatment and inadequate size of biopsy sample could explain the negative probe results in 19% cases. This study highlights the immense potential of gene probes in diagnosing leprosy in children.

Chronic diarrhea in children of tropics.

Syndrome of prolonged diarrhea is quite frequent in tropical children. Careful clinical appraisal can help in separating these children into distinct clinical entities which have different underlying etiological factors. In most cases diagnosis is possible on clinical grounds supplemented by simple investigations. A step by step approach as outlined is extremely helpful in planning a rational management.

Diagnostic upper GI endoscopy for hemetemesis in children: experience from a pediatric gastroenterology centre in north India.

Upper GI endoscopies were done in 236 children (upto 12 years of age) presenting with history of hemetemesis. Varices were the commonest lesions (in 39.41%) followed by esophagitis (23.73%). Gastritis, gastric ulcer, duodenal ulcer and oesophageal ulcers were identified in 7.20%, 1.27%, 0.42% and 0.42% cases respectively. Cause of bleeding could not be ascertained in 27.54% cases. No significant premedication or procedure related complications were observed. Upper GI endoscopy is thus a safe and useful mode of investigation in cases of hemetemesis in children.

Profile of accidents in children.

Out of 5031 children admitted to S.N. Hospital, Agra during one year, there were 716 cases (14.2%) of accidents. Most cases were in the age group of 4-9 years; boys were affected more commonly than girls. The maximum cases occurred due to fall (44.4%), followed by road traffic accidents (26.4%) and burns (11.5%). The consequences in terms of morbidity and mortality was also high. Kerosene oil ingestion was the most common encountered form of poisoning. Incriminating environmental factors could be identified in 51.8% cases and included poorly protected roofs (23.7%), poor state of roads (10.0%), defective vehicles (7.5%), and houses opening directly on the streets (7.3%). More than half of the accidents took place at home (58.7%), followed by those on streets (30.3%) or at farmhouses (57%). Injuries caused by sharp and blunt objects were more common in villages. Only 21.4% children had received first aid, often by the family, before reaching the hospital. The overall mortality rate was 53.1/1000, but in cases of burns the mortality was (146.3/1000). This study suggests that falls and traffic accidents have the highest incidence and mortality in childhood accidents and modification of the home environment can be an effective measure to prevent such incidents.

Prevalence of rheumatic heart disease in school children.

A total number of 8449 school children, in the 5-15 years old, group were examined clinically for evidence of valvular lesions and confirmed by roentgenographic electrocardiographic and echocardiographic findings. Twelve children (0.14%) were suffering from rheumatic heart disease (RHD). The disease was significantly more (p < 0.05) prevalent in the higher age group of 11-15 years as compared to younger children. Boys (0.18%) were affected more than girls (0.09%). The disease was more frequent among children belonging to economically backward group (0.34%) and those living in large families (0.28%). Children living in the slums had significantly (p < 0.05) higher prevalence (0.41%) than those residing in urban areas (0.06%). Only 3 out of 12 (25%) were previously diagnosed cases and remaining were diagnosed for the first time. Past history of rheumatic activity was seen in 41.67% cases. Mitral valve involvement was most frequent, being detected in 10 (83.33%) cases. Majority of cases (58.33%) had the development of symptomatic RHD within 2 years of having suffered from RF. Our study helped to detect the hitherto undiagnosed cases of RHD and showed that its prevalence was higher in older children and those from urban slums.

Per rectal diazepam therapy in convulsive disorders.

One hundred and twenty children with persistent convulsions (lasting > or = 10 min) were treated with per rectal diazepam (dosage: 0.2 to 0.7 mg/kg/dose). Another group of 100 age matched children with convulsions, along with those who did not respond to rectal therapy were given intravenous diazepam in a dosage of 0.2 to 0.3 mg/kg/dose. Rectal treatment was effective in 80.83% cases while intravenous diazepam was effective in 90% cases which is statistically just significant (p < 0.05). No significant difference was observed in the efficacy of two routes of administration in controlling convulsions of different clinical types and various etiological groups (p < 0.05), except for primary generalized type where intravenous route was more effective than the rectal one (p < 0.05). No significant side-effect was observed with rectal therapy. Among the 23 (19.17%) children in whom rectal therapy failed, 12 (10%) responded to intravenous diazepam while the remaining 11 (9.17%) cases were resistant to both routes of administration.