Study of clinical, radiological, and pulmonary function characteristics of patients having asthma-chronic obstructive pulmonary disease overlap syndrome

Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome defined as a syndrome characterized by persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD. This overlap makes the difference between COPD and asthma with persistent airflow limitation difficult, especially in smokers and elderly people. Objective: The objective of the study was to study the clinical features, radiological and pulmonary function characteristics of patients having asthma-COPD overlap syndrome. Materials and Methods: A cross-sectional study carried out at the Department of Respiratory Medicine, Government Medical College, Baroda, attached to SSG Hospital, Vadodara. A total of 100 patients enrolled which were clinically diagnosed with chronic airway obstruction as defined in the GOLD/GINA asthma-COPD overlap syndrome (ACOS) guidelines. Results: In this study, a total of 100 patients were enrolled, out them 76 patients were male and 24 patients were female. Fifty-three patients were from urban area and 47 patients from rural area. Most patients belong to age ranging from 40 to 86. Ninety-nine patients had a breathlessness and it was the most common symptom followed by chronic cough in 93 patients, sputum production in 70 patients, wheezing in 70 patients, running nose in 65 patients, and chest tightness in 46 patients. In smoking history, 25 patients were current smoker, 49 patients were ex-smoker, and 26 patients had never smoked in their life. In pulmonary function test, 26 patients had a normal test, 13 patients had obstructive abnormality with no significant bronchodilator reversibility, 54 patients had a obstructive abnormality with significant bronchodilator reversibility, and 7 patients had a restrictive abnormality. Conclusion: Clinically diagnosed ACOS patients were mostly males, belong to middle age groups, had breathlessness, wheezing, chronic cough with sputum production, and rhinitis and sneezing as the major symptoms. The pulmonary function tests revealed majority of the patients having obstructive pattern in pulmonary function test (spirometry). Furthermore, a majority of these patients had significant positive bronchodilatory response.

A study of inter-pedicular distances of the lumbar vertebrae measured in dried vertebrae in Gujarat.

The reduced inter-pedicular distance is one of the common causes of primary narrowing of the spinal canal. Stenosis of the spinal canal due to decreased inter-pedicular distance is to the best of our knowledge, virtually unexplored so we under took this study of inter-pedicular distance. Eisestein S measured inter-pedicular distance in Caucasoid, Zulu Negroid and Sotho Negroid population which is compared with data of present study. Methods: All measurements were made by using Electronic Digital Vernier Calipers. Transverse diameter of the lumbar spinal canal was measured as the minimum distance between the medial surfaces of the pedicles of a given vertebra (Inter-pedicular distance. Results & Observation: Inter-pedicular distances of lumbar vertebral canal at levels L1 to L5 was measured in dry vertebrae of 63 subjects (32 male, 31 female) from Gujarat of age group 35 to 80 yrs. Mean transverse diameter (Inter-pedicular distance) is minimum at L1 (22.6 mm in male and 21.3 mm in female) and maximum at L5 (27.0 mm in male and 26.4 mm in female) showing a gradual increase from level L1 to L5. The inter-pedicular distance increased steadily from L1 to L5 in all populations in both sexes. The Gujarati population has greater IPDs at all level from L1 to L5 than that of Zulu Negroid and Sotho Negroid. But IPDs in Gujaratis are lower at L1, & L2 in male and L1, L2 & L3 in female and greater at L3, L4 & L5 in male and L4 & L5 in female than that of Caucasoid. Conclusions: A comparison between the present data and the data published data on inter-pedicular distance at lumbar levels of other populations also shows that there are marked differences between the mean values reported for the population of different geographic areas. The present study confirms that there is ethnic as well as racial variation in the size of the lumbar vertebral canal, thus, emphasizing the need to have normal values and ranges for the transverse diameter of the canal for different populations.

Cubosome: A novel approach for nanotechnology.

Cubosome dispersions are thermodinamically stable, bioadhesive and biocompatible.Because of their properties, cubosome are versatile systems, administrable by different ways such as orally, percutaneously and parenterally. The discovery of cubosomes is a unique story and spans the fields of food science, differential geometry, biological membranes, and digestive processes. Despite the early realization of their potential, the manufacture of cubosomes on a large scale embodied difficulty because of their complex phase behaviour and viscous properties. Contributions to cubosome research have come from the fields of biology, material science, medicine, and mathematics and much is known about their formation and properties. At the center of much of the discovery and innovation is the technique of cryo-transmission electron microscopy. Another cubosome advantage is related to the simple production procedure and the chemico-physical stability. With respect to liposome, cubosome possesses a larger ratio between the bilayer area and the particle volume and a larger breaking resistance. Cubosome structure by means of electron microscopy, “light scattering”, x-ray and “NMR”, nevertheless few researchers have been studying the potential of cubosome as “delivery systems”.

Assessment of dietary compliance to gluten free diet and psychosocial problems in indian children with celiac disease.

Objective. To assess dietary compliance to Gluten Free Diet (GFD), to identify barriers to compliance and to study the impact of diet on the psychosocial behavior of children with celiac disease. Methods. Children diagnosed with celiac disease and followed up for more than 6 months, were assessed for dietary compliance. After this assessment, patients were subjected to an interview, consisting of self administered questionnaire, by the investigator who was blinded to initial results of initial assessment. Psychosocial parameters were assessed by standard Pediatric Symptom Checklist (PSC) containing 35 items. Dietary compliant and non-compliant groups were compared for assessed factors affecting the dietary compliance. Cases were also compared to healthy controls for psychosocial parameters. Results. A total of 70 patients were assessed for dietary compliance: 53(75%) were found to be dietary compliant, 13(18%) dietary non-compliant while 4 had doubtful dietary compliance. Final analysis was done for 64 patients who had complete assessment; 4 patients with doubtful dietary compliance and 2 patients who had incomplete assessment, were excluded. Dietary compliance was higher in younger children (>80%) compared to adolescents (44%); in children with higher maternal education; in parents having better knowledge and understanding of disease. Compliance was better in nuclear families; with less number of siblings (68.3% of compliant had <2 siblings compared to 23% in non- compliant); in families with higher per capita income. Dietary compliance was also better in children who presented with typical symptoms of celiac disease (72% of dietary compliant presented with loose motion as presenting symptom compared to only 15% in non-compliant). Celiac children had problems related to adjustment such as difficulty in maintaining diet at school, restaurants, trips, etc.45% patients complained that their teachers don’t understand the nature of their disease. Pediatric Symptom Checklist (PSC) score was above cut-off in 4 children of dietary non-compliant group. Few individual PSC items such as complaints of aches and pains; is irritable, angry; does not listen to the rules, blames other for mistakes; teases others; refuses to share, were more common in celiac children than control. Conclusions. Noncompliance to gluten free dietary regimen is seen in18 % of cases. Dietary noncompliance is more common in the adolescent age group, in joint families and those who have more number of siblings. Dietary restrictions have impact on child’s social activities and thus psychosocial parameters (PSC score) are better in the dietary compliant group.

Chylothorax: A rare presentation of Constrictive Pericarditis.

A 22-year male patient presented as bilateral chylous pleural effusion. There was no evidence of intra-abdominal or pulmonary pathology. Further investigation proved constrictive pericarditis as the most likely etiology. Patient underwent pericardiectomy by a cardio thoracic surgeon. The diagnosis was of tuberculous pericarditis. Patient responded to antitubercular treatment. Constrictive pericarditis as a cause of chylothorax is rare but should be considered in the differential diagnosis of chylothorax.

A clinical study of effect of oral atenolol on normal intraocular pressure and systemic blood pressure.

Atenolol is a newer betablocker, widely used as an antihypertensive drug. It cause a large and rapid fall in IOP when used orally and topically. A total of 33 patients both having normal and raised IOP were included in the study. The drug was given in a dose of 50 mg. tab. orally once a day for 7 days at 8 A.M. and IOP recorded after 24 hours, 72 hours and on 7th day. It produces significant and sustained fall in IOP in both normal and raised IOP patients besides lowering of systematic B.P. and pulse rate. The IOP on patients with systemic hypertension with Atenolol will be reduced and stoppage of therapy may cause glaucoma damage.