Effect of 5 min of controlled breathing at 0.1 Hz frequency on short-term heart rate variability

Background: Respiration is an important contributor to heart rate variability (HRV). It has been well established that decreasing the breathing frequency increases the HRV and the HRV is maximum at a breathing frequency of 0.1 Hz (6 breaths/min). Many studies have investigated the changes in HRV parameters during 0.1 Hz breathing, but only a few studies have explored the persisting effects, if any, of 0.1 Hz breathing after spontaneous breathing is resumed. Aim and Objectives: The aim of this study was to study the immediate effect of 5 min of controlled deep breathing at 0.1 Hz frequency, on short-term HRV. Materials and Methods: Twelve healthy volunteers were made to perform deep slow breathing at the rate of 6 breaths per minute following recorded prompts, for 5 min. Their baseline 5-min short-term HRV parameters before the controlled breathing were compared with the short-term HRV parameters of three 5-min segments of ECG recorded successively after the resumption of spontaneous breathing using repeated measures ANOVA. Results: There was no significant difference in the short-term HRV parameters measured before and after the 5 min of deep breathing. Conclusion: Controlled breathing at 0.1 Hz frequency for 5 min does not produce a significant immediate change in the short-term HRV of healthy individuals.

Role of Prescription Practice in Ensuring Patient Safety in the Primary Health-Care Settings in India

“Completeness (a measure of adequacy)” and the “appropriateness (a measure of the quality of care)” are two dimensions of good prescription practice. The study assessed the prescription practices at the primary health centers (PHCs); to demonstrate the effect of individual and system‑level factors, on adequacy and appropriateness of prescription practices, with special reference to e‑prescription over manual prescription given the rising acceptance of teleconsultation in health care. A total of 600 manual and 1000 e‑prescriptions were randomized using a probability‑proportional‑to‑size sampling method to distribute/allocate samples across manual and e‑prescriptions. Findings revealed that while adequacy and appropriateness of prescriptions depend on individual training and clinical practice; adequacy of prescription, especially the manual was compromised by systemic factors, such as nonavailability of space in a prescription, forcing doctors to prioritize documentation of diagnosis, advising tests, and prescribing medicines, over other details (chief complaints and examination findings).

Diurnal variation of central corneal thickness and intraocular pressure in eyes with pseudoexfoliation

Purpose: Pseudoexfoliation syndrome (PXS) is an age related microfibrillopathy characterized by deposition of whitish flaky material over various ocular tissues. PXS eyes are known to have thinner corneas and thus can lead to an underestimation in intraocular pressure measurement. The purpose of this study was to find if there is any variation in central corneal thickness and intraocular pressure in PXS eyes and if there was any relationship between them. Methods: A prospective observational study was done on 141 eyes of 85 patients with PXS without glaucoma between November 2015 to April 2017 in the department of Ophthalmology in a tertiary hospital. CCT and IOP were measured by a handheld ultrasonic pachymeter (DGH Technology INC. Pachette 2, USA) and Goldmann applanation tonometer respectively at 4 different times during office hours. Results: A significant reduction of about 10 ?m in mean CCT and 1.4 mmHg in mean IOP was noted over the 4 sessions which was statistically significant (P < 0.001). A significant correlation exists between IOP and CCT in PXS eyes at all times during the day (P < 0.001). Conclusion: The CCT measurements show significant thinning throughout the day, similar drop in IOP was also noted. Our study shows that there is a significant correlation between diurnal variation of CCT and IOP. Hence, it is prudent to measure CCT along with IOP at all times.

Pathology of a H5N1, highly pathogenic avian influenza virus, in two Indian native chicken breeds and a synthetic broiler line.

In this study, susceptibility to H5N1 virus infection was studied in two Indian native chicken breeds viz. Kadaknath and Aseel (Peela) and an Indian synthetic broiler strain (Synthetic dam line (SDL-IC). Fifty birds from each genetic group were infected intra-nasally with 1000 EID50 of a highly pathogenic avian influenza virus (HPAIV) strain A/chicken/Navapur/India/7972/ 06 (H5N1) and observed for a period of 10 days. Significant differences in severity of clinical signs, gross lesions and time for onset of symptoms were observed. The overall severity of clinical signs and gross lesions was less in SDL-IC broilers as compared to the other two genetic groups. The mortality percentages were 100, 98 and 92% with Mean Death Time (MDT) of 3.12, 5.92 and 6.96 days, respectively for the two native breeds Kadaknath and Aseel (Peela), the and SDL-IC broiler strain. Comparison of histological lesions revealed differences in disease progression among the genetic groups. Vascular lesions such as disseminated intravascular coagulopathy (DIC) were predominant on 3 days post infection (dpi) in Kadaknath, and on 5 and 6 dpi in Aseel (Peela) and SDL-IC broiler. The mean log2 HA titres of the re-isolated virus from various organs of H5N1 AIV infected birds of the three genetic groups ranged from 2.32 (lung, trachea and bursa) to 5.04 (spleen) in Kadaknath; 2.32 (lung) to 6.68 (brain) in Aseel (Peela); and 2.06 (liver) to 7.01 (lungs and kidney) in SDL-IC broiler. These results suggest that the susceptibility to H5N1 highly pathogenic avian influenza virus infection differed among the three breeds; Kadaknath being highest followed by Aseel (Peela) and synthetic SDL-IC broiler.This is possibly the first report on the differences in the susceptibility of the India native breeds to H5N1 virus infection and its severity.

Is there need for a transformational change to overcome the current problems with postgraduate medical education in India.

In spite of the existence of a dual system of postgraduation, one under the Medical Council of India (MCI) and the other on a parallel track under the National Board of Examinations, postgraduate medical education in India is beset with several problems. For example, the curriculum has not been revised comprehensively for several decades. The diploma course under the MCI has become unpopular and is largely a temporary refuge for those who do not get admission to degree courses. The level of skills of the outgoing graduate is falling and the increase in the number of seats is taking place in a haphazard manner, without reference to the needs. In spite of increase in seats, there is a shortage of specialists at the secondary and tertiary care levels, especially in medical colleges, to share teaching responsibilities. Further, the distribution of specialists is skewed, with some states having far more than others. To remedy these ills and fulfil the requirements of the country over the next two decades, a working group appointed by the erstwhile governors of the MCI was asked to suggest suitable modifications to the existing postgraduate system. After an extensive review of the lacunae in the present system, the needs at various levels and the pattern of postgraduate education in other countries, it was felt that a competency-based model of a 2-year postgraduate course across all specialties, the use of offsite facilities for training and a criterion-based evaluation system entailing continuous monitoring would go a long way to correct some of the deficiencies of the existing system. The details of the proposal and its merits are outlined for wider discussion and to serve as a feedback to the regulatory agencies engaged in the task of improving the medical education system in India. We feel that the adoption of the proposed system would go a long way in improving career options, increasing the availability of teachers and dissemination of specialists to the secondary and primary levels, and improving the quality of outgoing postgraduates.

Production of 2-hydroxy-4-methoxybenzaldehyde in roots of tissue culture raised and acclimatized plants of Decalepis hamiltonii Wight & Arn., an endangered shrub endemic to Southern India and evaluation of its performance vis-a-vis plants from natural habitat.

Axillary buds obtained from field grown plants of D. hamiltonii were used to initiate multiple shoots on Murashige and Skoog's medium (MS) supplemented with 2 mg L(-1) 6-benzyl aminopurine (BA) and 0.5 mg L(-1) indole-3-acetic acid (IAA). Profuse rooting was achieved when the actively growing shoots were cultured on MS medium supplemented with 1.0 mg l(-1) indole-3-butyric acid (IBA). Regenerated plants were grown successfully in the plains, in contrast to wild growth in high altitudes and rocky crevices of hilly regions. Roots of different sizes from one-year-old tissue culture raised field grown plants had the same profile of 2-hydroxy-4-methoxybenzaldehyde as that of wild plants. A maximum of 0.14% and 0.12% 2-hydroxy-4-methoxybenzaldehyde was produced in roots of one year old tissue culture derived plants and greenhouse grown plants respectively.

Marker assisted detection of gene (1Dx5) and translocation (1B/1R) in wheat genotypes.

Detection of 1Dx5 gene and presence of 1B/1R wheat rye translocation were studied in nineteen elite Indian wheat genotypes using AS-PCR and STS markers, respectively. Fifteen genotypes had 1B/1R translocation whereas ten showed presence of 1Dx5 gene. More than 50 per cent of the genotypes tested were found positive for both 1Dx5 and 1B/1R translocation. The results are in conformity with HMW glutenin SDS-PAGE profile for 1Dx5 and cytological observations for 1B/1R translocation.

Metabolic response of roots to osmotic stress in sensitive and tolerant cereals--qualitative in vivo [31P] nuclear magnetic resonance study.

High resolution [31P] nuclear magnetic resonance (NMR) spectroscopy was used to investigate the changes in phosphate metabolism and intracellular pH in intact root segments of relatively osmotic stress sensitive species maize (Zea mays L) and insensitive species pearl millet (Pennisetron americanum (L) Leeke) exposed to hyper osmotic shock. The results were used to understand the adaptive mechanism of the two species. The hyper osmotic shock resulted in large build-up of phosphocholine and decrease in glucose 6-phosphate (G-6P) and UDPG levels in both the crops. The osmotic shock produced a large vacuolar alkalinization and decrease in pH across tonoplast membrane in maize roots. However, the roots of pearl millet were able to adapt to the stress and maintained pH gradient across tonoplast with marginal vacuolar alkalinization. This may be attributed to the sustained activity of primary tonoplast pumps and increased activity of H+-ATPase that normally maintain pH gradient across tonoplast.

In vivo qualitative changes of 31P NMR in stressed maize roots vis-à-vis carbon substrate determining the degree of stress.

High resolution 31P nuclear magnetic resonance spectroscopy was used to investigate the changes in phosphate metabolism and intracellular pH in intact maize (Zea mays L) root segments to hyper osmotic shock. The results were compared with the happenings under field conditions, when the stress was given gradually. Effect of sugar substrate on adaptation of tissue to both kinds of situations was also studied. The hyper osmotic shock resulted in large vacuolar alkalinization and a decrease in pH across tonoplast membrane. There was gradual build up of phosphocholine and decrease in glucose 6P and UPDG levels. In gradual stress, the root segments were able to adapt to the stress and maintained pH gradient across tonoplast, with marginal alkalinization of vacuoles. The presence of sugar substrate reduced the impact of stress significantly, commensurate with the increased activity of plasmalemma H(+)-ATPase. The latter providing the driving force for uptake of organic molecules and ions required for osmoregulation.

Antiinflammatory and antipyretic activity of Michelia champaca Linn., (white variety), Ixora brachiata Roxb. and Rhynchosia cana (Willd.) D.C. flower extract.

Methanolic extracts of the flowers of M. champaca, I. Brachiata and R. cana were found to possess antiinflammatory activity against cotton pellet granuloma in rats at a dose level of 100 mg/kg body weight, sc. The latter two drugs showed higher activity (AIA) as compared to that of M. champaca. They reduced the protein content, acid phosphatase, glutamate pyruvate transaminase and glutamate oxalo-acetate transaminase activities in liver and serum. A significant reduction in the ascorbic acid content in adrenals was also observed in drug-treated animals. R. cana was recorded to possess significant antipyretic activity from the first hour of administration. These pharmacological properties may be traced to the presence of flavonoids in the flowers of these plants.

Characterization of alternatively spliced PIG-A transcripts in normal and paroxysmal nocturnal hemoglobinuria cells

The genetic lesion in paroxysmal nocturnal hemoglobinuria (PNH) cells resides in a DNA element that 1) encodes a product required for assembly of GlcNAc-inositol phospholipid and 2) is commonly affected in different patients. In this study, three alternative mRNA transcripts (1600, 1200 and 950 bp) that derive from this genetic element in normal cells were characterized. The 1200-bp transcript was found to arise from splicing out of 374 bp of exonic sequence extending from positions 407-780. The 950-bp transcript was found to arise from removal of this and 284 bp of additional exonic sequence beginning further upstream at position 123. Analyses of transcripts expressed in Epstein-Barr virus (EBV)-transformed B lymphocytes prepared from two PNH patients showed that both failed to express normal 1600-bp transcripts. One expressed truncated transcripts of 1000 and 800 bp generated by an alternate splice which utilized a downstream signal in place of the normal intronic splice signal. The other expressed a 1600 bp-transcript with multiple nucleotide changes but normal 1200- and 950- bp "spliced" transcripts

Acute pancreatitis with disseminated intravascular coagulation.

Acute Pancreatitis is seen very frequently. We report a case of acute pancreatitis with a rare complication of disseminated intravascular coagulation (DIC), who recovered completely.