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The present study evaluates the Murraya Koenigii (CuLE) and Tinospora Crispa (TiSE) antimutagenic effect and the impact of industrial soil and solid waste leachate on Drosophila larvae. Larvae were exposed to leachate prepared at different pH (7, 4.93, 2.88) and treated with TiSE and CuLE at different concentration (4 g/L and 6 g/L) mixed with standard Drosophila medium. Emphasis was given to the binding interaction of heavy metals with proteins in Drosophila. The change in structure and molecular composition in Drosophila by leachate containing heavy metals induced toxicity has been studied by using Fourier transform infrared (FTIR) spectroscopy. Results from the study demonstrated that CuLE/TiSE administration restored the level of oxidative stress as evidenced by an enhanced antioxidant system and a decrease in lipid peroxidation and protein oxidation. The amide I and amide II bands spectral shifting revealed the binding interaction. The shift in the peak of PO2- asymmetric stretching might be due to compositional changes in nucleic acids. Single-cell electrophoresis was performed to detect the DNA damage which also proved to be ameliorated by administration of CuLE/TiSE. The result concludes that CuLE/TiSE may have great potential in the protection of Drosophila larvae from leachate induced oxidative stress through antioxidant and antimutagenic mechanisms this might help to cope with environmental toxicants.Communicated by Ramaswamy H. Sarma.
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OBJECTIVES: Mutations in the exon 4 of the COMT gene are associated with chronic persistent surgical pain (CPSP). Especially COMT mutated allele G472A (Val158Met) associated with CPSP patients is reported in different ethnic population. The purpose of this study is to evaluate the prevalence of genetic mutations and structural variations in exon 4 of COMT that can be related to the appearance of CPSP in patients under sternotomy. MATERIALS AND METHODS: One hundred patients with American Society of Anesthesiologists (ASA) physical status grades i, ii and iii, who underwent sternotomy procedures, were selected to assess the development and magnitude of the CPSP evaluated with pain questionaries' at the end of three months after surgery. This was correlated with COMT allele presence. The exon 4 of COMT gene (that contains the G472A allele) was studied. The polymerase chain reaction (PCR) products were sequenced and mutated sequences were deposited in GenBank®. The structural analysis of COMT was performed using ProCheck® and distortions of three-dimensional tertiary structural orientation was evaluated with root-mean-square deviation (RMSD) score. RESULTS: Genetic analysis carried out through PCR showed 220 bp amplicons. The 25% of patients with CPSP showed a Numeric Rating Scale (NRS) > 4 pain score. The 20% of these patients have known Val158Met mutation, 5% of patients showed novel mutations c.382C>G, c.383G>C, p.(Arg128Ala). The mutations in COMT gene contributed major structural variations in COMT leading to the formation of inactive COMT that correlates with CPSP. CONCLUSION: The results of the present study showed that both novel and previously reported mutations in COMT gene has strong association with CPSP.
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Catecol O-Metiltransferasa , Dolor Crónico , Dolor Postoperatorio/genética , Alelos , Catecol O-Metiltransferasa/genética , Dolor Crónico/genética , Exones , Humanos , MutaciónRESUMEN
INTRODUCTION: As the population ages and the prevalence of comorbid conditions increases, the need for feasible, validated methods of comorbidity surveillance in chronic diseases such as multiple sclerosis (MS) increases. METHODS: Using kappa (k) statistics, we evaluated the performance of administrative case definitions for comorbidities commonly observed in MS by comparing agreement between Manitoba (MB) administrative data and self-report (n = 606) and Nova Scotia (NS) administrative data and self-report (n = 1923). RESULTS: Agreement between the administrative definitions and self-report was substantial for hypertension (k = 0.69 [NS], 0.76 [MB]) and diabetes (k = 0.70 [NS], 0.66 [MB]); moderate for hyperlipidemia (k = 0.53 [NS], 0.51 [MB]) and heart disease (k = 0.42 [NS], 0.51 [MB]) and fair for anxiety (k = 0.27 [NS], 0.26 [MB]). In NS, agreement was substantial for inflammatory bowel disease (k = 0.71) and moderate for epilepsy (k = 0.48). CONCLUSION: Administrative definitions for commonly observed comorbidities in MS performed well in 2 distinct jurisdictions. This suggests that they could be used more broadly across Canada and in national studies.
TITRE: Performance des définitions administratives de cas pour les affections concomitantes de la sclérose en plaques au Manitoba et en Nouvelle-Écosse. INTRODUCTION: Au fur et à mesure du vieillissement de la population et de l'augmentation de la prévalence d'affections concomitantes, le recours à des méthodes fiables et efficaces de surveillance des affections concomitantes de maladies chroniques telles que la sclérose en plaques (SP) s'avère de plus en plus nécessaire. MÉTHODOLOGIE: Nous avons évalué, au moyen de la statistique kappa (k), la performance des définitions administratives de cas pour les affections concomitantes fréquemment observées en lien avec la SP en comparant les concordances entre les données administratives et les données provenant d'autodéclarations au Manitoba (MB) (n = 606) et en Nouvelle-Écosse (NS) (n = 1 923). RÉSULTATS: Les concordances entre les définitions administratives et les autodéclarations étaient bonnes pour l'hypertension (k = 0,69 [NS] et 0,76 [MB]) et le diabète (k = 0,70 [NS] et 0,66 [MB]), modérées pour l'hyperlipidémie (k = 0,53 [NS] et 0,51 [MB]) et la cardiopathie (k = 0,42 [NS] et 0,51 [MB]) et médiocres pour l'anxiété (k = 0,27 [NS] et 0,26 [MB]). La concordance était bonne en Nouvelle-Écosse pour la maladie inflammatoire chronique de l'intestin (k = 0,71) et modérée pour l'épilepsie (k = 0,48). CONCLUSION: Les définitions administratives étaient performantes dans les deux provinces pour plusieurs affections concomitantes fréquemment observées en lien avec la SP. À la lumière de ces résultats, il semble que ces définitions puissent être utilisées plus largement au Canada et dans les études nationales.
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Ansiedad/epidemiología , Depresión/epidemiología , Diabetes Mellitus/epidemiología , Epilepsia/epidemiología , Cardiopatías/epidemiología , Hiperlipidemias/epidemiología , Hipertensión/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Esclerosis Múltiple/epidemiología , Adulto , Ansiedad/diagnóstico , Comorbilidad , Bases de Datos Factuales , Depresión/diagnóstico , Diabetes Mellitus/diagnóstico , Epilepsia/diagnóstico , Femenino , Cardiopatías/diagnóstico , Humanos , Hiperlipidemias/diagnóstico , Hipertensión/diagnóstico , Enfermedades Inflamatorias del Intestino/diagnóstico , Clasificación Internacional de Enfermedades , Masculino , Manitoba/epidemiología , Persona de Mediana Edad , Nueva Escocia/epidemiología , AutoinformeRESUMEN
Anti-myelin basic protein (MBP) antibodies in pediatric-onset MS and controls were characterized. Serum samples were obtained from 94 children with MS and 106 controls. Paired CSF and serum were obtained from 25 children with MS at time of their initial episode of acute demyelinating syndrome (ADS). Complementary assays were applied across samples to evaluate the presence, and the physical binding properties, of anti-MBP antibodies. While the prevalence and titers of serum anti-MBP antibodies against both immature and mature forms of MBP were similar in children with MS and in controls, binding characteristics and formal Surface Plasmon Resonance (SPR) studies indicated surprisingly high binding affinities of all pediatric anti-MBP antibodies. Serum levels of anti-MBP antibodies correlated significantly with their CSF levels, and their presence in children with MS was associated with significantly increased risk of an acute disseminated encephalomyelitis-like initial clinical presentation. While antibodies to both immature and mature forms of MBP can be present as part of the normal pediatric humoral repertoire, these anti-myelin antibodies are of surprisingly high affinity, can access the CNS during inflammation, and have the capacity to modulate disease expression. Our findings identify an immune mechanism that could contribute to the observed heterogeneity in spectrum of clinical presentations in early-onset MS.
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Autoanticuerpos/fisiología , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/inmunología , Vaina de Mielina/inmunología , Proteínas del Tejido Nervioso/inmunología , Factores de Transcripción/inmunología , Enfermedad Aguda , Adolescente , Autoanticuerpos/sangre , Autoanticuerpos/líquido cefalorraquídeo , Biomarcadores/sangre , Biomarcadores/líquido cefalorraquídeo , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Esclerosis Múltiple/sangre , Esclerosis Múltiple/líquido cefalorraquídeo , Proteína Básica de Mielina , Proteínas del Tejido Nervioso/sangre , Proteínas del Tejido Nervioso/líquido cefalorraquídeo , Factores de Riesgo , Síndrome , Factores de Transcripción/sangre , Factores de Transcripción/líquido cefalorraquídeo , Adulto JovenRESUMEN
Randomized controlled trials have demonstrated the efficacy of disease-modifying drugs (DMDs) in persons with relapsing-remitting multiple sclerosis (MS) and secondary progressive MS with superimposed relapses. However, these brief studies of selected patients have focused mainly on reducing attacks and must be complemented by evaluations in 'realworld' clinical settings to establish the effectiveness of DMD programs in slowing disease progression and to inform health policy and program decision-making. We assessed the effectiveness of DMDs as administered in a comprehensive publicly funded drug insurance program that provides DMDs to a geographically defined population of MS patients who meet specific eligibility criteria. Data from 1752 MS patients (10,312 assessments) seen between 1980 and 2004 at a regional MS Clinic serving the entire population of Nova Scotia, Canada were analysed. Using survival methods we observed a statistically significant reduction in disease progression to specific Expanded Disability Status Scale endpoints following the introduction of this program. Subgroup analyses of patients eligible for treatment using hierarchical linear regression methods also suggested that disease progression was slowed in patients treated with the first DMD prescribed. These findings provide evidence supporting DMD program effectiveness that can be used to inform the broader implementation of such programs.
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Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/patología , Adolescente , Adulto , Edad de Inicio , Anciano , Niño , Bases de Datos Factuales , Evaluación de la Discapacidad , Progresión de la Enfermedad , Femenino , Acetato de Glatiramer , Humanos , Inmunosupresores/uso terapéutico , Interferón Tipo I/uso terapéutico , Estimación de Kaplan-Meier , Modelos Lineales , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/epidemiología , Nueva Escocia , Péptidos/uso terapéutico , Población , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Salud Pública , Proteínas Recombinantes , Factores Socioeconómicos , Adulto JovenRESUMEN
BACKGROUND: The incidence of acquired demyelination of the CNS (acquired demyelinating syndromes [ADS]) in children is unknown. It is important that physicians recognize the features of ADS to facilitate care and to appreciate the future risk of multiple sclerosis (MS). OBJECTIVE: To determine the incidence, clinical features, familial autoimmune history, and acute management of Canadian children with ADS. METHODS: Incidence and case-specific data were obtained through the Canadian Pediatric Surveillance Program from April 1, 2004, to March 31, 2007. Before study initiation, a survey was sent to all pediatric health care providers to determine awareness of MS as a potential outcome of ADS in children. RESULTS: Two hundred nineteen children with ADS (mean age 10.5 years, range 0.66-18.0 years; female to male ratio 1.09:1) were reported. The most common presentations were optic neuritis (ON; n = 51, 23%), acute disseminated encephalomyelitis (ADEM; n = 49, 22%), and transverse myelitis (TM; n = 48, 22%). Children with ADEM were more likely to be younger than 10 years, whereas children with monolesional ADS (ON, TM, other) were more likely to be older than 10 years (p < 0.001). There were 73 incident cases per year, leading to an annual incidence of 0.9 per 100,000 Canadian children. A family history of MS was reported in 8%. Before study initiation, 65% of physicians indicated that they considered MS as a possible outcome of ADS in children. This increased to 74% in year 1, 81% in year 2, and 87% in year 3. CONCLUSION: The incidence of pediatric acquired demyelinating syndromes (ADS) is 0.9 per 100,000 Canadian children. ADS presentations are influenced by age.
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Enfermedades del Sistema Nervioso Central/epidemiología , Enfermedades Desmielinizantes/epidemiología , Adolescente , Distribución por Edad , Canadá/epidemiología , Enfermedades del Sistema Nervioso Central/diagnóstico , Enfermedades del Sistema Nervioso Central/tratamiento farmacológico , Niño , Preescolar , Demografía , Enfermedades Desmielinizantes/diagnóstico , Enfermedades Desmielinizantes/tratamiento farmacológico , Encefalomielitis Aguda Diseminada/epidemiología , Femenino , Glucocorticoides/administración & dosificación , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Incidencia , Lactante , Inyecciones Intravenosas , Imagen por Resonancia Magnética , Masculino , Metilprednisolona/administración & dosificación , Mielitis Transversa/epidemiología , Neuritis Óptica/epidemiología , Distribución por SexoRESUMEN
BACKGROUND: Little is known about social anxiety in MS. OBJECTIVE: We estimated the prevalence of social anxiety symptoms and their association with demographic and clinical features in a clinic-attending sample of patients with MS. METHODS: Patients attending the Dalhousie MS Research Unit for regularly scheduled visits completed the Social Phobia Inventory (SPIN), the Hospital Anxiety and Depression Scale (HADS), and the Health Utilities Index (HUI). Neurological disability was determined by ratings on the Expanded Disability Status Scale (EDSS). RESULTS: A total of 251 patients completed self-report scales of anxiety and depression symptoms. In all, 245 (98%) provided sufficient data for analysis. In all, 30.6% (n=75) had clinically significant social anxiety symptoms as defined by a SPIN threshold score of 19. Half of those with social anxiety had general anxiety (HADSA>or=11) and a quarter had depression (HADSD>or=11). Severity of social anxiety symptoms was associated with reduced health-related quality of life and not related to neurological disability. CONCLUSIONS: Social anxiety symptoms are common in persons with MS, contribute to overall morbidity, but are unrelated to the overall severity of neurologic disability. Greater awareness and routine systematic inquiry of social anxiety symptoms is an important component of comprehensive care for persons with MS.
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Esclerosis Múltiple Crónica Progresiva/epidemiología , Esclerosis Múltiple Crónica Progresiva/psicología , Esclerosis Múltiple Recurrente-Remitente/epidemiología , Esclerosis Múltiple Recurrente-Remitente/psicología , Trastornos Fóbicos/epidemiología , Adulto , Ansiedad/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Encuestas y CuestionariosAsunto(s)
Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Fármacos Neuroprotectores/uso terapéutico , Evaluación de la Discapacidad , Progresión de la Enfermedad , Relación Dosis-Respuesta a Droga , Acetato de Glatiramer , Humanos , Interferones/uso terapéutico , Péptidos/uso terapéutico , Proyectos de Investigación , Resultado del TratamientoRESUMEN
A failure of autoreactive T cells to undergo apoptosis may contribute to the pathogenesis of multiple sclerosis (MS). The role of the inhibitor of apoptosis (IAP) family of anti-apoptotic proteins such as X-linked IAP (XIAP), human inhibitor of apoptosis-1 (HIAP-1), human inhibitor of apoptosis-2 (HIAP-2), neuronal apoptosis inhibitory protein (NAIP) and Survivin in relapsing-remitting, secondary-progressive, primary-progressive or benign forms of MS is unclear. We report here that expression of the IAP family of genes in peripheral blood samples and brain tissues from MS cases support a role for differential regulation of these potent anti-apoptotic proteins in the pathology of MS. XIAP mRNA and protein levels were elevated in peripheral blood mononuclear cells from patients with active disease relative to normal subjects. In patients with active MS, HIAP-1 and HIAP-2 mRNA levels were elevated in resting T cells while NAIP mRNA was increased in whole blood. In post-mortem MS brain tissue, XIAP and HIAP-1 in myelin lesions were co-localized with microglia and T cells, respectively. Only in primary-progressive patients was Survivin expression elevated suggestive of a distinct pathological basis for this subtype of MS. Taken together, these results suggest that patterns of inhibitor of apoptosis expression in immune cells may have value in distinguishing between MS subtypes and offer insight into the mechanisms responsible for their distinct clinical courses.
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Proteínas Inhibidoras de la Apoptosis/genética , Proteínas Inhibidoras de la Apoptosis/inmunología , Esclerosis Múltiple/genética , Esclerosis Múltiple/inmunología , Adulto , Anciano , Autoinmunidad/genética , Autoinmunidad/inmunología , Proteína 3 que Contiene Repeticiones IAP de Baculovirus , Western Blotting , Encéfalo/patología , Encéfalo/fisiología , Enfermedades Desmielinizantes/genética , Enfermedades Desmielinizantes/inmunología , Enfermedades Desmielinizantes/patología , Femenino , Expresión Génica/inmunología , Perfilación de la Expresión Génica , Humanos , Factores Inmunológicos/genética , Factores Inmunológicos/inmunología , Proteínas Inhibidoras de la Apoptosis/metabolismo , Masculino , Microglía/inmunología , Proteínas Asociadas a Microtúbulos/genética , Proteínas Asociadas a Microtúbulos/inmunología , Proteínas Asociadas a Microtúbulos/metabolismo , Persona de Mediana Edad , Esclerosis Múltiple/patología , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/inmunología , Proteínas de Neoplasias/metabolismo , Proteína Inhibidora de la Apoptosis Neuronal/genética , Proteína Inhibidora de la Apoptosis Neuronal/inmunología , Proteína Inhibidora de la Apoptosis Neuronal/metabolismo , Survivin , Linfocitos T/inmunología , Linfocitos T/metabolismo , Ubiquitina-Proteína Ligasas , Proteína Inhibidora de la Apoptosis Ligada a X/genética , Proteína Inhibidora de la Apoptosis Ligada a X/inmunología , Proteína Inhibidora de la Apoptosis Ligada a X/metabolismoRESUMEN
OBJECTIVE: Our objective was to estimate the effectiveness of disease-modifying drugs (DMDs) in delaying multiple sclerosis (MS) disability progression in relapsing-onset (R-onset) definite MS patients under "real-world" conditions. METHODS: Treatment effect size, for DMDs as a class, was estimated in absolute terms and relative to MS natural history. A basic model estimated annual Expanded Disability Status Scale (EDSS) change before and after treatment. An expanded model estimated annual EDSS change in pretreatment years, treatment years on first drug, treatment years after drugs were switched, and in years after treatment stopped. Models were populated with 1980 through 2004 clinical data, including 1988 through 2004 data for all Nova Scotians treated with DMDs. Estimates were made for relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and R-onset groups. RESULTS: Estimated pretreatment annual EDSS increases were approximately 0.10 of one EDSS point for the RRMS group, 0.31 for the SPMS group, and 0.16 for the R-onset group. Estimates of EDSS increase avoided per treatment year on the first drug were significant for the RRMS group (-0.103, 0.000), the SPMS group (-0.065, 0.011), and the R-onset group (-0.162, 0.000); relative effect size estimates were 112%, 21%, and 105%. Estimated EDSS progression was faster in years after drug switches and treatment stops. CONCLUSIONS: Our estimates of disease-modifying drug (DMD) relative treatment effect size, in the context of "real-world" clinical practice, are similar to DMD treatment efficacy estimates in pivotal trials, though our findings attained statistical significance. DMDs, as a class, are effective in delaying Expanded Disability Status Scale progression in patients with relapsing-onset definite multiple sclerosis (MS) (90%), although effectiveness is much better for relapsing-remitting MS than for secondary progressive MS groups.
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Antirreumáticos/administración & dosificación , Esclerosis Múltiple Crónica Progresiva/tratamiento farmacológico , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adulto , Ensayos Clínicos como Asunto/normas , Ensayos Clínicos como Asunto/estadística & datos numéricos , Estudios de Cohortes , Interpretación Estadística de Datos , Bases de Datos como Asunto , Evaluación de la Discapacidad , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Esclerosis Múltiple Crónica Progresiva/epidemiología , Esclerosis Múltiple Crónica Progresiva/fisiopatología , Esclerosis Múltiple Recurrente-Remitente/epidemiología , Esclerosis Múltiple Recurrente-Remitente/fisiopatología , Nueva Escocia/epidemiología , Prevención Secundaria , Resultado del TratamientoRESUMEN
The study examines selection for kidney transplantation and determines who are referred, how many had contraindications and whether comorbidity indices predict transplant status. Of 113 consecutive adult incident end-stage renal disease (ESRD) patients at this single center 47 (41.6%) were referred. Using published guidelines, 48 (42.5%) had a specific contraindication. However 26 (23%) were neither referred nor had contraindications. An ESRD mortality score, acute renal failure status and albumin were independent predictors of referral but only the mortality score was predictive of contraindication status. The Charlson and ESRD comorbidity indices were less predictive of contraindication or referral status. In a comparison of patients who were Candidates (referred and no contraindication, n = 39) compared to those who were Neither (not referred and no contraindications, n = 26), age was the most discriminating factor (c = 0.99, 95% CI 0.97-1.00). Comorbidity and mortality indices were inferior. Neither patients were older (75 +/- 7 years) and had comorbidity scores that were higher than Candidates but similar to those with contraindications (ESRD index; Neither 3.3 +/- 2.5, Candidate 1.4 +/- 1.8, and contraindication 4.1 +/- 3.4). Comorbitity indices do not help explain selection practices whereas age is an important discriminator. How many Neither patients would benefit from transplantation is not known.
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Trasplante de Riñón/estadística & datos numéricos , Listas de Espera , Lesión Renal Aguda/cirugía , Adulto , Anciano , Comorbilidad , Humanos , Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/cirugía , Persona de Mediana Edad , Selección de Paciente , Análisis de SupervivenciaRESUMEN
Four published genome screens have identified a number of markers with increased sharing in multiple sclerosis (MS) families, although none has reached statistical significance. One hundred and five markers previously identified as showing increased sharing in Canadian, British, Finnish, and American genome screens were genotyped in 219 sibling pairs ascertained from the database of the Canadian Collaborative Project on Genetic Susceptibility to MS (CCPGSMS). No markers examined met criteria for significant linkage. Markers located at 5p14 and 17q22 were analyzed in a total of 333 sibling pairs and attained mlod scores of 2.27 and 1.14, respectively. The known HLA Class II DRB1 association with MS was confirmed (P<0.0001). Significant transmission disequilibrium was also observed for D17S789 at 17q22 (P=0.0015). This study highlights the difficulty of searching for genes with only mild-to-moderate effects on susceptibility, although large effects of specific loci may still be present in individual families. Future progress in the genetics of this complex trait may be helped by (1) focussing on more ethnically homogeneous samples, (2) using an increased number of MS families, and (3) using transmission disequilibrium analysis in candidate regions rather than the affected relative pair linkage analysis.
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Predisposición Genética a la Enfermedad , Esclerosis Múltiple/genética , Canadá , Familia , Femenino , Ligamiento Genético , Marcadores Genéticos , Genoma Humano , Antígenos HLA-DR/genética , Cadenas HLA-DRB1 , Humanos , Desequilibrio de Ligamiento , Masculino , Núcleo Familiar , Programas InformáticosRESUMEN
National Immunization Days (NIDs) are an additional opportunity to reach a large number of children and can be used to undertake additional activities beside immunization. This study highlights an attempt to assess nutritional status of under five children by using a NID. Seven thousand four hundred and thirteen underfives were selected randomly from urban, rural and slums areas of Chandigarh. Nutritional status was assessed by using weight for age criteria. Prevalence of protein energy malnutrition (PEM) was found to be about 42% while 22.7%, 14.5%, 4.1% and 0.7% children had grade I, II, III and IV PEM respectively. The prevalence of PEM was significantly higher among females (47.6%), in 1-3 years age group (53.80%), in slum area (67%) and children of labour class (60.5%) (p < 0.001). With increase in family size, the prevalence of malnutrition also significantly increased, and decreased with high literacy rate in parents (p < 0.001). The prevalence of PEM in present study (42%) was comparable to a community based survey (51.6%) among pre-school children of an ICDS block of Chandigarh. National immunization days can be successfully used to assess nutritional status of children. This approach can be used by others for screening common childhood problems, preparing normogram for a region or country, administering Vitamin A and educating mothers.
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Estado Nutricional , Preescolar , Femenino , Humanos , Programas de Inmunización , India , Lactante , Recién Nacido , MasculinoRESUMEN
The present study was conducted in Union Territory of Chandigarh to find out the utilization pattern of manpower engaged in the implementation of Pulse Polio Campaign (PPI) on 7th December, 1997 with the objective to achieve a coverage close to 100% and thereby, eradicating poliomyelitis. Over 100,000 under-five children were expected to participate on PPI day. Out of 240 polio centres established in the Union Territory, 16 were selected by stratified random sampling covering 14,858 children. The observing teams recorded the information about the children and presence of staff members throughout the day between 8.00 a.m. and 5.00 p.m. It was observed that nearly half of the children received the polio drops within the first three hours while only a little over 5% visited polio centres in the last two hours. The average number of manpower varied between 5 and 6 throughout the day (more than the recommended four). The staff posted at urban, rural and slum centres did not visit the houses except for the few volunteers in slums. Unimmunized children should be identified by the staff in last two hours when the load at polio centres is extremely low. Adequate utilization of the full potential of the manpower will help in enhancing the PPI coverage close to 100%.
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Programas de Inmunización , Vacuna Antipolio de Virus Inactivados/administración & dosificación , Niño , Humanos , India , Recursos HumanosRESUMEN
Disturbances of hearing in multiple sclerosis patients have been variably reported, likely because standard audiologic testing emphasizes assessment of peripheral, rather than central, auditory function. This study investigated a group of patients with multiple sclerosis (MS), prospectively selected on the basis of magnetic resonance imaging (MRI) scans. Five of these patients had demyelinating lesions that included the rostral auditory fibre tracts, while another seven patients had lesions restricted to brainstem auditory sites. A further four had no lesions in the distribution of their auditory pathways. A comprehensive battery of audiometric tests, including standard audiometry and retrocochlear testing, was performed. In addition, their findings on electrophysiologic testing, including auditory brainstem responses (ABR) and middle latency responses (MLR), were studied. Finally, their performances in gap detection and speech recognition in continuous and interrupted background noise were examined to assess their auditory temporal resolution. The MS patients were found to be selectively impaired under the interrupted masker of this speech-in-noise paradigm, confirming a temporal processing defect. Furthermore, these patients' performances suggested a predominant role of forebrain pathways in mediating auditory temporal resolution.
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Vías Auditivas/fisiopatología , Audición/fisiología , Esclerosis Múltiple/fisiopatología , Prosencéfalo/fisiopatología , Adulto , Audiometría/métodos , Corteza Auditiva/fisiopatología , Enfermedades Auditivas Centrales/patología , Enfermedades Auditivas Centrales/fisiopatología , Vías Auditivas/patología , Tronco Encefálico/patología , Tronco Encefálico/fisiopatología , Enfermedades Desmielinizantes/patología , Enfermedades Desmielinizantes/fisiopatología , Potenciales Evocados Auditivos/fisiología , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Humanos , Colículos Inferiores/fisiopatología , Imagen por Resonancia Magnética , Persona de Mediana Edad , Ruido , Estudios Prospectivos , Psicoacústica , Tiempo de Reacción/fisiología , Percepción del Habla/fisiología , Factores de TiempoRESUMEN
OBJECTIVE: To determine the role of open lung biopsy in immunocompetent patients with community-acquired pneumonia who require hospitalization. DESIGN: A group of 1,118 patients with severe community-acquired pneumonia that required hospitalization were enrolled in the study. Of the patients, 26 underwent open lung biopsy. Another 18 of these patients were immunocompromised and were excluded from this segment of the study. SETTING: Tertiary care 800-bed hospital from November 1981 to May 1989. RESULTS: Progressive diffuse pulmonary infiltrates and negative conventional cultures were the indications for biopsy in most of these patients. Eighteen (69 percent) were immunocompromised. The eight immunocompetent patients underwent a retrospective review of their course in hospital. Three patients died. The diagnostic yield from open lung biopsy was 25 percent. A specific histologic diagnosis was made in one patient--lipoid pneumonia. The pulmonary histologic finding were nonspecific in the remaining patients, but in four, in combination with the clinical data, gave useful information and resulted in therapy change. Culture of a pulmonary tissue yielded cytomegalovirus in one other patient. Serologic testing had a low yield in this group with three patients having a positive result. CONCLUSIONS: Open lung biopsy is rarely necessary in immunocompetent patients with community-acquired pneumonia. In a small group of patients where it is necessary, however, both positive and negative results are important in directing therapy.
Asunto(s)
Biopsia , Infecciones Comunitarias Adquiridas/patología , Pulmón/patología , Neumonía/patología , Adulto , Anciano , Femenino , Hospitalización , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Neumonía/diagnóstico , Neumonía/inmunologíaRESUMEN
Previous studies have reported variable prevalence of pain in multiple sclerosis (MS) and have not documented the impact of pain on daily living. In this consecutive series, we report on data collected from structured interviews with 85 patients seen within a 16-month period at a regional referral clinic. The prevalence of pain for the month preceding assessment was 53%. There were no significant differences between patients who did and those who did not report pain on the basis of patient demographics (age, gender) and disease characteristics (disease subtype, duration and neurologic symptom severity). Disease duration and neurologic symptom severity were significantly correlated with the number of hours of pain per week but were not correlated with pain severity, the number of pain sites or pain-related distress. There was wide variability in the number of pain hours/week reported with 17.6% of the sample reporting continuous pain for the month preceding assessment. Sixty-five percent of patients with pain reported taking medications for pain and 90% of these patients evaluated their medication(s) as 50% effective or better. Nevertheless, patients with pain reported poorer mental health and more social-role handicap. Discussion focuses on the need for routine assessment of pain and the comprehensive evaluation of the effectiveness of pain interventions in the therapeutic management of patients with MS.
Asunto(s)
Esclerosis Múltiple/complicaciones , Dolor/etiología , Adulto , Anciano , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/psicología , Dolor/psicología , Dimensión del Dolor , Escalas de Valoración Psiquiátrica , RecurrenciaRESUMEN
The allelopathic effect of parthenium (Parthenium hysterophorus L.) leaf residue (dry leaf powder, DLP) on water hyacinth (Eichhornia crassipes Mart Solms.) was studied. The treatment caused wilting starting from the margins of the older leaves and desiccation of above-water plant parts (shoot). Appearance, persistence, and disappearance of symptoms depended on the level and duration of the treatment and recovery of the treated plants, if it occurred. The treatment drastically reduced the number of healthy leaves (HLN) and the plant biomass at 0.25% (w/v) DLP; the treated plants recovered in about one month. At and above 0.50% (w/v) DLP, the plants were killed in about one month, resulting in sinking of the dead mass in water. Physiological effects of the treatment included deterioration of membrane integrity, loss of dehydrogenase activity with concurrent drastic reduction or total failure of water absorption by the roots, and reduction of chlorophyll contents in the leaves. The results indicate that the inhibitors leached out of the DLP affected the water hyacinth plants through changes in macromolecules: protein, lipid, and nucleic acid, resulting in root dysfunction and other inhibitory activities both in the root and shoot. Phenolic and other inhibitors including those found in the parthenium plant (except sesquiterpene lactones which have not been tested) at 50 ppm, exceptp-hydroxybenzoic acid, did not affect the treated plants. Such a high concentration of the allelochemicals is unlikely to be present in the medium at the lethal dose (0.50% w/v) of the DLP. Even withp-hydroxybenzoic acid, the plants recovered subsequently and grew normally. Thus, it appears that other allelochemicals including sesquiterpene lactones were mainly responsible for the inhibitory activity of the DLP on water hyacinth plants.
RESUMEN
The relative effect of residue of leaf, flower, stem, and root of parthenium (Parthenium hysterophorus L.) on growth of water hyacinth was studied. The inhibitory activity of the residue as shown by its effect on biomass and healthy leaf number (HLN) of treated plants was in the order: leaf and flower >stem >root. Total phenolic acids in the medium after 72 hr of suspending the plant part residue were maximum in flower followed by leaf, root, and stem, successively. The dry leaf powder (DLP) and dry flower powder (DFP) at and above 0.50% (w/v) and dry stem powder (DSP) at 1.00% (w/v) killed water hyacinth in about one month. Dry root powder (DRP) at the highest dose (1.25% w/v) reduced the growth of the treated plants drastically, but the plants recovered after about one month. The DSP at 0.50% (w/v) and DRP at 0.25-0.75% (w/v) supported growth of treated plants, probably due to lower levels of inhibitors, allowing utilization of constituents of the residue as nutrients. Using wheat seedlings as a reference material, it was observed that in aquaculture at different levels of parthenium plant parts residue, water hyacinth plants were much more sensitive to inhibitory activity. Thus, water hyacinth is suggested as a material for bioassay of inhibitory activity of the parthenium plant residue.