Simple view of reading in Spanish: A longitudinal study / Concepción simple de la lectura en español: un estudio longitudinal

Objectives: Test the validity of the Simple View of Reading (Gough & Tunmer, 1986) in Spanish and analyze the contributions of decoding and linguistic abilities to reading comprehension. Method: This longitudinal study assessed a sample of 71 Spanish speaking children at Grade 1 and Grade 3. At each time point, a battery of tests assessed children's linguistic abilities, decoding and reading comprehension. The authors used the classic model of SVR: model 0 (pseudoword accuracy reading and listening comprehension) and a complex model: Model 1 (linguistic abilities and decoding). Results: Results of regression analyses showed that the original model of the SVR, explained little variance of reading comprehension in Spanish in comparison with the results obtained in English. However, a complex model explained 51% and 55% of the variance of reading comprehension in first and third grade respectively. The unique contribution of linguistic abilities increased from 27% in first grade to 43% in third grade and the contribution of decoding decreased from 24% in first grade to 2% in third grade. Conclusions: The results are explained in terms of the transparent nature of Spanish orthography and educational implications are discussed.(AU)

ObjetivosEvaluar la validez de la concepción simple de la lectura (Gough y Tunmer, 1986) en español y analizar la contribución de la decodificación y las habilidades lingüísticas a la comprensión lectora. Método: Se trata de un estudio longitudinal en el que se evaluó a 71 estudiantes hispanohablantes en 2 fases: en primer y en tercer curso de primaria. A todos ellos se les aplicó una serie de pruebas para evaluar las habilidades lingüísticas, la decodificación y la comprensión lectora en cada una de las fases. Los autores utilizaron el modelo original de la concepción simple de la lectura: modelo 0 (precisión en la lectura de seudopalabras y comprensión oral) y un modelo más abierto: modelo 1 (habilidades lingüísticas y decodificación). Resultados: Tras un análisis de regresión, se encontró que el modelo original de la concepción simple de la lectura explicó una varianza muy pequeña de la comprensión lectora en español en comparación los resultados obtenidos en inglés. Sin embargo, un modelo más abierto logró explicar el 51 y el 55% de la varianza de la comprensión lectora en el primer y el tercer curso de primaria, respectivamente. La contribución única de las habilidades lingüísticas se incrementó de un 27% en el primer curso a un 43% en el tercer curso y el aporte de la decodificación disminuyó de un 24% alcanzado en el primer curso a un 2% en el tercer curso. Conclusiones: Los resultados se explican en términos de la transparencia del sistema ortográfico del español. Los hallazgos tienen importantes implicaciones que son discutidas.(AU)

NT-proBNP in Myocarditis after a Scorpion Sting Envenomation.

OBJECTIVE: This study was to evaluate the levels of NT-proBNP in patients with myocarditis which occurred after a scorpion sting envenomation. MATERIAL AND METHODS: A total of 30 patients with scorpion sting envenomation and 21 patients with heart failure which was caused by cardiomyopathy, were prospectively studied. The data included the patient demographics, clinical features, echocardiography and the NT-proBNP levels. RESULTS: An echocardiographic evidence of myocarditis with a left ventricular ejection fraction of less than 50%, was found in 22 patients. In all the 22 patients, NT-proBNP was significantly elevated. The NT-proBNP levels were very high in the patients with severe LV dysfunction. However, it was in the normal range in the patients without an evidence of myocarditis. The elevated NT-proBNP levels were correlated with the LV dysfunction and myocarditis. When they were compared with the patients with heart failure which was caused by cardiomyopathy, the NTproBNP levels were found to be significantly more elevated in scorpion sting myocarditis. CONCLUSIONS: The NT-proBNP levels were significantly elevated in myocarditis which occurred after a scorpion sting envenomation.

Echocardiography guided therapy for myocarditis after scorpion sting envenomation.

OBJECTIVE: This study was to evaluate echocardiographic findings and its usefulness in clinical management of patients with scorpion sting envenomation. MATERIAL AND METHODS: A total of 84 consecutive patients were prospectively studied. The data included demographics, at the time of presentation to the hospital, the clinical features, echocardiographic findings, admission to intensive care unit, use of inotropic medication, time to discharge, and mortality. RESULTS: Out of 84 patients studied 60 patients (71.4%) had echocardiographic evidence of myocarditis (LVEF <50%). Majority of patients had LVEF <40% (50 patients, 83.3%). Severe LV dysfunction (LVEF <30%) was noted in 20 patients (33.3%). No patient had significant valvular regurgitation. RV dysfunction was noted in half of the patients who had LV dysfunction. RV dysfunction was not seen in isolation. Twenty four patients without evidence of myocarditis on echocardiography were observed in general wards and were discharged in 24 to 48 hours of admission. Ten patients with mild LV dysfunction (LVEF 50-40%) and 20 patients with moderate LV dysfunction were observed in high dependency units with regular monitoring for 24 to 48 hours. Only 3 patients were put on inotropics support and others could be discharged in 72 to 96 hours. All the patients with severe LV dysfunction and moderate LV dysfunction with significant RV dysfunction were admitted in intensive care unit irrespective of symptoms (Total 30 patients). These patients were put on inotropics support. Among severe LV dysfunction group, 4 patients required ventilator support and 2 (2.3%) patients died with refractory shock and multi-organ failure. Tachycardia, muffled and or gallop heart sounds and hypertension didn't predict presence of LV dysfunction. Persistent hypotension requiring inotropics support was a marker of severe LV dysfunction. CONCLUSION: Echocardiography is a useful tool in emergency to assess LV function in patients with scorpion sting envenomation. It can guide therapy by identifying patients with severe LV dysfunction.

Evaluation of internal dose to members of the public at the Kaiga site, India, due to the ingestion of primordial radionuclide 40K.

Four 220 MWe pressurised heavy water reactors are under operation at Kaiga in the state of Karnataka in India. Environmental radiological survey of the surrounding areas of the Kaiga site is carried out by Bhabha Atomic Research Centre, Mumbai. The estimated dose to the members of the public due to ingestion of radioactive isotope of potassium, a natural radionuclide, in the surroundings of the Kaiga site is 136 µSv (13.6 mrem) per year. The value indicates that the dose to the public due to operation of the nuclear reactors in Kaiga is insignificant in comparison with the dose due to unavoidable natural radioactivity.

Elevated Cardiac Troponin (cTnI) Levels Correlate with the Clinical and Echocardiographic Evidences of Severe Myocarditis in Scorpion Sting Envenomation.

OBJECTIVE: This study was to evaluate the predictive value of the cardiac troponins in scorpion sting myocarditis at a tertiary care hospital in Raichur, (Karnataka state) India. METHODS: A total of 84 consecutive patients were prospectively studied. The data included the demographics, the time of presentation to the hospital, the clinical features, the cardiac troponin levels and the echocardiographic findings. RESULTS: 12 patients with only local symptoms had troponin levels of less than 0.01µg/L. 12 patients with local and systemic symptoms without an echocardiac evidence of myocarditis had troponin values of 0.01 to 0.11 µg/L. 60 patients with an echocardiographic evidence of myocarditis had troponin levels of above 0.11 µg/L. 6 patients with severe myocarditis who required ventilator support or which led to death had troponin values which were higher than 10 µg/L. CONCLUSIONS: High cardiac troponin levels predict myocarditis in scorpion sting envenomation and they can be a useful tool in guiding the therapy early.

Acute gonococcal Fitz-Hugh-Curtis syndrome: a case report.

A case of acute Fitz-Hugh-Curtis syndrome in a young woman with purulent peritonitis and acute purulent appendicitis and oophoritis is presented. Open emergency appendectomy was performed and peritoneal pus was drained. Neisseria gonorrhoeae was cultured from the peritoneal pus. The hepatic enzymes were found to be raised. The patient was successfully managed and is asymptomatic after three months follow-up. To our knowledge, this is the first case of Fitz-Hugh-Curtis syndrome reported from Kuwait.

Transfer coefficient of 137Cs from feed to cow milk in tropical region Kaiga, India.

In the transport model for the prediction of the concentration of (137)Cs in milk, the transfer coefficient from feed to milk, F(m), is an important parameter. Site-specific transfer coefficient from feed to cow's milk, for (137)Cs in the Kaiga environment, a nuclear power station site in India, determined over a period of 10 y is presented in this paper. The value is determined from (137)Cs concentration in milk and grass samples of the Kaiga region and the result ranged from 6.43E-03 to 1.09E-02 d l(-1) with a geometric mean value of 8.0E-03 d l(-1). The result is compared with that for (40)K, determined concurrently at the same region and ranged from 3.06E-03 to 3.48E-03 d l(-1) with a geometric mean value of 3.26E-03 d l(-1). This parameter is quite useful in decision-making for implementing countermeasures during a large area contamination with (137)Cs in tropical areas like Kaiga.

Soil to leaf transfer factor for the radionuclides ²²6Ra, 4°K, ¹³7Cs and 9°Sr at Kaiga region, India.

Transfer factors are the most important parameters required for mathematical modeling used for environmental impact assessment of radioactive contamination in the environment. In this paper soil to leaf transfer factor for the radionuclides 4°K, ²²6Ra, ¹³7Cs and 9°Sr is estimated for Kaiga region in Karnataka state, India. Among the plants in which study is carried out, ²²6Ra, 4°K, ¹³7Cs and 9°Sr activity in leaves of herbaceous plants is higher than that of tree leaves. Soil to leaf transfer factor for ²²6Ra, 4°K, ¹³7Cs and 9°Sr was found to be in the range of 0.03-0.65, 0.32-8.04, 0.05-3.03 and 0.42-2.67 respectively.

Outcome of head injury patients undergoing surgical management: a tertiary level experience.

BACKGROUND: Head injury is the major cause of death in a neurosurgical patient. OBJECTIVE: To find the outcome, and treatment modality affecting the outcome in patients with head injury. METHODS: Nine hundred eighty seven patients presenting to National Institute of Neurological and Allied Sciences, Kathmandu, with head injury from September 2009 to October 2010 were included in the study. Patients were categorized according to post resuscitation Glasgow Coma Score. Outcome was assessed at discharge using Glasgow Outcome Score and analyzed for any correlation with modality of treatment and severity of injury. RESULTS: Among 987 patients with head injury,152 (15.4%) had severe, 126 (12.8%) had moderate and 709 (71.8%) had mild head injuries. Three hundred twelve (31.6%) patients required definitive and supportive surgical intervention. One hundred eighty two required cranial surgical intervention. Overall mortality was 10% (99), 137 patients (13.9%) had unfavorable outcome and 850 (86.1%) had favorable Glasgow Outcome Score of 4 and 5. Mortality was 53.2%, 9.5% and 0.8% in severe, moderate and mild head injury group respectively. Mortality rate was significantly higher (64.6%) in severe head injury group managed conservatively than those in same group treated with supportive and definite surgical intervention (44.8%) (p=0.016). CONCLUSION: Mortality in head injury patients depend upon severity of injury. Mortality in severe head injury group can be reduced by supportive and definite surgical intervention.

Estimation of site-specific deposition velocities and mass interception factor using 7Be and the prediction of deposition pattern of radionuclides at Kaiga site, India.

Site-specific wet, dry deposition velocities and mass interception factors at Kaiga site, where three PHWR type power plants are operational, using 7Be as a tracer are presented. Mean wet and dry deposition velocities for Kaiga site were found to be 7.4 x 10(-2) m s(-1) and 3.0 x 10(-4) m s(-1), respectively. Mass interception factors for vegetation were found to be 0.7-5.6 m(2) kg(-1) dry weight with a mean of 2.4 m(2) kg(-1) dry weight. The site-specific data were used for the prediction of radionuclide distribution pattern in soil and vegetation in the case of a hypothetical air contamination.

Minimally invasive open lumbar discectomy: An alternative to microlumbar discectomy.

BACKGROUND: Lumbar disc surgery has come a long way since its fi rst description by Dandy in 1929. Evolving through the transdural approach and a laminectomy for the removal of a disc, it now surpasses the primal technique with essentially a minimally invasive procedure, an extradural approach without laminectomy. OBJECTIVE: The objective of this study is to ascertain the effectiveness of Minimally Invasive Open Lumbar Discectomy in the treatment of lumbar disc prolapse. MATERIALS AND METHODS: It is a descriptive study entailing the patients with paramedian or central disc prolapse at single or two consecutive lumbosacral levels undergoing surgery at the National Institute of Neurological and Allied Sciences, Bansbari, Nepal, over a period of one and a half years. Patients who underwent either laminectomy or bilateral fenestration were excluded. Results of surgery were measured prospectively in terms of primary outcome measure (outcome at six months follow up as measured with Prolo Functional and Economic Scale) and secondary outcome measures (radicular pain relief, mobilisation, complication, and residual disc). RESULTS: In the series of 137 consecutive patients, 120 fulfilled the criteria. 98.33 % of patients had an improvement in the radicular pain and ambulation was commenced from the fi rst post-operative day. There were three instances of inadvertent dural tear without fascicle injury, and one instance of residual disc requiring reoperation. At 6 months, 97.5 % had good to excellent (grade 4, or 5) results reaching the premorbid states in the Prolo Functional and Economic Scale. CONCLUSION: The results of Minimally Invasive Open Lumbar Discectomy compare favourably with those of a microlumbar discectomy, and could therefore be an alternative to the latter in resource deprived circumstances.

Antenatal dexamethasone treatment leads to changes in gene expression in a murine late placenta.

Antenatal steroids like dexamethasone (DEX) are used to augment fetal lung maturity and there is a major concern that they impair fetal growth. If delivery is delayed after using antenatal DEX, placental function and hence fetal growth may be compromised even further. To investigate the effects of DEX on placental function, we treated 9 pregnant C57/BL6 mice with DEX and 9 pregnant mice were injected with saline to serve as controls. Placental gene expression was studied using microarrays in 3 pairs and other 6 pairs were used to confirm microarray results by semi-quantitative RT-PCR, real-time PCR, in situ hybridization, western blot analysis and Oligo ApopTaq assay. DEX-treated placentas were hydropic, friable, pale, and weighed less (80.0+/-15.1mg compared to 85.6.8+/-7.6mg, p=0.05) (n=62 placentas). Fetal weight was significantly reduced after DEX use (940+/-32mg compared to 1162+/-79mg, p=0.001) (n=62 fetuses). There was >99% similarity within and between the three gene chip data sets. DEX led to down-regulation of 1212 genes and up-regulation of 1382 genes. RT-PCR studies showed that DEX caused a decrease in expression of genes involved in cell division such as cyclins A2, B1, D2, cdk 2, cdk 4 and M-phase protein kinase along with growth-promoting genes such as EGF-R, BMP4 and IGFBP3. Oligo ApopTaq assay and western blot studies showed that DEX-treatment increased apoptosis of trophoblast cells. DEX-treatment led to up-regulation of aquaporin 5 and tryptophan hydroxylase genes as confirmed by real-time PCR, and in situ hybridization studies. Thus antenatal DEX treatment led to a reduction in placental and fetal weight, and this effect was associated with a decreased expression of several growth-promoting genes and increased apoptosis of trophoblast cells.

High diversity of group A Streptococcal emm types in an Indian community: the need to tailor multivalent vaccines.

BACKGROUND: Concern about the emergence of antibiotic-resistant strains and about morbidity and/or mortality related to rheumatic fever and rheumatic heart disease has been a continuous impetus for the development of a safe, effective vaccine against group A Streptococcus (GAS). To date, >120 GAS M types are known, as identified by serological typing. In general, serum immunoglobulin G directed to the hypervariable NH2 terminal portion of M protein leads to complement fixation and opsonophagocytosis of the homologous streptococcal serotype by polymorphonuclear leukocytes, and the protection is type specific. The sequence variation at the N terminus ultimately affects the binding of opsonic antibodies. Because of hypervariability in these opsonic sequences from different M types, it was relevant to use epitopes derived from these multiple sequences in a "multivalent vaccine" design for evaluation of protection against these M types of GAS. Thus, any attempts to design vaccines for a given community will require information on N terminal-sequence typing and variation. METHODS: In the present study, we performed molecular characterization of isolates recovered from patients in northern India--to our knowledge, for the first time--in an attempt to study the circulating M types and their N terminal sequence variability. RESULTS: We report tremendous diversity in GAS strains recovered from symptomatic patients, with implications on the design of appropriate vaccines. Fifty-nine isolates represented 33 different sequence types. Very few novel types and no predominant clones were found. CONCLUSIONS: The high diversity of emm types encountered in a single year suggests that any M protein-based multivalent vaccine would have to be specifically tailored for this region.

A cognitive tool to diagnose predominantly inattentive ADHD behavior.

Poor performance on tests of reading comprehension could be the result of weak word-recognition skills, inconsistent attention (ADD), or a combination of the two. Identifying the source of the reading disability (RD) reliably has been difficult because inconsistent attention interferes with reading and weak word recognition skill makes attention wander. The situation is further complicated by the fact that there are no objective diagnostic tests for ADD (Breggin, 1998; Diller, 1998). We proposed a new model of differential diagnosis of ADHD-I/RD and field-tested its utility in two studies. The new diagnostic procedure utilizes intra-individual differences seen in the performance of at-risk learners on tasks related to reading that vary in the degree of sustained attention required for successful performance. The hypothesis is that children whose attention is inconsistent would perform more poorly on tests such as listening comprehension, which require sustained attention, than on tests such as reading comprehension, which are more tolerant of inattention. Such differences will not be seen in the test scores of children who have only a reading disability because their performance on reading tests is determined more by the difficulty level of the tests than by the sensitivity of the tests to attention. The validity of this new model was evaluated by determining the relationship between differences seen in the scores of tests that differ in their attention requirement and the degree of inconsistency in sustained attention as measured by Conners' CPT. The results of the two studies indicate this to be a viable approach. The results of the second study are presented in this report.

Aerobic bacterial isolates from burn wound infections and their antibiograms--a five-year study.

A retrospective study of major aerobic bacterial isolates from pus/wound swabs taken from patients admitted to the burn unit at Govt. Medical College Hospital, Chandigarh, India, over a period of 5 years (June 1997-May 2002) was undertaken. The study was carried out to determine the bacterial profile and antimicrobial susceptibility of the isolates and to describe the change in trends over the study period. The pus/wound swabs yielded very high culture positivity (96%) for 665 total isolates. Pseudomonas aeruginosa was found to be most common isolate (59%) followed by Staphylococcus aureus (17.9%), Acinetobacter spp. (7.2%), Klebsiella spp. (3.9%), Enterobacter spp. (3.9%), Proteus spp. (3.3%) and others (4.8%). Although P. aeruginosa continued to remain the predominant isolate over the five years, a constant and significant increase in the incidence of Acinetobacter spp. was found. Amikacin was found to be the most effective drug against gram negative bacteria, however, resistance to it was significantly increased over 5 years. For S. aureus and P. aeruginosa netilmicin and piperacillin were found to be the most effective drugs. Most of the isolates showed high level resistance to antimicrobial agents.

Hepatolithiasis with biliary ascariasis--a case report.

BACKGROUND: Biliary ascariasis is regarded as possible etiological factor for hepatolithiasis. Here we report one case of a patient with hepatolithiasis with biliary ascariasis who developed a liver abscess, which was treated with partial hepatectomy. CASE PRESENTATION: A young adult female presented with epigastric pain and vomiting with repeated attacks of cholangitis. ERCP showed evidence of multiple intrahepatic calculi with the development of abscess in the left lobe of liver. The patient underwent partial hepatectomy and was found to have biliary ascariasis on histology. She was treated with antihelmenthic therapy and has had an uneventful postoperative period of 2 years. CONCLUSION: Biliary ascariasis with hepatolithiasis, although rare, should be considered in endemic countries.