CLINICAL AND OBJECTIVE TEST CHARACTERISTICS OF VESTIBULAR MIGRAINE: IMPLICATIONS FOR DIAGNOSIS AND MANAGEMENT.

The research we provided look at a number of factors, such as age, unilateral testing, and squinting both during the ictal and interictal periods to define vestibular migraine. One hundred and ten adults with recurrent spontaneous and positional vertigo participated in the study, which the investigators did. Vestibular migraines (VM) or probable vestibular migraine constituted the two diagnoses given to the patients (n = 29 and n = 76, respectively). The findings revealed those surveyed frequently complained of headache (85.3%), spinning vertigo (76.2%), and Mal de Débarquement (60.2%), with movement hypersensitivity (32.6%). After an episode, 75.2% of individuals having vestibular migraine showed spontaneous squinting, whereas 16.5% did so among assaults, although fixing was forbidden. 27.3% of people had clear spatial squinting after an assault, while 57.3% did so after assaults. In 51.2% of instances, the direction of ictal spontaneous Nystagmus was straight, while in 19.5% of cases, it was vertical. Positional and spontaneously ictal squinting was evaluated at speeds between 0.0 and 59.3 degrees per second and 0.0 and 99.9 levels per minute, respectively. In 92.6% and 25.1% of instances, respectively, the interact spontaneous and positional nystagmus velocities were typically less than 3 degrees/second. When contrasted with the time within assaults, squinting speeds were substantially greater after an assault. According to additional tests, 98.6% of those tested exhibited normal lateral video head impulse test gains, indicating that their vestibule-ocular responses were in place. The calorie test findings were symmetrical in 86.4% of the instances, showing normal vestibular function. In 90.4% and 95.2% of cases misogynic potentials displayed symmetrical magnitudes. In 69.8% and 98.1% of instances, misogynic possibilities were identical. In 89.3% of cases, the audiometer data is generally uniform and age-consistent. In outcome, low-velocity squinting that can be horizontal, vertical, or torsional motions occur throughout a sensory migraines event. The investigation also discovered that patients with vestibular migraine often had acceptable audio vestibular test findings.

Nipah virus: a narrative review of viral characteristics and epidemiological determinants.

OBJECTIVES: The objectives of this article are to highlight the properties of the Nipah virus (NiV) and discuss its epidemiological determinants. STUDY DESIGN: A review of conjectures, epidemiological and clinically related studies, and identification and discussion of preventive approaches is conducted. METHODS: A review of the current literature is performed going through online search engines: PubMed and Google Scholar. The search strategy was focused on two main components, first on the NiV ('Nipah' OR 'Nipah Virus') and subsequently on its epidemiology, including determinants and preventive measures ('Epidemiology/determinants' OR 'Epidemiology/prevention'). RESULTS: NiV infection is an emerging zoonotic infectious disease causing sporadic outbursts in many developing countries within Asia, Africa, and South America. Pteroid bats are the natural reservoirs, but human-to-human transmission is possible. Clinical course ranges from non-specific influenza-like symptoms to rapidly progressive respiratory and neurologic complications. Vector control has been challenging because of its widely distributed ecological niche. Currently, no definitive treatment protocols are available in humans, but profound breakthrough in vaccine technology and successful equine vaccines has shown the way for the development of NiV vaccine and immunization in the near future. CONCLUSIONS: The NiV poses a significant public health risk because of its intricate transmission cycle, unpredictable viral course, murky management protocol, and unavailability of vaccine. Complicated by emergence and subsequent reemergence, prevention and containment are the two most important public health promotion strategies. Early anticipation, intergovernmental preparedness and cooperation, and surveillance of zoonotic infections still remain the key to mitigate the risk.

Structural, mechanical, dielectric properties and magnetic interactions in Dy3+-substituted Co-Cu-Zn nanoferrites.

Sol-gel-synthesized Co-Cu-Zn ferrite nanoparticles diluted with Dy3+ ions were investigated in terms of their structural, morphological, elastic, magnetic and dielectric properties. X-ray diffraction patterns showed the formation of a single-phase cubic spinel structure. As the concentration of Dy3+ ions was increased, the lattice length gradually increased from 8.340 to 8.545 Å, obeying Vegard's law. The Williamson-Hall (W-H) method was employed to observe the change in the lattice strain. Crystallite size obtained from W-H plots followed a pattern similar to that observed using the Scherrer equation. The cation distribution suggested a strong preference of Dy3+ ions for the octahedral B site while Cu2+ and Fe3+ ions were distributed over both A and B sites. The microstructures of the samples were visualized using transmission electron microscopy. Mechanical properties such as stiffness constant, longitudinal and transverse wave velocities, Young's modulus, bulk modulus, rigidity modulus, Poisson's ratio and Debye temperature were investigated by acquiring infrared spectra recorded in the range of 300 to 800 cm-1. Replacement of Fe3+ ions with the strongly magnetic Dy3+ ions increased the saturation magnetization and coercivity. Dielectric constant increased with Dy3+ substitution but decreased with applied frequency.

Phenylketonuria: Our Experience in Nine Years at a Tertiary-level Referral Institute.

INTRODUCTION: Phenyl ketonuria is an inborn error of amino acid metabolism resulting in excessive phenyl alanine levels in blood resulting in a spectrum of neurological defects. PATIENTS AND METHODS: We retrospectively went through the records of patients diagnosed as Phenyl ketonuria in the last nine years in our team and patients who's data could be accessed were analyzed in detail. Details of laboratory tests, imaging clinical features, course were recorded. OBSERVATION: A total of 32 patients were identified in nine years of which data was available only for 15 patients. Age at diagnosis varied from 2.5 years to 7 years. 73% were males. Global developmental delay, Microcephaly. Seizures blond hair, spasticity, regression, Ocular Hypertelorism, low set ears, Seborrhea, Hypotonia, Family history of mental retardation and Consanguinity was common one patient showed a large hypo pigmented area in left arm with eczematous rash. RESULTS OF LAB TESTS: Urine ferric chloride test and DNPH was positive in all cases. Tandem mass spectroscopy showed elevated phenyl alanine, normal tyrosine and elevated PHE tyrosine ratio in all cases. MRI showed symmetrical Flair hyperintensities in T2 weighted images in the parieto occipital region hypo on T1 with no diffusion restriction in 11 cases and MRS was normal. Genetic testing showed one non consanguineous family having carrier state. Follow up is from 1 year to 5 years. Seizures controlled in all. Regular fallow up shows change in hair color and gain of mile stones. There was no mortality. CONCLUSION: Phenyl ketonuria is a controllable metabolic disease. However there is considerable delay before diagnosis resulting in persistence of sequelae in children with PKU as well as normal children born to PKU mothers which needs attention to prevent these complications.

Effect of La3+ Impurity on Magnetic and Electrical Properties of Co-Cu-Cr-Fe Nanoparticles.

In this work a series of Co0.7Cu0.3Cr0.5La(x)Fe1.5-(x)O4 were synthesized via sol-gel auto-combustion technique through the incorporation of La3+ into the raw powders. The structural magnetic and resistivity properties of the synthesized Co-Cu-Cr-La ferrites were investigated. X-ray diffraction data indicated that, after La3+ doping, samples consisted of the main spinel phase in combination with a small amount of a foreign LaFeO3 phase. The addition of La3+ resulted in the reduction of particle size and an increase of porosity of the synthesized samples. The infrared spectra were recorded on the range from 300-800 cm(-1). The two primary bands corresponding to tetrahedral v1 at 595-605 cm(-1) and octahedral v2 at 389-413 cm(-1) were observed. The octahedral site radii increased rapidly with La3+ substitution while the tetrahedral site radii slowly increased. Deviation from the ideal oxygen positional parameter is found to decrease with La3+ substitution. The saturation magnetization of the samples decreased with the amount of La3+ ions doped and the coercivity shows an opposite trend. La3+ substitution affects the hopping between Fe2+ <-> Fe3+, resulted in increase in resistivity.

Transduction and utility of the granulocyte-macrophage colony-stimulating factor gene into monocytes and dendritic cells by adeno-associated virus.

The genetic manipulation of antigen-presenting dendritic cells (DC) offers promise for stimulating the immune response, in particular for anticancer and antiviral protocols. As adeno-associated virus (AAV) has shown promise as a gene delivery vector for transducing a variety of hematopoietic cell types, we have investigated AAV's ability to genetically alter DC. In this analysis, we modified the standard granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) treatment of adherent monocytes to generate DC. In our protocol, adherent monocytes were first infected with an AAV/GM-CSF/Neo vector, and the addition of IL-4 was delayed for 2 days to allow for a brief period of monocyte proliferation. AAV-mediated transduction of the GM-CSF and Neo genes into monocytes/DC precursors was demonstrated by G418 selection, GM-CSF secretion, GM-CSF RNA expression (reverse transcriptase-polymerase chain reaction amplification [RT-PCR]), and cell proliferation. Cells resulting from infection with AAV/GM-CSF/Neo virus, and subsequent IL-4 and tumor necrosis factor-alpha (TNF-alpha) treatment, displayed multiple classic markers consistent with mature DC. Finally, chromosomal integration of the AAV vector was also demonstrated in sorted CD83+ DC. These data strongly suggest that AAV vectors will be useful for the genetic manipulation of DC and suggest that the transduction of the GM-CSF gene was able to fully replace the need for exogenous GM-CSF in the production of mature DC.

Results and histological development of various surgical techniques for correcting eversion of the third eyelid in dogs.

An experimental study was made of 20 dogs in order to compare various surgical techniques used to correct eversion of the third eyelid, namely resection of most of the cartilage, resection of the central portion of the cartilage, and cartilage homotransplantation. An analysis was made of histological results obtained 45 days after operation, the most satisfactory result being recorded for homotransplantation of the third eyelid cartilage.

Canine pyometra: a study of the urinary proteins by SDS-PAGE and Western blot.

Canine pyometra often causes glomerulonephritis by immune complex deposition in the glomeruli. Proteinuria, ranging from moderate to severe, may be present secondary to renal damage. To determine urinary protein excretion due to pyometra, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) was conducted on urine from 15 bitches with pyometra and 10 healthy bitches. To characterize urinary immunoglobin excretion, Western blot analysis of the urine samples using antibodies to canine IgG and IgA was also performed. Nine bands were detected by electrophoresis in bitches with pyometra, while only four were detected in the healthy animals. The urinary proteins from bitches with pyometra were primarily of glomerular origin; 58% were of medium-high molecular weight (MW), and the remainder were low MW. None of the healthy dogs had IgG or IgA in their urine, whereas three bitches with pyometra had IgG in their urine and another bitch with pyometra had both IgG and IgA. The low proportion of bitches with urinary immunoglobins was probably be due to early diagnosis of the disease. Although only a limited number of dogs was used, this study is apparently the first to characterize the electrophoretic pattern of urinary proteins and to quantify urinary excretion of IgG and IgA in bitches with pyometra.

Characterization of renal damage in canine leptospirosis by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting of the urinary proteins.

Canine leptospirosis is a zoonotic disease that can cause interstitial nephritis. As a consequence of the renal damage, proteinuria may occur. To determine the urine protein pattern in the disease we performed sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) on the urine from 10 dogs with leptospirosis and 20 healthy dogs. Western blotting analysis of the urine samples with antibodies against canine IgG and IgA was also performed to identify these immunoglobulins in the urine. Urine electrophoresis showed three new bands in the dogs suffering from leptospirosis. Only two of the dogs with leptospirosis showed detectable concentrations of IgG and IgA in urine, while a third animal showed IgG alone. The study showed a 36.7% increase in the excretion of low molecular weight proteins in dogs with leptospirosis but almost no change in the high molecular weight protein pattern. These results, together with the low number of animal with detectable concentrations of IgG and IgA in the urine, support the view that canine leptospirosis is characterized by interstitial nephritis.

Temporal variations in blood glutathione peroxidase (GSHPx) activity in sheep at pasture in a Mediterranean area.

The present study evaluates blood GSHPx activity in 18 sheep flocks at range, to identify those seasons with the highest risk of selenium deficiency. Samples were taken from 1108 15-day-old lambs during the two usual lambing periods in this geographical area (autumn-winter and spring-summer). The overall mean values in the first period (146.69 +/- 3.41 i.u./g Hb) was higher than in the second one (107.50 +/- 3.53 i.u./g Hb). This may be explained by the special features of the climate in the Mediterranean area, which allow an optimum growth of grass from October to May. Therefore, the lambs born in spring-summer are from pregnancies in months when feeding is based only upon grazing. However, lambs born in autumn-winter comes from ewes gestating during the summer, when supplementation with cereal grains is given. As a conclusion, lambs born in spring-summer in this area are at higher risk to selenium-deficiency related disorders.

Evaluation of total protein content in tears of dogs by polyacrylamide gel disk electrophoresis.

Concentration of total proteins was measured and sodium dodecyl sulfate-polyacrylamide gel disk electrophoresis was performed on tear and plasma samples obtained from 26 healthy dogs, and the results were compared. Mean +/- SEM concentration of total proteins in tears was 0.63 +/- 0.04 g/dl, and significant effects of age or gender were not found. The protein composition of tears in dogs was complex, and bands from light and heavy chains of immunoglobulins were identified by electrophoresis.

Keratoconjunctivitis sicca and diabetes mellitus in a dog.

Diabetes mellitus and keratoconjunctivitis sicca were diagnosed in a female Poodle. The dog was treated for diabetes and keratoconjunctivitis sicca until blood glucose concentrations were within normal limits. Treatment for keratoconjunctivitis sicca was suspended then, and signs of this disorder did not appear again. Most of the factors known to predispose to keratoconjunctivitis sicca were not applicable to this dog. On the basis of observations made in this dog, we suggest that diabetes mellitus and keratoconjunctivitis sicca may be linked. Clinical signs of the disorders developed simultaneously and resolved when diabetes mellitus was controlled with insulin.

Relationships between some soil parameters and the blood glutathione peroxidase activity of grazing sheep.

The relationships between some soil parameters and blood glutathione peroxidase (GSHPx) activity in 15-day-old lambs was studied on 18 sheep farms. Soil samples were analysed for the proportions of sand, silt and clay, pH, and the concentrations of calcium, phosphorus, iron, nitrogen and sulphates. On the farms where the lambs had adequate GSHPx activity (> or = 130 i.u./g Hb) the soils contained significantly more clay, phosphorus and sulphates, and significantly less iron and nitrogen, than on the farms where the lambs did not have adequate GSHPx activity.

[Urination disorders in HIV infected patients]. / Troubles mictionnels chez les patients infectés par le VIH.

OBJECTIVES: Manifestations of urological involvement, including tumour development, infection and impaired micturition are frequent in patients with acquired immunodeficiency syndrome. The frequency and consequences of dysuria itself are difficult to evaluate due to the concomitant effects of underlying infections, obstructive or neurological pathologies. METHODS: Thirty-nine HIV-positive patients presenting impaired micturition including isolated dysuria, urine retention pollakiuria or urge incontinence were followed prospectively from February 1989 to September 1992. Each patient underwent a complete neurological and urological examination. Imaging included CT-scan or magnetic resonance imaging of the brain or spinal cord, echography of the bladder and prostate, intravenous pyelography or ascending and micturition urethrocystography as required. Urinary function tests were used to determine the cause and exact type of impairment to establish therapeutic protocols. RESULTS: A neurological origin was found in 61.5% of the cases. Cerebral toxoplasmosis and HIV encephalitis were the most commonly found causes. Symptomatic relief was obtained in most patients with bladder- sphincter active drugs. After a mean follow-up of 9 months (range 2-24 months), long-term improvement was achieved in 57.9%. Seventeen patients (44%) died within a delay of 2 to 24 months (mean 8 months) after onset of dysuria. CONCLUSION: Signs of impaired micturition are frequently encountered in HIV-infected patients. A full work-up is needed for diagnosis and treatment adaptation. Neurological disease is the most frequent underlying cause and would appear to be a sign of poor prognosis.

Salmonella types and antibiotic susceptibility: a six months survey.

A total of 51 Salmonella strains were isolated during the six month period of May 1998 till October 1998. Of these, 41 (80.3%) were Salmonella typhi, 5 (9.8%) Salmonella pararyphi A,2 (3.9%) Salmonella worthington and 1 (1.9%) Salmonella senftenberg. The prevalent phage and biotype of Salmonella typhi was E1 (75%) and type 1 (90.2%) respectively. The commonest pattern of multiple drug resistance in Salmonella typhi was ACCoT and 92.5% of these belonged to phage E1. Out of the five Salmonella paratyphi A, one belonged to phage type 1 and the others were untypable. Similarly both the strains of Salmonella typhimurium were untypable. Thus the predominant isolate was Salmonella typhi and the commonest phage and biotype were E1 and biotype1 respectively.

Baseline MxA mRNA expression predicts interferon beta response in multiple sclerosis patients.

BACKGROUND: Myxovirus resistance protein A (MxA) is a molecule induced after interferon-beta injection, mostly used to evaluate its bioactivity. There is little available data on clinical utility of baseline MxA mRNA status. The objective of the study is to investigate whether baseline MxA mRNA expression can predict relapse and disease progression in multiple sclerosis patients treated with interferon-beta. METHODS: Baseline blood samples were obtained before the first interferon-beta dose was administered to evaluate MxA mRNA expression using real-time polymerase chain reaction (PCR). Demographic and clinical variables were prospectively recorded to define treatment responder and non responder groups. RESULTS: 104 patients were included in the study. Baseline MxA mRNA expression was significantly lower in the group of patients who met the definition of responders (1.07 vs 1.95, Student t test, p<0.0001). A threshold of 1.096 was established using Receiver Operating Characteristic analysis to differentiate between responders and non-responders (sensitivity 73.9%, specificity 69.0%). Survival analysis using this threshold showed that time to next relapse (p<0.0001) and to EDSS progression (p = 0.01) were significantly higher in patients with lower MxA titers. CONCLUSION: The results suggest that baseline MxA mRNA levels may be useful for predicting whether multiple sclerosis patients will respond or not to interferon-beta treatment.

Screening patients with tuberculosis for diabetes mellitus in Gujarat, India.

SETTING: Anklav Tuberculosis Unit, Anand, Gujarat, India. OBJECTIVE: To determine in a cohort of TB patients 1) the prevalence of diabetes (DM) and impaired fasting glucose (IFG), 2) the time taken for diagnosis, 3) demographic and clinical factors associated with DM and IFG, and 4) the number needed to screen (NNS) for diagnosing new cases of DM and IFG. DESIGN: Descriptive study. TB patients registered between January and September 2012 were asked whether they had a history of DM. Those with unknown DM were tested for random and fasting blood glucose (FBG). FBG of ≥126 mg/dl and 110-125 mg/dl were considered indicative of DM and IFG, respectively. RESULTS: Of 556 TB patients, 553 (99%) were assessed: 36 (6.5%) had diabetes (14 had been previously diagnosed DM and 22 were newly diagnosed), and 39 (7%) had IFG. The median (interquartile range) time to DM diagnosis was 5 (1-17) days. Age ≥35 years was associated with DM. The NNS was 25 and 14 for one new case of DM and IFG, respectively, with a lower NNS in males, those aged ≥35 years, those with smear-positive pulmonary TB, retreatment patients and smokers. CONCLUSION: This pilot project shows that it is feasible and valuable to screen patients with TB for DM in a routine setting, resulting in earlier identification of DM and opportunities for better management of comorbidity.

Posture and gait abilities in patients with myotonic dystrophy (Steinert disease). Evaluation on the short-term of a rehabilitation program.

OBJECTIVES: To evaluate the effects of a rehabilitation program in terms of balance, gait and muscle strength in a population of patients with myotonic dystrophy. PATIENTS: Twenty patients benefited, as outpatients in a hospital setting, from a rehabilitation program with clinical and instrumental evaluations. The evaluation focused on quantitative balance measurement by clinical and stabilometer tests, gait assessed by Locometre and extensors and flexors knee muscle strength measured in isokinetic concentric mode at 60°/s. RESULTS: After the rehabilitation program, we observed a significant improvement in the patients' balance capacities measured with the Berg Balance Scale (BBS), fast gait speed and muscle strength. However, the instrumental evaluation did not report any gains for static balance and spontaneous gait speed after the training program. No correlation was found between the various improvements. CONCLUSION: A rehabilitation program focused on strength, gait and balance allowed for significant improvements in some parameters of myotonic dystrophy. These results attest to the relevance of a short-term rehabilitation protocol for these patients in the framework of a multidisciplinary therapeutic care. The disparity observed in the results measured for these patients suggest the contribution of cognitive involvement in the limitations felt by patients with myotonic dystrophy in the areas of gait and balance.

Altered biology of adeno-associated virus type 2 and human papillomavirus during dual infection of natural host tissue.

Adeno-associated virus (AAV), a common genital virus, may have a "protective" role against human papillomavirus (HPV)-associated cervical cancer. Epidemiological studies indicate a negative correlation between AAV infection and the incidence of cervical cancer. In contrast, HPV is positively associated with cervical cancer. To investigate interactions between these two viruses we used the organotypic "raft" culture system. The raft culture system is capable of supporting the complete HPV life cycle. Raft tissues that were actively replicating HPV were superinfected with AAV type 2 (AAV-2). We observed a multiplicity of infection (m.o.i.)-dependent enhancement and inhibition of HPV DNA replication, concomitant with AAV-2 replication. The data suggest that at low m.o.i. of AAV-2 infection, HPV DNA replication was slightly increased compared to controls and AAV-2 replicated poorly. At high AAV-2 m.o.i., HPV DNA replication was reduced and AAV-2 replicated to high levels. AAV-2 replication was increased in the presence of HPV compared to primary human keratinocyte, squamous cell carcinoma, and HaCat raft cultures infected with AAV-2 alone. These data suggest that HPV may provide types of "enhancer/helper" functions for AAV-2 replication and progeny formation. Infection with AAV-2 had significant effects on epithelial morphology. During infection with low m.o.i. of AAV-2 the epithelium stratified to a greater extent than in controls. With high m.o.i. of AAV-2 infections, tissue cytopathic effects were observed, indicating an additional factor responsible for the effect of AAV-2 on HPV replication and infection. Our results demonstrate a complex interaction between AAV-2, HPV, and skin during dual infection.

Response to barium selenate supplementation in sheep kept at pasture in the Mediterranean area.

This work evaluated the efficacy of barium selenate supplements in the prevention of disorders related to Se deficiency in sheep maintained at pasture in the Mediterranean area. Ewes on five farms were divided into two equal groups of 1,750 animals: a) the treated group and b) the control group. The animals of the treated group were injected subcutaneously, in the first third of gestation, with a barium selenate compound at a dose of 1 mg Se/kg. The ewes in the control group did not receive any supplement of Se and/or vitamin E. The two groups were managed under the same feeding and husbandry practices throughout the experiment. After lambing, blood glutathione peroxidase (GSHPx) and serum aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH) activities were measured in the lambs born to both group. Blood GSHPx activity was higher in the treated animals, with statistically significant differences due to the response to injection of barium selenate. Mean global serum activities of AST and CK tended to be higher in the control group, as a consequence of the protection given to the treated group by the supplement, but the differences were not statistically significant. This was possibly due to the absence of clinical cases of nutritional myodystrophy (NMD) in the animals of the control group. Therefore it can be stated that barium selenate supplementation can prevent Se deficiency in sheep herds maintained at pasture in this area.