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   2014| January-March  | Volume 3 | Issue 1  
    Online since April 15, 2014

 
 
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ORIGINAL ARTICLES
Pharmacological and anti-oxidant evaluation of Aspirin, nimodipine and its combination for anti-Parkinson's activity in MPTP induced rat model
Nilesh S Ambhore, Maruthi Prasanna, A Shanish Antony, MN Satish Kumar, K Elango
January-March 2014, 3(1):14-22
DOI:10.4103/2278-344X.130603  
Background: Mitochondrial damage and oxidative stress plays important role in Parkinson's disease (PD). Mitochondria are very crucial part in the cell and have many cellular functions including the generation of ATP and intracellular calcium (Ca 2+ ) homeostasis. Mitochondria also contribute in the formation of reactive oxygen species (ROS) and activating the programmed cell death response, apoptosis. Usually ROS is eliminated by antioxidants present in body, but in case of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induction all the antioxidants become ineffective. Aim: The present study investigated the effects of the non selective cyclooxygenase (COX) inhibitor aspirin and L-type calcium channel inhibitor nimodipine in the prevention of motor impairments and observed anti-oxidant effects in rats after induction of early phase of Parkinson's disease by using neurotoxin MPTP. Materials and Methods: The PD was induced in animals by single injection of MPTP. After 48 hrs of induction animals were treated with aspirin and nimodipine for 60 days, then behavioral, biochemical and antioxidant parameters were evaluated to examine the effectiveness of treatment. Statistical analysis was carried out by using one-way ANOVA followed by Bonferroni multiple comparisons test. Results: The treatment with combination (Aspirin 50mg/kg, Nimodipine 30mg/kg) showed significant (P < 0.001) increase in brain dopamine level, improves the complex I activity and also ameliorate the amount of antioxidant enzymes like superoxide dismutase (SOD), glutathione reductase (GSH), catalase (CAT) and decrease in lipid peroxidation. Conclusions : These results strongly suggest that combination shows a good neuroprotective effect compared to single treatment on motor, biochemical and antioxidant parameters in early phase of Parkinson's disease.
  9 2,595 338
CASE REPORTS
Acute renal failure: A fatal complication following multiple hornet stings
Yatendra Singh, Subhash Chandra Joshi, Sandeep Raj Saxena, Mohammad Kalil
January-March 2014, 3(1):56-59
DOI:10.4103/2278-344X.130618  
Hornet (wasp) stings are common worldwide. Most of the time they produce non fatal local allergic reactions, but sometimes can be fatal when mass stinging causes multisystem involvement We report a case of acute renal failure (ARF) following multiple hornet stings. A 28 year male presented with pain and swelling of the body following multiple hornet stings. After 3 days, he developed progressive decrease in urine output with dark colored urine. Physical examination revealed oedematous swelling mainly on exposed parts. On investigating, progressive elevations in renal function test was found. The markers of muscle injury were grossly elevated and liver enzymes were also deranged. These findings suggest multisystem involvement predominantly ARF secondary to rhabdomyolysis. After eight sessions of hemodialysis the patient improved completely. Timely intervention of multiple hornet stings causing ARF with multiorgan involvement by hemodialysis prevents mortality as well as other complications.
  2 4,969 212
EDITORIALS
IJHAS: Crossing the critical phase of two years
Suresh Bhojraj
January-March 2014, 3(1):1-1
DOI:10.4103/2278-344X.130592  
  2 843 133
ORIGINAL ARTICLES
Implication of pollen sensitivity among patients suffering from chronic urticaria: Current scenario
BG Parasuramalu, R Balaji, BC Sharath Kumar
January-March 2014, 3(1):4-8
DOI:10.4103/2278-344X.130597  
Background: Studies have implicated house dust mites and foods sensitivity in chronic urticaria based on skin prick test (SPT) and in vitro analysis. There are no studies telling the importance of pollen sensitivity in these patients. Objective: To study the implication of pollen sensitivity in chronic urticaria patients along with foods and dust mite allergens using SPT method. Materials and Methods: This study was conducted in Allergy Clinic, Preventive Medicine Unit, Kempegowda Institute of Medical Sciences Hospital, Bangalore from January 2005 to March 2010. Totally 300 patients with confirmed clinical diagnosis of chronic urticaria were recruited and were subjected for SPT with 123 allergen extracts and the results were analyzed and interpreted. Results: Out of 300 chronic urticaria patients, 171 (57%) were in the age group of 20-39 years. One hundred and forty-six (48.67%) were males and 154 (51.33%) were females. One hundred and eighty-one (60.33%) were having only chronic urticaria. One hundred and forty (46.67%) of urticaria patients were having symptoms from 6 weeks to 1 year. Forty-four (14.67%) had a family history of atopy. Majority of urticaria patients (with or without comorbid conditions) were sensitive to food allergens (164, 54.66%) followed by pollens (92, 30.66%), dust mites (60, 20%), and others. Among food allergens, majority (15, 5%) were sensitive to masoor dal followed by almonds (14, 4.66%), ginger (13, 4.33%), and yeast (13, 4.33%). Among pollens, majority (32, 10.66%) were sensitive to Prosopis juliflora followed by Parthenium hysterophorus (17, 5.66%), Peltophorum pterocarpum (17, 5.66%), and Chenopodium album (16, 5.33%). Among dust mites, 42 (14%) and 39 (13%) were sensitive to D. farinae and D. pteronyssinus, respectively. Conclusion: Pollens sensitivity is also implicated in chronic urticaria patients along with foods and dust mite allergens.
  2 1,427 188
Postural correction for kyphosis improves the dyspnea index and pulmonary functions in patients with chronic obstructive pulmonary disease: A randomized trial over 12 weeks
Gajanan S Gaude, Ravi Savadatti, Jyothi Hattiholi
January-March 2014, 3(1):44-51
DOI:10.4103/2278-344X.130615  
Background: Patients with chronic obstructive pulmonary disease (COPD) tend to attain forward shoulder posture and kyphosis and this affects their respiratory functions. Correcting this posture leads to straightening of the spine leading to improvement in the lung functions. The present study was carried out to evaluate the additional effect of correction of kyphosis in COPD patients. Objectives: The objective of the following study is to evaluate the effect of postural correction with respiratory muscle training in patients with COPD. Settings and Study Design: A randomized controlled prospective study in a tertiary care hospital in out-patients for 12 weeks. Materials and Methods: Confirmed cases of COPD were randomly divided into two groups by computer generated randomization: Study and control group. Study group patients received combination of respiratory muscle training and postural correction by a brace, whereas the control group received only respiratory muscle training exercises. The outcome measures evaluated were maximal inspiratory pressure, spirometry values, dyspnea scores and 6-min walk distance (MWD). Statistical Analysis: Statistical analysis was performed using Statistical Package for the Social Sciences version 16. Descriptive statistics are reported as means and standard deviation. Results: A total of 120 patients were included in the study with 60 in each group. Both groups showed a significant improvement in the inspiratory muscle strength, lung functions, dyspnea index and functional capacity at 8 weeks and 12 weeks of intervention. However, the interscapular distance, percentage of kyphotic index (KI) and grades of a plumb line (PL) measurement reduced significantly in the study group when compared to the control group (P < 0.01). There was also significant improvement in the 6-MWD and reduction of Borg scale of dyspnea when compared to the control group (P < 0.01). The pulmonary functions improvement was better in the study group after 12 weeks of therapy. Similarly, there was a significant reduction in KI % and PL grades in the study group as compared to the control group. Conclusions: The postural correction is a meaningful addition to pulmonary rehabilitation programs directed toward COPD patients in improving the overall quality-of-life.
  1 4,345 430
Unsafe injection practices: An occupational hazard for health care providers and a potential threat for community: A detailed study on injection practices of health care providers
Harsh D Shah, Abha D Mangal, Hiren R Solanki, Dipesh V Parmar
January-March 2014, 3(1):28-32
DOI:10.4103/2278-344X.130607  
Background: In developing countries, unsafe injection practices are widely prevalent which invites potential risk to them and to the community also. Recent outbreaks of blood borne viruses (BBVs) in India were mainly due to unsafe injections use. Aims: This study was aimed to carry out detailed observation on injection practices and prevalence of needle stick injuries among the health care providers. Settings and Design: A cross-section observational study was conducted in Government Institutes by simple random sampling of a district of Gujarat. The sample size of study subject was 251 varying from female health workers, staff nurses, medical officers, internees, lab technicians and PG residents of Government Institutes. Materials and Methods: The study subjects were selected by simple random sampling as per their population proportion to the size. The criteria were set to stamp the unsafe injection practices and the consent was obtained from the respected authorities and detailed analysis was performed. Statistical Analysis: The frequency distribution, Chi-square and odds ratio analysis were done in SPSS 17 and Microsoft Excel 2007. Results: The study revealed, majority subjects were observed with the needle touching non-sterilized places accounted 64.14% unsafe injections. During the study, it was found that, out of 161 who were practicing unsafe injection methods had proportion of injuries was 65% (104/161) with significant association.(P < 0.05) Conclusions: There had been constant break in aseptic environment, which may harm health care providers and improper behavior may transmit BBVs infections to community. Hands on training, infection control measure, implementation of rational drug/injection policy, surveillance with immediate response system are the need to tackle this future threat.
  1 4,682 300
Morphological, physico-chemical and structural characterization of mucilage isolated from the seeds of Buchanania lanzan Spreng
Sudarshan Singh, Sunil B Bothara
January-March 2014, 3(1):33-39
DOI:10.4103/2278-344X.130609  
Context: Mucilage isolated from the seeds of Buchanania lanzan a wild Indian plant. This mucilage can be commercially exploited, by evaluating physico-chemical properties of this mucilage. Materials and Methods: Various physico-chemical parameter using scanning electron microscopy (SEM), molecular weight, X-ray diffraction (XRD) spectrometry, zeta potential (ZP), Fourier transform infrared (FT-IR) spectroscopy and 1D ( 1 H and 13 C) nuclear magnetic resonance (NMR) have been employed to characterize mucilage in the present study. Results: SEM analysis suggests that the mucilage has irregular particle size. Thermogravimetry analysis suggested that mucilage had good thermal stability with two stage decomposition. The weight-average molecular weight of mucilage was determined to be 4883, by gel permeation chromatography. The XRD pattern of the mucilage indicated a completely amorphous structure. The ZP was obtained 1.56 and −9.49 mV in water and 0.1 N NaCl respectively. The major functional groups identified from FT-IR spectrum include 3459/cm (-OH), 1667/cm (Alkenyl C-H and C = C stretch), 1407/cm (-COO-) and 1321/cm (-CH 3 CO). Analysis of mucilage by paper chromatography and 1D NMR indicated the presence of rhamnose, arabinose and fructose. Conclusion: The spectral and chromatography analysis of mucilage indicate that the mucilage is composed of basic sugar moiety such as (arabinose, rhamnose, fructose and mannose) as complex carbohydrates.
  1 3,170 345
Comparison of static and dynamic balance among collegiate cricket, soccer and volleyball male players
P Ratan Khuman, Thongam Kamlesh, Lourembam Surbala
January-March 2014, 3(1):9-13
DOI:10.4103/2278-344X.130599  
Background: Athletes from different sports requires balance control for their better performance depending on game type they involved. When prescribing balance exercises to athletes in different sports, it may be important to recognize performance variations. Objective: The objective of the present study was to compare the static and dynamic balance among collegiate cricket, soccer and volleyball male players. Materials and Methods: A total of 150 students, college level male players from five different colleges were requited for the study with purposive sampling. They were assigned into three different groups according to their types of sports, cricket n = 50, soccer n = 50, volleyball n = 50. The static and dynamic balance was assessed using flamingo balance test (FBT) and star excursion balance test (SEBT) in institutional based sports physiotherapy department. Results: Intra-group comparison for FBT and SEBT score shows no significance difference (P > 0.05). Multiple comparison of FBT and SEBT score between groups reveals significantly difference between cricket and soccer player (P = 0.000), between cricket and volleyball player (P = 0.000) and between soccer player and volleyball players (P = 0.000). FBT and SEBT score were significantly higher in soccer players than volleyball and cricketer were found to have the least score compared with soccer and volleyball players. Conclusion: There is significance difference in static and dynamic balance among collegiate cricket, soccer and volleyball male players. The soccer players demonstrate higher balance than volleyball players and the volleyball players have a higher balance than that of cricketers both statically and dynamically.
  1 8,688 842
SHORT COMMUNICATIONS
Simple, non-invasive and cost-effective method for detection of Chlamydia trachomatis infection (a silent, sexually transmitted pathogen that can cause infertility)
Trupti Bajpai, GS Bhatambare, G Shrivastava, KB Patel
January-March 2014, 3(1):66-69
DOI:10.4103/2278-344X.130623  
Background: Chlamydia trachomatis (C. trachomatis), an obligate intra-cellular bacterial pathogen has been recognized as one of the major cause of sexually transmitted infections throughout the world. Being asymptomatic, these infections have severe ramifications for the reproductive health of women leading to the long term complications like infertility. Screening women for C. trachomatis is highly desirable in developing countries. Aims: To determine the prevalence of Chlamydia trachomatis infection in infertile women attending In vitro fertility (IVF) centers. Also to highlight the importance of non-invasive serological diagnostic tool for screening infertile women to rule out Chlamydia as one the causes of infertility. Materials and Methods: The present study was carried out in the Microbiology section of Central Laboratory of a tertiary care hospital from Sep. 2012 to August 2013. Serum samples from 128 suspected women patients were diagnosed by C. trachomatis IgG ELISA (Calbiotech). Positive and borderline positive samples were retested after one month of initial testing by the same method. Results: Out of 128 serum samples tested, six (4.68%) samples were found to be positive for C.trachomatis IgG while seven (5.46%) samples were borderline positive. Paired sera-analysis finally confirmed 8.59% sero-positivity. Conclusion: IgG antibody detection is an effective and non-invasive tool for the detection of Chlamydia and more viable option than other techniques in India. Screening of women with secondary infection for C. trachomatis is strongly recommended to allow early therapeutic interventions. Since, a significant proportion of women expressed the evidence of exposure to C.trachomatis in our study; this cannot be ignored as one of the probable cause of infertility in women.
  1 1,764 190
CASE REPORTS
Kikuchi-Fujimoto disease: A rare cause of generalized lymphadenopathy
Sachin R Agrawal, Veena Lakhotiya, Sheetal Ingale, Ajitprasad Jain
January-March 2014, 3(1):60-62
DOI:10.4103/2278-344X.130620  
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare benign condition of uncertain etiology mainly seen in young females. Although the disease presents most commonly as cervical lymphadenopathy and fever, it may rarely present as generalized lymphadenopathy. A 14-year-old female patient presented with multiple progressive swellings in the neck. On evaluation, she was found to have generalized lymphadenopathy. Histopathological examination of cervical lymph node confirmed the diagnosis of KFD. Paracortical area of coagulative necrosis with abundant karyorrhetic debris surrounded by various types of histiocytes at the periphery is the characteristic histological features of the disease. KFD is a rare benign self-limited disease of lymph node with resolution of signs and symptoms in 1-4 months. Differential diagnosis of KFD should be kept in mind in patients presenting with generalized lymphadenopathy since it may be misdiagnosed as more serious pathology like lymphoma.
  - 1,937 162
Botox injection as a temporary measure for correcting gummy smile
Anil Sargur Ramu, Vijai Shivappa, Zeinab Siraj
January-March 2014, 3(1):63-65
DOI:10.4103/2278-344X.130621  
The exposure of more than 3 mm of the gum during the smile is known as gingival or gummy smile (GS). Botulinum toxin (BT) has been used since 1989 for cosmetic reasons to treat frown lines and since, then its use has been tried for various cosmetic procedures, the effects of which can last from 6 weeks to 8 months. BT has been tried as an initial and temporary option for treatment of GS cases due to the ease and safety of the applications. We hereby report a case of GS induced by orthodontic treatment for proclination correction by extracting upper and lower first premolars treated effectively by local administration of BT. Though the treatment effects lasts for 6 months to 1 year the cosmetic benefits are worth the treatment procedure.
  - 1,790 238
EDITORIALS
Death knell for tobacco in 21 st century
Surender N Gupta, Naveen Gupta
January-March 2014, 3(1):2-3
DOI:10.4103/2278-344X.130594  
  - 1,242 162
LETTERS TO EDITOR
Cronkhite-Canada syndrome: A rare form of gastrointestinal polyposis causing malabsorption
Faheem Arshad, Ramees Mohiud Mir, Gul Javaid, Mushtaq Ahmad Khan
January-March 2014, 3(1):70-72
DOI:10.4103/2278-344X.130625  
  - 1,470 144
Should we stop cilostazol before central neuraxial blockade?
Abhijit S Nair
January-March 2014, 3(1):73-74
DOI:10.4103/2278-344X.130627  
  - 10,752 429
ORIGINAL ARTICLES
Prolongation of post-operative spinal analgesia: A randomized prospective comparison of two doses of oral clonidine
Anita Kumari, Sukhminder Jit Singh Bajwa, Jasbir Kaur Bains, Kanwarjit Singh
January-March 2014, 3(1):23-27
DOI:10.4103/2278-344X.130604  
Background and Aims: Efforts to prolong analgesia with various intrathecal and oral adjuvants have been tried with varying success. The present study was aimed to explore and to compare the potential beneficial effects of prolongation of spinal analgesia with two different doses of oral clonidine. Materials and Methods: A randomized double-blind study was carried out among 60 (American Society of Anesthesiologists)-I and II patients with aged range from 25 to 65 years undergoing lower abdominal surgery. They were divided randomly into three groups of 20 each. Group 1 patients were administered placebo whereas Group 2 and 3 received oral clonidine tablets (0.15 and 0.30 mg respectively) 1-h prior to surgery. Subarachnoid block was administered as per standard protocol. Time to onset of analgesia at T-10, time to achieve maximum sensory level, dermatomal regression and time to rescue analgesia were observed. Side-effects such as hypotension, bradycardia, nausea and vomiting were noted. Statistical analysis was performed using ANOVA with post-hoc Students unpaired t-test and Chi-square test and value of P < 0.05 was considered to be significant. Results: The demographic profile and initial block characteristics were comparable among the three groups (P > 0.05). Two segment regression was 78.3 ± 10.44 min, 150.2 ± 23.07 min and 149.3 ± 18.33 min in Groups 1-3 respectively. Time to rescue analgesia was significantly prolonged in Groups 2 and 3 compared with Group 1 (P < 0.05). Incidence of hypotension was higher in Group 2 (P < 0.05). Conclusion: Optimal dose of oral clonidine that produces clinically useful prolongation of spinal anesthesia using bupivacaine appears to be 0.15 mg when compared with 0.3 mg when overall efficacy is being compared.
  - 1,765 209
Bioelectric impedance phase angle in breast carcinoma
Ruchi Tyagi, Shashank Mishra, Mukesh Kumar, Naveen Gaur, Rajesh Misra, Akshay Prasad
January-March 2014, 3(1):52-55
DOI:10.4103/2278-344X.130617  
Context: Worldwide breast cancer is the most frequently diagnosed life threatening cancer and the leading cause of death in women. Bioelectric impedance analysis (BIA) affords an emerging opportunity to assess prognosis because of its ability to non invasively assess cell and plasma membrane structure and function by means of phase angle. Aims: To compare the phase angle between patients of breast cancer and their matched control with the help of BIA. Settings and Design: After taking clearance from ethical committee, a total of 34 female cases of histologically proven infiltrating ductal breast carcinoma were included from the surgery IPD, department of surgery. Equal numbers of the matched controls were recruited from the friends and relatives of cases. Materials and Methods: Bio Electrical Impedance Analyzer (BIA) BODY STAT QUAD SCAN 4000 was used to measure resistance (R) and reactance (Xc) by recording a voltage drop in applied current. Phase angle is the ratio of reactance to resistance and is a measure of cell vitality. Statistical analysis used: Unpaired "t" test was applied. Results: In control group, the phase angle showed a mean of 5.479 whereas in test group, it showed a mean value of 4.726. The P value showed a significant difference (P < 0.0001). The smaller the phase angle values were higher was the tumor, nodes, metastases (TNM) staging. The phase angles differed significantly from the healthy age matched control values. Conclusions: This study demonstrated that phase angle is a strong predictor of severity of breast cancer and differed significantly between the two groups.
  - 2,251 219
Insulin sensitivity and skeletal muscle function in adult men with type II diabetes mellitus
N Roopashree
January-March 2014, 3(1):40-43
DOI:10.4103/2278-344X.130611  
Background: Insulin resistance (IR) is an important component in the pathogenesis of type II diabetes. As skeletal muscle is known to be the key site for glucose disposal, any physiological or structural alterations might lead to IR. Aim: Assessment of insulin sensitivity and skeletal muscle function in diabetic men. Materials and Methods: A total of 30 diabetic men were matched with 30 controls. Static and dynamic endurance for muscle function and insulin sensitivity was calculated by homeostatic model assessment. Results: Diabetic men showed early onset of fatigue (P < 0.05) and faster decline of muscle strength for static endurance (P < 0.05) even though muscle mass (MM) was comparable to controls. They had a decreased beta cell function, increased IR and decreased sensitivity. Conclusions: As the diabetic men are prone for skeletal muscle dysfunction, they have to adopt preventive strategies including resistance-training exercise program to improve skeletal muscle function. Skeletal muscle being one of the key sites for glucose disposal, improving the skeletal muscle function will in turn help in improving the insulin sensitivity.
  - 1,512 167
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