Diaphyseal femoral fractures in children treated with titanium elastic nail system

Femur fractures are common long bone injuries in children which account for less than 2% of all paediatric fractures. Although these fractures are dramatic and disabling injuries for the child and parent, the good part is that they unite rapidly with minimal complications if aligned well. Various methods have been used successfully to treat these fractures, but they differ in their stability and potential for complications. The aim of our study was to see the outcome of titanium elastic nailing system in diaphyseal femoral fracture in children. The study included total of 30 children's (19 boys and 11 girls) of diaphyseal femoral fracture treated with titanium elastic nailing system and they were followed up at 2, 6, 12 and 24 weeks. The average duration of callus formation was 3.5 weeks with radiological union mean time of 9.5 weeks. Full weight bearing was possible in a mean time of 10 weeks. According to flynn's scoring criteria, excellent and good results were in 24 cases (80%) and 6 cases (20%) respectively. The nail irritation was present in 3 childrens and there was no post operative infection, physeal injury and implant failure. Titanium elastic nail is a safe and satisfactory mode of treatment and is relatively easy to perform in disphyseal fracture of femur in children. It avoids the chances of physeal injury, infection and offers rapid healing.

The treatment of trigger thumb in children: conservative or surgical?

The trigger thumb is an uncommon condition in infants and children which occurs due to pathology of flexor pollicis longus or A1 pulley. The objectives in our study were to determine the treatment outcome of trigger thumb. The study included total of 45 patients (24 males and 21 females) with trigger thumb. The mean age of onset was 28.5 months (3 months -7 years). There was overall success rate of 72.41% following conservative treatment and the success rate appears to be higher in the younger age group. The outcome of children who underwent surgery was 91.66% with recurrence rate of 8.33% and superficial wound infection rate of 4.16%. Our study suggests that surgery is not urgent, postponing surgery does not interfere with the result, trying conservative methods to get a higher chance of recovery is reasonable before the elective surgery. So conservative approach should be adopted in treating trigger thumb.

Constitutional, organopathic and combined homeopathic treatment of benign prostatic hypertrophy: a clinical trial

BACKGROUND

Benign Prostatic Hypertrophy (BPH) is common in older men. This study compared homeopathic treatment strategies using constitutional medicines (CM) or organopathic medicines (OM) alone or in combination (BCOM) in patients suffering from BPH.

METHODS

220 men aged 30-90 years were recruited in Odisha, India. Patients presenting symptoms of prostatism, with or without evidence of bladder outflow obstruction were included in the study. Patients with serum prostate specific antigen (PSA)> 4 nmol/mL, malignancy, complete urine retention, stone formation and gross bilateral hydronephrosis were excluded. Patients were sequentially allocated to OM, CM or BCOM. The main outcome measure was the International Prostate Symptom Score (IPSS).

RESULTS

73, 70 and 77 patients respectively were sequentially allocated to OM, CM or BCOM. 180 patients (60 per group) completed treatment and were included in the final analysis. Overall 85% of patients showed improvement of subjective symptoms such as frequency, urgency, hesitancy, intermittent flow, unsatisfactory urination, feeble stream, diminution of residual urine volume but there was no reduction in prostate size. Treatment response was highest with BCOM (38.24%) compared to OM (31.62%) and CM (30.15%). Effect sizes were highest for the decrease in IPSS, residual urine volume and urinary flow rate.

Comparative study in surgical outcome of intracapsular fracture neck of femur in active elderly patients treated with hemiarthroplasty with Austin Moore's and bipolar prosthesis

Fracture neck of femur is most commonly encountered fractures in elderly population. Hemiarthroplasty is generally considered to be the treatment of choice in most active elderly patients. However, there is inadequate evidence to support the choice between unipolar or bipolar prosthesis. This study was conducted to analyze the outcome regarding pain, hip function, complication and acetabular erosion in patients randomly selected and treated with Austin Moore's or Bipolar hemiarthroplasty in our setup. The study included total of 40 patients (17 males and 23 females) with intracapsular neck of femur fractures with mean age of 67 years (55-85 years). 20 patients each were treated with Hemiarthroplasty using Austin Moore's and Bipolar prosthesis. The patients were followed up at intervals of 2 weeks, 6 weeks, 24 weeks and 1 year after the operation and evaluated clinically and radiologically. There were no significant differences between the groups regarding complication. The Harris hip score were 81.95% (SD - 2.99) in Austin Moore's hemiarthroplasty and 79.15% (SD - 2.94) in Bipolar hemiarthroplasty (p = 0.812), whereas acetabular erosion was 20.05% in Austin Moore's hemiarthroplasty and 5% in Bipolar hemiarthroplasty (p = 0.758) with no mortality seen during lyear follow up. The intracapsular neck of femur fracture in active elderly patients treated with Austin Moore's hemiarthroplasty had better outcome regarding pain and hip function whereas high acetabular erosion compared to patients treated with Bipolar hemiarthroplasty though the difference is statistically insignificant.

Complete neurological recovery after delayed onset resuscitation in a normothermic witnessed arrest

Cardiac arrest following aortic dissection carries high morbidity and mortality, primarily due to poor neurological outcomes. Most efforts are directed towards perfusing vital organs and replenishing oxygen and adenosine triphosphate (ATP) stores during and immediately after arrest. Methods of reperfusion (including external cardiopulmonary resuscitation (CPR), open CPR, extracorporeal life support and ventricular assist devices) and other ATP preservation methods, such as pharmaceutical agents and hypothermia, are maximally beneficial only if started early during cardiac arrest. We describe a case of aortic rupture with arrest on the table which was re-perfused after 20 minutes, using cardiopulmonary bypass (CPB), but still managed to recover without neurological sequelae.

High pressure structural and vibrational properties of the spin-gap system Cu2PO4(OH)

The structural and vibrational properties of the spin-gapped system Cu(2)PO(4)(OH) have been investigated at room temperature under high pressure up to ~20 GPa by Raman scattering and synchrotron-based x-ray diffraction and infrared (IR) spectroscopic measurements. The orthorhombic phase (space group Pnnm, z = 4) remains stable up to at least 7 GPa where it undergoes a weakly first order structural transition (with negligible volume drop) to a monoclinic phase (space group P2(1)/n, z = 4) with an abrupt monoclinic distortion. Refinement of atomic positions has been performed for the low pressure phase. The conspicuous changes in the vibrational spectra (Raman as well as far-IR) confirm this phase transition. At further higher pressures the monoclinic angle increases rapidly and the system transforms irreversibly into a disordered phase. Detailed vibrational analyses have been performed in the orthorhombic phase and pressure-induced structural evolution has been correlated with the vibrational modes corresponding to the Cu-O bonds. A strong negative pressure dependence of hydroxyl mode frequencies (as observed from the mid-IR absorption spectra) supports the pressure-induced structural disordering at higher pressures.

Determinants of Infant Mortality in a Developing Region in Rural Andhra Pradesh

BACKGROUND & OBJECTIVES

Despite several interventions implemented for the improvement of infant survival, the pace of decline in infant mortality in the State of Andhra Pradesh during the last two decades has been rather slow. This paper examines determinants of infant mortality in a rural population of about 45000 in Medchal region of Andhra Pradesh, India.

METHODS

Data obtained through continuous (longitudinal) enumeration of household population and also from the cross-sectional survey of households carried out during 2008-09 in the study area were analyzed. A univariate analysis was carried out and followed by an application of binary logistic regression model to identify significant factors associated with infant mortality.

RESULTS

Despite a substantial increase in institutional deliveries in the study area, infant mortality rate remained relatively constant at 43±1. Socioeconomic variables such as education and household economic status and environmental variables such as access to safe drinking water and sanitation facility and use of clean cooking fuel emerged as significant predictors of infant survival.

INTERPRETATION & CONCLUSIONS

Promoting institutional deliveries by providing cash assistance to women by itself cannot be expected to bring down infant mortality to a low level in the absence of an improvement in socioeconomic and environmental conditions of the households.

Antifungal and antioxidative potential of oil and extracts derived from leaves of Indian spice plant Cinnamomum tamala

Plant—based antimicrobials and antioxidants represent a vast untapped source for medicines and food supplements and hence have enormous therapeutic potential. Present work reports the fungicidal potential of Cinnamomum tamala Nees & Eberm (Lauraceae) leaf oil against five food spoilage and pathogenic fungi. In addition antioxidant efficacy of seven different solvent extracts derived from leaf was also evaluated using in vitro models. The oil demonstrated potent antifungal activity against Aspergillus niger, A. fumigatus, Candida albicans, Rhizopus stolonifer and Penicillium spp. in agar diffusion assay. Zone of inhibition ranged from 17-25 mm. The MFC values of oil against all the test fungi were found to be 230μg/ml. Phytochemicals present in C. tamala leaf were extracted in several solvents for assessing their effect in oxidative defense. The extracts exhibited appreciable antioxidant activity in β-carotene bleaching assay and reducing power assay. The antioxidative activities of extracts were compared with the activities of standard antioxidant compounds BHA and ascorbic acid. Petroleum ether, ethanol, acetone and chloroform extracts exhibited about 30-67% antioxidant activity in β-carotene bleaching assay. Aqueous and ethanol extracts exhibited better reducing power which increased gradually with increasing amount of the extract concentration showing dose dependent response. Results indicated that natural phytochemicals present in C. tamala leaf extracts have potential to prevent growth of food spoilage/pathogenic fungi. In addition they also have capability to mitigate the oxidative stress by antioxidant response.

Outcome of pertrochantric fracture of the femur treated with proximal femoral locking compression plate

Pertrochantric femoral fractures are one of the most common fracture in old patients with variety of complications. However fixing Pertrochantric femoral fractures properly is clinically challenging. We report the outcome of pertrochantric femoral fractures treated with Proximal Femoral Locking Compression Plate (PFLCP) using Minimal Invasive Percutaneous Plate Osteosynthesis (MIPPO) techniques which were evaluated clinically by Harris hip score and radiologically for a union at fracture site and implant related complication. The study included total of 33 patients (20 males and 13 females) with Pertrochantric femoral fractures. The mean ages of the patients were 57 years (23-88 years). Pertrochantric femoral fractures included both Intertrochantric and Subtrochantric femoral fractures. Patients were followed up at 2 weeks, 6 weeks, 3 months, 6 months and 1 year after the operation. Among the 33 patients, the union rate was 95% (31 patients). However there were 1 case of implant breakage and 1 case of non union. According to Harris Hip score the excellent and good results were 87.87% with no mortality during 1 year follow up period. The PFLCP can be feasible alternative to the treatment of Pertrochantric femoral fractures by providing biological healing and mechanical stability with limited occurrence of complications.

High order interactions of xenobiotic metabolizing genes and P53 codon 72 polymorphisms in acute leukemia

Polymorphisms in xenobiotic metabolizing genes are associated with altered metabolism of carcinogens in acute leukemia (AL). This study applied two data mining approaches to explore potential interactions among P53 and xenobiotic metabolizing genes in 230 AL patients [131 acute myeloid leukemia (AML) and 99 acute lymphoblastic leukemia (ALL)] and 199 controls. Individually, none of the genotypes showed significant associations with AML risk. However, in ALL the CYP1A12A TC genotype was associated with increased risk (OR = 2.02; 95% CI = 1.14-3.58; P = 0.01), whereas the GSTM1 null genotype imparted reduced risk (OR = 0.55; 95% CI = 0.31-0.96; P = 0.03). In classification and regression tree analysis, combinations of GSTM1 present, CYP1A12C AA or GG, EPHX1 exon3 TC, and EPHX1 exon4 AA or GG genotype strongly enhanced the risk of AML (OR = 5.89; 95% CI = 1.40-26.62; P = 0.01). In ALL, combinations of CYP1A12A TT, P53 GG or CC and GSTP1 AG genotypes conferred the highest risk (OR = 4.19; 95% CI = 1.45-12.25; P = 0.004). In multifactor dimensionality reduction analysis, a four locus model (GSTP1, P53, EPHX1 exon3, and CYP1A12A) was the best predictor model for ALL risk. The association between this model and ALL risk remained true even at low prior probabilities of 0.01% (false positive report probability = 0.05). Interaction entropy interpretations of the best model of ALL revealed that two-way interactions were mostly synergistic. These results suggest that high order gene-gene interactions play an important role in AL risk.

Implication of DNA repair genes in prostate tumourigenesis in Indian males

BACKGROUND & OBJECTIVES

Prostate cancer (CaP) is the fifth most common cancer among Indian men. Tumour protein p53 (TP53) gene increases the fidelity of DNA replication and homologous recombination by transcriptional transactivation of mismatch repair (MMR) genes. DNA repair thus has a potential role in molecular carcinogenesis of CaP. The aim of the present study was to identify mutations, and polymorphisms in TP53 gene and MMR protein expression in CaP in Indian male population.

METHODS

TP53 codon 72 polymorphism was analysed in 105 CaP, 120 benign prostatic hyperplasia (BPH) cases and 106 normal controls. Mutational analysis of TP53 was done in DNA extracted from formalin fixed paraffin embedded tissue of 80 CaP and 24 BPH cases. Expression of MMR proteins viz. hMLH1, hMSH2, hPMS1 and hPMS2 was studied in 80 CaP, 15 prostatic intraepithelial neoplasia (PIN) and 15 BPH cases.

RESULTS

A somatic C/A variation at the intronic boundary of exon 7 in TP53 gene was observed in one each biopsy samples from CaP and BPH. A significant association of codon 72 TP53 Pro/Pro genotype was observed with the risk of CaP (OR, 2.59, P=0.02) and BPH (OR, 6.27, P<0.001). Immunohistochemical analysis of MMR proteins showed maximum loss of hPMS1 expression in cases of CaP and PIN while no loss in expression of MMR proteins was observed in BPH cases. The study also identified a significant loss of hPMS2 protein in poorly differentiated tumours (Gleason score >7) than in well differentiated tumours (Gleason score 3-6) (P<0.05).

INTERPRETATION & CONCLUSIONS

The results of the present study demonstrate that TP53 codon 72 polymorphism plays significant role in the pathogenesis and susceptibility to CaP and BPH. Also, an aberrant MMR protein expression could be involved in progression of prostate cancer through PIN, early CaP to aggressive CaP. The loss of hPMS2 protein expression may serve as a marker for progression of CaP.

Genetic characterization of two hill stream fish species Barilius bendelisis (Ham.1807) and Barilius barna (Ham.1822) using RAPD markers

Genetic structure of four wild populations of two hill stream fishes Barilius bendelisis (Ham.1807) and B. barna (Ham. 1822) from Uttarakhand, India, was studied using RAPD markers. Eight selective primers provided distinct and consistent RAPD profiles in both the species, producing a total of 47 and 35 scorable bands in B. bendelisis and B. barna respectively. The bands in the range 666-4,830 bp were scored for consistent results. The RAPD profiles generated by all the eight primers revealed varying degrees of polymorphism (25.00-50.00 %). The average genetic diversity (h) was estimated as 0.1661 and 0.1606 among the four populations of B. bendelisis and B. barna respectively.

Association of androgen receptor, prostate-specific antigen, and CYP19 gene polymorphisms with prostate carcinoma and benign prostatic hyperplasia in a north Indian population

The genes involved in androgen pathway and metabolism have been reported to contribute considerably to prostate carcinoma (CaP) risk. The present study investigated the association of androgen receptor (AR), prostate-specific antigen (PSA or KLK3), and cytochrome P450 (CYP19) gene polymorphisms in CaP (n=105) and benign prostatic hyperplasia (BPH) (n=120) in comparison to normal healthy controls (n=106) in an Indian population. We also evaluated the functional consequences of these gene variants on AR and PSA mRNA expression. Significant association of short AR CAG repeats (≤24) with risk of CaP (odds ratios [OR]=2.98, p<0.001) and BPH (OR=1.96, p=0.01) was observed; however, CYP19 gene polymorphism was not found to be associated with disease phenotype (p>0.05). PSA G-158A SNP was found to be significantly associated with risk of CaP (AA: OR=2.68, p=0.016 and GA: OR=2.07, p=0.018) p-trend 0.031 and BPH (AA: OR=3.46, p<0.001 and GA: OR=2.47, p=0.03) p-trend 0.009, respectively. PSA G-158A genotype independently increased the risk of developing BPH (OR=16.37, p<0.001), irrespective of AR CAG repeat length. Using quantitative real-time polymerase chain reaction, we found a significant upregulation of AR and PSA mRNA expression in CaP comparison to BPH. While short AR CAG (≤24) repeats were associated with higher AR mRNA expression in CaP (p=0.002), the PSA SNP did not correlate with its mRNA expression. Interestingly, significantly higher risk estimates for CaP were observed for the combined analysis of short AR CAG and CYP19 genotypes (A2A2) (OR=7.18, p<0.001) or A2A3 (OR=7.60, p=0.004). Our results suggest significant association of androgen signaling gene polymorphisms with risk of CaP and BPH and provide evidence for a putative functional role of AR CAG repeat in regulating its mRNA expression and warrant the need of larger studies in the Indian population to confirm our results.

Effect of losartan, an angiotensin II type 1 receptor antagonist on cardiac autonomic functions of rats during acute and chronic inhibition of nitric oxide synthesis

We studied the effect of losartan on baroreflex sensitivity (BRS) and heart rate variability (HRV) of adult Wistar rats during acute and chronic inhibition of nitric oxide synthesis by N(G)-nitro-L-arginine methyl ester (L-NAME). Chronic L-NAME administration (50 mg/kg per day for 7 days, orally through gavage) increased mean arterial pressure (MAP), heart rate but significantly decreased BRS. In addition, a significant fall of standard deviation of normal RR intervals, total spectral power, high frequency spectral power and a rise of low frequency to high frequency (LF: HF) ratio was seen. Acute L-NAME administration (30 mg/kg, i.v. bolus dose) also raised MAP and impaired HRV but it was associated with augmented BRS for bradycardia reflex. Losartan treatment (10 mg/kg, i.v.) in both acute and chronic L-NAME treated rats, decreased MAP but the difference was not significant. On the other hand, losartan administration normalized depressed BRS for bradycardia reflex and significantly reduced LF to HF ratio in chronic L-NAME treated rats. But this improvement was not observed in acute L-NAME group. These results indicate importance of mechanisms other than renin-angiotensin system in the pressor response of both acute as well as chronic L-NAME. However, autonomic dysregulation especially following chronic L-NAME appears to be partly angiotensin dependent.

Multiple analytical approaches reveal distinct gene-environment interactions in smokers and non smokers in lung cancer

Complex disease such as cancer results from interactions of multiple genetic and environmental factors. Studying these factors singularly cannot explain the underlying pathogenetic mechanism of the disease. Multi-analytical approach, including logistic regression (LR), classification and regression tree (CART) and multifactor dimensionality reduction (MDR), was applied in 188 lung cancer cases and 290 controls to explore high order interactions among xenobiotic metabolizing genes and environmental risk factors. Smoking was identified as the predominant risk factor by all three analytical approaches. Individually, CYP1A1*2A polymorphism was significantly associated with increased lung cancer risk (OR = 1.69;95%CI = 1.11–2.59,p = 0.01), whereas EPHX1 Tyr113His and SULT1A1 Arg213His conferred reduced risk (OR = 0.40;95%CI = 0.25–0.65,p<0.001 and OR = 0.51;95%CI = 0.33–0.78,p = 0.002 respectively). In smokers, EPHX1 Tyr113His and SULT1A1 Arg213His polymorphisms reduced the risk of lung cancer, whereas CYP1A1*2A, CYP1A1*2C and GSTP1 Ile105Val imparted increased risk in non-smokers only. While exploring non-linear interactions through CART analysis, smokers carrying the combination of EPHX1 113TC (Tyr/His), SULT1A1 213GG (Arg/Arg) or AA (His/His) and GSTM1 null genotypes showed the highest risk for lung cancer (OR = 3.73;95%CI = 1.33–10.55,p = 0.006), whereas combined effect of CYP1A1*2A 6235CC or TC, SULT1A1 213GG (Arg/Arg) and betel quid chewing showed maximum risk in non-smokers (OR = 2.93;95%CI = 1.15–7.51,p = 0.01). MDR analysis identified two distinct predictor models for the risk of lung cancer in smokers (tobacco chewing, EPHX1 Tyr113His, and SULT1A1 Arg213His) and non-smokers (CYP1A1*2A, GSTP1 Ile105Val and SULT1A1 Arg213His) with testing balance accuracy (TBA) of 0.6436 and 0.6677 respectively. Interaction entropy interpretations of MDR results showed non-additive interactions of tobacco chewing with SULT1A1 Arg213His and EPHX1 Tyr113His in smokers and SULT1A1 Arg213His with GSTP1 Ile105Val and CYP1A1*2C in nonsmokers. These results identified distinct gene-gene and gene environment interactions in smokers and non-smokers, which confirms the importance of multifactorial interaction in risk assessment of lung cancer.

Does the Milk Income Loss Contract program improve the technical efficiency of US dairy farms?

Due to volatility in the income of dairy farmers, the 2002 farm bill introduced the Milk Income Loss Contract (MILC) payments that were extended in the 2008 farm bill. It has been argued that MILC payments would help large dairy farms and squeeze out small dairy operations. This paper contributes to this policy issue by empirically assessing the effect of MILC payments on the technical efficiency of US dairy farms. Using a large-scale dairy farm survey containing information from 2005, we apply a data envelopment analysis method to estimate technical efficiency of the dairy farms. A Tobit regression model was estimated to examine the roles of human capital of the farm operator, different farming practices, farm sizes, and MILC payments on technical efficiency of the dairy farms. Results indicate that the effects of the MILC payments were heterogeneous among farms of different sizes. Significant effects of MILC payments were only evident among large farms. In contrast, no significant effects were found for medium and small farms.

Wilms tumor-1, claudin-1 and ezrin are useful immunohistochemical markers that help to distinguish schwannoma from fibroblastic meningioma

The aim of this study is to identify immunohistochemical (IHC) markers that can reliably separate schwannoma (SCHW) and fibroblastic meningioma (FM). We selected 106 cases of intracranial SCHW (n = 56) and FM (n = 50) and constructed a tissue microarray (TMA) of core diameter of 1.0 mm from archival formalin-fixed paraffin-embedded tissue. A TMA-IHC was performed using 14 antibodies. After IHC staining, 98 cores were found suitable for evaluation. The IHC staining was scored as 0-2+ (0, negative; 1+, weak and/or focal 2+ strong and/or diffuse positive). A discriminant analysis (DA) (Wilks'Lambda test) was performed to assess the relative importance of these biomarkers in classifying the two groups FM and SCHW. It showed that WT-1 (Wilks'λ 0.085, p < 0.001), EMA (Wilks'λ 0.253, p < 0.001), S100 (Wilks'λ 0.487, p < 0.001), Claudin-1 (Wilks' λ 0.57, p < 0.001) and Ezrin (Wilks'λ 0.656, p < 0.001), SPARC (Wilks'λ 0.751, p < 0.01), NP-Y (Wilks'λ, 0.819, p < 0.001) and EGFR (Wilks'λ 0.845, p = 0.026) were some of the statistically significant markers that discriminated SCHW and FM. For sensitivity and specificity for SCHW the significant markers [Area under the curve (95% CI), p-value] by ROC analysis were WT-1 [0.990(0.000, 1.000), <0.001], S100 [0.880(0.808, 0.951), <0.001] while for diagnosing FM the most sensitive and specific markers were EMA [0.957(0.914, 1.000), <. 001], Claudin-1 [0.857(0.782, 0.932), <0.001] and ezrin [0.792(0.700,0.884),<0.001]. WT-1, Claudin-1 and Ezrin may be potentially useful immunohistochemical adjuncts to EMA and S100 that differentiate SCHW from FM.

Synthesis and DNA binding studies of Ni(II), Co(II), Cu(II) and Zn(II) metal complexes of N1,N5-bis[pyridine-2-methylene]-thiocarbohydrazone Schiff-base ligand

The thiocarbohydrazone Schiff-base ligand with a nitrogen and sulphur donor was synthesized through condensation of pyridine-2-carbaldehyde and thiocarbohydrazide. Schiff-base ligands have the ability to conjugate with metal salts. A series of metal complexes with a general formula [MCl2(H2L)]·nH2O (MNi, Co, Cu and Zn) were synthesized by forming complexes of the N1,N5-bis[pyridine-2-methylene]-thiocarbohydrazone (H2L) Schiff-base ligand. These metal complexes and ligand were characterized by using ultraviolet-visible (UV-Vis), Fourier Transform Infrared (FT-IR), 1H and 13C NMR spectroscopy and mass spectroscopy, physicochemical characterization, CHNS and conductivity. The biological activity of the synthesized ligand was investigated by using Escherichia coli DNA as target. The DNA interaction of the synthesized ligand and complexes on E. coli plasmid DNA was investigated in the aqueous medium by UV-Vis spectroscopy and the binding constant (Kb) was calculated. The DNA binding studies showed that the metal complexes had an improved interaction due to trans-geometrical isomers of the complexes than ligand isomers in cis-positions.

Subclinical hypothyroidism in eastern Nepal: a hospital based study

BACKGROUND

Subclinical hypothyroidism itself is associated with serious complications and also there is a known risk of subclinical hypothyroidism patients getting converted into overt disease.

OBJECTIVES

The objective of the present study was to fi nd out the prevalence of subclinical hypothyroidism in the suspected cases i.e. amongst the cases attending the thyroid laboratory at B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

MATERIALS AND METHODS

It was a retrospective cross sectional study. Data of the free T3, free T4 and TSH estimations of the year 2007 of the Thyroid lab at BPKIHS, Dharan, Nepal was analyzed. ELISA based free T3, free T4 and TSH tests in the serum had been performed in all the cases.

RESULTS

Total cases were 1714 including 24.446% males and 75.554% females. Cases with raised TSH levels were 26.021%, cases with normal TSH levels were 54.66% and cases with low TSH levels were 19.316%. Total 350 cases (20.42 %) had subclinical hypothyroid dysfunction which includes 84 (4.901 %) males and 266 (15.519%) females. And the maximum percentage of cases in either gender was between the age groups 20 -59 years.

CONCLUSION

The prevalence of subclinical thyroid hypothyroidism amongst the suspected cases was 20.42 % which is much higher compared to the other parts of the world. The highest percentage was found in the female age group 20 - 59 years. The routine screening of the whole population is not cost effective and on the basis of the present study it is suggested that there may be routine screening of the selected populations, especially women between 20 to 59 years of age in Nepal region. The preferred screening method advised is a sensitive ELISA based TSH test.

Gastroretentive drug delivery system of acyclovir-loaded alginate mucoadhesive microspheres: formulation and evaluation

In the present study, mucoadhesive alginate microspheres of acyclovir were prepared to prolong the gastric residence time using a simple emulsification phase separation technique. The particle size of drug-loaded formulations was measured by SEM and the particle size distribution was determined using an optical microscope and mastersizer. The release profile of acyclovir from microspheres was examined in simulated gastric fluid (SGF pH 1.2). The particles were found to be discreet and spherical with the maximum particles of an average size (70.60 ± 2.44 µm). The results indicated that the mean particle size of the microspheres increased with an increase in the concentration of polymer and decreased with increase in stirring speed. The entrapment efficiency was found to be in the range of 51.42-80.46%. The concentration of the calcium chloride (% w/v) of 10% and drug-polymer ratio of 1:4 resulted in an increase in the entrapment efficiency and the extent of drug release. The optimized alginate microspheres were found to possess good mucoadhesion (66.42 ± 1.01%). The best fit model with the highest regression coefficient values (R²) was predicted by Peppas model (0.9813). In Gamma scintigraphy analysis, the section of GIT was critically analyzed and much differentiation was present at each time point after oral administration, which revealed that the optimized formulation demonstrated gastroretention in vivo for more than 4 h, which revealed that optimized formulation could be a good choice for gastroretentive systems.

Growth, biomass production and photosynthesis of Cenchrus ciliaris L. under Acacia tortilis (Forssk.) Hayne based silvopastoral systems in semi arid tropics

The growth, biomass production and photosynthesis of Cenchrus ciliaris was studied under the canopies of 17 yr old Acacia tortilis trees in semi arid tropical environment. On an average the full grown canopy of A. tortilis at the spacing of 4 x 4 m allowed 55% of total Photosynthetically Active Radiation (PAR) which in turn increased Relative Humidity (RH) and reduced under canopy temperature to -1.75 degrees C over the open air temperature. C. ciliaris attained higher height under the shade of A. tortilis. The tiller production and leaf area index decreased marginally under the shade of tree canopies as compared to the open grown grasses. C. ciliaris accumulated higher chlorophyll a and b under the shade of tree canopies indicating its shade adaptation potential. The assimilatory functions such as rate of photosynthesis, transpiration, stomatal conductance, photosynthetic water use efficiency (PN/TR) and carboxylation efficiency (PN/CINT) decreased under the tree canopies due to low availability of PAR. The total biomass production in term of fresh and dry weight decreased under the tree canopies. On average of 2 yr C. ciliaris had produced 12.78 t ha(-1) green and 3.72 -t ha(-1) dry biomass under the tree canopies of A. tortilis. The dry matter yield reduced to 38% under the tree canopies over the open grown grasses. The A. tortilis + C. ciliaris maintained higher soil moisture, organic carbon content and available N P K for sustainable biomass production for the longer period. The higher accumulation of crude protein, starch, sugar and nitrogen in leaves and stem of C. ciliaris indicates that this grass species also maintained its quality under A. tortilis based silvopastoral system. The photosynthesis and dry matter accumulation are closely associated with available PAR indicating that for sustainable production of this grass species in the silvopasture systems for longer period about 55% or more PAR is required.