Stretch-induced MAP kinase activation in cardiac myocytes: differential regulation through beta1-integrin and focal adhesion kinase

Mitogen-activated protein (MAP) kinases have been implicated in hemodynamic load induced heart failure. Both angiotensin II (Ang II) and mechanical stretch activate MAP kinases in cardiac myocytes. In this study, we used a neonatal rat ventricular myocyte (NRVM) model to determine the role of focal-adhesion kinase (FAK) in beta1 integrin mediated MAP kinase activation in response to mechanical stretch in presence and absence of Ang II receptor blockade (ATB). NRVM plated on deformable membranes coated with collagen IV were exposed to 20% equiaxial static-stretch. beta1 integrin signaling was blocked by adenovirus-mediated expression of a dominant-negative form of beta1D integrin (tac-beta1D). FAK signaling was disrupted by infecting NRVM with adenovirus expressing FAK-related non-kinase (FRNK). Western blot analysis was used to assess the phosphorylation of MAP kinases. In the presence and absence of ATB, mechanical stretch caused maximal phosphorylation of ERK, p38 and JNK at 5 min, which was significantly attenuated in NRVM expressing tac-beta1D. In the presence of ATB, FRNK overexpression significantly increased basal phosphorylation of ERK (40.2+/-8.6% P<0.05), p38 (39.5+/-11.7%, P<0.05), JNK (86+/-29.4%, P<0.05) and stretch-induced p38 (48.1+/-8.7%, P<0.05) and JNK (85.0+/-19.4%, P<0.05) phosphorylation. However, in the absence of ATB, FRNK overexpression significantly reduced basal and stretch-induced phosphorylation of only ERK. Examination of FAK activation revealed that beta1 integrin was required for stretch-induced phosphorylation of FAK at Y397 and Y925, but not Y861. In summary, mechanical stretch-activated ERK1/2, p38 and JNK through FAK independent and dependent mechanisms. Beta1 integrin was required for FAK independent activation of all three MAP kinases, whereas cross-talk between beta1 integrin and Ang II receptors mediated FAK dependent regulation of ERK1/2.

Occupational physical demands and same-level falls resulting in fracture in female workers: an analysis of workers' compensation claims

OBJECTIVES

To examine the association between occupational physical demands and risk of same-level falls resulting in fracture in female workers' compensation claimants.

METHODS

From workers' compensation claims for same-level falls, 7286 female workers from three age groups (18-49, 50-59 and 60-79 years) were randomly selected. Levels of occupational physical activity, standing and sitting were assigned using occupational codes. Fracture occurrence was determined using the International Classification of Diseases codes. Risks of same-level falls resulting in fracture were compared by quartiles of physical activity, standing and sitting.

RESULTS

In the 18-49-year age group, physical activity, standing and sitting at work were not significantly associated with risk of same-level falls resulting in fracture (p value trend: 0.07, 0.18 and 0.10, respectively). In the 50-59 and 60-79-year age groups, increasing duration of standing and decreasing duration of sitting were associated with decreasing risk of same-level falls resulting in fracture (p value trend: standing<0.001, 0.01; sitting<0.001, 0.02). In the 50-59-year age group, the relative risks of same-level falls resulting in fracture were 0.53, 0.41 and 0.82 for the second, third and highest quartiles of physical activity, respectively, as compared with workers in the lowest quartile (95% confidence interval 0.35 to 0.80, 0.23 to 0.72, 0.56 to 1.21, respectively). In the 60-79-year age group, there was a similar, but not significant, U-shaped association between occupational physical activity and risk of same-level falls resulting in fracture.

CONCLUSION

Moderate occupational physical demands may be associated with a decreased risk of same-level fall resulting in fracture in female workers' compensation claimants>or=50 years of age.

Suicide notes: psychological and clinical profile

OBJECTIVE

Suicide is one of the leading causes of mortality in developing as well as developed countries. Psychological autopsy is supplementary to medical autopsy in finding out the correct cause of death. Suicide notes form an important component of psychological autopsy.

METHOD

In the present study, psychosocial and clinical profile of 40 suicide note writers is present. The contents of suicide notes were also analysed.

RESULTS

A majority of suicide note writers were to 21 to 30 years of age (55%) and were males (65%). Home was the most common place for committing suicide (80%) and hanging was the most common method. All suicide notes were handwritten and a last wish was mentioned in 30%. Suicide note was most commonly addressed to a sibling (20%). Disturbed love affair and financial problems were the common reasons mentioned in suicide notes. Hopelessness and depression was the most common diagnosis in 52.5% cases.

CONCLUSION

More studies are warranted to detect and analyze the suicide notes so that they not only help in confirming cause of death as suicide but also help in suicide prevention programs.

A boy with acute urinary retention: a Mullerian duct remnant (2006: 3b)

Vestiges of the Mullerian duct systems are found in the male and these may occasionally give rise to symptoms. We report a case of acute urinary retention in a male child secondary to a Mullerian duct remnant. Subsequent MRI was done to reach the final diagnosis.

Efficacy and safety of kanamycin, ethionamide, PAS and cycloserine in multidrug-resistant pulmonary tuberculosis patients

BACKGROUND

We carried out this study to determine the efficacy and safety of a regimen containing kanamycin, ethionamide, isoniazid, para-aminosalicylic acid (PAS) and cycloserine in the treatment of multidrug-resistant tuberculosis (MDR-TB).

METHODS

A prospective, uncontrolled study of 39 pulmonary tuberculosis patients, who had received adequate first-line antituberculosis treatment including supervised category II retreatment regimen, and were still sputum smear positive for acid-fast bacilli (AFB) in whom sputum culture revealed isolates of M. tuberculosis resistant to rifampicin and isoniazid with and without resistance to other antituberculosis drugs. They received kanamycin (initial 4-6 months), ethionamide, isoniazid, PAS and cycloserine for a minimum period of two years.

RESULTS

Out of 39 patients, 29 (74.3%) achieved sputum conversion within six months and remained so at the end of two years. Two (5.1%) patients died, six (20.6%) patients were lost to follow up, and two (5.1%) patients remained sputum smear-positive for AFB through out the period of study. Twenty-nine patients, declared cured, were followed for an average period of 16 months (3-48 months), during which two (6.9%) patients relapsed, four (13.8%) patients were lost to follow-up and remaining 23 remained sputum smear-negative. Eight (21.1%) patients developed major side effects which required stoppage/change of drugs.

CONCLUSION

In MDR-TB patients, regimen consisting of ethionamide, isoniazid, PAS and cycloserine and kanamycin appears to be effective and safe.

Prediction model for peak expiratory flow in North Indian population

OBJECTIVE

To establish a model for predicting peak expiratory flow rate (PEFR) in North Indian healthy population. Study subjects. Eight hundred and ninety-seven healthy, non-smoker individuals (681 males and 216 females) in the age group of 10-60 years.

METHODS

The study was carried out at a health exhibition organised by the Government of Uttar Pradesh, at King George's Medical University, Lucknow. Only healthy, non-smoker individuals were enrolled for the study. Age was noted in completed years and weight in kg and height in cm were taken without shoes. PEFR was measured by Mini Wrights peak flow meter in standing position after prior instructions and demonstration of technique to each individual. The test was performed three times on each subject and best of the three attempts was selected for data computation. The statistical solftware SPSS was used to fit the model and perform residual analysis.

RESULTS

The highest reading for males was recorded in the age group of 20 to 24 years and for females in the age group of 25 to 29 years. Using age, height and weight, we established a regression model for predicting PEFR values for males and females separately in the age group 19-60 years. In the age group 10-18 years, the model for predicting PEFR was same for both the sexes. PEFR values were found to be more in males as compared to females. The predictive power of the model as described by explained variation was found to be 80 and 82 percent for males and females, respectively.

CONCLUSIONS

Prediction model for north Indian subjects was drafted for age range 10-60 years. While separate models were required for males and females because of sex related differences in the age group 19-60 years, a common model sufficed for age group 10-18 years.

Evaluation of self-care manual in bronchial asthma

BACKGROUND

Asthma continues to be a substantial cause of morbidity. Various educational programmes have shown an increase in knowledge and self-management skills of asthmatic patients and also revealed a reduction of severe attacks, hospitalisations and days lost from work.

METHODS

A self-care manual on bronchial asthma was prepared. A total of 523 bronchial asthma patients were enrolled in the study. Out of these, 260 patients were included in the study group to whom self-care manual was provided and 263 were included in the control group to whom no specific instructions were given. After the initial interview (0 week), follow up of all the patients was carried out at two weeks, six months and at one year.

RESULTS

Out of the enrolled patients, 240 (92.31%) and 240 (91.25%), 212 (81.54%) and 210 (79.85%), and 204 (78.46%) and 194 (73.76%) patients completed the follow up at two weeks, six months and one year in the two groups, respectively. Various parameters analysed were knowledge of the patients, their symptomatology, various triggering factors which were inducing and/or precipitating symptoms, the self-care measures they adopted at the time of acute attacks and the indices of asthma morbidity during the last one year. The knowledge scores were significantly higher at all the three follow up visits (F = 633. 98, p < 0.001) as compared to the baseline in the study group patients. In both the groups, the symptom scores decreased at all the follow up visits (F = 71.78, p < 0.001 in the study group and F = 24.19, p < 0.001 in the control group). Multiple logistic regression analysis showed a significant improvement in knowledge and symptoms in the study group as compared to controls after adjusting for various confounding variables (p < 0.001). The number of patients whose symptoms were induced and/or precipitated by exposure to various triggering factors was significantly reduced in study group for all the triggers. There was a statistically significant decrease in the number of severe attacks, number of emergency visits and need of injections during last one year in both the groups, though the differences were more marked in the study group. However, there was a significant decrease in hospital admissions and absence from school/or job in the study group at one year as compared to the control group.

CONCLUSION

The self-care manual was effective in self-management of bronchial asthma.

Strangulation deaths during 1993–2002 in East Delhi (India)

Strangulation is one of the common modes of violent asphyxias. Frequently, the deaths from strangulation are homicidal in nature. To study the pattern of the strangulation deaths in the capital city of Delhi, a retrospective analysis of 10 years records from the period 1993-2002 was undertaken in the department of Forensic Medicine and Toxicology at UCMS and GTB Hospital. During the above period, 8385 Forensic autopsies were conducted out of these 98 (1.17%) cases were found to be of strangulation. These 98 cases were analyzed in detail and showed that: (a) incidence of strangulation have increased many folds in comparison in 1970s; (b) maximum incidence of strangulation is amongst individuals in third decade of life; (c) male, female ratio was 3:2; (d) ligating material was found present in neck in 40% cases; (e) fractures of the neck bones/cartilage were observed in 80% cases; and (f) other associated injuries were seen in as high as approximately 90% of cases. The paper describes and discusses the findings in detail.

A girl with abnormal head and eye movements: Joubert syndrome (2005:3b)

We describe a mentally retarded patient with developmental delay, abnormal head and eye movements with suspected blindness and episodes of abnormal breathing. Subsequent CT and MRI were performed to reach to the final diagnosis. The clinical history and the imaging findings were classical for Joubert syndrome.

Accidental ligature strangulation deaths in East Delhi (India)

Ligature strangulations are usually homicidal. Accidental cases are quite uncommon, especially among adults. A retrospective ten-year study conducted in East Delhi revealed that in a total of 98 cases of death due to strangulation, five cases (approximately 5%) among all medico-legal deaths were of fatal ligature strangulation, involving adults who were neither intoxicated nor indulging in paraphiliac activity. The causative agent in three cases was a cycle rickshaw, in one case it was a rotatory part of a machine, and the fifth case occurred due to entanglement while tying up a cow. The cases and their autopsy findings have been described in this paper, together with the review and preventive aspects of such cases.

Effect of garlic (Allium sativum) oil on exercise tolerance in patients with coronary artery disease

The effect of six weeks garlic oil administration was observed on cardiac performance and exercise tolerance in 30 patients of coronary artery disease. After initial treadmill stress test, they were administered garlic oil in the dose of four capsules twice a day for 6 weeks and treadmill stress test was repeated. Garlic significantly (P<0.01) reduced heart rate at peak exercise and also significantly reduced the work load upon the heart resulting in better exercise tolerance (P<0.05) as compared to the initial test. It appears to be a good adaptogen to be utilized in patients with coronary artery disease.

Protective effect of ginger, Zingiber officinale Rosc on experimental atherosclerosis in rabbits

The effects of air dried ginger powder (0.1g/kg body weight, po, for 75 days) were studied on experimentally induced atherosclerosis in rabbits by cholesterol feeding (0.3g/kg body weight, po). Cholesterol feeding for 75 days lead to distinct development of atheroma in the aorta and coronary arteriesof the rabbits and this was significantly inhibited by about 50% following ginger administration. There was distinct decrease in lipid peroxidation and enhancement of fibrinolytic activity in ginger treated animals. However, ginger did not lower blood lipidsto any significant extent. This distinct protection from the development of atherosclerosis by ginger is probably because of its free radical scavanging, prostaglandin inhibitory and fibri properties.

Surgeons-Take care of pre and par-Surgical rituals

Surgeons must become convinced regarding the strict adherence to a meticulous operating room ritual and an equally careful aseptic technique for the pre and post opcrative care Surgeons have lived with the risk of contracting potentially fatal vual diseases for the last three decades The author reviens here, the hazards of blood exposure and the measures that ought to be taken.

Incidence of lymphomas in head and neck region

In the present study 109 cases of Heck swellings were subjectedto F.V.A.C. examination. H vases teere found to he positive for lymphomas with 62.5% eases presenting as cervical lymphade.nopathy. Median age of presentation tints 48 years with preponderance of femulr patients. 57.2% of the patients presented in stage I of the disease.

Clinicopathological study of tumous of hypopharynx

Thirty cases of tumors of hypopharyiix were admitted in EST department ofRujendra Hospital, Patiala for ciinicopathological study. Peak age incidence of tumours was seen in 6th decade of Life. Males were affected more than females (23:7), Alcohul consumption, smoking and poor orodental hygiene were important predisposing factors responsible for the disease. Maximum number of cases the growth was seen in pyrifarm fossa (80%). Dysphagia, neck mass and throat pain were commonest symptoms. AU cases were found to be Mstologicalty squamous cell carcinoma. Most of the patients presented in advanced stage with cervical lymphnode metastasis in 60% of cases.

A study on mass hysteria (monkey men?) victims in East Delhi

During the summer month of May 2001 East Delhi came in grip of an outbreak of mass hysteria. Initial reports alleged that some monkey like creature attacked and caused injuries among number of persons. A medical board was set up to examine and find out the cause of injuries in the victims of the outbreak as a part exercise to apprehend the culprit. The study describes the sociodemographic pattern and injuries observed in these cases. Majority of victims were adult males, belonging to low socioeconomic strata and having low educational level. The incidents occurred mainly during night at the time of power failure. The type, distribution and characteristic of the injuries suggested of their accidental nature. The paper also discusses the role of forensic experts and press in such outbreak.

Conservation of wild animals by assisted reproduction and molecular marker technology

Wild animals are an integral component of the ecosystem. Their decimation due to abrupt natural calamities or due to gradual human intervention would be disastrous to the ecosystem and would alter the balance in nature between various biotic components. Such an imbalance could have an adverse effect on the ecosystem. Therefore, there is an urgent need to put an end to the ever increasing list of endangered species by undertaking both in situ and ex situ conservation using tools of modern biology, to ascertain the degree of genetic variation and reproductive competence in these animals. This review highlights the development and use of molecular markers such as microsatellites, minisatellites, mitochondrial control region, cytochrome b and MHC loci to assess the genetic variation in various Indian wild animals such as the lion, tiger, leopard and deer. The review also presents data on the semen profile of the big cats of India. Reproductive technologies such as cryopreservation of semen and artificial insemination in big cats are also highlighted.