Abstract
Objective
This study aims to conduct a survey on the pediatric head injury cases admitted to our hospital to identify the incidence, age, sex, mechanism and type of injury, other associated ...injuries, initial presentations, computed tomography finding, management, length of hospital stay, outcome in the form of condition at discharge, and outcome analysis using Glasgow outcome score (GOS).
Methods
This is a retrospective study of all children ≤ 18 years admitted for head injury to our hospital during the period August 2013 to June 2014. A total of 247 pediatrics head injury patients in between the age of 0 and 18 years were admitted and treated. In all cases age, sex, presenting symptoms, mechanism, type, severity, other associated injuries, management, duration of hospital stay, GOS, and so on, are analyzed from the stored pediatrics master register, computerized discharge tickets, patients profiles, admission register, death register, and bed head tickets.
Results
Of all the patients, there was a male preponderance (
p
< 0.001). The most common presenting feature was altered sensorium. The mean duration of hospitalization in our study is 4.0615 with 89.06% of patients staying < 7 days (
p
-value ≤ 0.001). Most common mechanism of head injury in children was found as road traffic accident (
p
< 0.001). Most common type of injury was extradural hematoma and about 62% intracranial pathology shows no skull fracture. Mortality rate is low as compared to all head trauma victims.
Conclusion
Outcome of pediatric head injury depends on initial presentation. Early recognition and prompt management contributes to decrease mortality and disability. Younger males are at a greater risk. Most injuries are mild-to-moderate in nature with high rate of good recovery.
Piperaquine-dihydroartemisinin combination is the latest addition to the repertoire of ACTs recommended by the World Health Organization (WHO) for treatment of falciparum malaria. Due to the ...increasing resistance to artemisinin derivatives, CSIR-CDRI has developed a prospective short acting, trioxane antimalarial derivative, CDRI 97-78. In the present study, a liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) method for the simultaneous quantification of piperaquine (PPQ) and 97-63, the active metabolite of CDRI 97-78 found in vivo, was developed and validated in 100 μL rat plasma using halofantrine as internal standard. PPQ and 97-63 were separated using acetonitrile:methanol (50:50, v/v) and ammonium formate buffer (10 mM, pH 4.5) in the ratio of 95:5(v/v) as mobile phase under isocratic conditions at a flow rate of 0.65 mL/min on Waters Atlantis C18 (4.6 × 50 mm, 5.0 µm) column. The extraction recoveries of PPQ and 97-63 ranged from 90.58 to 105.48%, while for the internal standard, it was 94.27%. The method was accurate and precise in the linearity range 3.9-250 ng/mL for both the analytes, with a correlation coefficient (r) of ≥ 0.998. The intra- and inter-day assay precision ranged from 2.91 to 8.45% and; intra- and inter-day assay accuracy was between 92.50 and 110.20% for both the analytes. The method was successfully applied to study the effect of oral co-administration of PPQ on the pharmacokinetics of CDRI 97-78 in Sprague-dawley rats and vice versa. The co-administration of CDRI 97-78 caused significant decrease in AUC0-∞ of PPQ from 31.52 ± 2.68 to 14.84 ± 4.33 h*µg/mL. However, co-administration of PPQ did not have any significant effect on the pharmacokinetics of CDRI 97-78.
Abstract
Objectives
The objective of this study was to analyze different parameters such as clinicoradiological presentation, surgical outcome, and factors associated with prognosis of traumatic ...brain injury patients undergoing decompressive craniectomy (DC).
Materials and Methods
This observational study was done on all the cases of DC undertaken in our hospital during July 2013 to June 2015. In all cases, the age, sex, mode of injury, severity of injury, associated injuries, indications, computed tomography (CT) finding, complications, and outcomes in the form of morbidity and mortality were analyzed.
Results
Out of all head injury patients admitted, only 3.036% underwent DC. The most common age group affected was 19 to 40 years (
n
= 49; 43.75%;
p
-value < 0.001). Male to female ratio was 3.8:1; 66.07% presented with Glasgow coma scale (GCS) score ≤ 8. Pupillary abnormality was found in 34 (30.35%) patients. ASDH was the most common (
n
= 97; 86.66%) CT finding. Road traffic accident (RTA) was the most common mode of injury found in 69.64% of patients. Aspiration pneumonia and ventilator-associated pneumonia were the most common nonneurosurgical complication found in 14.28% of patients. Total number of deaths was 30 (26.78%). On analysis, patients with low admission GCS, pupillary dilatation, trauma due to RTA, associated injury, and aspiration pneumonia show high mortality (
p
< 0.05). Eighty-two (73.21%) patients survived and 54 (48.21%) patients discharged with good neurological condition.
Conclusion
DC yields good results in traumatic brain injury. GCS score < 8, associated subarachnoid hemorrhage, midline shift, intraoperative brain bulge, associated chest injury and long bone fracture, cerebral infraction, old age > 40 years, male sex, alcoholics, pupillary dilation, and aspiration pneumonia are the independent factors for increased mortality and disability.
To study lysyl oxidase-like 1 (LOXL1) expression in freshly collected lens capsules from pseudoexfoliation syndrome (XFS), pseudoexfoliation glaucoma (XFG), and normal cataract control individuals. ...We also investigated the effects of four glaucoma drug medications on LOXL1 expression in primary human lens epithelial cell cultures to see if they could affect LOXL1 expression.
Lens capsules were collected at the time of cataract surgery. Controls were matched to age, sex, and ethnicity. Total RNA was isolated from individual lens capsule samples and real-time PCR was performed on each sample using primers flanking the sixth exon of the LOXL1 gene. Cell cultures were grown to confluence in four separate six-well plates at 37 °C in 5% CO2. Each plate was then treated with one of four different glaucoma drugs (brinzolamide 1%, brimonidine tartrate 0.1%, timolol maleate 0.5%, and latanoprost 0.005%) once daily for seven days (at both 1:1,000 and 1:100 concentrations relative to media). Controls were not treated with any drug but media was changed in the same manner. After one week of treatment, cells were harvested and total RNA isolated. Real-time PCR was performed on each group of cells.
Seven XFS, seven XFG, and ten cataract control specimens were analyzed. LOXL1 expression was detected in the lens capsule specimens from each of the four groups. Significant expression differences were found between the control and XFG groups and XFS and XFG groups. No significant difference was observed between the control and XFS group. No significant decrease in LOXL1 expression was seen with drug incubation of the four medications (Brinzolamide, Timolol, Latanoprost, and Brimonidine) at the 1:1,000 drug:media concentrations versus controls. At 10-fold higher concentrations (1:100 drug:media), brinzolamide, timolol maleate, and latanoprost showed small increases in LOXL1 expression relative to controls. This effect was not observed with brimonidine tartrate.
These results establish that LOXL1 expression is reduced in lens capsule specimens from XFG individuals but not XFS. The drug treatment incubation studies suggest that the change in LOXL1 expression observed in XFG is not attributable to glaucoma drug therapy. If a causative functional relationship can be validated, modification of LOXL1 expression in affected tissues may represent a novel treatment strategy for this disorder.
Benzanthrone (BNZ) is a polycyclic aromatic hydrocarbon found in industrial effluent causing skin, respiratory, gastrointestinal, genitourinary, nervous and hemopoietic toxicity. While its toxicity ...has been well studied, its metabolism in humans has not been investigated. The aim of this study was to characterize species differences in the in vitro metabolism of BNZ in rat and human liver microsomes and to identify the CYP isoforms involved in its metabolism. Upon incubation in liver microsomes, BNZ was found to be a direct substrate of phase I metabolism in both rat and human, undergoing oxidation and reduction. The K
in rat, 11.62 ± 1.49 μM, was two-fold higher than humans (5.97 ± 0.83 μM) suggesting higher affinity for human CYPs. Further, incubation with human rCYPs, BNZ was found to be substrate of multiple CYPs. The predicted in vivo hepatic clearance was 63.55 and 18.91 mL/min/kg in rat and human, respectively, indicating BNZ to be a high clearance compound. BNZ was found to be a moderate inhibitor of human CYP1A2. BNZ metabolism by multiple CYPs indicates that single enzyme genetic polymorphism is unlikely to have profound effect on the toxicokinetics of BNZ and default uncertainty factor of 3.16 might be sufficient to capture the intraspecies kinetic variability.
Clustering is the process of classifying objects into different groups by partitioning sets of data into a series of subsets called clusters. Clustering has taken its roots from algorithms like ...k-medoids and k-medoids. However conventional k-medoids clustering algorithm suffers from many limitations. Firstly, it needs to have prior knowledge about the number of cluster parameter k. Secondly, it also initially needs to make random selection of k representative objects and if these initial k medoids are not selected properly then natural cluster may not be obtained. Thirdly, it is also sensitive to the order of input dataset.Mining knowledge from large amounts of spatial data is known as spatial data mining. It becomes a highly demanding field because huge amounts of spatial data have been collected in various applications ranging from geo-spatial data to bio-medical knowledge. The database can be clustered in many ways depending on the clustering algorithm employed, parameter settings used, and other factors. Multiple clustering can be combined so that the final partitioning of data provides better clustering. In this paper, an efficient density based k-medoids clustering algorithm has been proposed to overcome the drawbacks of DBSCAN and kmedoids clustering algorithms. The result will be an improved version of kmedoids clustering algorithm. This algorithm will perform better than DBSCAN while handling clusters of circularly distributed data points and slightly overlapped clusters.
MEMS (Micro Electro Mechanical System) are usually defined as highly miniaturized devices combining both electrical and mechanical components that are fabricated using integrated circuit batch ...processing techniques. Pressure sensors are usually manufactured using square or circular diaphragms of constant thickness in the order of few microns. In this work, a comparison between circular diaphragm and square diaphragm indicates that square diaphragm has better perspectives. A new method for designing diaphragm of the Piezoresistive pressure sensor for linearity over a wide pressure range (approximately double) is designed, simulated and compared with existing single diaphragm design with respect to diaphragm deflection and sensor output voltage.
Skull fractures account for a large number of traumatic brain injuries and these injuries warrant urgent medical attention. Their variety in location, the magnitude of intra-cranial injuries, and a ...fairly cautious approach to reconstruct primarily have led to a lack in consensus in the management of these injuries. The long standing practice of removal of bone is giving way to single stage repair. The aim of the study was to analyze the benefits and adverse effects of primary reconstruction of skull using combination of the fractured fragments of bone and titanium mesh as the cranioplasty material.
Patients with compound fractures of skull, between the ages of 18–65years, were planned for primary reconstruction with fractured bone fragments and titanium mesh after dealing with the intra-cranial lesion. Patients were observed daily for clinical signs of infections and alternate day lab checks (WBC counts) were performed. Post-operative CT scans with 3-diamensional skull reconstruction was obtained before discharge and assessment of cosmetic results were done.
Eleven male (mean age 32.63 ± 10.87 years) patients underwent primary reconstruction of compound skull fractures. The mean interval between injury and operation was 62.2 ± 21 h. The mean duration of surgery was 162.7 ± 32.3 min 9 had a Glasgow outcome Score (GOS) of 5, 1 had GOS 4, 1 had death, resulting from sepsis. Mean follow-up is 2.81 months and no complications could be observed within this period.
Primary reconstruction of compound fractures should be attempted in any possible case, even in ones with delayed presentation. When done with native bone fragments and titanium mesh provides cosmesis, protection, prevention of skin flap syndrome and better strength of construct. Although the rate of infection has been nil in our series, a larger series with longer follow-up is warranted before introducing into clinical practice.
Evaluation of malocclusion in MPDS Varma, Kvv Pratap; Reddy, Raja Bhaskar; Kishore Reddy, S Nanda ...
The journal of contemporary dental practice,
2013-Sep-01, Letnik:
14, Številka:
5
Journal Article
Myofascial pain dysfunction syndrome (MPDS) is a disorder which is characterized by facial pain and limited mandibular function because of the complex nature of this disease. Malocclusion was never ...evaluated in MPDS patients to know its role. Electromyographic silent period durations of masseter were used for objective assessment of MPDS patients.
To evaluation of role of malocclusion in MPDS patients and also to study the EMG masseteric silent period pattern in MPDS patients in different malocclusions.
Two groups, groups I and II of 75 subjects each, were included in this study. Groups I and II constituted the normal subjects and MPDS patients respectively. All these subjects in both the groups were again subdivided based on Angle's class I, II and III malocclusion. Electromyographic (EMG) silent period of masseteric muscle on both sides was measured for all the subjects in both the groups to know whether it differs according to the type of malocclusion.
The silent period was more in group II (MPDS patients). There was no signifcant difference in the silent periods in Angle's class I, II and III malocclusion in group I, whereas in group II, there was a signifcant difference in the silent period in Angle's class II compared to Angle's class I and III. There was no signifcant difference between males and females.
MPDS patients are more in Angle's class I malocclusion. Silent period is more in Angle's class II malocclusion of MPDS group. CLINICAL SIGNIFCANCE: The EMG masseter silent period duration can be advantageously utilized as an adjunct to clinical examination for diagnosis of myofascial pain dysfunction syndrome. It is enough if one side masseter muscle is measured for silent period duration.
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