Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30General SciencesSTUDIES ON MYCOFLORA ASSOCIATED WITH ROOTS OF SOLANUM INDICUM LINN. AND CHANGES IN CHEMICHAL CONSTITUENTS UNDER INFLUENCE OF RELATIVE HUMIDITY
English0106M. RashidiEnglish S. S. DeokuleEnglishThe present investigation was designed to investigate associated fungi and deterioration of chemical constituents in drug Solanum indicum Linn. roots under influence of different relative humidities. Associated fungi isolated and identified according standard references. In the present study, total 20 fungi were associated with roots. F. semitectum, F. xysporum and F. solani showed high percentage incidence while minimum percentage incidence recorded in case of Sordaria fimicola, Neurospora sitophila, Thraustotheca sp., A. flavus, Aphanomyces sp., Chaetomium globosum and Rhizopus oryzae. The drug stored under the influence of different relative humidities viz. 30, 50, 75, 96 and 100% showed variation in percentage incidences of fungi as well as biodeterioration of chemical constituents such as sugars, proteins, phenols and glycosides. The drug stored under high relative humidity 96 and 100% and with the length of incubation days 45 and 60 days showed maximum deterioration of chemical constituents.
Englishdeterioration, fungi, chemical constituents, percentage incidence.INTRODUCTION
In Sanskrit plant Solanum indicum is called, "Brahati"and" Vrihati", and it is commonly called as "Brahanta", "Birhatta" and "Indian Nighte shade". This herbal plant belongs to the "Solanaceae" family. It is a common plant in all over world. Fruit and roots contain wax, fatty acids and alkaloids: Solanine and Solanidin. It is useful in asthma, dry cough, difficult parturition, chronic fibrile effection worms, scorpion sting also dysuria. The roots are one of the ingredients of Dashmoola Kautha of Hindi medicine. The roots take internally manifests strongly exciting qualities. It is employed in difficult parturition and in toothache and also used in fever, work complaints and colic (Kritikar and Basu, 1984). There are not any report concentrating on the subject mycoflora associated with roots of drug S. indicum and changes in their chemical constituents due to spoilage, therefore, this survey was carried out to determine the percentage incidence of fungi associated with the roots of this plant stored at different relative humidities and second part of this study involved determination of quality and biodeterioration of chemical constituent amounts in samples in relation to fungal contamination.
MATERIAL AND METHODS
The roots of S. indicum were collected from different localities. It was brought to the laboratory in separate polyethylene bags to avoid aerial contamination. Blotter test method, as recommended by International Seed Testing Association (1966) was adopted for isolation of fungi. Agar plate method was also used. The roots were sterilized with 2% NaOCl solution before plating. In order to evaluate the chemical changes in relation to fungi associated, the samples were stored in small muslin cloth bags under different RH levels i.e. 33, 55, 75, 96,100 % and at 28 ± 3?C temperature for 90 days (Wink and Sears, 1950). At an interval of 15 days, samples were taken out and washed thoroughly with sterilized distilled water and plated in Petri plates. The isolation of mycoflora was recorded from first day to 60th day of storage. Fungi were identified by using references such as Raper and Thom (1949), Barnet and Hunter (1972) and Nelson et al. (1983). Some parts of samples after washing with distilled water were dried in oven for chemical analysis. The changes take place in total proteins, phenols and glycosides amounts in the samples were estimated by the methods of Lowry et al. (1951), Singh et al. (1978) and Kokate et al. (2002). Anthrone method for total sugars and Dinitrosalicilic acid (DNSA) method for reducing sugars amount were also followed (Sadasivam and Manickam, 1992). Data from the experiment were analyzed by SPSS software in which statically significance was determined at 0.05 % probability levels.
RESULTS AND DISCUSSION
Total 20 fungi were isolated from the fresh roots of Solanum indicum in varying percentages (Table 1) such as F. semitectum 26.39%, F. oxysporum 10.92%, F. solani 10.82%, Theilavia terricola 9.25%, Scytallidium thermophilum 6.98%, Trichoderma sp. 6.05%, A. niger 5.11%, Papulaspora immerse 4.41%, F. lateritum 3.13%, Syncephalestrum racemosum 2.12%, Drechslera bicolor 1.93%, F. equiseti 1.66%, Sordaria fimicola 0.57%, Neurospora sitophila 0.67%, Thraustotheca sp. 0.76%, A. flavus 0.86%, Aphanomyces sp. 0.77%, Chaetomium globosum 0.38% and Rhizopus oryzae 0.28%. Fresh roots of S. indicum stored under different relative humidity and deterioration of sugars in each tested relative humidity observed (Table 2). In case of 30, 50, 75, 96 and 100 % RH, after 15 days of incubation TS (Total sugar) and RS (Reducing sugar) values observed 41.66, 26.33%; 41.28, 25.88%; 40.02, 25.33%; 39.64; 24.47% and 36.61, 23.89%, they showed more deterioration after 90 days of incubation period 25.25, 22.26%; 23.35, 22.26%; 21.21, 20.81%; 20.53, 20% and 20.20, 19.68%. Protein contents in the roots of S. indicum stored under 30 and 50 % RH reduced to 18.75, 17.36, 15.69 % and 17.77, 16.66 and 15.69 % after 30, 60 and 90 days of incubation days. At 96 and 100 % RH showed considerable deterioration 16.66, 13.88, 12.77% and 16.25, 13.47 and 12.36% after 30, 60 and 90 days of storage (Table 3). The total phenol content in roots was 7.84% (Table 4), this value of phenol was deteriorated to 4.37 % under 100 % RH and after 90 days of incubation period. Minimum reduction observed under 30 and 50 % RH and maximum reduction observed under 96 and 100 % RH. In all tested relative humidity, total amount of phenol, after 30, 60 and 90 days of incubation observed 7.5, 7.32, 7.28, 6.88 and 6.73% (30 days ); 7.46, 6.88, 6.69, 5.92, 5.49% (60 days); 6.88, 6.53, 6.31, 5.31 and 4.37% (90 days). The roots stored under 30 % RH showed reduction to 9.80% in total glycosides amount (Table5) after 15 days, this value deteriorated to 9.32% after 90 days of incubation. In case of 50 and 75 % RH also decline in total glycosides observed, 9.70, 9.48, 8.99, 8.1%; 9.48, 9.32, 8.93, 8.09 % after 15, 30, 60 and 90 days of storage. Similarly, under 96 and 100 % RH maximum reduction in total glycosides observed, after 15 days to 90 days of storage total amount of glycosides deteriorated from 9.52, 9.32% to 7.93 and 7.9% respectively Analysis of variance revealed that relative humidity and different incubation days were effective on reduction of sugars (TS, RS), proteins, phenols and glycosides value. The fungi isolated from drug roots of S. indicum in various % incidence spoils the roots and ultimately affect on changes of chemical constituents. During the period of storage (first day to 90th days and under 30 to 100% RH) biochemical analysis of roots were showed that samples stored at 30 and 50% RH recorded minimum deterioration of chemical constituents but under 75, 96 and 100% RH showed the significant reduction in the sugars, proteins, phenols and glycosides content. The prolong storage period is also effected on associated mycoflora and their growth on roots and continuously reduction of medicinal values. Changes in chemical constituents may be due to active interference of fungi in breakdown of constituents and utilization by them. Several workers have been showed deterioration of chemical constituents under storage due to spoilage of fungi in different plants (Deokule and Kabnoorkar, 2008; Kabnoorkar and Deokule, 2009; Dutta and Roy, 1987, Bilgarmi et al. 1978, Roy et al. 1987, Inman, 1962, Marx et al. 1966).
CONCLUSION
The result of this investigation indicate that the maximum reduction of chemical constituents is after 60th to 90th days of incubations while total percentage incidence of fungi are also maximum in mycoflora associated with samples. The result indicates that the quality of herbal drugs may be retained by storage condition at lower RH (below 50% RH) and short storage period.
ACKNOWLEDGMENT
Authors thank to the head of the Department of Botany, University of Pune for providing necessary facilities and encouragement. Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.
Englishhttp://ijcrr.com/abstract.php?article_id=1508http://ijcrr.com/article_html.php?did=15081. Barnet HL, Hunter BB. Illustrated Genera of Imperfect Fungi. Minneapolis Burgress Publishing Company. Minneapolis; 1972
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8. Kiritikar KR. Basu BD. Indian Medicinal plants 2nd edition. Vol1. Published by L. M. Basu, Allahabad;1984
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30General SciencesANTIFUNGAL ANTIBIOTIC PRODUCTION BY STREPTOMYCES SP. ISOLATED FROM SOIL
English0716Shipra SinghEnglish Anita RawatEnglish Deepak Chand SharmaEnglish19 Actinomycetes isolate were obtained from soils samples collected from various ecological niches of Western Uttar Pradesh (Meerut). They were selected for their antimicrobial producing capabilities against some selected microbial strains including fungus (Aspergillus sp.), Yeast (Candida sp.), gram-stain-positive bacteria (Bacillus sp.) and gram-stain-negative bacteria (Burkholderia sp.). Out of 19 isolates, 12 (63%) were found to have antimicrobial activity, among them 53% and 26% isolates were found active against gram-stain-positive and gram-stain-negative bacteria, respectively. Antifungal activity was recorded in 42% isolates, among them 32% were active against Aspergillus sp. and 11% were found active against Candida sp. Only one isolate (SS12) was found to produce broad spectrum antibiotic effective against all test microorganisms. 16S rDNA sequencing and BIOLOG analysis of SS12 suggested that it may be a novel species of genus Streptomyces.
EnglishAntifungal antibiotic, BIOLOG, 16S rDNA, Streptomyces, ActinomycetesINTRODUCTION
Actinomycetes, group of heterotrophic, hyphae forming, gram-stain-positive bacteria identified as one of the major group of soil population (Kuster, 1964). These prokaryotes have diverse metabolic requirements and have been explored and exploited for ages in search of various primary and secondary metabolites, such as antibiotic, enzymes and immune modulators (Moncheva et al., 2002). Approximately 70-80% of the antibiotic market is attributed to Actinomycetes; among them more than 50% is contributed by the genera Streptomyces and Micromonospora (Pandey et al., 2004). According to World Health Organization over prescription, excessive and improper use of antibiotics has resulted in the development of Multiple Drug Resistant (MDR) strains of pathogenic microbes. The prevalence of antimicrobial resistance among key microbial pathogens is increasing at an alarming rate worldwide (Singer et al., 2003). This strike back of pathogens is increasing globally and may render the current antimicrobial agents insufficient to control at least some microbial infections (Walsh et al., 2011). This makes the search of novel antimicrobial agents with clinical importance more significant to counter drug resistant microbes. In the present study we have focused on isolation of Actinomycetes from terrestrial soils in ecological niches and check their potential to produce antimicrobials.
MATERIAL AND METHODS
Collection of soil samples Several diverse habitats were selected for the isolation of Actinomycetes. These habitats include cow barns, garden soil, medical waste dumps, garbage dumps etc. Soil samples collected from at least 4 different places at each site. The samples were taken from a depth of 10- 15 cm after removing top soil (Ogunmwonyi et al., 2008), placed in polyethylene bags, closed tightly and stored in a refrigerator at 4°C and processed with in 24h. Test microorganism The test microorganisms used to evaluate the antimicrobial property of isolates were obtained from Subharti medical college, Meerut. The strains represent the various groups of microbes like Aspergillus sp. (Mycellial form of fungi), Candida sp. (Budding form of fungi), Bacillus sp. (gram-stain-positive) and Burkholderia sp. (gram-stain-negative). Isolation of Actinomycetes 1g of soil sample was mixed aseptically in 100mL of sterilized normal saline, and maintained at 50-55 ºC for 1h followed by spreading on petri plates containing Actinomycetes Isolation Agar (AIA) and plates were incubation at 28°C for 10 days (El-Nakeeb and Lechevalier, 1963; Kuster and Williams, 1964). The colonies showing typical morphology (Williams and Cross, 1971) were purified and stored at 4°C in agar slants and as glycerol stock at -20°C. The pretreatment with heat enhances the population of Actinomycetes in soil sample. Screening of Actinomycetes for antimicrobial activity Dual plate assay method The center of PDA plates was point inoculated with test fungi and antagonist bacterial cultures were point-inoculated at the periphery of the plate. Each plate was incubated at 28?C, for 72- 96 hours in an inverted position (Huang et al., 1976). The zone of inhibition of the fungus around each isolate was measured. Identification of the potent Actinomycetes isolate The isolated cultures (Actinomycetes) were classified on the basis of its phenotypic, morphological and biochemical characters. Morphological and microscopic characterization Morphological and cultural characters of the selected actinomycetes strains were studied by inoculating the selected strain into sterile ISP media. The media were sterilized and poured into sterile Petri dish. After solidification of the media, the culture of the selected strain was streaked on the media surface aseptically and incubated at 28 °C for 7 days. Morphological properties such as colony characteristics, type of areal hyphae, aerial mass colour, growth of vegetative hyphae, reverse side pigments, melanoid pigments, fragmentation pattern, spore formation and spore chain morphology were observed (Shirling and Gottileb, 1966).A smear of the selected strain was prepared on a clean glass slide and after performing Gram’s staining was examined under oil immersion (100 X) (Williams, 1993). Biochemical characterization of isolates The isolate was biochemically characterized by sending the cultures to BTK biosciences, New Delhi for Biolog® system analysis (Biolog, USA). Molecular Identification of the strain SS12 DNA isolation of SS12 10 mL of nutrient broth was inoculated with the bacterial isolate and incubated at 30ºC in shaker at 250 rpm. After 12 h, 100µL of glycine (0.1%) solution was added to broth culture and incubated further for 6 h. Genomic DNA was extracted accoeding to Bazzicalupo and Fani (1994). Extracted genomic DNA was electrophoresed on 0.8% agarose gel in TRIS-acetate-EDTA (TAE) buffer (1X) at 80 V for 60 min. Ethidium bromide (0.5 g mL-1 ) was added at the time of gel casting. After the run, gel was visualized under UV transilluminator. Amplification of 16S rDNA 16S rDNA regions of bacterial isolates were amplified from bacterial genomic DNA by polymerase chain reaction, using eubacterial universal primers: Gm3f 5 AGA GTT TGA TCM TGG 3 (8 to 23) Gm4r 5 TAC CTT GTT ACG ACT T 3 (1492 to 1507) Reaction was set in 50µL volume with sterile triple distilled water, Taq DNA Pol. and MgCl2 15 mM (1X), dNTP mix (10 mM, 0.25 mM), Primer Gm3f (0.25 M), Primer Gm4r(0.25 M), Taq DNA polymerase (1.0 U),Target DNA (template), 20-100ng. The amplification cycle consisted of initial denaturation step at 95 °C for 7 min followed by 25 consecutive cycles of 60 sec at 94 °C, 60 sec at 51 °C, 60 sec at 72 °C and three touchdown cycles were successively performed at 54, 53 and 52 °C followed by final extension at 72 °C for 10 min. Positive and negative controls were invariably maintained. The PCR product was run on 0.8% agarose gel and visualized under UV. Sequencing of isolate SS12 The 16S rDNA sequence of the bacterial isolates was determined by dideoxy chain termination method by sending the samples to Chromus India Pvt. Ltd. (Banglore, India). Analysis of sequence data and identification of the bacterium Blast database of the National Centre for Biotechnology information (NCBI) was used to compare the sequences of isolates with known 16S sequences in the existing database. The results obtained were also confirmed by comparing with Ribosomal Database Project. Sequences were aligned through multiple sequence alignment, ClustalW programme, from the European Bioinformatics Institute (EBI) accessible on net (http://www.ebi.ac.uk/clustalW) and phylogram was constructed to understand evolutionary relatedness using MEGA 3.0 (Kumar et al. 2001). Nucleotide sequence accession numbers The 16S rDNA nucleotide sequence obtained in the study was submitted to the GenBank database. RESULT AND DISCUSSION Screening of soil sample Soil samples were collected from eight different locations in Meerut. Emphasis was given to collect soil from places where industrial wastes and household garbage were being dumped. Total 31 actinomycetes strains with varying morphological characteristics were picked up and their pure culture was maintained at 4°C for further studies. Pertinent details of the soil samples and the actinomycetes are shown in Table 1. Soil is known as reach source of Actinomycetes having antifungal activity against plant fungal-pathogens, 110 isolates were screened by Aghighi et al. (2004), from which 14 isolates were found active against various fungal isolates. Screening of isolates for antimicrobial activity Dual plate assay The antimicrobial spectrum of the actinomycetes isolates was confirmed by growing the actinomycetes isolate with the test cultures (Aspergillus sp., Candida sp., Bacillus sp. and Burkholderia sp.). Out of 19 isolates 12 (63%) showed antimicrobial activity against at least one test organism. 53% isolates were found active against at least one gram-stain-positive bacteria and 26% active against at least one gram-stainnegative bacteria and only 32% isolates were active against the fungal test microorganism. Onlyten (53%) isolates were effective against Bacillus sp., five (26%) against Burkholderia sp., two (11%) against Candida sp. and only six (32%) were found to be active against Aspergillus sp. Only one isolate was found effective against all the microorganisms tested (Fig. 1 and Table 2). In a similar study (Oskay, 2004), 50 isolates of actinomycetes were isolated from 10 farming soil samples collected in Manisa Province, Turkey. Approximately 34% of the isolates produced broad and narrow spectrum antibiotics, 16% of the isolates produced antibacterial substance that were active against only gram-stain-positive bacteria 6% of the isolates were active against gram-stain-negative bacteria and 12 % of the isolates were active against both gram-stain-positive and gram-stain-negative bacteria. SS12 was selected for further study due to larger zone size and broad spectrum of activity. Morphological and cultural characteristics of strain SS12 Microscopic observation (1000X magnification) after Gram’s staining revealed that SS12 is a Gram-stain-positive and rod-shaped microorganism (Hucker and Conn, 1923). Other morphological characteristics such as colony characteristics, type of areal hyphae, aerial mass colour, and growth of vegetative hyphae, reverse side pigments, melanoid Pigments, fragmentation pattern and spore formation are detailed in Table 3. They indicate that strains SS12 belongs to the genus, Actinomycetes (Fig. 2) (Shirling and Gottlieb, 1966). Biochemical characterization of isolates Biochemical properties of isolate did not matched with the available data of BIOLOG. The suggested match didn’t belong to actinomycetes; two major possibilities were worked out including novel species or contamination. Second possibility was rejected by the fact that positive and negative control was normal (Fig 3, Table 4). Identification of actinomycetes by biochemical properties are of prime interest (Moncheva et al., 2002) Analysis of sequencing data and identification of the isolates The band of genomic DNA was observed near well and PCR amplicon had a molecular weight of 1.5kb (Fig 4b). The 16S rDNA of the isolate was sequenced, and the sequence of the isolate is shown in Fig 4c. The sequence of 16S rDNA obtained was searched for homogenous sequences in the GenBank database. The results obtained were confirmed by NCBI. This bacterial strain was identified as the member of the genus Streptomyces (BankIt1564851). The isolate did not showed similarity with known isolates of the database. As shown by similarity tree constructed by ClustalW2, and designated as Streptomyces sp. SS12 (Fig. 5). CONCLUSION Nineteen isolates from terrestrial soil of ecologically stressed niches were isolated and their antimicrobial activity against bacteria and fungi was studied. One isolate was found to be the producer of broad spectrum antibiotic and its morphological, cultural and molecular identification indicate that the isolate belongs to genus Streptomyces. Further studies to optimize the culture parameter for economic production of antifungal antibiotic resulted in the enhancement of production level.
Englishhttp://ijcrr.com/abstract.php?article_id=1509http://ijcrr.com/article_html.php?did=15091. Aghighi S, Bonjar GHS, Rawashdeh R, Batayneh S and Saadoun I. First report of antifungal spectra of activity of Iranian Actinomycetes strains against Alternaria solani, Alternaria alternate, Fusarium solani, Phytophthora megasperma, Verticillium dahlia and Saccharomyces cerevisiae. Asian J Plant Sci 2004; 3(4): 463-471.
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4. Huang HC and Hoes JA. Penetration and infection of Sclerotinia sclerotiorum by Coniothyrium minitans. Can J Bot 1976; 54: 406-410.
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10. Ogunmwonyi IN, Igbinosa OE, Aiyegoro OA and Odjadjare EE,. Microbial analysis of different top soil samples of selected site in ObafemiAwolowo University, Nigeria Scientific Research and Essay 2008; 3 (3): 120-124.
11. Oskay MA, Usame T, and Cem A,. Antibacterial activity of some actinomycetes isolated form farming soils of Turkey. Afr J Biotechnol 2004; 3(9): 441-446.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30General SciencesBIODIVERSITY OF ENTOMOPATHOGENIC FUNGI IN NEW CULTIVATED SOIL WITH THEIR USING TO CONTROL OF GALLERIA MELLONELLA
English1731Abd El- Ghany T.M.English El-Sheikh H.H.English Abd El-Rahman G. A.English Abd El-Nasser A. M.EnglishChemical control for pests has been a serious concern for human and animal health; therefore this study was undertaken to screening of entemopathogenic fungi that are effective against against Greater wax moth Galleria mellonella. entemopathogenic fungi were isolated from different agricultural soil samples by plate dilution and baiting techniques. The crude extract of isolated fungi were screened against G. mellonella. Applied different fungal crude extracts of iolates achieved variable results on both larval and adult mortality percentages. The effect of crude extracts of Beauveria bassiana (Siwa isolate), Aspergillus tamarii, Fusarium solani, F. oxysporum, F. chlamydosporum and B. bassiana (El-Farafra isolate) giving total death percentages (82.48, 45.36, 37.12, 49.48, 53.6 and 74.22, respectively) to G. mellonella larvae comparing with the control treatment 0%. The results exhibited significant effects of B. bassiana (El-Farafra and Siwa Oasis isolates) against G. mellonella (larval and pupal weights). The % of larvae death increased with increasing the concentration of crude extract of B. bassiana (El-Farafra and Siwa isolates). Also pupal death percentage of G. mellonella increased while adult emergence decreased with increasing concentration of crude extract of El-Farafra and Siwa isolates of B. bassiana. On the other hand, crude extract of B. bassiana (El-Farafra isolate) was more active than B. bassiana (Siwa isolate) at high concentration (50 mg/ 0.5ml) while at other concentration crude extract of B. bassiana (Siwa isolate) was more active than B. bassiana (El-Farafra isolate). At the same time, different fractions of B. bassiana (Siwa isolate) extract were tested to determine the active metabolite. The bioactive compound was separated and identified as Beauvericin with using Thin layer chromatography, Fourier Transform Infrared (FT-IR) and analytical X ray.
EnglishSoil; Entomopathogenic Fungi; Beauvericin; Bioactivty.INTRODUCTION
Of the nearly one million known species of insects, about 15.000 species are considered pests and about 300 require some form of control. Fortunately, most insect pests have pathogenic microorganisms associated with them. There are two aspects of economic problems caused by insects. One concerns the loss of production that results from damage to crops and to the health of human and domestic animals, the other concerns the cost of attempt to prevent or control such production lose. At the same time with increasing agriculture, insects become more and more important competitors of human food damaging or even destroying the crops (Bale et al., 2008). The use of agrochemicals, although decreasing the attack of insects and phytopathogenic microorganisms, still represents a high risk to field workers and consumers. Over the last 25 years, chemical pesticides have become less attractive for numerous reasons including increased cost, the development of pesticide-resistant insects and weeds, concerns raised about human health hazards, and deleterious effects upon non-target organisms (Evans, 2008). Nowadays biological control as a practical science is very appreciated and as a solvent for long term usage of chemical pesticides problem is completely notified. Biological control is regarded as a desirable technique for controlling insects, due to its minimal environmental impact and preventing the development of resistance in vectors. Biological control (or biocontrol, which is synonymous) has been defined a number of times (Eilenberg et al., 2001). Entomopathogenic fungi have been found in many diverse habitats and associated with a broad range of insect hosts (Samson et al., 1988). These habitats include aquatic, forest and agricultural ecosystems that are of direct importance to insect-vector control, silviculture and crop protection (Bing et al., 2008), associated with insects (Pereira et al., 2009). Numerous laboratory and field studies indicate that entomopathogenic fungi (EPF) can provide a safe and effective control of many important insect pests (Lazreg et al., 2007; Stafford and Allan, 2010). The soil environment is usually the conventional isolation site for hypocrealean entomopathogenic fungi (Keller and Zimmerman, 1989; Hajek, 1997 (, and several species can be found in both cultivated and more natural habitats (Vanninen, 1996; Klingen et al., 2002). Bidochka et al. (1998) found Beauveria. bassiana to be affiliated with shaded and uncultivated habitats (i.e., forests) and B. bassiana also occurred frequently in hedgerow soils at a Danish locality (Meyling and Eilenberg, 2006). Agamy (2002) recovered the entomopathogenic fungus B. bassiana from soil samples from vegetable fields in El-Badrashin, Egypt. Eight fungi with differing incidence rates were isolated by Balogun and Fagade (2004) from Zonocerus variegates (Nigeria). These are Fusarium sp., B. bassiana, Metarhizium sp., Aspergillus flavus, Penicillium sp. , A. niger and Mucor sp. Fungi are known to produce a vast array of secondary metabolites that are gaining importance for their biotechnological applications (Siddhardha et al., 2009). Fungal secondary metabolites with high therapeutic value as antibiotics, cytotoxic substances, insecticides, compounds that promote or inhibit growth, attractor, repellent etc (Demain, 1999; Vey et al., 2001). Wasti and Hartmann (1978) investigated the effect of two toxins derived from B. bassiana, and other fungi on larvae of Galleria mellonella (L.) and Lymantria dispar (L.) by topical application and intra haemocoelic injection, the toxins from B. bassiana was the most effective. Fuguet et al. (2004) investigated the production of macromolecular insecticidal toxins by two selected strains of B. bassiana. Entomopathogenic fungi secrete a wide range of toxic metabolites in artificial culture and, in a few cases, in vivo (Vey, 1998). As B. bassiana is known to produce low mol. wt compounds such as beauvericin and bassianolide (Vey et al., 2001), toxicity was expected in dialysates prepared from filtrates, yet the dialysates had no lethal effect on the insect host. A toxic protein, bassiacridin, was purified from a strain of the entomopathogenic fungus B. bassiana isolated from a locust (Quesada and Vey, 2004). The work aimed to screening of entomopathogenic fungi from new cultivated soil with identification of bioactive compound of highly potency isolates .
MATERIALS AND METHODS
Sites of collection samples
Eighty new cultivated soil samples were collected from four different regions (Siwa Oasis, El Baharia Oasis, El Farafra Oasis and Matrouh region ) with four location distributed in the Western desert and cultivated with different fruits and crops. Surface soil samples (5-15 cm depth) were collected from underneath different field plants for isolation of entomopathogenic fungi.
Media used and isolation techniqes
Czapek-Dox Agar (CzDA), Malt Extract Agar (MEA), Potato Dextrose Agar (PDA) media were used for isolation, identification and growth of isolated fungi. Two methods were used for entomopathogenic fungi , Soil Plate method according (Warcup, 1950) and Insect bait method with using newly hatched larvae of Galleria mellonella which were supplied from Plant Protection Department, Desert Research Center, Egypt. Insect-associated fungi were isolated from soil samples by using the ‘Galleria bait method’s (Marston and Brown 1974; Zimmermann, 1986; Woodring and Kaya, 1988; Meyling, 2007). Identification of fungal isolates Both light and high-vacuum JEOL JSM-5500LV scanning electron microscope were used for examination and identification of the fungal isolate according to Raper and Fennel (1965) and Samson et al. (1995) in the Regional Centr of Mycology and Biotechnology, Al Azhar University, Egypt. Fungal growth and their toxicity against Galleria mellonella Fifteen isolates were used to bioassay. Each isolate was cultured on potato dextrose broth medium at 28 ±2 oC. After inocubation period eight days, the growth medium was extracted by n-butanol. The butanolic extract was filtered on anhydrous of sodium sulphate and then concentrated. Different concentrations of the crude extract was tested to toxicity against 15 days old of G. mellonella larvae at different perids, the percentages of mortality were counted. Fractions of crude extract of more active isolates were prepared and examined against 15 days old Galleria larvae, 10 fractions was tested at concentration of 0.1 mg active ingredient from each fraction /1 ml distilled water. Determination of LC 50 was calculated according to Finney, (1964). Fractions of crude extract were used to determine the active fraction.Thin layer chromatography, Fourier Transform Infrared and Philips analytical X-ray were used to identify the active metabolite .
RESULTS
Screening of entomopathogenic fungi
Different fungal isolates were isolated from different regions cultivated with different plants (Table 1 and Fig. 1) with Baiting and Plate dilution. Thirty isolates were isolated by Plate dilution while 15 isolates only were isolated by Baiting technique. In case of the soil sample that was taken from under the jwava trees in Tazzola site (located in Siwa Oasis), Fusarium solani was isolated by baiting technique while Alternaria alternata was isolated by plate dilution. The same observation was repeated for the soil samples from under the mint of El-Caf and El-Negilah sites, cucumber of El-Kasr, lareng of El-Heyz and from the soil sample of potato plantation that cultivated in El-Lewa Sobah village. On the contrary, certain fungi were isolated by both techniques. This observation was done on A. terreus that isolated from the soil under apricot trees in El-Ezzaah site and Beauvaria bassiana that isolated from the soil under date trees in Tazzola. Some fruit trees or crops that cultivated in more than one place had a high diversity of their soil-associated fungi. Where, in the soil samples of apricot trees that cultivated in ElEzzaah, Ras El-Hekmah, El-Kasr and El-Hayz sites, each of A. terreus, P. brasilianum, R. solani and A. flavus were detected respectively.
Effect of fungal crude extracts on both larval and adult stages
Applied different fungal crude extracts of iolates achieved variable results on both larvae and adult mortality percentages comparing with the check treatment. The effect of crude extracts of B. bassiana (Siwa isolate), A. tamarii, F. solani, F. oxysporum, F. chlamydosporum and B. bassiana (El-Farafra isolate) giving total death percentages (82.48, 45.36, 37.12, 49.48, 53.6 and 74.22, respectively) to G. mellonella larvae comparing with the control treatment 0 % (Table 2). On the other hand, the larvicidal effect of P. brasilianum, Mucor miehei, A. alternata, Macrophomena sp, Rhizopus oryzae and A. niger on G. mellonella larvae was weak. Fungal crude extracts, as shown in Table (2), were characterized by their latent effects on the pupal stage. The dead pupae ( Pupae which didn’t emerge as adult symbolized as P.d.). The % of pupal death was 12 % for B. bassiana (ElFarafra isolate) compared with 2 % F. oxysporum. The percent of viable pupae which turn out to be emerged as adult moths was also stated (Table 2). The highest moth emergence percentage was obtained from the larvae previously treated with P. brasilianum extract (86 %) while the least recorded one was 14% that achieved from the crude extract of B. bassiana (Siwa isolate).
Effect of different concentrations of B. bassiana crud extract on G. mellonella larvae.
Highest mortality percentages of Galleria larvae was achieved with B. Bassiana particularly siwa isolate and therefore the effect of different concentrations of their extract on the 15 days old Galleria larvae was studied (Fig. 2 and 3). The % of larvae death increased with increasing concentration of crude extraction of B. bassiana (Siwa isolate) . B. bassiana (El-Farafra ) extract with 50 mg /3 ml caused the lowest cumulative larval death (11%) and 18 % when the applied concentration was 50 mg/2.5 ml. On the other hand, the fungal extract of 50 mg/0.5ml caused the highest larval mortality (55%). Focusing on the effect of applied concentrations of Siwa isolate on this parameter, similar trend could be observed. As the highest cumulative larval death percentage (64%) was achieved at the highest applied concentration, such percent was declined to 10% by applying 50 mg/3 ml concentration. Larval mortality with active extract of B. bassiana (El-Farafra isolate) increase by time of application in an ascending order (Fig. 4). Considerable larval death occurred after 96 hours after application while negligible death percentages were estimated before it. At 50 mg/0.5 ml concentration, the larval death percentage after 72 hours post treatment was 0 % then increased to record 13, 10 and 10 larval mortality percentages after the 4th, 7th and 9th days, respectively. Through the whole tested concentrations, the highest larval death percentage was observed after 10 days of application. With the application of B. bassiana (Siwa isolate) extract, the larval death percentages was recorded at 72 hours post treatment with most applied concentrations (Fig. 5), the high potency of B. bassiana (Siwa isolate) extract succeeded to show its influence faster than B. bassiana (El-Farafra isolate). The highest larval death percentages for the crude extract of Siwa isolate through all its applied concentrations was achieved after the 7th day of treatment.
Effect of different concentrations of B. bassiana crud extracts on Pupal death and adult emergence of G. mellonella. Pupal death percentage of G. mellonella increased while adult emergence decreased with increasing concentration of crude extract of B. bassiana (El-Farafra and Siwa isolates). On the other hand, crude extract of B. bassiana (ElFarafra isolate) was more active than B. bassiana (Siwa isolate) at high concentration (50 mg/ 0.5ml) while at other concentration crude extract of Siwa isolate was more active than B. bassiana (El-Farafra isolate) (Figs. 6 and 7). Crude extract of El-Farafra isolate was currently active against Pupal of G. mellonella at low concentration 50 mg/ 3 ml while at this concentration crude extract of B. bassiana (Siwa isolate) was not active. Adult emergence at the lowest concentration (50 mg /3 ml) was 87% for B. bassiana (El-Farafra isolate) and 92% for B. bassiana (Siwa isolate) extracts.
Effect of B. bassaina crude extracts on larval and pupal weight gains Larval weight gain was forced to decline under the influence of both the vigor state of the Beauveria extract and the tested concentration. As the untreated larvae weighted about 0.23 gm the weight gain of treated ones recorded their minimum weight at 50 mg/0.5 ml concentration of B. bassiana extracts (0.05 and 0.01 gm of B. bassiana El-Farafra and Siwa isolates respectively). According to the calculated values of L.S.D., all applied concentrations of both extracts were significantly differed from the check trail. Such significant differences in the larval weights between treated and check ones declared the extending entomopathogenic influence of these extracts ( Table 3). The effect of B. bassiana (Siwa isolate) extract on the development and growth of G. mellonella adult was observed (Fig.8) ,where the abnormalities apperead on the body of adult G. mellonella compared with the control accompanied with a deficiency of weight.
Effect of different fractions of crude extraction B.bassiana (Siwa isolate) on G. mellonella larvae
Fractions of B. bassiana Siwa extract the total larval death percentage of fraction 8, which exceeded 90% categorized this fraction as the highest entomopathogenic one. Fraction 9 by its recorded 50% total larval death was ranked in the second cohort, whereas the total larval death of the reminder fractions was ranged between 36 to 5 percentages that attained for fractions 10 and 1 respectively. Where, after the 2nd day of treatment the larval death percentage for this fraction (8%) was the highest one among the other fractions. For all testing fractions, the highest larval death percentages were attained either at the 10th or 11th day post treatment. For fractions 8 and 9, the recorded larval death during these inspection dates (10th or 11th day) was the highest among all fractions (Fig. 9).
Virulence of B. bassiana spore suspension on larval stage of G. mellonella
Mortality percentage in larvae of G. mellonella increased with increasing the time elapsed posttreatment, as well as the increasing concentration of spore suspension (Table 4 and 5). After the 3rd day of treatment, larval mortality was only recorded at the concentrations of 40 and 60 x106 spores/ml with almost low percentages (6 and 10 % respectively). For the intermediate concentrations (15 and 20x106 spores/ml), larval mortality was delayed to initiate 4th days post treatment by 4 and 6 % at 15 and 20x106 spores/ml respectively. Whereas larval mortality was commenced after the 5th day of application at the lowest concentrations (5 and 10 x106 spores/ml). As mentioned in Table (4), larval mortality percentages were of direct proportional relationship with the administered spore concentrations. The highest applied concentrations (40 and 60 x106 spores/ml) achieved 100 % larval mortality after the 10th day of application. At the later inspection date (12th day) the induced larval mortality percentages due to the lowest concentrations was ranged between 70 % for 15 x106 spores/ml and 44% for 5 x106 spores/ml (Table 4). On the same sequence, the bioassay test of B. bassiana fungal spores that isolated from siwa oasis was illustrated in Table (5), where larval mortality was commenced at 3 days post treatment. At the highest applied concentrations (40 and 60 x 106 spores /ml) larval mortality percentages achieved 100 % at the 9th day of application (Table 5).
Identification of active compound
The active extract of B. bassiana was fractinated and each fraction was tested as insecticid on Galleria larvae, Fraction 8 was the highest one among the other fractions and caused mortality percentage (91.83%). The fraction given promising results (Fraction 8) subjected to refractionation for purification and identification of active compound by using Thin layer chromatography, Fourier Transform Infrared (FT-IR) and analytical X ray. The data of fourier transform infrared of compound illustrated in the Table (6). X rayes indicated the presence of beauveicin as Colorless crystal, 1H NMR (CDCl3), δ 0.37 (3H, d, J = 6.6Hz, γ1-CH3, Hiv), 0.76 (3H, d, J = 6.6Hz, γ2- CH3, Hiv), 1.97 (1H, m, β-CH, Hiv), 2.93 (1H, dd, J = 11.9, 14.5Hz, β-CH(H), Phe), 2.98 (3H, s, N- CH3), 3.34 (1H, dd, J = 4.9, 14.5Hz, β-CH(H), Phe), 4.89 (1H, d, J = 8.5Hz, α-CH, Hiv), 5.51 (1H, dd, J = 4.8, 11.8Hz, α-CH, Phe), 7.20(5H, ar CH, Phe), 13C NMR (CDCl3), δ 17.4 (q, γ1- CH3, Hiv), 18.2 (q, γ2- CH3, Hiv), 29.6 (d, β- CH, Hiv), 32.2 (q, N- N- CH3), 34.7 (t, β- CH2, Phe), 57.2 (d, α-CH, Phe), 75.4 (d, α-CH, Hiv), 126.7 (d, ar CH, Phe), 128.4 (d, ar CH, Phe), 128.8 (d, ar CH, Phe), 136.6 (s, ar C, Phe), 169.3 (s, CO), 169.8 (s, CO), HRFABMS m/z, [M+H]+ 784.4164 (calcd for C45H58N3O9, 784.4173). From the above data of X-rays explained that fraction may contain beavericin. From the mentioned data documented, this compound may beauvericin.
DISCUSSION
As an alternative to chemical pesticides, the entomopathogenic fungus Beauveria bassiana is currently under intensive study as a promising biocontrol agent for insects and other arthropod pests (Kirkland et al., 2004;Howard et al. 2010). In our results the Beauveria bassiana is the common entomopathogenic fungus that isolated from soil cultivated with fruits (Dates) and crops (Faba). Entomopathogenic fungi are widespread in agroecosystems. The hypocrealean species B. bassiana have broad host ranges in agroecosystems. Recent advanced researches elucidated aspects of the ecology of the fungi that are relevant for conservation biological control. It is suggested that B. bassiana is associated with insect hosts above ground (Meyling , 2007), also grows naturally in soil through out the world and acts as a potent parasite on various insect species (Arti and Nilofer , 2010). Recently, B. bassiana has been linked to plants as an endophytic fungus (Arnold and Lewis, 2005). Recently Amy et al. (2009) reported that entomopathogenic fungi are commonly found in forested soils. The variability in the isolated fungi in our study may be due to type of soil or type of cultivated plants. Keller and Zimmerman (1989) stated that, a number of factors, including soil type (texture, cation exchange capacity, organic matter content, pH, etc.), moisture (water availability) and the presence of a viable soil micro-flora can influence the persistence and/or efficacy of entomopathogenic hyphomycetous fungi. In this study, soil-associated fungi were isolated by two isolation techniques, Galleria bait method and soil plate method, such isolation methods were well documented by several authors (Zimmermann, 1986; Bing et al., 2008 and Amy et al., 2009). According to the pre-mentioned fungal categories, opportunistic fungi were the second group. Among the isolated fungi, Aspregillus spp., Fusarium sp., Mucor sp. are opportunistic isolates (Bing and Zhong, 2008). On the same trend, the later authors identified such opportunistic fungi as fungal species other than well-known insect pathogens but can infect insects. During their research they found that, the most commonly isolated species of this group were Fusarium oxysporum, F. solani, Aspergillus flavus and Mortierella spp. In the current study, G. mellonella larval mortality that induced by opportunistic fungal isolates may be due to the characteristic of the fast growing opportunistic fungi, which may infect, injured or weakened insect (Hajek et al., 1997). From our observation, most fungal crude extracts had an insecticidal activity and it was easy to conclude that, the applied concentration of the different crude extracts achieved variable results on both larval and adult mortality of G. mellonella. Then from this screening test, B. bassain (Siwa and El Farafra isolates) was the promising agent upon achieving the highest percent mortality 86 and 78% respectively comparing with other isolates. The obtained results by Quesada et al. (2006) indicated that, extracts from two two B. bassiana isolates gave significant mortalities when applied either on alfalfa leaf discs or incorporated into artificial diet. The toxic effect of such extracts may be due to the fungal exudates (toxins) that excreted into the in-vitro growth media. Maketon et al. (2008) stated that each of Metarhizium anisoplias, Beauveria bassiana, Verticillium lecanii and Hirsutella citriformis achieved high mortality percentages of cotton jassid. Concerning with weight gain of treated larvae and pupae, our results stated that the tested concentration significantly diminish both larval and pupal weight. Such weight deficiency may be attributed to the antifeedent and/or mouthpart paralysis of Galleria larvae that exposed to crude extract contaminated media. Roberts (1981) declared the effect of fungal extracts on insect growth. Weight deficiency may be attributed to the effect of the applied treatments in decreasing the larval ability to convert ingested and digested food into body matter. In other study, Wilps (1989) stated that the reduction in weight gain of treated larvae were explained according to the fact that, there were considerable decrease in the amount of toxin ingested food (eaten diet) to that portion converted into body weight. As previously mentioned in our results the active ingredient that responsible for achieving theses symptoms was beauvericin. Griffin (1994) stated the following fact, fungi secret wide array of compounds that are biologically active against other organisms. Beauveria bassiana which has entomopathogenic properties may secret bassianin, beauvericin, bassianolide, beauverolides and tenellin (McCoy,1996).
CONCLUSION
B. bassiana that isolated from Siwa and El Farafra Oases achieved 82.48 and 74.22 total death % of G. mellonella, respectively (the highly potent isolates), their extracts adversely affected larval mortality. Comparing with control treatment, both extracts successfully decreased the larval weigh gain. The obtained data shed light on the higher efficacy of B. bassiana (Siwa isolate) extract as entomopathogenic agent than B. bassiana (ElFarafra isolate). The acftive compound was separated and identified as beauvericin. At the same time the larval mortality percentages were of direct proportional relationship with the administered spore concentrations of B. bassiana.
Acknowledgements:
The authors acknowledgement the team researchers of Regional Center for Mycology and Biotechnology, Al-Azhar University and Plant protection Departement Desert Research Center, egypt for providing necessary laboratory facilities.The authors are also grateful to authors and publishers of all those articles, from where the literature for this article has been reviewed and discussed.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareMONTEGGIA FRACTURE-DISLOCATION TYPE 3 WITH POSTERIOR INTEROSSEOUS NERVE (PIN) INJURY: A CASE REPORT
English3237Ravish.V.NEnglish Karthik SubramanianEnglish I. SureshEnglishFracture of proximal two-thirds of ulna and dislocation of the proximal radio-ulna joint in the same upper limb is called Monteggia fracture- dislocation. Four clinical variants of this fracture- dislocation have been described according to Bado’s classification depending upon the fracture location and direction of dislocation of the radial head. Monteggia fracture-dislocation type 3 is a rare variety and its association with posterior interosseous nerve injury is not widely documented. We report the case of a 13 year old male who presented with one day old history of painful and swollen left elbow and weakness of his ipsilateral hand, following a self fall. On careful clinical examination and imaging (x-ray), he was diagnosed to have sustained Monteggia type 3 fracture-dislocation with posterior interosseous nerve (PIN) injury. After adequate pre-operative follow-up, the patient was treated by open reduction of the radial head, annular ligament reconstruction and open reduction, internal fixation of the fracture ulna with DCP and screws. The patient was followed up at regular intervals. His recent radiograph of the left forearm and elbow shows satisfactory union at the fracture site with complete recovery of the posterior interosseous nerve injury.
EnglishMonteggia fracture-dislocation, Bado’s classification, Posterior interosseous nerve injury.INTRODUCTION
The term Monteggia fracture- dislocation describes fracture of proximal two-thirds of ulna and dislocation of the proximal radio-ulna joint in the same upper limb1 . Four clinical variants of this fracture- dislocation have been described according to Bado’s classification depending upon the fracture location and direction of dislocation of the radial head2 . Monteggia type 3 fracture dislocation consists of fracture of proximal third ulna, just distal to coronoid process with lateral dislocation of the radial head. It is a rare variety of all Monteggia variants3 and its association with posterior interosseous nerve injury is not widely documented. We report the case of a 13 year old male who presented with post-traumatic painful left elbow due to Monteggia type 3 fracture-dislocation with posterior interosseous nerve (PIN) injury.
Case History
A 13 year old young male presented with complaints of severe pain and swelling in his left elbow following a fall on an out-stretched hand and inability to move his left elbow. The pain was acute in onset following the trauma, aggravated on movements on the affected limb, associated with diffuse swelling and deformity of the left elbow. On physical examination, there was tenderness over the radial head and proximal third of ulna. The radial head was palpable as a bony prominence on the lateral aspect of his elbow, in continuity with the shaft. There was crepitus, abnormal mobility and loss of transmitted movements in the proximal third shaft of left ulna. There was weakness of extensors of the thumb and four fingers of his left hand, but the power of dorsiflexion of his wrist was normal. Radial pulse of the ipsilateral upper limb was well felt. Conventional plain radiographs of his left elbow revealed fracture of the proximal third ulna just distal to the coronoid process and lateral dislocation of the radial head (Figure 1).
After adequate pre-operative workup, exploration of the left elbow was done using a Boyd’s approach3. The radial head was reduced and the annular ligament reconstructed using triceps tendon. The fracture of proximal third ulnar shaft was reduced and fixation was done with dynamic compression plate (DCP) and screws (figure 2 and figure 3).
The patient recovered extension of his four fingers and thumb by six weeks after surgery. The movements of his right elbow were normal at a follow-up examination two months after surgery and radiographs showed satisfactory fracture union (figure 5).
The patient was followed up at regular intervals thereafter. He showed normal range of movements at elbow, not associated with pain at the completion of one year and his recent radiograph showed complete union at the fracture site (Figure 6).
DISCUSSION
Fractures of the proximal two-thirds of ulna combined with dislocation of the proximal radio-ulnar joint were described in 1814 by Monteggia2 . Bado coined the term ‘Monteggia fracture-dislocation’ in 19672 . Numerous classification schemes have been developed, but Bado's classification has been widely accepted worldwide. Bado's classification2 divides Monteggia fracturedislocation into four types: Type 1 consisted of fracture in the proximal two thirds of the ulna with anterior dislocation of the radial head. This is the most common Monteggia injury in children, representing around 70%. Type 2 consisted of fracture in the proximal two thirds of the ulna with posterior dislocation of the radial head. This type is more commonly seen in elderly children and adults. Type 3 consisted of fracture of ulna, just distal to coronoid process at the metaphysis with lateral dislocation of the radial head. This fracture pattern often is associated with radial nerve or PIN injuries and a coexisting intra-articular obstruction to radial head reduction, which requires surgical reduction of the radial head. Type 4 consisted of fracture of the proximal or middle third of the ulna, anterior dislocation of the radial head, and fracture of the proximal third of the radius below the bicipital tuberosity. A hybrid lesion similar to a type III Monteggia lesion has been described in which anterior dislocation of the radial head was associated with a fracture of the metaphyseal region of the ulna that extended into the olecranon2 . Monteggia fracturedislocation type 3 is a rare variety, constituting only about 10-15% of all Monteggia variants3 . Stability of the proximal radioulnar joint is provided by the surrounding ligaments, primarily the annular ligament. The annular ligament maintains the position of the radial head within the radial notch of the ulna through the entire range of rotation, becoming tighter in supination because of the shape of the radial head. The substance of the annular ligament is reinforced by the radial collateral ligament at the elbow joint. Hence, annular ligament reconstruction forms an important step in maintaining the radial head reduction2 . The Monteggia lesion probably can be caused by any of the three proposed mechanisms, but the most common mechanism is a fall on an outstretched hand that forces the elbow into complete extension, locking the olecranon into the humerus2 . The biceps brachii muscle, inserting into the biceps tuberosity on the proximal radius, is a major deforming force. It is active in the pathomechanics of Monteggia fracture-dislocation, violently pulling the proximal radius away from the capitellum as the elbow goes into extension. During treatment, the effect of the biceps must be regulated by elbow flexion to prevent recurrence of the radial head dislocation2 . Nerve injuries in closed forearm fractures are relatively uncommon5 . There is a close relation between the posterior interosseous nerve and the proximal radius6 , with the nerve coursing anterior and anterolateral to the radial head and neck on its path through the supinator muscle. With anterolateral dislocations of the radial head, direct trauma may cause paresis of the nerve. In adults, there is a more discrete organization of the proximal border of the superficial head of the supinator, forming the ‘Arcade of Frohse’. This band is not as well defined in children, which may partially account for the lower incidence of permanent injury to the posterior interosseous nerve in children7 , as well as the high incidence of resolution once reduction of the radius is obtained2 . It is necessary to make an accurate diagnosis and render proper treatment by reduction and annular ligament reconstruction, when a Monteggia fracture-disloaction occurs, to avoid possible posterior interosseous nerve palsy due to excessive pronation and supination even several decades later4,8,9 .Internal fixation with plates allows excellent control of the fracture fragments and therefore permits accurate restoration of the anatomy, which remains the key principle in treating forearm fractures as it preserves maximal forearm function. In this case, immediate restoration of the elbow anatomy was done by reduction of the radial head with annular ligament reconstruction and fixation of fracture ulna with DCP and screws.
CONCLUSION
Fracture of proximal two-thirds of ulna and dislocation of the proximal radio-ulna joint in the same upper limb is called Monteggia fracture- dislocation. Four clinical variants of this fracture- dislocation have been described according to Bado’s classification depending upon the fracture location and direction of dislocation of the radial head. Monteggia fracture-dislocation type 3 is a rare variety, constituting only about 10-15% of all Monteggia variants and its association with posterior interosseous nerve (PIN) injuries is not widely documented. It is necessary to make an accurate diagnosis and render prompt treatment by reduction of the radial head dislocation and fixation of the ulna fracture to avoid PIN palsy. Regular follow-up till the recovery of PIN is essential.
CONSENT
Written informed consent was obtained from the patient for publication of this case report and accompanying images.
COMPETING INTERESTS
The authors declare that they have no competing interests.
Englishhttp://ijcrr.com/abstract.php?article_id=1511http://ijcrr.com/article_html.php?did=15111. Abdullahi Agaba-Idu Musa. Monteggia fracture-dislocation: a case report, its’ initial management and review of bado’s classification. Afr Health Sci. 2006; 6(4): 252–254.
2. Beaty JH, Kasser JR, editors. Rockwood and Wilkins Fractures in children. 7th edition. Philadelphia: Wolters Kluwer; 2012: 446- 475.
3. Canale ST, Beaty JH, editors. Campbell’s Operative Orthopaedics. 11th edition. Philadelphia: Mosby Elsevier; 2008; 3420- 24.
4. Cho CH, Lee KJ, Min BW. Tardy posterior interosseous nerve palsy resulting from residual dislocation of the radial head in a Monteggia fracture: a case report. Journal of Medical Case Reports 2009; 3:9300.
5. Spinner M, Freundlich BD, Teicher J. Posterior interosseous nerve palsy as a complication of Monteggia fractures in children. Clin Orthop Relat Res.1968; 58:141-145.
6. Jessing P. Monteggia lesions and their complicating nerve damage. Acta Orthop Scand. 1975; 46:601-609.
7. Stein F, Grabias SL, Deffer PA. Nerve injuries complicating Monteggia lesions. J Bone Joint Surg Am. 1971; 53:1432-1436.
8. Lichter RL, Jacobsen T. Tardy palsy of the posterior interosseous nerve with a Monteggia fracture. J Bone Joint Surg Am. 1975; 57:124-125.
9. Hashizume H, Nishida K, Yamamoto K, Hirooka T, Inoue H. Delayed posterior interosseous nerve palsy. J Hand Surg Br. 1995; 20:655-657.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareOVERWEIGHT AND OBESITY IN YOUNG ADULTS: FOOD FOR THOUGHT
English3842Kavita Vasudevan P.English Umamaheswari K.English Vedapriya D.R.English Palanivel ChinnakaliEnglishResearch question: What is the magnitude of overweight and obesity among young adult students of a medical college? Setting: All undergraduate medical college students of a private medical college in Pondicherry. Design: Facility based cross-sectional study. Using a pre-tested semi-structured questionnaire all subjects were interviewed after taking informed consent. Weight, height, waist circumference and hip circumference were measured. Overweight, obesity and central obesity was estimated by using standard criteria. Results: prevalence of overweight or obese was 26.7 % & 35.2% resp. using the standards for Asian Indians and 29.1% and 3.8% resp. using the WHO cut-offs. About 23.3 5%and 10.9% of the subjects had larger waist circumferences and higher waist-hip ratios The prevalence was significantly more in males when compared to females. Conclusion: Overweight and obesity is a problem in this study group which calls for primary preventive measures like health education, dietary modification, physical activity and periodic screening.
Englishoverweight, obesity, young adults, primary preventionINTRODUCTION
The global epidemic of overweight and obesity – ‘globesity’ is becoming a public health problem in many parts of the world. Rapidly changing diet and lifestyles is fueling this global obesity epidemic. It is associated with an increased risk of developing various non-communicable diseases including hypertension, coronary heart disease, diabetes, stroke and some forms of cancers.(1) The National Family Health Survey-3 (NFHS-3) has reported that nutrition transition is underway in India with high proportion of overweight co-existing with high rates of malnutrition.(2) The age-group from 18-21 years is an important phase in life; physically, mentally and emotionally. This is the period of transition from adolescence to adulthood. Proximity to biological maturity at this time may provide final opportunities for primordial and primary prevention of health problems. Overweight and obesity during this period are associated with development of risk factors for obesity related diseases. Studies using anthropometric measurements to assess nutritional status have been focused more on under-five children and school children. But the emergence of obesity and its sequelae as public health problems has renewed interest in the adolescent anthropometry.(3) Medical students joining Medical Colleges represent this group. There are very few studies on the health and nutritional status for this group in our country. This study aims to assess the prevalence of overweight and obesity in medical students.
METHODOLOGY
This study was conducted in a private medical college in Pondicherry wherein 100 students are admitted every year. Institute Ethical committee clearance was obtained before starting the study. The purpose of the study, and the procedure was explained to each student in detail. All students currently studying in the college, willing to participate, were enrolled for the study. Informed consent was obtained from each student. The height, weight, waist circumference and hip circumference were measured. The weight was taken on a weighing scale with standard minimum clothing to the nearest 0.5kg. Height was measured on a vertical scale with the heel, buttocks and occiput against the wall and the head in the frankfurt plane to the nearest 0.5cm. Waist circumference (WC) was measured at the level of the highest point of the iliac crest and hip circumference was the largest diameter around the buttocks. The cut-off for WC to quantify abdominal obesity indicating high risk was taken as 90 cm for men and 80cm for women. Waisthip ratio was calculated by using the formula WHR= (waist circumference in cm)/ (Hip circumference in cm). WHR of more than 0.85 in women and 0.95 in man was considered as abdominal obesity. Body mass index (BMI) was calculated by the formula BMI= (weight in kg)/ (height in mts) 2 . BMI was used to categorise the nutritional status of the subjects as per the recommended cut-offs for Asian Indians. (Normal BMI: 18.0-22.9 kg/m2 ; Overweight: 23.0-24.9 kg/ m2 ; Obesity: >25 kg/m2 ).(4,5) It was also compared with the WHO cut-offs.
STATISTICAL ANALYSIS
Data was entered in MS Excel and analyzed by using SPSS software v17.0. Students’ t test was used to compare means and Chi-square test was used to compare proportions between groups. A pvalue of 0.05 or less was considered statistically significant.
RESULTS
A total of 471 students were included in this study of which 59.7% were males. The mean age for girls was 21.2 ± 2.1 (range 18-36yrs ) and for boys was 21.7 ± 2.2 (range 18-31yrs ). Only 5(1.1%)of them, all girls; were married. Socioeconomic status was assessed by using the Prasad’s classification based on per capita income. About 95.4% of the respondents belonged to class II or above. Table 1 shows the distribution of the study population based on their gender and semester of study. The biggest proportion of female and male subjects was in V semester and I semester respectively. Table 2 shows the mean anthropometric parameter of the study population. The male subjects were found to be significantly taller, heavier, had larger waist circumferences and higher body mass index compared to female subjects. Figure 1 shows the distribution of body mass index of the study subjects based on south-asian cut-offs and WHO cut-offs. Using the south-asian cut-offs majority of the subjects were found to overweight or obese (26.7 % & 35.2% resp.) with sub-optimal BMI. The WHO classification which has higher BMI cut offs for overweight and obesity shows that majority have normal BMI(60.3%). The proportion of overweight and obesity was 29.1% and 3.8% resp. About 23.3 5%and 10.9% of the subjects had larger waist circumferences and higher waist-hip ratios(table 3)indicating abdominal obesity.
DISCUSSION
The risk factors of today are the diseases of tomorrow. Identifying the risk factors in populations occupies a central place in the surveillance system because of the importance of the lag time between exposure and disease. Therefore, public health strategies have to be driven by the motive of identifying risk factors in populations in different settings.(6)Obesity is an important risk factor in the pathogenesis of hypertension, dyslipidemias, diabetes mellitus and cardio-vascular diseases. Identifying overweight and obesity early and managing it with rational approaches is crucial in control of cardio-vascular diseases. This study has found a prevalence of overweight and obesity in this group of medical students as 26.7% and 35.2% respectively using the BMI cutoffs for Asian Indians. Using the WHO BMI cutoffs the prevalence of overweight or obesity was found to be 32.9%. This prevalence is higher than that reported by studies in medical college students in Delhi and West Bengal.(3,7) This difference may be due to the differences in sample size of the studies, age of the subjects and dietary practices. In this study most of the students belonged to the upper socio-economic class indicating the effect and quality of the feeding practices in their childhood and adolescence. The National Family Health Survey-3 (NFHS-3) has reported a prevalence of overweight in women as 14.8% and in men 12.1% with an higher prevalence in urban areas when compared to rural areas. This is lower than the present study as the population studied in NFHS-3 was adults in the age group 15-45yrs(2). Studies from Kerala and gujrat(6,8) among adults in the age-group 15- 60 yrs have reported a prevalence similar to this study. All the above mentioned studies from India have used BMI cut-offs as stated by WHO for assessing obesity. This would make international comparisons possible but may underestimate the true burden. It would be advisable to use the criteria relevant to Asians Indians as suggested in various publications by the government of India with respect to body mass index, waist circumference and waist-hip ratio.(4,5) The prevalence of overweight, obesity and central obesity was more in males than in females. This is different from that reported by some other studies (6, 9). Shah et al reported that overweight, obesity and central obesity is higher in women, whereas Mehan et al have reported higher abdominal obesity in women based on waist circumference and waist-hip ratio. But in both the studies the age group of the subjects(15-45yrs) was different from that of the current study. This study has shown that overweight and obesity is a health problem in the group studied. Belonging to higher socio-economic status, changing diets and lifestyles may have contributed to this high prevalence. This requires planning of strategies, focusing on the young adults to prevent obesity-related sequelae.
CONCLUSION
Overweight and obesity is a problem in this study group which calls for primary preventive measures like health education, dietary modification, physical activity and periodic screening. Physical activities like sports, yoga, periodic screening of students, maintaining health cards for students could be made essential during medical training course. Further studies in similar groups, across the country are needed to substantiate the findings of this study.
ACKNOWLEGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1512http://ijcrr.com/article_html.php?did=15121. Vedapriya D R, Mittal A, Mahajan P, Kavita V, Balamuruganvelu S, Umamaheswari K. Prevalence Of Overweight Among Adults In Arural Area Of Tamil Nadu. Ind. J Nutr Dietet.2010; 47:404-8
2. Fact sheet: National Family Health Survey NFHS-III 2005-06. Ministry of Health and Family Welfare. Govt. of India
3. Chabra V, Grover VL, Agrawal K, Kanan AT. Nutritonal status ans blood pressure of medical students in Delhi. IJCM.2006;31(4):248-51.
4. National Programme for Prevention and Control of Diabetes, Cardio-vascular diseases and Stroke. A manual for Medical Officer. Government of India-WHO collaborative programme 2008-09.
5. Mishra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. JAPI 2009; 57(2):163-70.
6. Mehan MB, Surabhi S, Solanki GT. Risk factor profile of non-communicable diseases among middle income (18-65 years) freeliving urban population of India. Int J Diab Dev Ctries 2006; 26(4): 169-76.
7. Gupta S, Ray TG, Saha I. Overweight, obesity and influence of stress on body weight among undergraduate medical students. IJCM 2009; 34(3): 255-57.
8. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK et al. Risk factor profile of non-communicable diseases: results of a community-based study in Kerala, India. Ind J Med Res 2010; 131:53-63.
9. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: The need & scope. Ind J Med Res 2010; 131:53-63.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareA CROSS-SECTIONAL STUDY OF MORBIDITY PATTERN OF RURAL AGRICULTURAL WORKERS IN SOUTH INDIA
English4351Kulkarni Rajesh R.English Shivaswamy M.S.English Mallapur M.D.EnglishBackground and aims: 72% of Indian population lives in rural area, where their main occupation is agriculture. Agriculture workers do not have trade unions and have no access to occupational health services. The present study was aimed to know the morbidities of agricultural workers. Methods and Material: This cross-sectional study was done from January 2009 to December 2009 among 400 agricultural workers of age 16 to 60 years residing at a sub-centre area of the PHC administrated by Medical College in South India, using predesigned and pretested questionnaire. Statistical analysis was done by using percentages and chi square test. Results: Among the study participants 55.75% were men and 44.25% were women, with male to female ratio of 1.25:1. Most of the agricultural workers (89.5%) were Hindus and 47% were illiterates; of the 400 study participants, 295 (73.75%) belonged to Class V socio-economic status. Majority (62%) of agricultural workers suffered from morbidities associated with oral cavity, followed by morbidities associated with musculoskeletal system (21.7%) and respiratory system (19%). Increasing age, gender and poor educational status were significantly associated with morbidities of oral cavity, musculoskeletal system, respiratory system, anaemia and animal bites. Conclusion: The present study suggests that, agricultural workers had a multitude of health problems. In order to overcome the situation, information, education and communication (IEC) activities needs to be strengthened and special health check-up camps to be conducted with emphasis on improvement of health.
EnglishAgricultural workers; Morbidity pattern; Occupational healthINTRODUCTION
The literature linking health to labour productivity is built on the concepts of household production theory developed by Becker (1965). In Becker’s framework, households are treated also as producers of “commodities” instead of solely consumers of goods and services. This framework was extended by Grossman (1972, 1999) to analyze the demand for health. In Grossman’s model, health is viewed as a durable capital stock that yields an output of healthy time. [1] India lives in its 600,000 villages. Nearly 72% of Indian community lives in rural area, where their main occupation is agriculture. Indian agriculture accounts for 25% of total gross domestic product (GDP) on which 75% of country’s population depends on. Agricultural workers do not have trade unions and have no access to occupational health services. [2] Occupational health in the agricultural sector is a new concept. These agricultural workers have a multitude of health problems, a fact which is often forgotten because of misconception that occupational health is mainly concerned with industry and industrialized countries. These health problems of workers in agriculture may be accidents (machine injuries, snake and insect bites), toxic hazards (chemical exposures and insecticide poisoning), physical hazards (extreme conditions, solar radiation), respiratory problems (farmer’s lung, occupational asthma). [3] A study of women farmers in mixed cropping systems found that the vast majority suffered from intense muscular fatigue, heat exhaustion, and skin disorders, forcing them to take days off from attending to crops.[4] Poor health will result in a loss of days worked or in reduced worker capacity, which, when family and hired labour are not perfect substitutes or when there are liquidity constraints, is likely to reduce output.[5] For example, prolonged exposure to pesticides could cause cardiopulmonary problems, neurological and hematological symptoms, and adverse dermal effects, which could significantly hamper farmers’ work capacity in the field and reduce their management and supervision abilities.[6] As pointed by the World Bank (2007), illness and death from HIV/AIDS, malaria, tuberculosis and other diseases reduce agricultural productivity through the loss of labour, knowledge of productive adults and assets to cope with illness. [7] Morbidity has been defined by World Health Organization (WHO) as any departure, subjective or objective, from a state of physiological well being. The term is used equivalent to such terms as sickness, illness, disability etc. The WHO Expert Committee on Health Statistics noted in its sixth report that morbidity could be measured in terms of three units that is persons who were ill, illness (period or spell of illness) that these persons experienced and duration (days, weeks etc) of these illnesses. [8] The lack of coordination of policy making between agriculture and health undermines efforts to overcome ill health among the rural poor and gives short shrift to agriculture’s role in alleviating many of the world’s most serious health problems. [9] .
AIMS AND OBJECTIVES
To assess the morbidity pattern of agricultural workers residing in rural field practice area of Medical College in South India
MATERIALS AND METHODS
Study design, period and area This community based cross-sectional study was conducted from January 2009 to December 2009 in the rural field practice area of Primary Health Center (PHC) attached to Medical College in South India. The PHC has five sub-centers catering 18 villages having total population of 31,510. One sub-centre was selected among the five sub-centres using sample random sampling technique. Sample size and technique Since no previous studies had been recorded on agricultural workers morbidity in this area, the prevalence was considered to be 50% and the sample size was calculated as 400. All agricultural workers residing in six villages coming under selected sub-centre were listed. By four digit random number table method, 400 participants were selected. Selection criteria Agricultural workers residing in the study area for at least one year preceding the date of survey aged between 16 years to 60 years were included in the study. Recent migrants, pregnant and lactating women working as agricultural workers were excluded from the study. Procedure The study was approved from Institutional Ethics Committee of the Medical College. The study participants were interviewed in their households/fields. Based on the selection criteria, the study participants were selected and written informed consent was obtained from all the participants. The data was collected using predesigned and pretested proforma. Data regarding demographic variable like place of residence, age, sex, education status, marital status, socio-economic status and type of family were recorded. The personal history was taken for diet, sleep pattern, appetite and personal habits. Study variables Self reported illness symptoms experienced by the subjects (one month preceding the survey) were enquired and noted. History of trauma, animal bite, allergy, zoonotic diseases, and poison consumption one month preceding the survey were enquired and noted. A thorough general physical examination and systemic examination was conducted by the investigator to know the morbidities. Two more subsequent visits were made to collect data from those who were absent during first visit. Statistical analysis The data was tabulated using MS Excel sheet and analysis was done using percentages, rates and ratios. Chi square test was used to find the association between attributes.
RESULTS
Among the study participants 55.75% were males and 44.25% were females with male to female ratio of 1.25:1. Equal distribution (39%) was seen in the age group of 30 to 45 years and 45 to 60 years. There were 87 (21.75%) people with age between 15 to 30 years. Majority of the people were (89.5%) Hindus and 10.5% were to Muslims. The other demographic features are as shown in Table 1. Morbidity Pattern The general physical examination revealed majority (31%) had pallor, followed by fever (10.75%), skin abnormalities (4.5%), icterus (0.5%) and kyphosis (0.25%). The tachycardia and tachypnoea were noted in 20.25% and 9.75% respectively. The blood pressure measurement findings showed 17.25% of subjects had hypertension. Provisional diagnosis among the study participants showed, majority (62%) suffered from morbidity associated with oral cavity like dental caries (25.50%), dental stains (21.75%), dental calculus (11.50%) and oral submucous fibrosis (3.75%). The other morbidities seen were as mentioned in Table 2. Among the top ten morbidities, majority (62.5%) of the study participants had morbidities associated with oral cavity followed by musculoskeletal system (21.75%) and respiratory system (19%) (Graph 1). The present study showed significant association between morbidities of oral cavity, musculoskeletal system, respiratory system, cardiovascular system, eyes, central nervous system, anaemia and endocrine system with increasing age (Table 3). Also significant association was found between morbidities of oral cavity, musculoskeletal system, respiratory system, cardiovascular system, eye, gastrointestinal system, skin and animal bites with educational status (Table 4). However no significant association was found between socioeconomic status with morbidity pattern.
DISCUSSION
India, a land of agriculture, has formed the scaffolding for many agro-based industries. Morbidity is more common among these industrial workers; being a developing nation, India is faced with traditional public health problems like communicable diseases, malnutrition, poor environmental sanitation and inadequate medical care.[10] However, globalization and rapid industrial growth in the last few years has resulted in emergence of occupational health related issues. Agriculture is the main occupation in India giving employment to about 58% of the people. This is in contrast to the industrialized nations, like USA and Western Europe, where the employment in the agricultural sector is between 4 - 12%. [11]
Agriculture being the principle occupation in the country exposes a considerable proportion of population to this occupational related hazard. The major occupational diseases/morbidity of concern in India are silicosis, musculo-skeletal injuries, coal workers’ pneumoconiosis, chronic obstructive lung diseases, asbestosis, byssinosis, pesticide poisoning and noise induced hearing loss. [11] India is a developing nation and presents the demographic features similar to the other developing nations of the world. Emerging occupational health problems are to be tackled along with the existing traditional public health problems like communicable diseases, malnutrition, poor environmental sanitation and inadequate medical care. [11] Hence the present study was undertaken to assess the morbidity pattern of agricultural workers. In the present study among the study participants majority (62%) suffered form morbidity associated with oral cavity like dental caries (25.50%), dental stains (21.75%), dental calculus (11.50%) and oral sub-mucous fibrosis (3.75%), followed by musculoskeletal system (21.75%) and respiratory system (19%). The statistics for the over [11] A study estimated an annual incidence of occupational disease between 924,700 and 1,902,300 and 121,000 deaths in India. [12] Based on the survey of agriculture injury incidence study in Northern India, they estimated annual incidence of 17 million injuries per year, (two million moderate to serious) and 53,000 deaths per year in agriculture alone. [13] A study in 2006 showed that women farmers in mixed cropping systems found that the vast majority suffered from intense muscular fatigue heat exhaustion and skin disorders .[4] According to ILO, the agricultural sector is one of most hazardous health world wide. Agricultural work possesses several characteristics that are risky for health; exposure to wealth, close contact with animals and plant, extensive use of chemicals and biological products, difficult working posture and lengthy house and use of hazardous agricultural tools and machinery. [14] In the present study significant association was found between morbidities of oral cavity like dental caries, dental stain, dental calculus, Oral submucous fibrosis, musculoskeletal system, morbidity like osteoarthritis, sciatica, spondylosis, respiratory system, morbidities like upper respiratory tract infection, lower respiratory tract infection, hypertension, eye morbidities, stroke, anaemia, diabetes mellitus with increasing age. Also morbidities of oral cavity, musculoskeletal system, respiratory system, cardiovascular system, eyes, gastrointestinal system, skin trauma and animal bites were significantly associated with educational status of study participants. However, this study finding were limited to the self reported symptoms and signs elicited only and laboratory investigations could not be done in all cases due to time restraint.
CONCLUSION AND RECOMMENDATIONS
Agricultural workers had a multitude of health problems associated with oral cavity, musculoskeletal and respiratory system. Creating awareness about benefits of toilets and harms of open air defecation may help to reduce the morbidities to a greater extent. Further strengthening the information, education and communication (IEC) activities and special health check-up camps with emphasis on improvement of health and awareness could help to combat the situation. CONFLICT OF INTEREST: None
ACKNOWLEDGEMENTS
Dr. V. D. Patil, Principal Jawaharlal Nehru Medical College, Belgaum for the permission to conduct this study; Staff of Primary Health Centre, Vantmuri and Sub centre of Bhutaramanahatti, Belgaum and all study subjects who participated in the study for their cooperation in data collection.
Englishhttp://ijcrr.com/abstract.php?article_id=1513http://ijcrr.com/article_html.php?did=15131. Ulimwengu J. Farmers’ health and agricultural productivity in rural Ethiopia. AFJARE 2009; 3(2): 83-100.
2. Lal S, Adarsh, Pankaj. Text book of Community Medicine – Preventive and Social Medicine. 2nd ed., New Delhi: CBS Publishers; 2009.
3. Park K. Park’s Textbook of Preventive and Social Medicine. 20th Ed., Jabalpur, India: Banarasidas Bhanot; 2009.
4. Cole D. Understanding the Links between Agriculture and Health for Food, Agriculture, and the Environment. Washington, DC; International Food Policy Research Institute (IFPRI): 2006.
5. Antle JM, Pingali PL. Pesticides, productivity, and farmer health: A Philippine case study. American J of Agricultural Economics 1994; 76(3): 418–30.
6. Spear R. Handbook of Pesticide Toxicology: General Principles. New York: Academic Press; 1991.
7. World Bank. World Development Report: Agriculture for development. Washington, DC: The World Bank; 2007.
8. WHO Expert Committee on Health Statistics. Sixth Report. WHO Technical Report Series, No. 164. Geneva: World Health Organization: 1959.
9. Lipton M, De Kadt E. Agriculture: Health linkages. Geneva: World Health Organization; 1988.
10. Prakash S, Manjunatha S, Shashikala C. Morbidity patterns among rice mill workers: A cross sectional study. Ind J Occup Environ Med 2010; 14(3): 91-3.
11. Saiyed HN, Tiwari RR. Occupational Health Research in India. Industrial Health 2004; 42: 141–8.
12. Leigh J, Macaskill P, Kuosma E, Mandryk J. Global burden of disease and injuries due to occupational factors. Epidemiol 1999; 10: 626-31.
13. Mohan D, Patel R. Design of safer agricultural equipment: Application of ergonomics and epidemiology. Int J Ind Ergonomics 1992; 10: 301-9.
14. Duggal R, Amin S. Cost of health care: A household level survey in an Indian district. Bombay: Foundation for Research in Community Health; 1989.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareHOMOCYSTEINE LEVELS AND ROLE OF OXIDATIVE STRESS IN PRIMARY OPEN ANGLE GLAUCOMA
English5258Sri Hari AttiEnglish A. SaseekalaEnglish Varun Siri A.EnglishObjective: Primary open angle glaucoma is the most commonest form of glaucoma which leads to vision loss if untreated. It has been hypothesized that oxidative damage may be involved in the pathogenesis of glaucoma and homocysteine may also have a role in development of glaucoma. The aim of our present study is to evaluate the role of oxidative stress and Homocysteine in Primary open angle glaucoma patients. Methods: We tried to assess Serum Homocysteine levels and the role of oxidative stress in patients by estimating the levels of lipid peroxidation assessing plasma Malondialdehyde (MDA) levels and antioxidant status by reduced glutathione (GSH), Vitamin-E ,Vitamin-C in blood. For this, we have taken 50 cases of primary open angle glaucoma patients compared with 75 age matched controls . Results: There were significant increase in the levels of MDA and significant decreases in the levels of antioxidants like GSH whereas there are significant increases in the levels of vitamin-E and Vitamin-C in breast cancer patients when compared with controls. No statistical significant difference was observed with Serum Homocysteine levels in cases when compared with controls. Conclusion: Our results indicate that oxidative stress is associated with the development of Primary open angle glaucoma which needs further studies.
EnglishOxidative stress, Malondialdehyde, Reduced glutathione (GSH) ,Vitamin-C, Vitamin-E and HomocysteineINTRODUCTION
Glaucoma is an eye disease in which the optic nerve is damaged in a characteristic pattern leading to permanently damaged vision in the affected eyes and blindness if left untreated. Glaucoma is the second leading cause of vision loss in the world affecting approximately 70 million people worldwide.(1) .Primary open angle glaucoma affects 1 to 2 percent of the population over the age of 40(2) which is the most common form of glaucoma. Elevated intraocular pressure due to reduction in aqueous outflow facility is the most significant risk factor. High intra ocular pressure usually occurs as a result of an increase in aqueous humor outflow resistance in trabecular meshwork. Recent evidences indicate that vascular risk factors may also play a role. Impaired microcirculation and abnormal perfusion may cause glaucomatous damage in the optic nerve head. Anatomical or functional abnormalities of the vessels of the optic nerve head such as arteriosclerosis or vascular dysregulation might be the causative factor(3,4). Homocysteine is an intermediary aminoacid formed during the conversion of methionine to cysteine. Elevated total plasma level of aminoacid Homocysteine has been identified as an independent risk factor of arteriosclerosis involving coronary, cerebral ,and peripheral arteries. High levels of Homocysteine causes lipid peroxidation, vascular endothelial injury, impaired vasomotor regulation, pro thrombotic surface, and therefore atherothrombogenesis.(5) Hyperhomocysteinemia is suggested to be an independent risk factor for premature vascular disease(6),myocardial infarction(7), and stroke(8).Furthermore, raised Homocysteine levels have recently been suggested as a risk factor for non-arteritic anterior ischemic optic neuropathy(9) and retinal vascular occlusive disease with thromboembolism.(10). Recently, higher levels of plasma Homocysteine in primary open angle glaucoma(11), pseudo exfoliation syndrome and glaucoma patients(12,13) were reported. The trabecular meshwork of patients with primary open angle glaucoma is characterized by specific morphologic and biochemical changes such as loss of trabecular meshwork cells, accumulation of extra cellular matrix ,and accelerated senescence.(14).It is assumed that these changes lead to an increased outflow resistance and thus to elevated intraocular pressure. The reasons for these changes are not clear. Various factors may play an elementary role in the pathologic course of the disease, such as genetic factors, increased levels of glutamate, changes in nitric oxide metabolism, and vascular changes. One factor which is increasingly important in the pathogenesis of primary open angle glaucoma is oxidative stress.(15). Oxidative stress represents a harmful state defined by the presence of pathologic levels of reactive oxygen species relative to antioxidant defense. Reactive oxygen species are molecules that oxidize more strongly than oxygen (o2) itself, or molecules containing oxygen that generate free radicals.ROS include superoxide, hydrogen peroxide and hydroxyl radical, which is the strongest oxidant produced in biological systems. Other reactive species, reactive nitrogen species include nitric oxide and peroxynitrite, a product resulting from the reaction between ROS and nitric oxide. Free radicals can be generated in an exaggerated manner and can injure tissues and organs by interacting with lipids, proteins or DNA(16).To survive, the human body has developed a complex, efficient and highly adaptive antioxidant defense system that includes two categories of antioxidants enzymatic such as glutathione peroxidase, glutathione reductase, superoxide dismutase, catalase and non enzymatic such as reduced glutathione, antioxidant vitamins and low molecular weight compounds such as urate. The eye is also protected against oxidative stress by several mechanisms involving antioxidant enzymes such as GSH and ascorbate.(17). Altered GSH and GSH activity has been reported in the trabecular meshwork and aqueous humor of patients with glaucoma.(18).
MATERIALS AND METHODS
The present study was conducted in department of ophthalmology and the department of Biochemistry , S.V.Medical college ,Tirupati. A total of 50 cases of primary open angle glaucoma patients belonging to the age group of 30-50 years were selected for this study. Age and sex matched 75 normal patients without glaucoma were selected as controls. Informed consent from all cases and controls were obtained. Ethical clearance was obtained for this study A detailed medical history was obtained to identify those with known or suspected diabetes mellitus, systemic hypertension, peripheral or coronary artery disease, venous thrombotic events, or cerebrovascular disease, and current drug therapy. Exclusion criteria included diabetes mellitus, systemic hypertension, peripheral or coronary artery disease, cerebrovascular disease ,major systemic illness, evidence of vasculitis, renal or hepatic disease, gastrointestinal malabsorption, cardiomyopathy, psychiatric illness, chronic alcohol abuse, smoking, anticonvulsant and immunosuppressive therapy, postmenopausal hormone replacement, current use of cholesterol lowering drugs, antidepressants, antimicrobial therapy and vitamin supplements. All subjects underwent a complete ophthalmic examination including visual acuity, slit lamp examination, intraocular pressure measurement using Goldmannn applanation tonometry, gonioscopy, and dilated fundoscopic examination and systemic examination. Inclusion criteria were as follows: Primary open angle glaucoma was defined by the presence of an open angle on gonioscopy, IOP≥22mm of Hg measured with a Goldman Applanation Tonometer, typical glaucomatous cupping and visual field defect in at least one eye on standard automated perimetry. Control subjects had no history of elevated IOP higher than 22 mm of Hg, no exfoliative material on the anterior lens capsule, normal visual fields and optic discs. 10ml of fasting blood samples were collected by venipuncture and for the separation of sera, 5ml of blood was centrifuged at 3000rpm for 5min and the remaining 5ml of blood was taken into a plain vial containing EDTA and was centrifuged at 3000rpm for 10min for the separation of plasma. The plasma MDA levels were estimated by using thiobarbituric acid reacting substances(TBARS) by the method of Yagi(19) and Sinnhuber et al(20).Reduced glutathione was determined by the method of Beutler et al(21). Serum Vit-E was measured by the method of Baker on the basis of reduction of ferric ions to ferrous ions by Vit-E and the formation of red colored complex with 2-2` dipyridyl at 520nm(22,23).The activity of Ascorbic acid was determined by the method of Tietz(24). Serum total homocysteine levels were determined by enzyme linked immunosorbent assay(ELISA) kit .All the results were expressed as mean ± SD and statistical comparisons were done using student t-test using the SPSS package.
Evaluation of oxidative stress is done based on the levels of MDA and statistically significant increase in the level of MDA was observed in open angle glaucoma patients when compared to controls. Statistically significant decreases were observed in the levels of enzymatic antioxidants like GSH and statistically significant increases in the levels of nonenzymatic antioxidants vitamin-E,C in cases when compared to controls. There was no statistical significant difference in the levels of serum homocysteine in cases when compared with controls. DISCUSSION Glaucoma, being a non systemic disease, is the most frequent etiology of irreversible blindness worldwide is an ocular pathology. Studies related to its effects on serum oxidative stress markers are quite limited in the existing literature. In this study, the role of homocysteine and the effects of oxidative stress and antioxidant status in glaucoma were studied. Glaucoma is an optic neuropathy, and oxidative stress plays an important role in its etiopathogenesis. In our study, a statistically significant relationship was found between the presence of primary open angle glaucoma and plasma MDA levels. The plasma MDA level, a byproduct of lipid peroxidation, is a reliable and commonly used biomarker of overall lipid peroxidation. As there are high aqueous concentrations of hydrogen peroxide and photochemical reactions in the anterior segment arising from aerobic metabolisms, the trabecular meshwork is exposed to high levels of oxidative stress.(25) Aqueous humor is known to contain several active oxidative agents such as hydrogen peroxide and superoxide anion(26).It has been suggested that chronic oxidative stress induced by such agents can compromise trabecular meshwork functions (27) and subsequently play a role in the pathogenesis of primary open angle glaucoma. Our finding of increased plasma MDA levels in primary open angle glaucoma patients is not only consistent with the role of oxidative stress in glaucoma but also supports the idea that plasma MDA levels may be used as a marker of oxidative stress on a group basis. We also observed significant decrease in the levels of reduced glutathione in cases when compared to controls. Circulating GSH can be depleted either by subjecting cells to oxidative stress, or by inhibition of synthesis. In patients with glaucoma , due to a high level of oxidative stress,(28) GSH could be overused implying a reduction of protection against ROS, possibly due to a defective redox cycle. Another possible explanation for reduced GSH levels may be due to defective intracellular synthesis. The liver is the major site for GSH synthesis. The precursors necessary for this synthesis are Lglutamate, L-cysteine and L-glycine. Although both glutamate and glycine are important, it seems that the major determinant of the rate of GSH synthesis is the availability of the amino acid cysteine.(29).Cysteine results from the metabolism of homocysteine and any interruption in the homocysteine-cysteine pathway would result not only in the accumulation of homocysteine but also in less available quantities from the second amino acid which may affect GSH synthesis. There is a significant increase in the levels of vitamin-E in cases when compared to controls. Vitamin-E acts as antioxidant and many in vivo and in vitro studies performed in normal and neoplastic cells have demonstrated that α –tocopherol had special effects, including gene regulation(30).This phenomenon also applies to ocular tissues.(31). It also has been established that vitamin-E derivatives act as neurohormones, and initiate various intracellular conduction pathways with a lock and key model. Retinal blood flow regulating and neuroprotective effects of vitamin-E in glaucoma patients have been clinically demonstrated.(32). Moreover, vitamin-E is recognized for prolonging life span in retinal cell cultures(33).Taking all the above factors into consideration, the elevation of vitamin-E in glaucoma indicates the exaggerated response of antioxidants to oxidative stress in glaucoma. There is also a increase in the levels of non-enzymatic anti-oxidants such as Vit-C, which states that there is an increased defense mechanism against oxidative damage in breast cancer. The increase in the levels of these non-enzymatic antioxidant parameters may be due to an increased turnover for preventing oxidative damage in these patients, thus suggesting an increased defense against oxidative damage. Our results support the researchers who showed over expression of antioxidants(34).Several other researchers reported decreases in the antioxidant level and increases in lipid peroxidation level(35). No statistical difference was observed in the levels of homocysteine levels in cases when compared with controls. Some studies have reported elevated serum homocysteine level in primary open angle glaucoma patients and suggested that thermo labile methylene tetrahydrofolate reductase deficiency may be in part the cause of the increased serum homocysteine level in patients with primary open angle glaucoma.(36).Our findings supports the study of researchers who observed no difference in homocysteine levels.(37). In conclusion, the present study revealed an increase in the levels of MDA, vitamin-E,C and decrease in the levels of reduced glutathione with no alterations in the levels of serum homocysteine in cases compared to controls suggesting the role of oxidative stress as a pathogenic mechanism in the development of glaucoma and further extensive studies are required in future to establish oxidative stress as a biomarker in the development of primary open angle glaucoma.
ACKNOWLEDGEMENTS
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1514http://ijcrr.com/article_html.php?did=15141. Quigley HA.Number of people with glaucoma world-wide.Brit J Ophthalmol 1996;80:389-393.
2. Leske MC. The epidemiology of open angle glaucoma: a review. Am J Epidemiol 1983; 118:166-91.
3. Flammer J,Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM et al. the impact of ocular blood flow in glaucoma. Prog Retin Eye Res 2002,21:359-393.
4. Hayreh SS: Blood flow in the optic nerve head and factors that may influence it.Prog Retin Eye Res 2001,20:595-624.
5. Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet 1999; 354:407- 13.
6. Clarke R,Daly L, Robinson K, Naughten E et al. Hyperhomocysteinemia:an independent risk factor for vascular disease.N Engl J Med 1991;324:1149-1155.
7. Stampfer MJ, Malinow MR, Willett WC,Newcomer LM et al.A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians.JAMA 1992;268:877-881.
8. Perry IJ, Refsum H, Morris RW et al.Prospective study of serum total homocysteine concentration and risk of stroke in middle -aged British men.Lancet 1995;346:1395-1398.
9. Kawasaki A,Purvin VA,Burgett RA.Hyperhomocysteinemia in young patients with non-arteritic anterior ischemic optic neuropathy. Br J Ophthalmol 1999; 83:1287-90.
10. Cahill M,Karabatzaki M, Meleady R,et al.Raised plasma homocysteine as a risk factor for retinal vascular occlusive disease.Br J Ophthalmol 2000;84:154-7.
11. Bleich S,Junemann A,Von Ahsen N,Lausen B,Ritter k et al.Homocysteine and risk of open angle. J Neural Transm 2002; 109:1499-1504.
12. Leibovitch I, Kurtz S,Shemesh G et al. Hyperhomocysteinemia in pseudo exfoliation glaucoma.J Glaucoma 2003;12:36-39.
13. Vessani RM,Ritch R,Liebmann JM, Jofe M.Plasma homocysteine is elevated in patients with exfoliation syndrome. Am J Ophthalmol 2003;136:41-46.
14. Liton PB, Challa P,Stinnett S, Luna C et al.Cellular senescence in the glaucomatous outflow pathway.Exp Gerontol. 2005; 40:745-748.
15. Izzotti A, Bagnis A, Sacca SC. The role of oxidative stress in glaucoma.Mutat Res.2006;612:105-114.
16. Valencia E, Hardy G, Marin A. Glutathione: nutritional and pharmacologic viewports:Part VI.Nutrition.2002;18:291- 292.
17. Richer SP,Rose RC.Water soluble antioxidants in mammalian aqueous humor:interaction with UV and hydrogen peroxide.Vision Res.1998;38:2881-2888.
18. Izzotti A,Sacca SC,Cartiglia C,De Flora S. Oxidative deoxyribonucleic acid damage in the eyes of glaucoma patients.Am J Med.2003;114:638-646.
19. Yagi K. Lipid peroxides and human diseases. Chem Phys Lipids, 1978; 45: 337- 351.
20. Sinnhuber RO, Yu TC. Characterization of red pigment formed in thiobarbituric acid determination of oxidative rancidity. Food Res, 1958; 23: 626-630.
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25. Stephen B, Koh H, Phil M, Henson D.Boulton M. The role of oxidative stress in the pathogenesis of age related macular degeneration.Surv Ophthalmol 2000;45:115-134.
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28. Ferreira SM,Lerner SF,Brunzini R,Evelson PA,Llesuy SF. Oxidative stress markers in aqueous humor of glaucoma patients. Am J Ophthalmol.2004;137:62-69.
29. Lu SC.Regulation of hepatic glutathione synthesis:current concepts and controversies.Faseb J.1999;13:1169-1183.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareACTIVITIES OF SOME ANTIOXIDANT ENZYMES AND LIPID PEROXIDATION IN LIVER CANCER PATIENTS
English5963Jain SumanEnglish Sharma RenuEnglish Sharma SumanEnglish Varadkar A.M. Department of Biochemistry and PhysiologyEnglish Geetanjali Medical College and HospitalEnglishIntroduction: Liver cancer is the leading cause of death due to malignancies worldwide. The extent of free radical induced oxidative stress can be exacerbated by the decreased efficiency of antioxidant mechanisms, The present study was conducted to investigate the extent of oxidative stress and the levels of antioxidants in the circulation of liver cancer patients. Method: Plasma thiobarbituric acid reactive substances (TBARS) and level of some antioxidant enzymes such as superoxide dismutase (SOD), catalase, and non enzymatic antioxidants vitaminC and vitamin E were estimated in the circulations of 50 liver cancer patients and an equal number of age matched normal subjects. Results: Significantly increased concentrations of plasma TBARS, significantly lowered levels of SOD, CAT, VitC and VitE were observed in liver cancer patients and may be due to their increased utilization to scavenge lipids peroxides as well as their sequestration by tumor cells. Increase levels of lipid peroxidation may be due to excessive oxidative stress.
EnglishAntioxidants, Peroxidative stress, Malondialdehyde (MDA), Superoxide Dismutase (SOD), catalase, vitaminC, vitaminEINTRODUCTION
Globally, primary liver cancer ranked seventh in men in 1975 and by 1990 it reached the fifth position with a 73% increase in the burden. (1) According to WHO more than 6,22,000 people across the world die because of the fatal disease. The disease is very much related to Hepatitis B and C virus. The exposure of these viruses is the primary reason of this disease, but smoking and liquor is also among the main reasons of liver cancer. (2) Role of oxidative damage in carcinogenesis is increasingly being appreciated. Free radicals are species capable of independent existence containing one or more unpaired electrons in their outer most orbital. Majority of tumors are caused by environmental factors which act almost always via free radicals. They are involved in both initiation and promotion of multistage carcinogenesis by damaging DNA, resulting in mutation protooncogene activation, inactivation or loss of tumor suppressor gene. (3) Oxidative stress plays important role in the pathogenesis of toxic liver diseases and also of some kinds of hepatic alterations (4) An antioxidant is the substance which delays or prevents oxidation of a substrates and constitutes the body’s primary defense against free radicals injury. Reducing the oxidative stress by supplementation of antioxidant could be effective option of chemoprevention and was suggested. (3) Oxidative stress caused by increased free radical generation and or decreased antioxidant level in the target cells and tissues has been suggested to play a important role in carcinogenesis. (5,6,7)
The levels of free radicals molecules are controlled by various cellular defense mechanisms consisting of enzymes Catalase (CAT), Superoxide Dismutase (SOD), Glutathione peroxidase and non enzymatic vitamin C and vitamin E glutathione components.(8) The present study is aimed to determine the extent of oxidative stress by measuring TBARS and antioxidant parameters in plasma of the patients with liver cancer. MATERIAL AND METHODS The study was conducted in R.N.T. Medical College and associated M.B. Hospital. Healthy subjects (50) & 50 liver cancer patients (outdoor & inward) were selected for this study. Patient Detailed present and past history of subjects was recorded on a separate proforma regarding their general information i.e. Age, sex, height, weight, caste, religion, dietary habits and education. The normal subjects were healthy medical students, staff members and attendant of patients, donors of blood bank of Maharana Bhupal Hospital/RNT Medical College Udaipur. Biochemical Estimations Lipid peroxide was estimated by measurement of thiobarbituric acid reactive substances (TBARS) in plasma by method of Yagi. (9) The lipid peroxidation was estimated at 532nm. Superoxide dismutase (SOD) was assayed by the method of Kakkar et al (10) based on the 50% inhibition of the formation of NADH-phenazine methosulphate nitroblue tetrazolium formazan at 520nm. Catalase activity was assayed by the method of Sinha(11) Hemolysate was treated with H2O2 (0.2mol/L) and the reaction was arrested after 60 sec by the addition of dichromate – acetic acid reagent cooled and the intensity of color read at 620nm. Various aliquots of H2O2 were used as the standard. A system devoid of the enzyme served as the control. Plasma vitamin C (ascorbic acid) was estimated by the method of Roe and Kuether (12) in which dehydroascorbic acid is coupled with 2, 4- dinitrophenylhydrazine and when treated with sulphuric acid forms an orange colour compound which was measured at 520nm. Plasma vitamin E(α-tocopherol ) was estimated by the method of Baker and Frank (13) The method involves the reduction of ferric ions to ferrous ions by α-tocopherol and the formation of a colored complex with 2, 2-dipyridyl. Absorbance of the chromophore was measured at 520nm. The data for biochemical analysis are expressed as mean, Standared Deviation. Statistical comparisons were performed by student’s‘t’ test. RESULTS Table 1 shows the level of lipid peroxidation in plasma of normal and liver cancer patients. Lipid peroxidation as assayed by thiobarbuturicacid reactive substances (TBARS) level was significantly higher in liver cancer patients as compared with normal subjects. Table 2 shows the level of antioxidants in the circulation of normal and liver cancer patients. The enzymatic antioxidants such as Superoxide dismutase (SOD) and Catalase in the hemolysate were significantly lower in liver cancer patients as compared with normal subjects. Also the nonenzymatic antioxidants vitamin C and vitamin E in plasma were significantly lower in liver cancer patients Vs control.
DISCUSSION
Oxidative stress is due to a disturbance in the balance between the production of ROS and the efficiency of the antioxidant defense. (14) Potential targets for free radical attack includes lipids, proteins and nucleic acids. (15) The epoxides generated due to increased oxidative stress may spontaneously react with nucleophilic centres in the cell and thereby covalently bind to DNA and RNA and protein. Such reactions may lead to cytotoxicity and carcinogenicity depending on the properties of the epoxides. (16) Moreover, severe oxidative stress is not only known to cause DNA and mutations in tumor suppressor genes but play important role in the promotion of multistep carcinogenesis. (17, 18) The end product of lipid peroxidation malondialdehyde, due to its high cytotoxicity and inhibitory action on protective enzymes is suggested to act as a tumor promoter and a cocarcinogenic agent. (19) Increased lipid peroxidation is observed in the plasma of cervical cancer patients also. (20) In our present work we noticed increased levels of circulating TBARS in liver cancer patients which can be attributed to the deficiency of antioxidant defense mechanisms. The antioxidant enzymes SOD and CAT widely distributed in all cells are present in high amounts in erythrocytes. SOD protects against O2 - by dismutation of the highly reactive superoxide anion to O2 and to a less reactive species to H2O2 . (21) Catalase protects the cell from H2O2. (22) In our case, we have observed low levels of SOD and Catalase in liver cancer patients. This correlates with the increase peroxidation activity. A decrease in the activity of catalase and SOD could be due to increase in lipid peroxidation products Malondialdehyde (MDA) which forms cross links inactivating several membrane bound enzymes and increase in lipid peroxides could be responsible for decreased SOD levels. Decreases catalase could be due to use of the enzyme because of increased peroxidation. Antioxidant vitamin E present in the cell along cell membrane. (23) and vitamin C is radical scavenging antioxidant (24) present in all cells as a reducing agent. A lipid peroxidation and its positive correlation with antioxidant vitamin E and vitamin C has been documented (25). Many studies regarding ovarian and other cancers also show inverse relationship between circulating levels of vitamin C and vitamin E. (26,27) )Due to low economic status and trends of using less fruits and vegetables people here are malnourished and thus prone to malignancy and thus associated with cancers (28) and also in liver cancer. (29)
CONCLUSION
Comparative prospective study was undertaken between healthy and liver cancer subjects with respect to lipid peroxidation and antioxidant level. MDA (malondialdehyde) levels (2.47±0.68) in healthy and patients had 3.93± 0.68 were significantly higher than controls. SOD (superoxide dismutase) levels were significantly lowered in patients as compared to healthy controls. Catalase levels were lower in patients than healthy controls. Vitamin C and Vitamin E were significantly lower in patients than healthy controls.
AKNOWLEGEMENT
We sincerely thank R.N.T. Medical College and associated hospital, Udaipur for extending all the facilities for conducting the work. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1515http://ijcrr.com/article_html.php?did=15151. Perin N. Global variation in cancer incidence and mortality. Current science. 2001; l81: 465.
2. New hope for liver cancer patients. 6th June. 2007; Newstract India.
3. Khanna K, Nikunji N and Khanna H.D. A study of antioxidant and their preventive potential in cervical Dysplasia... Asian Journal of Obs and Gynae Practice. 2002; l6: 3-11.
4. Diplock AT. Antioxidant nutrient and disease prevention: An overview. Am. J. Cli. Nutr1991; 53:189-193.
5. Halliwell B and J.M.C. Gutteridge. Free radicals in biology and medicines. 3rd ed. UK: Oxford Science Publications 1990; pp192.
6. Rajnesh C.P, Manimaran A, Sashikala KR, and Adaikappan P. Lipid peroxidation and Antioxidant status in patients with breast cancer. Singapore Med. J. 2008 49(8): 640- 643.
7. Lopaczynski, W and S.H. Zeisel. Antioxidants: Programmed cell death and Cancer Nutr. Res. 2001; 21:295-307.
8. Parol M, Leonardduzzi G, robino G, Albana E, Poli G, Dianzani M.. On the role of lipid peroxidation in the pathogenesis of liver damage induced by long- standing cholestasis.; Free radic Biol Med. 1996; 20 (3): 351-359.
9. Yagi K. Lipid peroxides and human diseases. Chem. Phys. Lipids. 1996; 45: 337- 351.
10. Kakkar P.S, Das B B and Viswanathan P N. A modified spectrophotometric assay of superoxidedismutase. Indian J. Biochem. Biophys.1984; 21:130-132.
11. Sinha K.A. Colorimetric assay of Catalase. Ann. Biochem.1984; 47:387-394.
12. Roe J.H. and Kuether C A. Detection of ascorbic acid in whole blood and urine through the 2, 4 DNPH derivatives of dehydro ascorbic acid. J. Biol. Chem.1943; 147:399-407.
13. Baker H, Frank O, De Angelis B and Feingod S. Plasma tocopherol in man at various times after ingesting free or acetylated tocopherol. Nutr. Rep. Int. 1980; 21: 531-536.
14. Kang D.H. Oxidative stress, DNA damage and breast cancer. AACN Clin.2002; Issues, 13: 540-549.
15. W.A. Cancer and free radicals. Basic Life Sci. 1986; 39: 45-59.
16. Tampo Y. and Tsukamoto M. The antioxidant action of 2-methyl- 6- (pmethoxyphenyl3, 7- dihydroimidazo [1,2- alpha]pyrazin-3-one (MCLA), a chemiluminescence probe to detect superoxide anions. FEBS Lett1998; 430: 348-352.
17. Ahmed M.I, Fayed ST, Hossein H and Tash FM, Lipid peroxidation and antioxidant status in human cervical carcinoma. Dis Markers 1999; 15: 283-291.
18. Halliwell, B. And Gutteridge M C , Free Radicals in Biology and Medicine. 3rd ed. London: Oxford 1999 pp: 152.
19. Diplock A, Rice-Evans AC, Burton RH, Is there a significant role for lipid peroxidation in the causation of malignancy and for antioxidants in cancer prevention? Cancer Res.1994; 54: 19525-19526.
20. Otamiri T. and Sjodahl R. Increased lipid peroxidation in malignant tissues of patients colorectal cancer. Cancer1989; 61: 122-125.
21. Manju V, Kalaivanisailaja J and Nalini N. Circulating lipid peroxidation and antioxidant status cervical cancer patients: a case-control study. Clin. Biochem. 2002; 35: 621-625.
22. Speranza M.J, Bagley AC and Lynch R E. Cells enriched for catalase are sensitised to toxicities of bleomycin, adriamycin and paraquat. J Biol. Chem.1993; 268: 19039- 19043.
23. McCord, J.M. The evolution of free radicals and oxidative stress. Am. J. Med 2000;108: 652–659.
24. Mates, J.M, Perez-Gomez C and De Castro I N. Antioxidant enzymes and human disease. Clin Biochem.1999; 32: 595-603.
25. Wagner B.A, Buettner G R, Burns P. Vitamin slows the rate of free radical mediated lipid in cells. Arch. Biochem. Biophys. 1996; 334: 261-267.
26. Fairfield K M, Hankinson S E, Rosner B A, Hunter D J, Colditz G A and Willett W C. Risk of ovarian carcinoma and consumption of vitamin A, C and E and specific carotenoids; a prospective analysis. Cancer 2001; 92: 2318-2326.
27. Bidoli E, Lavecchia C, Talamini R, et al., Micronutrients and ovarian cancer: a case – control study in Italy. Ann. Oncol 2001; 12: 1589-1593.
28. Aaron T.F, Sara H O, Laura M, Neal S and Susan H. Dietary antioxidant supplements, and risk of epithelial ovarian cancer. Nutr. Cancer 2002; 40: 92-98.
29. Eastwood, M.A. Interaction of dietary antioxidants in vivo: how fruits and vegetables prevent disease? QIM.1999; 92: 527-530.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareA STUDY OF STUDENTS PERCEPTION OF A COMMUNITY BASED CAMP APPROACH METHOD IN PREVENTIVE AND SOCIAL MEDICINE SUBJECT
English6467Vardhan V.V.English Raghavia M.English Rajini S.EnglishObjective: To study students perception towards the community based camp approach method in the subject of Preventive and Social Medicine. Methods: The study was carried out in Aaru Padai Veedu Medical College Pondicherry.53 medical students from Second year MBBS course were surveyed using a five point Likert scale.Data was analysed using the software package SPSS 12.0 and Epi info. Results and Conclusions: Overall, the students had positive attitude and response towards this learning method.Community based camp approach is an active learning method which gives a better understanding of the subject and improves their communication skills.
Englishperception,community based,learning,Preventive and Social medicineINTRODUCTION
The way Medicine is taught and learnt has undergone tremendous changes over the past few decades. Pedagogy or textbook based teaching or teacher-centred learning is gradually being replaced by student-centred learning. The active learning methods used can be helpful in understanding the subject better and be more interesting for the student. Community based camp approach is an effective method of active learning as it involves integration of social sciences with medical domain, task oriented assignments, active community involvement.1 Garg et al2 and Narayanan3 have shown the positive results with community based teachings in Mahatma Gandhi Institute of Social Sciences. Research on effects of various community based teaching methods are many but, research on students perception about the community based camp approach are very few.1 The objective of the present study was to learn about the students perception towards the community based camp approach method used in Community Medicine subject at the Vinayaka Missions, Aaru Padai Veedu Medical College and Hospital (AVMCH), Pondicherry.
MATERIALS AND METHODS
Aaru Padai Veedu Medical College and Hospital (AVMCH), Vinayaka Missions University (VMU) Pondicherry, India has undergraduate student strength of 100 students per year. Medical students begin their clinical posting in Community medicine during their third Semester. Students are divided into batches of 30 students each and the duration of their practical clinical posting in Community Medicine subject is two months.The present study was conducted in Community Medicine Departmentl.60 students from two batches posted from August 2011 to November 2011 over a period of 4 months were included in the present study. The study was approved by Ethical review board of the Institute and verbal informed consent was obtained from the participants at the beginning of the study. They were given a project on various public health related topics like personal hygiene, nutrition, immunisation, family planning and Communicable & Non communicable diseases .30 students were further divided into 5 groups of 6 students each. Each group of six students were guided by a faculty member, who acted as a facilitator for them. First week of the project included briefing sessions by the faculty on few theory topics, survey methodology, mapping in survey and preparing survey questionnaire .Second week of the project was given for data collection and preparing their own health education material i.e the posters on the topic alloted .Third week students visited Anganwadi center,Subcenter and Primary health Center to be familiar with the health care delivery system in India and also conducted health talks on the topics allotted with the help of IEC material prepared by them.In the fourth week, data compilation,analysis and presentation was done in the department in the presence of all faculty members.On the last day of the project, this study self-administered questionnaire based on 5 point likert scale4 and consisting of 15 items each, was distributed to all the 60 students.They were asked to respond to each item based on their experience during the project. They were given 15 minutes time to fill the questionnaire. Out of the 60 students participating in the survey questionnaire,only 53 were included for final analysis. Statistical Analysis:Data was analysed using software package SPSS 12.0 and consensus score was calculated using the Epi info package
RESULTS
The students’ response to the questionnaire is indicated in Table.1.The mean age of the participants was 19.08+/-0.80 Std deviation .About 33(62.3%) were females.Students were positive about all aspects of the project. The consensus ranged from a minimum of 25.3% to a maximum of 91 % for the 15 items questionnaire. The maximum consensus 91.0% was for ‘Participation in field surveys improved our understanding for survey technique’ followed by 89.4% for ‘Field visits to Families helped us to learn about their Socioeconomic status and environ mental factors related to the case’ for they had a direct interaction with the families in the community and also a better understanding of their living conditions.Also 83.4% consensus for it helped develop good communication skills and 81.2% consensus for Exposure visits to PHC ,Subcentre and Anganwadi were useful in understanding the health care delivery system in India There was a poor consensus 63.3% on’ Theory class on National health programs and Health care concepts contributed to our understanding’ and 68.9% on ‘Teaching methods used in the survey supported our learning’.This showed that theoretical knowledge imparted was less appreciated by the students.Similar study conducted by Dongre et.al5 revealed positive perception of the students with reference to the teaching method used.
CONCLUSION
Overall the students had positive responses with reference to the community based camp approach especially exposure visits,interaction with the families and developing good communication skills.Thus,the community based camp approach can be effective tool for active learning in public health and this model of learning can be replicated in all Medical Colleges.
ACKNOWLEDGEMENT
Authors are thankful to the Second year Medical students for their active participation.Authors are also thankful to the Social workers from Department of Community Medicine for their support and cooperation throughout the study.
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript.The authors are also grateful to authors /editors/publishers of all those articles,journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1516http://ijcrr.com/article_html.php?did=15161. Dongre AR, Deshmukh PR, Garg BS. Formative exploration of students’ perception about Community Medicine teaching at Mahatma Gandhi Institute of Medical Sciences, Sewagram, India. Online J Health Allied Scs.2008;7(3):2
2. Garg BS, Nayar S. Doctors for the rural poor. World Health Forum 1996;17:268-270.
3. Narayanan RP. Medical students leading social revolutions. The Clinical Teacher [online] March 2012[cited 2012 Sept 01];3(1). Available from URL: http://www.theclinicalteacher.com
4. 5-point vs. 6-point Likert Scales. [Internet] [cited 2012 March 08]; Available from: www.infosurv.com/images/Likert_Scale_Deb ate.pdf
5. Dongre AR, Deshmukh PR, Gupta SS, Garg BS. An Evaluation of ROME Camp: Forgotten Innovation in Medical Education. Education for Health [online] April 2010 [cited 2012 Aug 12];1:363. Available from URL: http://www.educationforhealth.net
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareEFFECT OF ULTRASOUND THERAPY WITH END RANGE MOBILIZATION OVER CRYOTHERAPY WITH CAPSULAR STRETCHING ON PAIN IN FROZEN SHOULDER - A COMPARATIVE STUDY
English6873Shahbaz Nawaz AnsariEnglish I. LourdhurajEnglish Shikhsha ShahEnglish Nikita PatelEnglishBackground: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness between the treatment modalities of Ultrasound therapy and End range mobilization over Cryotherapy and Stretching as a treatment program in alleviating pain of patients with frozen shoulder. Methods: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound therapy and End range mobilization of shoulder while subjects in Group II got Cryotherapy and Stretching of shoulder. Both the groups were treated for 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Statistical analysis was done considering pEnglishFrozen shoulder, ultrasound therapy, end range mobilization, cryotherapy, stretchingINTRODUCTION
Frozen shoulder clinically referred to as adhesive capsulitis has been described as a condition of “unknown etiology characterized by gradually progressive, painful restriction of all joint motion with spontaneous restoration of partial or complete motion over months to years”7 . Its clinical course is divided into stages of freezing, lasting from onset to between 10 and 36 weeks, characterized by severe pain and a gradual diminution of articular volume, frozen stage lasting between 4 and 12 months when pain decreases gradually but without appreciable improvement in motion and thawing stage which is marked by gradual return of motion and may last between 12 months to few years 10 . Ultrasound therapy (UST), one of the modalities used to treat frozen shoulder elevates tissue temperature to depths of more than 5 cm causing increased collagen tissue extensibility, pain threshold, and enzymatic activity. It also changes nerve conduction velocity, contractile activity of the skeletal muscle12. Cryotherapy is another important modality which controls pain by directly and rapidly modifying the sensation of pain and controlling the pain transmission with the activity of cutaneous thermal reception 3.
Frozen shoulder, an inflammatory condition where the movements are inhibited as a result of pain requires periodic mobilization and stretching. Mobilization techniques applied close to the articular surface in ventral, dorsal and inferior directions of the gleno-humeral joint are frequently used by physical therapists as an intervention for limited joint range of motion11 . Passive stretching is a therapeutic maneuver designed to lengthen pathologically shortened soft tissue by using an external force, applied either manually or mechanically for about 30 seconds and thereby facilitate increase in range of motion1 . Shoulder Pain and Disability Index (SPADI) is used to assess pain and routine functional skills of shoulder. A ten-point reduction in the score accurately distinguishes between people whose shoulder problems improve and those whose conditions remain stable and a ten-point gain distinguishes between people whose shoulder problems are unchanging and those whose problems are worsening 17 . Visual Analog Scale (VAS) provides a simple means of measuring subjective experience of pain and has been established as a valid and reliable tool in a range of clinic and research applications. VAS is one of the most frequently used measurement scale of pain in healthcare research and practice8 . There are various studies supporting the individual effects of ultrasound therapy, mobilization, Cryotherapy and capsular stretching in patients with frozen shoulder. However, combination of modalities has been less explored. This study attempts to find out the combined effect of Ultrasound therapy (UST) and End range mobilization (ERM) over cryotherapy and capsular stretching in reduction of pain in patients with frozen shoulder.
MATERIALS AND METHODS
All the participants in the study signed an informed consent form and the variable was recorded prior and after 4 weeks of intervention. Forty patients of either gender aged between 30 to 60 years and diagnosed to have frozen shoulder and a SPADI rating between 5 -6 since 2 months were randomized to two groups of 20 using block randomization after an initial screening for inclusion and exclusion criteria. Participants in group I underwent UST along with ERM and those in group II were given cryotherapy with capsular stretching as treatment strategies. Pain levels were estimated using a Visual Analogue Scale pre and post treatment and SPADI score was considered for inclusion. Participants known to have uncontrolled diabetes mellitus, orthopedic abnormalities around the shoulder and neuromuscular disorders were excluded.
PROCEDURE
Participants of group I were given pulsed ultrasound in sitting with a pulse ratio of 1:4 and an intensity of 1.5 W/cm2 for 10 minutes followed by end range mobilization (ERM) in loose pack position of the joint with participant in supine lying for a period of 20 minutes was given. The direction of mobilization was altered by varying the degree of rotation. Maitland mobilization grade 3–4 was administered for 2 minutes interspersed with a rest period of 30 seconds for 10-15 repetitions once a day, 6 days a week for 4 weeks 16 . Participants of group II were given cryotherapy using ice packs in the anterior, superior and posterior aspect of the shoulder for a period of 10 minutes followed by Capsular stretching and general stretching exercises of the shoulder for 20 minutes. This was administered once a day, 6 days a week for 4 weeks.
DATA ANALYSIS
Pre - post comparison between groups was done using Independent „t? test and that within the groups was analyzed using paired „t? test. The acquired „t? parameters are reported. The mean difference of pain in both groups was compared and the pattern of variation was observed. P value Englishhttp://ijcrr.com/abstract.php?article_id=1517http://ijcrr.com/article_html.php?did=15171. Available from http://www.physioroom.com/prevention/stre tching3.php downloaded on 23rd Feb, 2006.
2. Bulgen DY, Binder AI, Hazleman BL, Dutton J, Roberts S. Frozen shoulder: prospective clinical study with an evaluation of three treatment regimens. Ann Rheum Dis. 1984; 43:353–360.
3. Forster A, Palastanga N. Clayton?s Electrotherapy. Bailliere Tindall/W. B. Saunders. Eastbourne, 1999; 9th edition: pp: 199-208. ISBN 0-7020-1100-2
4. Grey RG. The natural history of “idiopathic” frozen shoulder. J Bone Joint Surg Br.1978; 60:564.
5. Kay NR. The clinical diagnosis and management of frozen shoulders. Practitioner.1981; 225:164 –172.
6. Lewit, K. (1977) Manuelle Medizin im Rahmen der medizinischen rehabilitation. 2. Auflage. Johann Ambrosius Barth Leipzig.
7. Lori B Siegal, Norman J Cohen, Eric P Gall. Adhesive capsulitis: A Sticky Issue; Am Fam Physician.1999; 59(7):1843-50.
8. McCormack HM, Horne DJ, Sheather S. Clinical applications of Visual Analogue Scales: A critical review; Psychol Med.1988; 18(4): 1007-19.
9. Mens JM, de Wolf AN. Wat is de meest adequate behandeling van een zogenaamde frozen shoulder? Respons.1991; 2(10):1–3.
10. Reeves B; The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975; 4(4): 193-196.
11. Rizk TE, Christopher RP, Pinals RS, Higgins AC, Frix R. Adhesive capsulitis: a new approach to its management. Arch Phys Med Rehabil. 1983; Jan; 64 (1): 29–33.
12. Robert A Donatelli, Micheal J and Wooden. Orthopedic Physical Therapy; 3rd ed, Churchill Livingstone publication. 2009; 153-158.
13. Robertson VJ, Baker KG. A review of therapeutic ultrasound - effectiveness studies, Physical Therapy. 2001; 81(7): 1339-50.
14. Rowe CR, Leffert RD. Idiopathic chronic adhesive capsulitis (“frozen shoulder”). In: Rowe CR, ed. The Shoulder. New York, Churchill Livingstone Inc. 1988; 155–163.
15. van der Korst JK. Periarthritis scapulohumeralis beschouwd vanuit de reumatologie. Nederlands Tijdschrift vor Fysiotherapi. 1980; 9:260 –263.
16. Vermeulen HM, Obermann WR, Burger BJ, Gea J Kok, Piet M Rozing, and Cornelia HM van den Ende. End-range mobilization techniques in adhesive capsulitis of the shoulder joint: a multiple-subject case report; Phys Ther 2000; 80:1240-1213.
17. Williams JW Jr, Holleman DR Jr, Simel DL. Measuring shoulder function with Shoulder Pain and Disability Index; J Rheumatol. 1995: 22(4): 727-32.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareA STUDY ON HISTOMORPHOLOGICAL FEATURES OF PERSISTENT ADULT HUMAN CADAVERIC THYMUS
English7476Raju SugavasiEnglish Indira Devi B.English Sujatha M.English Udaya Kumar P.English Kanchana Latha G.EnglishThe thymus is an encapsulated soft bilobed organ lies in the superior mediastinum and anterior part of the inferior mediastinum. Presence of Enlarged thymus in adult is not so common because thymus size and parenchyma gradually atrophies after puberty finally replaced by fibro fatty mass. Objectives: To Study the Histo morphology of the bilobed enlarged thymus in adult human cadaver. Materials and Methods: Collected persistent enlarged thymus in adult human cadaver then performed histological staining to study the parenchyma. Conclusion: we discussed morphological and histological facts about the present study. This study is clinically important for radiologists to make a differential diagnosis in case of a mediastinal mass.
EnglishCortex, Hassall’s Corpuscle, Thymus, RadiologistsINTRODUCTION
Thymus is made up of two pyramidal lobes, the two parts being joined in the midline by connective tissue that merges with the capsule of each lobe. It is located in the mediastinum behind the sternum and in front of the pericardium and great vessels of the heart in the adult. Thymus plays a significant role in the early development of immune system and function, as T lymphocytes develop and maturation takes place within it [1]. The gross appearance and size of thymus varies with age and physiological state. During neonatal and postnatal life thymus is essential for the normal development of lymphoid tissue [2]. Thymus is fully developed at birth itself then it undergo changes gradually as the age proceeds, these gross changes have been reported to start between 11-15 years [3]. The weight of thymus is about 40g at puberty then gradually atrophies to 10-15g later life finally majority of the parenchyma have been replaced by connective tissue and adipose cells [4]. As the growth of adipose tissue increases within perivascular space, so the volume of thymic epithelial space reduces, leads to less thymopoisis [5]. Increased incidence of serious infections in old age has been related with decreased thymic function [6].
MATERIALS AND METHODS
The present work was conducted in the Department of Anatomy, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India. This Study was conducted on enlarged thymus in 70 years old female cadaver (FIGURE: 01). The morphometry of reported thymus was consists of two lobes which was seen anterior to pericardium. The gland was seen to be extending from the neck below the thyroid gland into the superior and anterior mediastinum. The length, width of the gland measured as 13 cms, 3cms. We performed histological procedure to study the parenchyma of the gland after fixation, paraffin embedding, then taken Sections of 5microns thickness were stained with haematoxylin and eosin and examined the structure of adult enlarged thymus under 10x and 40x magnifications using a Binocular microscope. This histological study is taken into consideration due to poor literature availability.
RESULTS
Histological Observations In the present histological study of adult thymus found to be like its normal structure but observed some aging changes like increased capsular thickness, separation between lobules are not well demarked and interlobular septa was disappeared. The number of Hassal’s corpuscles was less but found the larger size in diameter. Parenchyma arranged as small islands between replaced connective and adipose tissue (FIGURE: 02).
DISCUSSION
Thymus descent from 3rd branchial arch during the 6th week of intra uterine life, epithelial out pouching from the ventral aspect of 3rd branchial arch starts to develop and move caudally forming a thymo pharyngeal duct. There was a very minor and rudimentary portion of thymic tissue which develops from ventral aspect of 4th pouch. Descent of heart and caudal migration of aortic sac lead to caudal migration of thymic rudiments. Occasionally thymus may persistent in adults. Reduction in the parenchyma of the gland and by middle age most of it has been replaced by fat although functional thymic tissue is found until 6th decade of life [7]. According to knowledge of previous published literature on rat and other animal experiments reveals that progressive increase in amount of connective tissue and fat cells between thymic lobules was found with advancing age [8]. Disappearance of septa, attrition of demarcation between cortex and medulla while loss of septa with increased fatty infiltration in aging rats was also a main feature of another study [9, 10]. Previous histological studies of rat thymus reported that there is decrease in number of Hassal's corpuscles with aging [11]. A histological study conducted on 40 human thymuses to compare different with ages reported that, in old age, there is definite increase in the thickness of capsule and interlobular connective tissue with Hassal's corpuscles decreasing in number but increasing in diameter [12].
CONCLUSION
In the present study, the histolomorphology of persistent adult thymus is similar and support to the previous reported literatures. Present study is important for radiologists to make a differential diagnosis in case of a mediastinal mass.
AKNOWLEDGEMENTS
I am greatful to Dr. Kanchana latha, HOD of Anatomy Department and also previous authors, publishers, editors of all of those articles, journals and books from where the literature of this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1518http://ijcrr.com/article_html.php?did=15181. PickerL, Siegleman M. in:Paul, WE, editor. Fundamental immunology. New York: Raven Press. 1993; 145-97.
2. Krishna Murthy JV, V. Subhadra Devi. Morphological features of human thymus glands from foetal to old age. Int J Biol Med Res. 2012; 3(2): 1502-1505.
3. Kendall, M.D., Johnson, H. and Singh, J. The weight of the human thymus gland at necropsy. J Anat. 1980; 131: 485-99.
4. Don W. Fawcett, Ronald P. Jensh, Bloom and Fawcett’s Concise Histology, 2 edition, Ch- 10, Pg – 153.
5. Flores, K.G., Li, J., Sempowski, G.D., Haynes, B.F. and Hale, L.P. Analysis of human thymic perivascular space during aging. J Clin Invest. 1999; 104: 1031-9.
6. Hale, Laura. P., Amy G. Clark, Jie Li., Paula, K. Greer and Virginia Byers Kraus.). Age related thymic atrophy in the guinea pig. Developmental and comparative immunology. 2001; 25: 509-18.
7. Haynes, B.F., Markert, M.L., Sempowski, G.D., Patel, D.D. and Hale, L.P. The role of thymus in immune reconstitution in aging, bone marrow transplantation, and HIV-I infection. Ann. Rev. Immunol. 2000; 18: 529-60.
8. Elcuman, E.A., and Akay, M.T. Age dependent immunolocalization of fibronectin and histological changes in the thymus of rats. Veterinary research communications. 1998; 22: 8: 525-32.
9. Smith, S.M. and Gomez-Ossa, L.J. A quantitative histologic comparison of the thymus in 100 healthy and diseased adults. Am J Clin Pathol. 1981; 76: 5: 657-65.
10. Majeed, N., Fatani, J.A., Moustafa, F.A. and Mohajir, A.M. Reappraisal of age-related morphological changes in the rat thymusmorphometric study. Funct Dev Morphol. 1991; 1: 2: 57-60.
11. Majeed, N., Fatani, J.A., Moustafa, F.A. and Mohajir, A.M. Reappraisal of age-related morphological changes in the rat thymusmorphometric study. Funct Dev Morphol. 1991; 1: 2: 57-60.
12. Shafqat Ali, Liaqat Ali Minhas, Muhammad Arshad. Histological comparison of human thymus glands between groups of different ages. Pakistan armed forces medical journal. Dec. 2009 (5).
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareCOMPARATIVE ANXIOLYTIC ACTIVITY OF VARIOUS DRUGS IN EXPERIMENTAL MODELS OF RATS
English7785Kedare Rahul VitthaEnglish B.B. GhonganeEnglish R.J. WaghEnglishObjective: The aim of present work was to evaluate the anxiolytic efficacy of traditional anxiolytics along with antihistaminic, antipsychotic and analgesic in rats. Materials and Methods: The elevated plus maze model (EPMM) , open field test(OFT) and novelty induced hypophagia model(NIHM) were used to assess the effect on anxiety. The activity of Buspirone, Hydroxyzine, Haloperidol, Fluoxetine and Pethidine was compared with Diazepam, a standard anxiolytic drug. Results: Diazepam produced maximum anxiolysis in all anxiety models. The high dose Buspirone (5 mg/kg) was more effective compared than the low and medium dose (1.25mg/kg, 2.5mg/kg).) which showed significant increase in the time spent and number of entries in open arm in EPMM. The same doses of Buspirone showed significant increased in number of ambulations and number of rearing in OFT. The high dose (5 mg/kg) of Buspirone showed significantly decreased latency in NIHM. Overall, the activity of high dose of Buspirone was significantly less when compared with Diazepam but significantly more when compared to Hydroxyzine, Haloperidol, Fluoxetine and Pethidine. Conclusion: The result of the present study showed that Diazepam produced maximum anxiolysis in all anxiety models. Buspirone (high dose), Fluoxetine, Hydroxyzine, Haloperidol and Pethidine have more significant anxiolytic activity as compared to control group in elevated plus maze and novelty induced hypophagia test. In open field test Buspirone(high dose), Hydroxyzine Fluoxetine, Haloperidol and Pethidine have more significant anxiolytic activity as compared to control group.
EnglishAnxiolytics, Diazepam, Buspirone , EPM model, OFT , Novelty induced hypophagiaINTRODUCTION
Anxiety disorder is increasingly recognized as a highly prevalent and chronic disorder having onset during the teenage years, with an incidence of 18.1% and lifetime prevalence of 28.8%. The disorder is associated with significant disability (including educational and occupational) which has negative impact on the quality of life1 . Currently, the benzodiazepines are the most commonly employed medicinal treatments for the common clinical anxiety disorders. Long-term use of benzodiazepines is associated with side effects like psychomotor impairment, confusion, aggression, excitement, physical dependence and tolerance2 . The selective serotonin reuptake inhibitors are also effective in alleviating symptoms associated with these forms of anxiety but have g.i. related and dermatological reactions. Azapirones, is another class of agents with beneficial effects in disorders marked by anxiety or dysphoria of moderate intensity.3 The other mild anxiolytics like antihistaminics, antipsychotics and analgesics have adverse effects like sedation , ANS related and respiratory depression respectively. Therefore present study was planned to evaluate the anxiolytic efficacy of traditional anxiolytics along with antihistaminics, antipsychotics and analgesics in rats.
MATERIALS AND METHODS
Male albino rats weighing between 150-250gm were used. The experimental protocol was approved by the Institutional Animal Ethics Committee. The animals were maintained under standard conditions in an animal house approved by the Committee for the Purpose of Control and Supervision on Experiments on Animals (CPCSEA). The rats were divided into nine groups with six in each group.
Drugs used – The following drugs were used in the study: Diazepam Benzyl alcohol, Batch no: 902895 Exp.date Feb.2013 (Ranbaxy); Buspirone hydrochloride (Product code B7148); Hydroxyzine dihydrochloride (Product code H 8885 )Sigma Aldrich Co, ; Haloperidol Batch no: Halo/ 0703005 , Exp.date Feb.2012 (Stadmed Private Limited); Fluoxetine Hydrochloride Batch no: JK 10021 Exp.date April 2013 (Cadila pharm.ltd.); Pethidine Hydrochloride Exp.date Oct 2011 (Neon labs Ltd.). The other chemicals were of analytical grade.
Elevated Plus Maze Model (EPMM): The EPM apparatus consisted of two open arms (30 cm length x 10 cm width x 2.5 cm height) and two closed arms (30 cm length x 10 cm width x 15cm height) emanating from a common central platform (10 cm x 10 cm). The two pairs of identical arms were opposite to each other. The entire apparatus was elevated to a height of 50 cm above the floor level. The animals received the treatment as per the schedule, 30 min before the start of the session. At the beginning of the session, a rat was placed at the centre of the maze, its head facing the closed arm. It was allowed to explore the maze for 5 min. The time spent in the open/closed arms and number of entries in open/closed arms (An entry was defined as the presence of all four paws in the arm) and time/entry ratio ( = time spent/ number of entries ) were recorded with the help of stop watch 4 .
Open Field Test (OFT) : The Open Field Test apparatus consisted of a wooden box (50 cm height x 50 cm length x50 cm width ), with a dark gray floor, subdivided into 16 equal fields( each square of 12 cm x 12 cm). The experimental room was a sound attenuated, dark room. The Open Field Test, above 100 cm from the apparatus 40W bulb was focused. After 30 min of treatment, the rats were placed individually in a corner square of the OFT and the ambulation (The number of squares crossed), latency (Time taken by the animal to leave square in which it was placed ) and number of rearing (number of time the animal stands on the rear paws) were recorded for 5 min5 .
Novelty Induced Hypophagia Model (NIHM): Rats were singly housed in a standard polypropylene cage (Home cage) for ten days before training began. After completion of training for 3 consecutive days, rats were presented with diluted (milk: water; 1:3) sweetened condensed milk in a home cage with 10 ml pipette. They were allowed access for 30 min daily. Home cage testing was done on day 4 for which rats were briefly removed (for 20 min) from their cages. The cage was cleaned with spirit swab and testing done as soon as rats were returned to their cages. The latency to drink and total milk consumed in 30 min was recorded .It was done under dim lighting (approx. 50 lux).
Rat that never drank during the 30 min of home cage testing were eliminated from the experiment. Novel cage (Clear Plexiglas cage) testing was done on day 5, when rats were placed into new clean cages of the same dimensions, with pipette containing the milk positioned. Novel cage testing occurred under bright lighting (approx. 1200 lux), with white paper placed under cages to enhance aversiveness. Thus, each rat was trained to drink milk (days 1–3), tested in its home cage (day 4), and then tested in a novel cage (day 5). Finally drinking latencies and total milk consumed between home cage and novel cage were compared 6 .
Statistical analysis: The statistical analysis was done by software Primer of biostatistics and significance was assessed using a One way ANOVA followed by Dunnett test. The values are expressed as Mean + SEM and P < 0.05 was considered significant.
values are Mean + SEM * P< 0.05 compared with control # P< 0.05 compared with standard – Diazepam In the elevated plus maze model, vehicle group showed tendency to remain in the closed arm which suggest anxiogenic effect. The known anxiolytics viz. Diazepam and Hydroxyzine have produced significant increase in entries and time spent in the open arm as compared to vehicle group (anxiolytic effect). Similarly, in the Fluoxetine, Haloperidol and Pethidine group significant increase in entries and time spent in the open arm as compared to vehicle group (anxiolytic effect) was seen. The Buspirone in all the doses tested has produced significant increase in entries and time spent in the open arm as compared to vehicle group(anxiolytic effect).However , this increase with highest dose ie.5.0 mg/kg is significantly less compared to Diazepam; but significantly more than Hydroxyzine, Fluoxetine, Haloperidol and Pethidine.
In the Open field model, The known anxiolytics viz. Diazepam and Hydroxyzine significant increase number of rearings and ambulation and decrease latency as compared to vehicle group (anxiolytic effect). Similarly, in the Fluoxetine, Haloperidol and Pethidine group have produced significant increase in number of rearings and decrease latency was observed as compared to vehicle group (anxiolytic effect).The Buspirone in all the doses tested has produced significant increase as compared to vehicle group(anxiolytic effect).However , this increase with highest dose ie.5.0 mg/kg is significantly less compared to Diazepam; but significantly more than Hydroxyzine, Fluoxetine, Haloperidol and Pethidine.
In the Novelty induced hypophagia model, The anxiolytics viz. Diazepam Hydroxyzine Fluoxetine, Haloperidol and Pethidine have produced significantly decrease latency as compared to vehicle group (anxiolytic effect). All doses of Buspirone produced significant decrease as compared to vehicle group (anxiolytic effect).However, this decrease with highest dose ie.5.0 mg/kg is significantly less compared to Diazepam .The consumption of milk significantly increased among known anxiolytics as compared to the vehicle group in a home cage. In Diazepam group consumption was more compared to vehicle group and other groups. All doses of Buspirone showed significantly increase consumption of milk as compared to vehicle group (anxiolytic effect).
RESULTS
The high dose Buspirone (5 mg/kg) was more effective compared to the low and medium dose (1.25mg/kg,2.5mg/kg).) and significantly increased the time spent and number of entries in open arm in elevated plus maze test. The results of high dose of Buspirone were significantly less when compared with standard drug Diazepam and significantly more as compared to the Hydroxyzine, Fluoxetine, Haloperidol and Pethidine. In open field test the same dose of Buspirone showed significant increased in number of ambulation and number of rearing. The high dose (5 mg/kg) of Buspirone showed significant decreased latency and increase milk consumption in novelty induced hypophagia test.
DISCUSSION
This study investigated comparative anxiolytic activity of various drugs in animal models. The elevated plus maze test, open field test and novelty induced hypophagia were used. In these models Diazepam 1 mg/kg served as a standard drug. All these models have been used to assess neurobehavioral profile of animals under the influence of anxiolytics7 . The elevated plus maze model is a well established model for testing anxiolytics and was used to evaluate psychomotor performance and emotional aspects of rodents. This model is based upon the natural aversion of rodents to heights and open spaces has been validated for both rats and mice , bidirectionally sensitive to pharmacological manipulations.8 Benzodiazepines are the most widely prescribed class of psychoactive drugs in current therapeutic use. Results obtained on the elevated plus maze after the treatment of Diazepam revealed anxiolytic activity. It increases entries and time spent in the open arm, when compared with control and other anxiolytic drugs. These parameters are the most representative indices of anxiolytic activity 9 . They enhance the response to GABA, by facilitating the opening of GABA-activated chloride channels.10 All doses of Buspirone (1.25, 2.5 and 5.0 mg/kg ) showed significant increase entries and time spent in the open arm .The results of high dose of Buspirone were comparable to Diazepam and more significant to when compared with other anxiolytics. The doses of Buspirone may have selective partial agonistic effect at cell body 5 -HT1A which may lead to an anxiolytic like effect. 11 Hydroxyzine showed significant increase entries and time spent in the open arm, when compared with control group but less significant on comparison with diazepam and high dose of buspirone group. It is a H1-receptor antagonist that penetrates the Blood brain barrier and produced mild anxiolytic actions without muscle relaxation 12 . Haloperidol showed significant increase entries and time spent in the open arm, when compared with control group, the results of previous studies shown that treatment with haloperidol induced a significant enhancement in the general activity of rats observed in an open field test .Which suggest that haloperidol has mild anxiolytic activity13 . Fluoxetine significantly increase the number of open arm entries and time spent in open arm and also decreased the latency to enter in open arm as compared to control. A single intraperitoneal dose of Fluoxetine effectively altered behavior .The mechanism underlying these acute behavioral changes are unlikely to be the same as those mediating the behavioral effects that emerge chronically. The acute behavioral effects may result from a sharp peak in blood levels of Fluoxetine and its active metabolite norfluoxetine14 . Pethidine showed significant increase in entries and time spent in open arm when compared with control group. Opioids decrease release of excitatory neurotransmitter in the central nervous system15 . The open field test was used to evaluate the animal emotional state and anxiety related behavior. It characterized by the normal aversion of the animal to an open, brightly light area. Thus, animals removed from their acclimatized cage and placed in environment express anxiety and fear, by showing alteration in all or some parameters. Diazepam showed significant increase in the number of square crossed, rearing and ambulation compared to control and other anxiolytics 8 . The high dose of Buspirone showed significant increased in number of square crossed, rearing and ambulation compared to the control group and less significant when compared with the diazepam. 10,13 Hydroxyzine , Fluoxetine , Haloperidol, and Pethidine significantly increased number of square crossed ,rearing and ambulation compared to the control group12,14,15 . The enhancement of neurotransmitters results in behavior associated anxiety, while antagonism in the system appears to produce an anxiolytics effect16 . The exposure to the novel environment resulted in a significant suppression of latency and food intake. Diazepam group showed significant decreased in latency and increased consumption of milk , when compared with control and others groups in home cage as well as novel cage testing. 8 All doses of Buspirone showed lesser latency to begin eating in the home and novel cage ,when compared with control group. There was significant increased food intake, when compared with control group. These results were less significant when compared with diazepam. 10 Hydroxyzine , Fluoxetine Haloperidol, and Pethidine significantly reduced latency and increased food consumption ( Home cage) , when compared with control group12,13,14,15 . All of the groups showed a greater latency to begin eating in the novel environment relative to the home cage, the complex interaction was examined by conducting an ANOVA on difference score calculated between home and novel cage17 .
CONCLUSION
The result of the present study showed that Diazepam produced maximum anxiolysis in all anxiety models. Buspirone (high dose), Fluoxetine, Hydroxyzine, Haloperidol and Pethidine have more significant anxiolytic activity as compared to control group in elevated plus maze and novelty induced hypophagia test. In open field test Buspirone (high dose), Hydroxyzine Fluoxetine, Haloperidol and Pethidine have more significant anxiolytic activity as compared to control group
Englishhttp://ijcrr.com/abstract.php?article_id=1519http://ijcrr.com/article_html.php?did=15191. Thippeswamy BS, Mishra B. Anxiolytic activity of nymphaea alba linn. In mice as experimental models of anxiety. Indian journal of pharmacology 2011; 43 (1).p50- 55.
2. Thandaga S, Mohmood R, Krishna V , Thippeswamy B.S., Veerapur V.P. Evaluation of anxiolytic effect of Erythrina mysorensis Gamb.in mice. Indian journal of pharmacology .2012;44:p 489-492.
3. Baldessarini Ross J. Drug therapy of depression and anxiety disorders; Bruton LL, Lazo Js, Parker KL, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 11 th ed. New York Mc GrawHill, Medical Publishing Division 2006 p277- 279.
4. Weinstock M , Poltyrev T,Youdim C B. Effect of TV3326 ,a novel monoamine oxidase cholinesterase inhibitor,in rat models of anxiety And depression. Psychopharmacology. 2002;160:p318-324
5. Okali C.O, Ezike A.C, Agwagah O.C., Akah P.A .Anticonvulsant and anxiolytics evaluation of leaf extracts of Ocimum gratissimum, a culinary herb. Pharmacology Research.2010; 2:(1) p 36-40.
6. Bodnoff S R. , Suranyi-Cadotte B, Quirionl R, Meaney M J. A comparison of the effects of Diazepam versus several typical and atypical anti-depressant drugs in an animal model of anxiety. Psychopharmacology .1989; 97: p277-279
7. Tabassum I , Siddiqui Z N, Rizvi S J. Effect of Ocimum sanctum and Camellia sinesis on stress induced anxiety and depression in male albino Rattus Norvegicus. Indian journal of pharmacology. 2010 ; 42 (5) p. 283-288
8. Rodgers R.J., Lee C., Shepherd J.K. Effects of diazepam on behavioural and antinociceptive responses to the elevated in male mice depend upon treatment regimen and prior maze experience. Psychopharmacology.1992; 106 p102-110.
9. Shafaghi B. Anxiolytic effect of Echium amoenum L.in mice. Iranian Journal of Pharmaceutical research .2002;1:p37-41
10. Barua C C , Anxiolytic effect of hydroehthanolic extract of Drymaria cordata L Wild. Indian journal of Exp. Biology 2009; 47: p 969-973.
11. 11).Moser P.C. An evaluation of the elevated plus maze test using the novel anxiolytics effect. Psychopharmacology .1989;99:p 48-53
12. Logothetis, Mylonas I. A., Baloyannis S., Pashlidou M. , Orologas, Zafeiropoulosi A., Kosta V, Theoharides T. C. A pilot, open label, clinicaltrial using HydroxyzineIn multiple sclerosis. International Journal Of Immunopathology and pharmacology.2005;18:( 4) p 771-778
13. Bernardi M. M.,. De Souza H, Palermo J. Effects of Single and Long-Term Haloperidol Administration on Open Field Behavior of Rats. Psychopharmacology.1981; 73:p171 - 175
14. Kerri A H, Daniel C L, Rene´ H, Dulawa S C .Behavioral Effects of Chronic Fluoxetine in BALB/cJ Mice Do Not Require Adult Hippocampal Neurogenesis or the Serotonin 1A Receptor. Neuropsychopharmacology. 2008; 33: P 406–417
15. Patti C. L. Effects of morphine on the plusmaze discriminative avoidance task: role of state-dependent learning. Psychopharmacology.2006; 184: p1–12
16. Rauniar GP, Deo S, Bhattacharya SK .Evaluation of anxiolytics activity of tensarin in Mice. Kathmandu University Medical Journal. 2007; 5: (2)18,p 188-194
17. Bechtholt A J , Tiffany E ,Irwin L. Anxiolytic effect of serotonin depletion in the novelty induced hypophagia test. Psychopharmacology.2007;190:p531-40
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN2012December22HealthcareSIGMOID VOLVULUS: A CASE REPORT OF THE SURGICAL TREATMENT
English8688Kiran T.English M. GanesanEnglish M. Krishna KumarEnglish Niran Kumar SamuelEnglishSigmoid volvulus is the third most common cause of intestinal obstruction. Various standard treatment methods have been suggested by many authors, associated with different mortality rates. We report a case of sigmoid volvulus with the simple modification in the standard surgical procedure of primary resection and anastomosis which hastened the recovery in our patient preventing the anastomotic leak.
EnglishSigmoid Volvulus, simple modification, primary anastomosis.http://ijcrr.com/abstract.php?article_id=1520http://ijcrr.com/article_html.php?did=1520Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareA STUDY ON THE PREVALENCE OF OVERWEIGHT AND OBESITY AND ITS INFLUENCING FACTORS IN RURAL ADOLESCENT SCHOOL GOING CHILDREN IN KERALA, INDIA
English8999Shiny GeorgeEnglish Jeffy BinuEnglish Biju Baby JosephEnglishBackground: Obesity has become a worldwide phenomenon cutting across regional and economic barriers. Childhood and adolescent obesity has emerged as an epidemic not only in the developed countries but also in the developing countries that are in rapid epidemiological transition, and India is no exception. 50-80% of the obese children will continue to be obese adults . However, whether or not obesity persists into adulthood, the obesity in childhood appears to increase the risk of subsequent morbidities . Objective: To assess the prevalence of overweight and obesity and its influencing factors in adolescent school going children in a rural area in Kerala. Research methodology: Height and weight were measured and obesity was assessed using international obesity task force criteria in 173 students of 13 -18 years. Details of influencing factors obtained using a pretested questionare. Results :The study revealed a high prevalence of overweight (16%) and obesity (7%). Prevalence of overweight and obesity was 19% and 6% among boys and 15% and 8% among girls respectively. Among the influencing factors sleeping time and fast food were found to be significant (p=0.01). Conclusion: Increased prevalence of overweight and obesity in rural adolescents emphasizes the need of early recognition of excessive weight gain relative to linear growth and early intervention after an increase in weight-for-height or BMI percentiles in children and adolescents .
Englishobesity, overweight, adolescentINTRODUCTION
Young people in their teens constitute the largest age group in the world, in a special stage recognized across the globe as the link in the life cycle between childhood and adulthood. Excessive amount of adipose tissue in children and adolescents and obesity in particular constitute a growing health problem throughout the world. Childhood and adolescent overweight and obesity are related to health risks, medical conditions, and an increased risk of adult obesity, with attendant impacts on morbidity and mortality. Childhood obesity is a serious health concern affecting over 155 million children in developed countries worldwide. The increasing prevalence of overweight, obesity and its consequences prompted the World Health Organization to designate obesity as a global epidemic1 . Data from NHANES IV indicate that 21% to 23% of children aged 6–17 years are overweight, and 9 to 13% of children aged 6–17 years are obese2 . In the United States, the prevalence of obesity among adolescents aged 12–19 years quadrupled from 1966 to 2003–2006 (from 4.6% to 17.6%) 3,4. Currently one in three (34.9%) U.S. adolescents are overweight or obese4 . It was predicted that by 2010, over 40% of children in the North American and Eastern Mediterranean WHO regions, 38% in the European region, 27% in the Western Pacific region, and 22% in South-East Asian region would be overweight/obese5 . Even in countries like India, which are typically known for high prevalence of under nutrition, a significant proportion of overweight and obese children now coexist with those who are under nourished6. Obesity is a complex condition which is influenced by a wide-range of genetic and non-genetic factors, with interactions between many of these. Obesity may be defined as excess accumulation of adipose tissue in the body7 . It is a chronic disease in which body weight exceeds the normal by at least 20 percent, which becomes a psychosomatic, social economic and aesthetic problem. Some factors in early life are associated with increased risk of obesity in childhood. These are parental obesity, more than 8 hours spend for watching TV per week, very early body mass index, catch up growth, weight gain in first year , birth weight and short sleep duration. Childhood obesity can adversely affect nearly every organ system and often cause serious consequences, including hypertension, dyslipidemia, insulin resistance/diabetes, fatty liver disease, psychosocial complications8 , increased risk of cardiovascular disease in adulthood9 ,Pulmonary disorders including obstructive sleep apnea and reactive airway disease10 . Higher BMI and greater adiposity have been associated with lower vitamin D levels in children11,12. Overweight/obese children are also at least two fold more likely to be iron-deficient than normal weight children13 . Complications of childhood obesity include acceleration in the timing of thelarche and menarche in girls,14 pubertal advancement in boys15 and adverse effects on maturation and alignment of developing bones in both16 . Serdula found a risk for adult obesity at least twice as High in obese children as in nonobese ones; approximately one-third of preschool children and 50% of school-age children become obese adults.17 Height- and weight-based anthropometric measurement is an excellent tool to gauge general nutritional status in a Population. Commonly used cut points for childhood overweight and obesity include: 110% or 120% of ideal weight for height; weight-for-height Z-scores of >1 and >2, and BMI at the 85th, 90th, 95th, and 97th percentiles.5 Studies from the rural areas in India mainly emphasized on under nutrition, and data on overweight/obesity was not available. We attempted to document the prevalence of obesity and overweight among adolescent school children of a rural area in Kerala and to identify the factors which influenced adolescent overweight and obesity.
MATERIALS AND METHOD
The present cross sectional study was undertaken in the Nehru Memorial Public School which is one of the private unaided school in Kaithakuzhy ,a rural area in Kollam district, Kerala state. 173 students in the age group of 13-18 years, who were studying in class IX to XII, were enlisted for the study. This study was carried out from June to August 2012.
A prior informed consent for the study was taken from the school authorities . A predesigned and pretested questionnaire was used to interview the study participants to elicit the information on their family characteristics like economic status, education and occupation of the parents. Information on individual characteristics like age, sex, eating habits, and time spent for television viewing , hours of sleeping , intake of junk food and fast food , time spent on outdoor games and indoor games were also collected. We administered the questionnaire to all children who attended school on the day of the survey. Children who were absent from school because of sickness or other reasons were not followed-up. During the data collection, the class teachers were asked to accompany the students. Data on weight and height were collected for each through direct physical examinations. Body weight was measured (to the nearest 0.5 kg) with the subject standing motionless on the weighing scale with feet 15 cm apart, and weight equally distributed on each leg. Height was measured (to the nearest 0.5 cm) with the subject standing in an erect position against a vertical scale. Height and weight were measured using standard procedure and the body mass index (BMI) was calculated as the weight in kilogram/height in meter2 . Overweight and obesity were assessed by considering the BMI for a particular age and sex. International Obesity Task Force (IOTF) classification was utilized for the estimation of overweight and obese subjects. Students who had a BMI for age-sex ≥ the 85th percentile to < the 95 percentile of the reference population were classified as overweight and who had a BMI for age-sex ≥ the 95th percentile of the reference population was classified as obese . The number of underweight, normal, overweight and obese was calculated.
Statistical Analysis
The data were entered into an Excel 2007 Microsoft spreadsheet and were analyzed using SPSS 15.0.1 (SPSS for windows, version 15.0.1.2001.) The continuous variables were presented as mean ± SD . Prevalence of overweight and obesity is presented as percentage. The associations were assessed by using the Pearson Chi-square test. For all the statistical tests, a p value of Englishhttp://ijcrr.com/abstract.php?article_id=1521http://ijcrr.com/article_html.php?did=15211. WHO consultation on obesity. Special issues in the management of obesity in childhood and adolescence. In Obesity Preventing and Managing the Global Epidemic, WHO, Geneva, 1998, pp.231– 247.
2. Troiana, R. P., Flegal, K. M., Kuczmarski, R. J., Campbell, S. M. and Johnson, C. L., Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys 1963 to 1991. Arch. Pediatr. Adolesc. Md., 1995, 149,1085–1091.
3. Ogden CL, Flegal KM, Carroll MD, et al. Prevalence and trends in overweight among US children and adolescents, 1999- 2000. J Am Med Assoc 2002;288:1728– 32.
4. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003-2006. J Am Med Assoc 2008;299:2401–5.
5. Joan C. Han, Debbie A. Lawlor, and Sue Y.S. Kimm Childhood Obesity – 2010:Progress and Challenges Lancet. 2010 May 15; 375(9727): 1737–1748.
6. Popkin BM., D Horton, S Kim, A Mahal and J Shuigao. Trends in diet nutritional status and diet related non communicable diseases in China and India: The economic costs of the nutritional transition, Nutr Rev. 2001;59:379-90.
7. Guillaume M. Defining obesity in childhood: current practice. Am J Clin Nutr 1999; 70:126S-130S.
8. Daniels SR. Complications of obesity in children and adolescents. Int J Obes (Lond). 2009; 33 (Suppl 1):S60–5. [PubMed: 19363511]
9. Owen CG, Whincup PH, Orfei L, et al. Is body mass index before middle age related to coronary heart disease risk in later life? Evidence from observational studies. Int J Obes (Lond). 2009; 33(8):866–77. [PubMed: 19506565]
10. Gilliland FD, Berhane K, Islam T, et al. Obesity and the risk of newly diagnosed asthma in schoolage children. Am J Epidemiol. 2003; 158(5):406–15. [PubMed: 12936895]
11. Alemzadeh R, Kichler J, Babar G, Calhoun M. Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism. 2008; 57(2):183–91. [PubMed: 18191047]
12. Yanoff LB, Parikh SJ, Spitalnik A, et al. The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans. Clin Endocrinol (Oxf). 2006; 64(5):523–9. [PubMed: 16649971]
13. Nead KG, Halterman JS, Kaczorowski JM, Auinger P, Weitzman M. Overweight children and adolescents: a risk group for iron deficiency. Pediatrics. 2004; 114(1):104–8. [PubMed: 15231915]
14. Bau AM, Ernert A, Schenk L, et al. Is there a further acceleration in the age at onset of menarche? A cross-sectional study in 1840 school children focusing on age and bodyweight at the onset of menarche. Eur J Endocrinol. 2009; 160(1):107–13. [PubMed: 18974233]
15. Mamun AA, Hayatbakhsh MR, O’Callaghan M, Williams G, Najman J. Early overweight andpubertal maturation-- pathways of association with young adults’ overweight: a longitudinal study. Int J Obes (Lond). 2009; 33(1):14–20. [PubMed: 18982007]
16. Taylor ED, Theim KR, Mirch MC, et al. Orthopedic complications of overweight in children and adolescents. Pediatrics. 2006; 117(6):2167–74. [PubMed: 16740861]
17. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T (1993). Do obese children become obese adults? - A review of the literature. Prev. Med., 22: 167- 177.
18. Chatterjee P., India sees a parallel rise in malnutrition and obesity. Lancet 2002; 360: 1948.
19. Ramachandran A, Snehlata C, Vinitha R, Thayyil M. The prevalence of overweight in urban Indian adolescent school children. Diabetes Res. Clin. Practice 2002; 57: 185–190.
20. Callahan ST, Mansfield MJ. Type 2 diabetes mellitus in adolescents. Curr Opin Pediatr. 2000; 12:310-315.
21. Deshmukh PR, Gupta SS, Bharambe MS, Dongre AR, Maliye C,Kaur S, et al. Nutritional status of adolescents in rural Wardha. Indian J Pediatr 2006;73:15-7.
22. Chhatwal J, Verma M, Riar SK. Obesity among the pre-adolescents and adolescents of a developing country (India). Asia Pac.J. Clin. Nutr., 2004; 13: 231–35.
23. Klesges RC , Klesges LM, Eck LH, Shelton ML. A longitudinal analysis of accelerated weight gain in preschool children. Pediatrics 1995; 95:126-130.
24. Rolls BJ, Kim-Harris S, Fischman MW, Foltin RW, Moran TH, Stoner SA. Satiety after preloads with different amounts of fat and carbohydrate: implications for obesity. Am J Clin Nutr 1994; 60:476- 487.
25. Blundell JE, Burley VJ, Cotton JR, Lawton CL. Dietary fat and the control of energy intake: evaluating the effects of fat on meal size and postmeal satiety. Am J Clin Nutr 1993; 57:772S-778S.
26. Poppitt SD. Energy density of diets and obesity. Int J Obes 1995; 19:S20-S26.
27. Berkey CS, Rockett HR , Field AE, Gillman MW, Frazier AL, Camargo Jr CA, et al. Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 2000; 105:56-65.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareEXTENSOR CARPI RADIALIS BREVIS SUPPLIED BY THE SUPERFICIAL BRANCH OF RADIAL NERVE - A CADAVERIC CASE REPORT
English100104Sharadkumar Pralhad SawantEnglish Shaguphta T. ShaikhEnglish S.D. LeleEnglish Shaheen RizviEnglish S.R. MenonEnglish R. UmaEnglishDuring routine dissection, of the right upper limb of a 70 years old donated embalmed male cadaver in the Department of Anatomy, K.J. Somaiya Medical College, Sion, Mumbai, India, we observed the variant nerve supply to Extensor carpi radialis brevis muscle. In the present case the nerve supply to extensor carpi radialis brevis was from the superficial branch of radial nerve i.e. the radial nerve proper. The finding was noted after thorough and meticulous dissection of the upper limbs of both sides. The arterial pattern of upper limb were also observed. The variation was unilateral. The left upper limb was normal. The photographs of the variations were taken for proper documentation. Conclusions: The awareness of the nerve supply to extensor carpi radialis brevis from superficial branch of radial nerve is clinically important for surgeons dealing with entrapment or compressive neuropathies, orthopaedicians operating on the fractures of the lower end of the humerus, anaesthetist performing pain management therapies on the upper limb and physiotherapist doing electromyography for evaluating and recording the electrical activity produced by skeletal muscles. A lack of knowledge of such type of variations might complicate surgical repair.
EnglishExtensor Carpi Radialis Brevis, Superficial Radial Nerve, Nerve Variation, Surgeons, Compressive Neuropathies, Orthopaedicians, Fractures, Anaesthetist, Pain Management Therapy, Physiotherapist, Electromyography.INTRODUCTION The extrinsic extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Extrinsic denotes their location outside the hand. Extensor denotes their action which is to extend, or open flat, joints in the hand. The extensor carpi radialis brevis is one of the superficial muscles of the extensor compartment of the forearm. The extensor carpi radialis brevis muscle is shorter and thicker than the extensor carpi radialis longus muscle. It arises from the lateral epicondyle of the humerus, by a tendon common to it and the three following muscles; from the radial collateral ligament of the elbow-joint; from a strong aponeurosis which covers its surface; and from the intermuscular septa between it and the adjacent muscles. The fibers end about the middle of the forearm in a flat tendon, which is closely connected with that of the extensor carpi radialis longus muscle, and accompanies it to the wrist; it passes beneath the abductor pollicis longus and extensor pollicis brevis, then beneath the dorsal carpal ligament, and is inserted into the dorsal surface of the base of the third metacarpal bone on its radial side. Under the dorsal carpal ligament the tendon lies on the back of the radius in a shallow groove, to the ulnar side of that which lodges the tendon of the extensor carpi radialis longus, and separated from it by a faint ridge. The tendons of the two preceding muscles pass through the same compartment of the dorsal carpal ligament in a single mucous sheath. The extensor carpi radialis brevis muscle may split into two or three tendons of insertion to the second and third or even the fourth metacarpal. The extensor carpi radialis longus and brevis muscles may unite into a single belly with two tendons. The cross slips between the two muscles may occur. The extensor carpi radialis intermedius rarely arises as a distinct muscle from the humerus, but is not uncommon as an accessory slip from one or both muscles to the second or third or both metacarpals. The extensor carpi radialis accessorius is occasionally found arising from the humerus with or below the extensor carpi radialis longus and inserted into the first metacarpal, the abductor pollicis brevis, the first dorsal interosseous, or elsewhere. The extensor carpi radialis longus muscle is supplied by the radial nerve and the extensor carpi radialis brevis muscle by the deep branch of the radial nerve (posterior interosseous nerve). The extensor carpi radialis longus and brevis muscles receive blood from the radial artery (1). It is a universally accepted fact that the variation in the nerve supply to any muscle of the extremity is of definite surgical importance in order to avoid any error surgery.
CASE REPORT
During routine dissection, of the right upper limb of a 70 years old donated embalmed male cadaver in the Department of Anatomy, K.J. Somaiya Medical College, Sion, Mumbai, India, we observed the variant nerve supply to Extensor carpi radialis brevis muscle. The radial nerve was divided at the level of the lateral epicondyle into two branches i.e. superficial and deep branches. The nerve to the extensor carpi radialis brevis arose from the superficial branch of radial nerve i.e. the radial nerve proper. The finding was noted after thorough and meticulous dissection of the upper limbs of both sides. The arterial pattern of upper limb were also observed. The variation was unilateral. The left upper limb was normal. The photographs of the variations were taken for proper documentation.
DISCUSSION
The nerve supply to the extensor carpi radialis brevis muscle is studied by many authors in the past (2, 3, 4, 5, 6, 7, 8). The superficial branch of the radial nerve i.e. radial nerve proper is a purely sensory nerve and the nerve supply to the extensor carpi radialis brevis muscle is from the posterior interosseous nerve. The standard text books did not mention about the nerve supply to the extensor carpi radialis brevis arising from the superficial branch of the radial nerve i.e. radial nerve proper (1). The incidence of the nerve supply to the extensor carpi radialis brevis muscle from the superficial branch of the radial nerve i.e. radial nerve proper had been reported by Salisbury, AlQattan and Brash as 56%, 48% and 21% limbs respectively (9, 10, 11). In the present case we observed the nerve supply to the extensor carpi radialis brevis muscle from the superficial branch of the radial nerve i.e. radial nerve proper. In tennis elbow the muscle involved is the extensor carpi radialis brevis (12). The non-inflammatory, chronic degenerative changes occurs in the origin of the extensor carpi radialis brevis muscle (13). The knowledge of the variant nerve supply to the extensor carpi radialis brevis muscle is important before injecting corticosteroid injections in the treatment of tennis elbow (14). The surgeons performing Z-shaped tenotomy on tennis elbow to lengthen the tendon of extensor carpi radialis brevis must be aware of this variation in order to avoid unwanted complications (15, 16). Variations in the nerve supply of the extensor carpi radialis brevis are important in the clinically. The extensor carpi radialis brevis may be spared in injuries to the posterior interosseous nerve, thereby explaining the preservation of some wrist function clinically after penetrating injuries which may otherwise result in a complete wrist drop. Similarly, the injuries to the superficial radial nerve, which is suppose to be a sensory nerve, may lead to pain during the extension of the wrist and slight weakness on the extension on the wrist joint due to involvement of the nerve supply of the extensor carpi radialis brevis (17). Recently, extensor carpi radialis brevis has also gained importance for use in ‘free functional muscle transfer’ i.e. transfer of a muscle with its motor nerve and vascular pedicle from one site of the body to another distant site, in order to restore the motor function (18). The knowledge of the variations in the nerve supply is thus important while this muscle is being harvested. It is well known that the normal origin and the course of the nerve to the extensor carpi radialis brevis lie very close to the posterolateral aspect of the radius, a frequent site of pathology (e.g. infections and tumours), trauma and surgical procedures (19, 20, 21). The anterior approach to the elbow and the variations in this approach are used frequently in the surgical management of proximal radial fractures, as well as a variety of other pathologies (22, 23). Such manouvers involve the separation of the extensor carpi radialis brevis distally, with resultant exposure of the radial nerve and its branches (24). Hence, the knowledge of variations of the nerve supply of the extensor carpi radialis brevis is essential in preventing injury to this nerve branch by the retractors.
Clinical Significance
The awareness of the nerve supply to extensor carpi radialis brevis from superficial branch of radial nerve is clinically important for surgeons dealing with entrapment or compressive neuropathies, orthopaedicians operating on the fractures of the lower end of the humerus, anaesthetist performing pain management therapies on the upper limb and physiotherapist doing electromyography for evaluating and recording the electrical activity produced by skeletal muscles. A lack of knowledge of such type of variations might complicate surgical repair.
CONCLUSION
The nerve supply to the extensor carpi radialis brevis from the superficial branch of the radial nerve is not a rare occurrence. This should be mentioned in the standard text-books of anatomy and plastic surgery. The knowledge of the variations in the nerve supply of extensor carpi radialis brevis is important for plastic surgeons performing ‘free functional muscle transfer’.
COMPETING INTERESTS
The authors declare that they have no competing interests.
AUTHORS' CONTRIBUTIONS
SPS wrote the case report, performed the literature review & obtained the photograph for the study. SDL, UR performed the literature search, SR assisted with writing the paper. STS conceived the study and SRM helped to draft the manuscript. All authors have read and approved the final version manuscript.
ACKNOWLEDGEMENT
All the authors are thankful to Dr. Arif A. Faruqui. We are also thankful to Mr. M. Murugan for his help. Authors also acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1522http://ijcrr.com/article_html.php?did=15221. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. The Nervous system. In: Gray’s Anatomy, 39th edn, Churchill Livingstone, New York; 2005; 879 - 880.
2. Hamilton WJ. Textbook of the Human Anatomy, 2nd edn, Macmillan Press Ltd., London 1976; 651.
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4. Tountas CP, Bergman RA. Anatomic variations of the upper extremity, Churchill Livingstone, New York; 1993; 11.
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6. Turck SL. Orthopaedic principles and their applications, 4th edn, JB Lippincott., Philadelphia; 1984; 497- 498.
7. Kaplan EB, Taleisnik J. The wrist. In: Kaplan‘s Functional and Surgical Anatomy of the Hand, 3rd edn, J. B. Lippincott, Philadelphia; 1984; 153-178.
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14. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg [Am] 2003;28(2):272–278.
15. Boyer MI, Hastings H (1999). "Lateral tennis elbow: "Is there any science out there?"". Journal of Shoulder and Elbow Surgery 8 (5): 481–91. doi:10.1016/S1058-2746(99)90081- 2. PMID 10543604.
16. Meyer NJ, Walter F, Haines B, Orton D, Daley RA. Modeled evidence of force reduction at the extensor carpi radialis brevis origin with the forearm support band. J Hand Surg [Am] 2003;28(2):279–287.
17. Lluch AL, Beasley RW. Treatment of dysesthesia of the sensory branch of the radial nerve by distal posterior interosseous neurectomy. J. Hand. Surg. 1989;14A: 121- 24.
18. Binhammer P, Manktelow RT, Haswell T. Applications of the extensor carpi radialis brevis for facial reanimation. Journal of Reconstructive Microsurgery. 1994;10: 109.
19. Prasartritha T, Liupolvanish P, Rojanakit A. A study of the posterior interosseous nerve and the radial tunnel in 30 Thai cadavers. J. Hand Surg 1993;. 18A: 107-12.
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23. Thomas SJ, Yakin DE, Parry BR, Lubahn JD, Erie PA. The anatomical relationship between the posterior interosseous nerve and the supinator muscle. J. Hand Surg. 2000;25A: 936-41.
24. Latev MD, Dalley AF. Nerve supply of the brachioradialis muscle: Surgically relevant variations of the extramuscular branches of the radial nerve. Clin. Anat. 2005; 18: 488- 92.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareEFFECT OF LEAD EXPOSURE ON BIOCHEMICAL PARAMETERS IN AUTOMOBILE WORKERS FROM BIJAPUR, KARNATAKA
English105112Nilima DongreEnglish Adinath SuryakarEnglish Arun PatilEnglish Basavaraj DevarnavadagiEnglish Jeevan AmbekarEnglish Dileep RathiEnglishBackground of the Study: In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. The heavy metal lead (Pb) is one of the most widely scattered toxic metals in the world. It has been used by mankind for over 9000 years. Lead in the environment may be derived from natural or anthropogenic sources. Aim and Objective: The aim of this study was to investigate the adverse effect of exposure to lead on a) systolic and diastolic blood pressure, b) serum calcium, ionized calcium, phosphorus and c) kidney functions, of automobile workers. Methods: For this study, two groups of thirty (30) automobile workers and thirty age matched healthy control subjects were selected from Bijapur city. Demographic, occupational and clinical data was collected using questionnaire. From these two groups, venous blood samples in EDTA and Plain bulbs and random midstream urine samples were collected in amber coloured bottles. The biochemical parameters were estimated using standard assay procedures. Statistical analysis of the data was done using independent student?s„t? test for parametric variables. Values were expressed as mean ± standard deviation (SD). P values of 0.05 or less were considered to be statistically significant. Results and Conclusions: As compared to controls, the automobile workers were found to have significantly increased (PEnglishAutomobile workers, Blood lead (Pb-B), Urinary Lead (Pb-U), Systolic and Diastolic blood pressure, Calcium, Phosphorus, Ionized Calcium, Kidney function tests and aminoaciduria.INTRODUCTION
Lead (Pb) is one of the most widely scattered toxic metals in the world. It has been used by mankind for over 9000 years. Lead in the environment may be derived from natural or anthropogenic sources. Lead and its compounds may enter the environment during mining, smelting, processing, use, recycling or disposal. Airborne lead can be deposited on soil and pollute water thus reaching humans through the food chain and drinking water. Levels of lead found in air, food, water, soil and dust vary widely throughout the world and depend upon the degree of industrial development, urbanization and lifestyle factors 1, 2 . Lead is absorbed by the gastrointestinal tract (GIT) via food, beverages, soil and dust in industrial zone. Diet, nutritional status, chemical form of the metal and the pattern of food intake affect lead absorption. Lead is not distributed homogeneously throughout the body. It is rapidly taken up in blood and soft tissues (half life 28-30 days) followed by a slower redistribution to bone (half life 27 years). Dietary lead which is not absorbed in GIT is excreted in faeces 3, 4 . A wide variation exists in individual?s susceptibility to lead poisoning, with a corresponding range in the spectrum of clinical findings. Sub acute or chronic toxicity is more common than acute poisoning. Early symptoms are often subtle, nonspecific and/or subclinical, involving the nervous system (restlessness, fatigue, irritability, sleep disturbance, headache, difficulty in concentrating, decreased libido etc.), GI system (abdominal pain, anorexia, nausea, constipation, diarrhoea etc.) or musculoskeletal system (arthralgia, myalgia). Other less common conditions include tremor, toxic hepatitis or acute gouty arthritis (saturnine gout). In general, severity of symptoms worsens with increasing blood lead levels. A high blood lead level may result in delirium, coma, and seizures associated with lead encephalopathy, a life threatening condition 5, 6, 7 . In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. It causes adverse effects in several organs and organ systems including nervous, renal, cardiovascular, reproductive, haematological and immune system 2, 7 . Adverse biochemical effects of lead are well known today. A correlation between clinical signs and symptoms with blood lead level and relevant biochemical changes may provide important information for making suitable changes in the working environment of workers. Therefore the present study was planned to find out the effect of lead on kidney functions, calcium and phosphorus metabolism, systolic and diastolic blood pressure of automobile workers.
METHODOLOGY
The study was carried out in 30 subjects with occupational exposure to lead i.e. Automobile workers (study group) and 30 normal healthy subjects (non-occupational lead exposure controls) from Bijapur. All the study group and control group subjects were in age ranging from 20 to 45 years. Prior to data and biological specimen collection, the workers were informed on the study objectives and health hazards of lead exposure. Informed consent was obtained from all the workers. Demographic, occupational and clinical data were collected by using questionnaire and interview. The ethical clearance was obtained from the institutional ethical committee. Most of the automobile workers had major complaints of muscle pains, itchy feeling, mild fatigue, aggressiveness, irritability, lethargy, poor concentration and abdominal discomfort etc. All the subjects of both the study group and controls belonged to average socio-economic strata of society. None of the subjects had any past history of major illness. Dietary intake and food habits of all subjects were normal. The subjects, who were on medication for minor illnesses, were excluded from this study. The workers selected for the study were non-smokers and non-alcoholic males, who were exposed to lead for more than 6 hrs/day and for 2 to 20 yrs period. The present study was carried out in the Dept. of Biochemistry, B.L.D.E.U?s Shi B.M.Patil Medical College Bijapur and Central Faciilty Centre, Shivaji University, Kolhapur. Venous blood samples were collected from the subjects and dispensed in plain screw cap test tube for the estimation of biochemical parameters from serum samples and also in test tube containing heparin as anticoagulant for estimating blood lead. To avoid the errors from the inadequate collection of 24 hrs urine samples, spot midstream urine samples were collected from each subject in amber
Where S Ca = Serum total calcium and
S Pr = Serum total protein
Serum inorganic phosphorus was estimated by Wang et.al; and Daly and Ertingshausens method 14,15 . Inorganic phosphorous combines with ammonium molybdate in presence of strong acids to form phosphomolybdate. The formation of phosphomolybdate is measured at 340 nm and is directly proportional to the concentration of inorganic phosphorous present. Urinary excretion of amino acids was analyzed by thin layer chromatography. The chromatography separation takes place by partitioning of the molecules from the mixture between the stationary
colour bottle at the time of blood collection. Both the blood and urine samples were immediately stored at 0 0 c to 4 0 c temperature. All biochemical parameters including kidney function tests were measured on the same day of the sample collection. Blood–lead (Pb-B) and urinary-lead (Pb-U) levels were estimated by the atomic absorption spectrophotometer (AAS) a Perkin Elmer model 303 fitted with a Boiling three slot burner. The spectrophotometer was connected to a readout Hitachi 165 recorder 8, 9 . Systolic and diastolic blood pressures of the workers were measured in resting i.e. supine position before the sample collection and expressed as mm of Hg 10 . Serum Calcium was estimated by Arsenazo III complex method in which calcium reacts with a dye Arsenazo III at pH 3.8 to form bluish purple colour complex and the intensity of the colour formed is directly proportional to the amount of calcium present in the sample 11 . Serum ionized calcium was calculated by employing the method of Mclean and Hasting as adopted by Beeler and Atrou using the following formula 12, 13 .phase and the mobile phase depending upon their relative affinity to each one of the phases 16 .
RESULTS
The results obtained in terms of mean values and SD of biochemical parameters of the study group and the control group are presented in Table 1.which shows Blood lead and urinary lead levels of automobile workers are significantly increased (PEnglishhttp://ijcrr.com/abstract.php?article_id=1523http://ijcrr.com/article_html.php?did=15231. World health organization, Biological indices of lead exposure and body burden. In: IPCS, Inorganic lead Environmental Health Criteria 118? Geneva Switzerland: WHO; 1995. 165:114-118.
2. Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological profile for lead, US Department of Health and Human Services, Atlanta Georgia USA: US Government Printing; 2005.102-225.
3. Casarett and Doull?s Toxicology “The Basic Science of Poisons” edited by Curtis D.Klaassen Chapter 23: Toxic effects of metals – 2008. p 943-947 7th ed. Mc Graw Hill publication.
4. Carl Zenz O, Bruce Dickerson and Edward P.Horvath edited Occupational medicine Ch 38. “Lead and its compounds –Leon A. Saryan and Carl Zenz. 1994; Page 506-540, 3rd ed Mosby publishing company.
5. IPCS Environmental health criteria 85 LeadEnvironmental effect Geneva WHO, 1989. 106.
6. D.A Gidlow, “Lead Toxicity” In depth review. Occupational Medicine. 2004. 54:76-81.
7. Arun J. Patil, Vinod R. Bhagwat, Jyotsna A. Patil, Nilima N. Dongre, Jeevan G. Ambekar and Kushal K. Das. Biochemical aspects of lead exposure in silver jewellery workers of Western Maharashtra (India). Journal of basic and clinical physiology and pharmacology 2006. Vol.17, No.4, 213-229.
8. Parson P J Slavin W. A rapid Zeeman graphite furnace AAS method for determination of lead in blood spectrochim Acta 1993. 48 B 925- 939.
9. A.A. Grenik. Determination of lead chelated with EDTA in blood after precipitation of protein with perchloric Acid. Brit. J Industr Med 1970.27, 40-42.
10. Jill A. Metz , Cynthia D.Morris ,Leslie A. Roberts , Michael R.McClung , and David A.McCarron. Blood Pressure, and calcium intake are related to bone density in adult males. British Journal of Nutrition . 1999; 81:383-388.
11. Biggs H.G Moorehead,W R Determination of Serum calcium. Clin Chem. 1974; 20 ,1458 – 1460.
12. Mcleans FL, Hastings AB. The state of calcium in the fluids of the body. J Biol Chem 1935;108:285-322
13. Beeler MF, Catrou PG. Disorders of calcium metabolism. In: Interpretations in Clinical Chemistry: A Textbook Approach to Chemical Pathology. Chicago: American Society of Clinical Pathologist; 1983. p. 34-44
14. Daly J A and Ertingshausen G. Direct method for determining Inorganic Phosphorus in serum with centrichem. Clinical Chem 1972; 18: 263.
15. Wang J, Chen C C, Osaki S. Optimization of the phosphorus –UV reagent. Clin Chem.1983; 29, 1255.
16. Varley?s Practical Clinical Biochemistry 6th ed. Allan H.Goewenlock in “Separative Procedures Chromatography”. 1987; 34-85.
17. Pachathundikandi S. K, Veghese E.T. Blood zinc protoporphyrin serum total protein and total cholesterol levels in automobile workshop workers in relation to lead toxicity our experience. Indian J Clin Biochem; 2006; 21(2): 114-117.
18. Kopp SJ, Baron JT, Tow JP,. Cardiovascular actions of Lead and relationship to hypertension: a review. Environ Health Perspect. 1988; 78: 01-9.
19. Suma Vupputiri, Jiang He, Paul Muntner, Lydia A. Bazzano, Paul K. Whelton, Vecihi Batuman. Blood Lead Level Is Associated With Elevated Blood Pressure in Blacks Hypertension. 2003; 41:463.
20. Nilima N. Dongre, Adinath N.Suryakar, Arun J. Patil, Indira A. Hundekari, Basavaraj B. Devaranavadagi. Biochemical Effects of Lead Exposure on Battery Manufacture Workers with Reference to Blood Pressure, Calcium Metabolism and Bone Mineral Density. Published online Ind J Clin Biochem. 2012. DOI 10.1007/s12291-012-0241-8.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareEFFECTIVENESS OF HEALTH EDUCATION ON INCREASING KNOWLEDGE ABOUT BREAST FEEDING PRACTICES AMONG POST-NATAL WOMEN
English113118Chandrashekhar R.English Shashidhar BasagoudarEnglish Sujata MuneshwarEnglishObjectives: 1.To study the knowledge about breast feeding practices among post-natal women. 2. To assess the effectiveness of health education session in increasing the knowledge about breast feeding practices among the post-natal women. Material and methods: An interventional study involving health education as the intervention conducted through audio-visual aid and lecture method. Knowledge was assessed as pre-test and post-test using prestructured questionnaire through interview method. Effectiveness was assessed through the increase in post test score compared to pre-test score. Results: Study showed that there was significant difference (p=0.000) between average score of pre test knowledge (14.25) and post test knowledge (18.40). Pre-test score ranged from 8 to 17 whereas post-test score ranged from 15 to 20. Conclusion: There was poor knowledge regarding some aspects of breast feeding practices among post-natal women. Health education session was effective in improving the knowledge about breast feeding practices among the postnatal women.
Englishhealth education, audio-visual media, breast feeding, knowledge.INTRODUCTION Breastfeeding is the normal way of providing nutrients for healthy growth and development of infants as the breast milk contains all the nutrients that a baby needs. 1 Breastfeeding should begin within an hour after birth. The first milk which is called “colostrum” is the most suitable food for the baby because it contains high concentration of protein and other nutrients. It should be "on demand", as often as the child wants day and night. Exclusive breast feeding should be done till 6 months of age. Followed by complimentary feeding and breast feeding should be continued till the age of 2 years. A child who is breast fed has greater chances of survival than a child artificially fed.2 Prolonged breast feeding does protect the infant from early malnutrition and some infections. It has been rightly said that breast feeding acts as first immunization. Adequate breastfeeding could save many young lives. But globally less than 40% of infants under six months of age are exclusively breastfed.3 In India 51% of the mothers will not give colostrum to the newborn soon after birth.4 According to NFHS-3 survey, in India, 46% of the under 3 year children are underweight and 38% are stunted.5 Lack of exclusive breast feeding and improper breast feeding is one of the major contributory factor for this high prevalence of malnutrition and its associated morbidities and mortality. For having a good practices related to breast feeding and to save the many infant lives, it is essential to have proper knowledge regarding the breast feeding practices. Raichur being one of the backward districts of Karnataka has shown poor values in various health related indicators. Hence a study was conducted in this area to assess the knowledge of post natal women regarding breast feeding and impact of health education session in increasing the knowledge. MATERIAL AND METHODS Study was carried out at the Urban health training centre (UHTC), Amtalab, Raichur, which is run by the department of Community medicine, Raichur Institute of medical sciences. All the Anganwadi workers coming under the catchment area of our UHTC were informed about the health education session and given the responsibility of motivating the postnatal women to the UHTC on the prefixed day (which was chosen during breast feeding week August 2012). Study was conducted among all those postnatal women who have attended the breast feeding awareness programme. Oral consent of the post-natal women for participation in the study was obtained after explaining about the study. Data was collected regarding demographic profile and knowledge of breast feeding practices through the prestructured questionnaire by interview method. Data was collected by prior trained interns and Post graduates. After the pre test interview, health education session was conducted involving all the participants. It was conducted through a video session and lecture method covering all the aspects of exclusive breast feeding, importance of breast feeding, complimentary feeding, hazards of bottle feeding etc. To assess the impact of the health education session a post test was conducted through the same questionnaire used for pre test. Change in terms of total score was assessed using Wilcoxon signed rank test and individual question was assessed using chi-square test. For both the test p value of Englishhttp://ijcrr.com/abstract.php?article_id=1524http://ijcrr.com/article_html.php?did=15241. Ghai OP, Paul VK, Bagga A. Ghai, essential paediatrics. 7th ed. Delhi: CBS publishers; 2009. p.122-8.
2. Park K. Textbook of preventive and social medicine. 21 st ed. Jabalpur: Banarsidas Bhanot; 2011. p. 491-7.
3. World health organization. 10 facts on breast feeding, available on http://www.who.int/features/factfiles/breastfe eding/en/index.html [cited on October 10, 2012]
4. Hungama survey report 2011 , available on http://hungamaforchange.org/HungamaBKDe c11LR.pdf [cited on October 10, 2012]
5. Ministry of health and family welfare. National family health survey -3. vol 1. 2007. p. 180-2.
6. Ekambaram M, Bhat VB, Padiyath Ahamed MA. Knowledge, attitiude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res 2010; 14 (2): 119-124.
7. Maseer Khan, Kulkarni PK, Zebunnisa, Chandrasekhar. Study on breast feeding practices among postnatal women in a tertiary care hospital in south Indian city. Int J Pharm Bio Sci 2012 July; 3(3): (B) 272 – 279.
8. Chudasama RK, Patel PC, Kavishwar AB. Determinants of Exclusive Breastfeeding in South Gujarat Region of India. J Clin Med Res 2009; 1(2):102-108.
9. Khresheh R, Suhaimat A, Jalamdeh F, Barclay L. The effect of a postnatal education and support program on breastfeeding among primiparous women: a randomized controlled trial. Int J Nurs Stud 2011 Sep; 48(9):1058- 65.
10. Froozani MD, Permehzadeh K, Dorosty Motlagh AR, Golestan. Effect of breastfeeding education on the feeding pattern and health of infants in their first 4 months in the Islamic Republic of Iran. Bulletin of the World Health Organization 1999; 77 (5): 381-5.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN2012December22HealthcareMANAGEMENT OF ORAL PYOGENIC GRANULOMA - A CASE SERIES
English119123Mythireyi D.English K. VinayagavelEnglishBackground: Pyogenic granuloma is a reactive tumor like lesion frequently seen in the oral cavity. It occurs in response to various stimuli such as chronic low grade irritation, traumatic injury, hormonal factors etc. It predominantly occurs in second decade of life in young females, possibly because of vascular effects of female hormones. Lesions have a similar frequency throughout the world. No racial predilection is reported. Clinically, pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous papules on a pedunculated or sometimes sessile base. Treatment consists of surgical excision along with eradicating the causative agents. Recurrence of the lesion can be prevented by complete excision of the lesion and by following proper oral hygiene measures by the patient. This article describes three cases which have been successfully managed and maintained.
Englishpregnancy tumor, pyogenic granuloma, surgical excisionINTRODUCTION
Pyogenic granuloma is one of the most common reactive tumor like lesion seen in the oral cavity. Hullihen’s1 description in 1844 was most likely the first pyogenic granuloma reported in English literature but the term “pyogenic granuloma” or “granuloma pyogenicum” was introduced by Hartzell2 in 1904. Pyogenic granuloma arises in response to various stimuli such as chronic low grade irritation, traumatic injury, hormonal factors or certain kind of drugs. It predominantly occurs in second decade of life in young females, possibly because of vascular effects of female hormones3 . Lesions have a similar frequency throughout the world. No racial predilection is reported. Although it was originally thought to be caused by pyogenic organisms, it is now believed to be unrelated to infection. So the term pyogenic granuloma is a misnomer because the lesion does not contain pus and is not strictly a granuloma. The pyogenic granuloma has been called “pregnancy tumor” and occurs in 1% of pregnant women3,4 . Clinically, pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous papules on a pedunculated or sometimes sessile base, which is usually hemorrhagic or compressible and may develop as a dumb bell shaped mass3 . This article describes three cases of pyogenic granuloma that were successfully managed.
CASE REPORT
1 A male patient 26 yrs of age reported to a private clinic with a chief complaint of growth in the inner aspect of gums of upper front teeth since 15 days. The growth which was initially a pin head size slowly increased to its present size and was stable. No relevant medical history. On intra oral examination, a small triangle shaped growth with its base at the incissive papilla on the palatal aspect of upper anterior teeth was seen. The growth was 0.5cm * 0.3cm in size, firm fibrotic with no associated bleeding on probing. The oral hygiene status was poor. Intra oral periapical radiograph revealed no bone loss. Non surgical periodontal treatment was opted. The treatment consisted of oral prophylaxis and oral hygiene motivation. When the patient was recalled for review after one week the lesion had subsided.
CASE REPORT 2
A 15 yr old female patient reported with a chief complaint of swelling in upper anterior region since 1 month. On intra oral examination there was a single well defined pedunculated swelling 3cm*2cm between right maxillary central and lateral incisor. Lesion was firm, fibrotic and non tender on palpation. The oral hygiene status was fair. The treatment comprised of oral prophylaxis and oral hygiene motivation. After one week , surgical excision of the lesion was done. Histopathological report revealed proliferating stratified squamous epithelium. Underlying connective tissue showed dilated blood vessels and inflammatory cell infiltration. On follow up after one year patient was normal with no symptoms of recurrence.
CASE REPORT 3
A 17 yr old female patient reported with a chief complaint of enlargement of gums in relation to lower front tooth region for the past 1 year. On examination there was a dumb bell shaped lesion in relation to 32,33 extending from labial to the lingual aspect in relation to mandibular anterior teeth. On palpation the lesion was soft and vascular with a tendency to bleed. Treatment plan consisted of oral prophylaxis followed by surgical periodontal management. On the first day through oral prophylaxis was done. Patient was recalled after 1 week and was reviewed. Since the lesion was still vascular surgical excision followed by periodontal flap surgery for through debridement was done. Histopathological report showed proliferating parakeratinised epithelium. Underlying connective tissue showed inflammatory cell infiltration and engorged blood vessels. Follow up after six months showed no symptoms of recurrence.
DISCUSSION
Pyogenic granuloma is a non neoplastic growth in the oral cavity. It may vary in size from few millimeters to several centimeters and are often painless. Gingiva is the most common site of occurrence accounting about 75% of all cases5 . According to Vilmann et al6 , majority of pyogenic granulomas are found on the marginal gingiva with only 15% of the tumors on the alveolar part. Other common sites are lips, tongue and buccal mucosa. Since it is a reactive tumor like lesion, chronic low grade irritation, traumatic injury, hormonal factors and certain kind of drugs could be considered as etiologic agents. Poor oral hygiene may be a precipitating factor in many patients3,4,5 . Many treatment techniques have been described for pyogenic granuloma. But before treating any case the etiology must be clearly identified and eradicated. Before attempting surgical excision of the lesion, a thorough oral prophylaxis should be done, because local factors such as plaque and calculus are the most important etiologic factors for pyogenic granuloma. If the lesion is small, painless and free of bleeding, oral prophylaxis, removal of causative irritants (foreign materials, source of trauma) and follow up is advised. The first case was managed successfully with the above mentioned treatment modality. If the lesion is large, a thorough oral prophylaxis followed by surgical excision extending down to the periosteum should be done along with scaling of adjacent teeth to remove the source of continuing irritation. The second and third cases were managed with this treatment plan. Other treatment protocols also have been suggested. Powell et al7 reported the use of Nd: YAG laser for excision of the lesion because of the lower risk of bleeding compared to other surgical techniques. White et al8 proposed that CO2 and Nd:YAG laser irradiation is successful in surgical management. Meffert et al9 used flash lamp pulsed dye laser on a mass of granulation tissue which did not respond to the usual treatment methods and concluded that previously resolute tissue responded well to a series of treatments with the pulsed dye laser. Ishida and Ramos-e-Silva10 believed that cryosurgery is a very useful technique for the treatment of pyogenic granuloma. Moon et al11 reported that sodium tetradecyl sulfate sclerotherapy successfully cleared the lesions in most patients without major complications. Parisi et al12 used a series of intralesional corticosteroid injections for treatment of pyogenic granuloma, particularly highly recurrent lesions. Preventive measures consists of adequate home care measures with regular dental check up and oral prophylaxis especially during pregnancy. Lesions removed during pregnancy may have a higher recurrence rate. After excision recurrence occurs in upto 16% of the lesions. Recurrence is believed to result from incomplete excision, failure to remove etiologic factors or re injury of the area. Some recurrences manifest as multiple deep satellite nodules that surround the site of the original lesion3 . Differential diagnosis of pyogenic granuloma includes peripheral giant cell granuloma, peripheral ossifying fibroma, peripheral odontogenic fibroma, hyperplastic gingival inflammation, Kaposi’s sarcoma, bacillary angiomatosis, angiosarcoma, metastatic cancer and hemangioma13 .
CONCLUSION
Pyogenic granuloma is a relatively common tumor like lesion of oral cavity. Successful management necessitates proper diagnosis and treatment planning. Although excisional surgery is the treatment of choice for pyogenic granuloma, removal of causative agents should be the first line of treatment. After surgical excision patient should follow proper oral hygiene measures to prevent recurrence of the lesion. High recurrence rate of this lesion could be attributed to improper excision of the lesion, or improper surgical debridement or failure of the patient to maintain proper oral hygiene. Importance of strict oral hygiene measures must be stressed to the patient.
ACKNOWLEDGEMENT
Authors acknowledge the great help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors and publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.
Englishhttp://ijcrr.com/abstract.php?article_id=1525http://ijcrr.com/article_html.php?did=15251. Hullihen SP (1844) Case of aneurism by anastomosis of the superior maxillae. Am J Dent Sc 4, 160 -162
2. Hartzell MB (1904) Granuloma pyogenicum J Cuttan Dis Syph 22, 520-525
3. Hamid Jafarzadeh, Majid Sanatkhani et al (2006) oral pyogenic granuloma: a review vol 48 no 4 167 -175
4. Neville BW, Damm ,Allen CM, Bouquot JE (2009) oral and maxillofacial pathology 3rd ed, WB Saunders, Philadelphia, 517-518
5. Regezi JA, Sciubba JJ, Jordan RCK (2003) Oral Pathology : ClinicalPathology Consideration 4th ed , BC Decker, Hamilton 141-142
6. Vilmann A, Vilmann P, Vilmann H (1986) Pyogenic granuloma evaluation of oral conditions. Br J Oral Maxillofac Surg 24, 376 – 382
7. Powell JL, Bailey CL, Coopland AT, Otis CN, Frank JL, Meyer I(1994) Nd:YAG laser excision of a giant gingival pyogenic granuloma of pregnancy. Lasers Surg Med 14, 178-183
8. White , Chaudhry SI, Kuder JJ, Sekandari N, Schloelch ML, Silverman S Jr(1998) Nd:YAG and CO2 laser therapy of oral mucosal lesions. J Clin Laser Med Surg 16, 299 -304
9. Meffert JJ, Cagna DR, Meffert RM (1998) Treatment of oral granulation tissue with the flashlamp plsed dye laser. Dermatol Surg 24, 845 -848
10. Ishida CE, Ramos-e-Silva M (1998) Cryosurgery in oral lesions. Int J Dermatol 37, 283-285
11. Moon SE, Hwang EF, Cho KH ( 2005) Treament of pyogenic granuloma by sodium tetradecyl sulfate sclerotherapy. Arch Dermatol 141, 644-646
12. Parisi E, Glick PH, Glick M (2006) Recurrent intraoral pyogenic granuloma with satellitosis treated with corticosteroids. Oral Dis 12, 70- 72
13. Kamal R, Dahiya P, Puri A. ( 2012 ) Oral pyogenic granuloma: Various concepts of etiopathogenesis. J Oral Maxillofac Pathol ;16:79-82
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30HealthcareFINE NEEDLE ASPIRATION CYTOLOGY FOR THE DIAGNOSIS OF TUBERCULOUS LYMPHADENITIS
English124130Sumit GiriEnglish Karandeep SinghEnglishBackground: Tuberculosis is a major public health problem in India and one of the main causes of lymphadenopathy. However, anti-tubercular treatment cannot be given only on clinical suspicion. Cytomorphology with acid fast staining proves to be a valuable tool in diagnosing these cases. Aim: To assess the role of FNAC in diagnosing tuberculous lymphadenitis and also to study the role of repeat aspiration cytology in patients with strong clinical suspicion of tuberculosis. Research Methodology: FNAC were done by cytopathologist after taking a detailed clinical history regarding duration of swelling, site, size, consistency and mobility. The alcohol fixed smears were stained with Papanicolaou stain, air-dried smears stained with May-Grunwald Giemsa (MGG) and Ziehl-Neelsen (ZN) stain for Acid-Fast Bacilli (AFB). Results: Out of 728 cases with lymphadenopathy of various aetiologies, 264 cases were diagnosed as tuberculous (TB) lymphadenitis. Four cytomorphologic patterns were observed: 1) Epithelioid granulomas with caseous necrosis: 142 cases (53.79%). 2) Epithelioid granulomas without caseous necrosis: 73 cases (27.65%). 3) Necrotising lymphadenitis: 38 cases (14.39%), and 4) Necrotising and suppurative lymphadenitis: 11 cases (4.17%). Ninety two cases were diagnosed as reactive lymphadenitis with activated histiocyte clusters and were advised a repeat aspiration after a course of antibiotics. Out of the 41 cases that turned-up for re-aspiration, 27 cases showed subsequent development of epithelioid granulomas, whereas the others continued to reveal features of reactive lymphadenitis. Conclusion: FNAC is a reliable, rapid and cost-effective, outdoor diagnostic procedure requiring minimal instrumentation and is highly sensitive to diagnose tuberculous lymphadenitis and repeat aspiration, after 3?4 weeks helps in providing the correct diagnosis of early tubercular lesions.
EnglishFNAC, Tuberculous lymphadenitis, AFB, Epithelioid granulomas.INTRODUCTION Tuberculosis (TB) remains a major public health problem worldwide, especially in the developing countries like India. About thirty percent of the tuberculous infections are extrapulmonal [1]. Peripheral tuberculous lymphadenopathy is the most common manifestation of extrapulmonary tuberculosis, mostly affects the cervical lymphnodes [1,2,3]. Since TB carries a high risk of morbidity and mortality and therefore accurate and timely diagnosis together with effective TB treatment is the mainstay of TB care and control. Open biopsy has been traditionally the standard for the diagnosis of tuberculous lymphadenitis. However, it can be associated with significant morbidity as well as delay in diagnosis. Fine needle aspiration diagnosis of pulmonary and extra-pulmonary tuberculosis is becoming increasingly popular diagnostic tool because of its simplicity, rapidity and performance friendly nature [4,5,6]. Fine needle biopsy (FNB) avoids the physical and psychological trauma occasionally encountered after open biopsy. It is convenient for the patient and the physician as well, useful for outpatients, and relatively painless [7]. FNB has been found to be a safe tool, a quick and inexpensive method of diagnoses with reasonable accuracy of 84.4−89.77% [8,9,10]. The present study was carried out to study the various cytomorphologic patterns in lymph nodes on FNAC and to evaluate the utility of reaspiration cytology for detecting the subsequent development of granulomas.
MATERIALS AND METHODS
This prospective observational study was carried out at the department of pathology, Dr. Hedgewar Arogya Sansthan Hospital, from May 2009 to September 2010. FNAC was performed by cytopathologists on 728 patients who presented with peripheral lymphadenopathy. A detailed clinical history was elicited and a thorough physical examination was done along with relevant laboratory investigations and chest X-ray before subjecting the patients to aspiration. After taking proper consent, aspirations were done using 23 gauze needle with attached 10 ml disposable syringe. In all cases, alcohol fixed and air-dried smears were made: alcohol fixed slides were stained by Papanicolaou (PAP) method and airdried smears were stained by May GrunwaldGiemsa (MGG). Special stain for acid fast bacilli (Z-N stain) was done in all cases where purulent or cheesy material was aspirated. A detailed cytomorphologic patterns were studied. A repeat aspiration was advised after 3−4 weeks in those patients who were diagnosed as reactive lymphadenitis with activated histiocyte clusters.
RESULTS
Out of the 728 patients presented with peripheral lymphadenopathy, 264 cases were diagnosed as tuberculous lymphadenitis and 92 cases as reactive lymphadenitis with activated histiocyte clusters. The age of the patient ranged from 4 to 68 years with a median age of 32 yrs. The age group between 21−30 yrs was mostly affected (Table 1). The male: female ratio was 2:1. Among the various sites of lymph node involvements, cervical lymph nodes were the most common-137 cases (51.89%) followed by axillary, inguinal and supraclavicular nodes (Table 2). On the basis of cytomorphological analysis, TB lymphadenitis were categorised into 4 patterns (Table 3): 1. Epithelioid granuloma with caseous necrosis- 142 cases (53.79%) which showed epithelioid granuloma, caseaous necrosis with or without giant cells in a background of lymphoid cells (Fig.1). 2. Epithelioid granuloma without caseous necrosis-73 cases (27.65%) which showed only epithelioid granuloma with or without giant cells (Fig. 2). 3. Necrotising lymphadenitis-38 cases (14.39%) which showed degenerating epithelioid cells in a necrotic background. 4. Necrotising and suppurative lymphadenitis-11 cases (4.17%) which showed degenerating and viable neutrophils in a necrotic background. A definitive cytologic diagnosis of TB lymphadenitis could be considered in the smears with the first two patterns, while the third and fourth could be dismissed as acute suppurative lymphadenitis in the absence of a positive ZN stain. Different patterns showed varied AFB positivity (Table 3). The necrotising lymphadenitis showed 94.74% AFB positivity while necrotising and suppurative lymphadenitis patterns showed 90.91% AFB positivity (Fig.3). The other two patterns i.e., epithelioid granuloma with caseous necrosis and epithelioid granuloma without caseous necrosis had AFB positive only in 48 (33.80%) and 11 (15.07%) cases respectively. Apart from the above four patterns, the present study also showed a fifth cytomorphologic pattern in 92 cases, comprising of ill formed or suspicious epithelioid cells without characteristic necrosis or giant cells. This pattern revealed tiny foci of activated histiocytes in a background of lymphoid cells in various stages of maturation. In such cases a follow-up re-aspiration was advised after 3−4 weeks to look for subsequent development of granuloma. But only 41 cases turned-up for repeat aspiration out of which 27 cases (65.85%) developed epithelioid granuloma, and AFB were seen in 10 cases. Fourteen cases (34.15%) still remained with reactive features.
DISCUSSION
Tuberculosis is a major public health problem in our country. The high rate of tuberculous lymphadenitis is due to low socioeconomic status, illiteracy, incomplete treatment, resistance and increased incidence of HIV. Tubercular lymphadenitis is a common manifestation of extrapulmonary tuberculosis and one of the main causes of lymphadenopathy. Mycobacterial infections are observed among late teens and young adults [11]. Due to high morbidity associated with the disease it affects the earning potential of the individual and their families. Considering the overall prevalence of tuberculosis in the Indian context, the presence of epithelioid cell granulomas is indicative of tuberculosis [12]. FNB has been very useful in the diagnosis of tuberculous lymphadenitis as it was discussed in numerous publications [9, 13−15]. Many authors described three cytomorphologic patterns [16,17]. Whereas some categorized cytologic features of tuberculous lymphadenitis into four groups: (1) epithelioid cell clusters with or without Langhans's giant cells, without necrosis, (2) epithelioid cell clusters with or without Langhans's giant cells, with necrosis, (3) occasional epithelioid cells without characteristic of necrosis nor giant cells, and (4) necrosis without epithelioid cell clusters nor Langhans's giant cells [18,19]. Our study also revealed four patterns similar to the study by Nayak et al [20]. The comparison between various cytomorphologic patterns by different authors is shown in Table 4. The present study showed that every age group of the population was affected by TB and the incidence of the disease was higher in males than in females. This is in correlation with the study by Gupta et al [20]. The cervical group of lymph nodes were the most commonly affected site (51.89%) which was similar to other studies [3,11,22]. The other affected sites were axillary and inguinal group of lymph nodes. These findings were similar to the study by Ng et al [23]. It is observed that there is an inverse relationship between granulomas and the presence of AFB [4,16,24,25]. Our study found higher AFB positivity in smears containing necrotic materials. It was similar to the study by Malakar et al [26]. TB lymphadenitis has unique stages as described by Jones et al [27]. The aspirates from stage one or two tuberculous lymphadenitis usually provide inflammatory cells as seen in reactive lymphadenitis. Thus, FNAC of these stages can only be non-specific reactive. Typical necrotic materials or tubercle bacilli can be seen in the advanced stages in which an abscess is readily formed in the core of the lymph node [8]. So aspirates from an early stage lymph node were the main cause of low sensitivity. If lymph node aspiration was done once in the early stage, the diagnosis is likely to be dismissed as a reactive node. This study shows that re-aspirating after three or four weeks improves the diagnostic efficacy of FNAC. It is therefore necessary to follow the patients whose clinical findings are compatible with TB lesions.
CONCLUSION
To conclude, every case of peripheral lymphadenopathy needs to undergo Fine Needle Aspiration Cytology. This technique coupled with Ziehl-Neelsen staining for Acid Fast Bacilli is an excellent method for diagnosing tuberculous lymphadenitis. It can even provide an important clue about the immune status of the patient. The study also included the significance of repeat aspiration cytology in patients with strong clinical suspicion of tuberculosis.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed
Englishhttp://ijcrr.com/abstract.php?article_id=1526http://ijcrr.com/article_html.php?did=15261. Van Altena R, Richter C, 2002. De kliniek en diagnostiek van pulmonale en extrapulmonale vormen van tuberculose. Ned Tijdschrift Med Microbiol 10 C, pp. 46−52.
2. Thompson MM, Underwood MJ, Sayers RD, Dookeran KA, Bell PR, 1992. Peripheral tuberculous lymphadenopathy: a review of 67 cases. Brit J Surg 79, pp.763−764.
3. Bezabih M, Mariam DW, Selassie SG. Fine needle aspiration cytology of suspected tuberculous lymphadenitis. Cytopathology 2002;13(5), pp. 284−90.
4. Nataraj G, Kurup S, Pandit A, Mehta P. Correlation of fine needle aspiration cytology, smear and culture in tuberculous lymphadenitis: a prospective study. JPGM 2002; 48(2): 113−6.
5. Metre MS, Jayram G. Acid fast bacilli in aspiration smears in tuberculous lymph nodes-an analysis of 225 cases. Acta Cytol 1987; 11: 17−9.
6. Arora B, Arora DR. Fine needle aspiration cytology in the diagnosis of tuberculous lymphadenitis. Indian J Med Res 1990; 91: 189−92.
7. Ponder TB, Smith D, Ramzy I, 2000. Lymphadenopathy in children and adolescents: role of fine-needle biopsy in management. Cancer Detect Prev 24, pp. 228−233.
8. Suh KW, Park CS, Lee JT, Lee KG. Diagnosis of cervical tuberculous lymphadenitis with fine needle biopsy biopsy and cytologic examination under ultrasosographic guides. Yonsei Med J 1993;34(4): 228−333.
9. Dasgupta A, Ghosh RN, Poddar AK, Mukherjee C, Mitra PK, Gupta G, Ganguly U, 1994. Fine needle biopsy cytology of cervical lymphadenopathy with special reference to tuberculosis. J Indian Med Assoc 92, pp. 44−46.
10. Singh JP, Chaturvedi NK, Das A, 1998. Role of fine needle biopsy cytology in the diagnosis of tuberculous lymphadenitis. Indian J Pathol Microbiol 32, pp. 100−104.
11. Grange J, Cristopher C, Yates M. Bacteriological survey of tuberculous lymphadenitis in south-east England. Journal of Epidemiology and Community Health 1982; 36: 157−61.
12. Pandit AA, Khilani PH, Prayag A. Tuberculous lymphadenitis: extended cytomorphologic features. Diagn Cytopathol 1995; 12: 23−7.
13. Masud KU, Wadood AU, Sanaullah, Baloch MA, Mirza JA, Sahibzada NJ, 1999. Role of FNB in the diagnosis of tuberculous lymphadenitis. Biomedica 15, pp. 54−59.
14. Gupta SK, Chugh TD, et al., 1993. Cytodiagnosis of tuberculous lymphadenitis. Acta Cytol 37, pp. 329−332.
15. Khan UF, ul Khan RAH, Ashraf J, Barki NU, 2001. Fine needle biopsy biopsy versus excision biopsy in tuberculous cervical lymphadenitis. J Rawal Med Coll 5, pp. 21−24.
16. Das DK, Pant JN, Chachra M et al. Tuberculous lymphadenitis: correlation of cellular components and necrosis in lymph node aspirate with AFB positivity and bacillary count. Indian J Pathol Microbiol 1990; 33: 1−10.
17. Llatjos M, Romeu J, Clotet B et al. A distinctive cytologic pattern for the diagnosing TB lymphadenitis in AIDS. J Acquir Immune Defic Syndr 1993; 6 (12): 1335−8.
18. Gupta AK, Nayar M, Chandra M, 1992. Critical appraisal of fine needle biopsy cytology in tuberculaous lymphadenits. Acta Cytol 36, pp. 391−394.
19. Lau SK, Wei WI, Hsu C, Engzell UC, 1990. Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy. J.Laryngol Otol 104, pp.24−27.
20. Nayak S, Puranik SC, Deshmukh SD et al. Fine needle aspiration cytology in the tuberculous lymphadenitis of patients with or without HIV infection. Diagn Cytopathol 2004; 31 (4): 204−6.
21. Gupta S, Rajak CL, Sood BP, Gulathi M, Rajwanshi A, Suri S. Sonographically guided fine needle aspiration biopsy of abdominal lymph node. J Ultrasound Med 1999; 18: 135−9.
22. Bhatt JV, Shah JM, Shah J. Clinicopathological profile of cervical lymphadenopathy. Journal of Applied Basic Medical Sciences 2000; 2(2); 35−9.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN2012December22HealthcareS-WAVE PROPAGATION IN A NON-HOMOGENEOUS INITIAL STRESSED ELASTIC MEDIUM UNDER THE EFFECT OF MAGNETIC FIELD
English131139Rajneesh KakarEnglish Shikha KakarEnglishThe propagation of magneto shear waves in a non-homogeneous, anisotropic, incompressible and initially stressed medium has been discussed in this study. The problem has been solved analytically using linear inhomogenities and the exact solution of frequency equations has been obtained. In fact, these equations are in agreement with the corresponding classical results when the medium is isotropic. The graphs have been plotted for frequency equations with MATLAB. It is observed that the shear waves have dependence on the direction of propagation, the anisotropy, magnetic field, non-homogeneity and the initial stress of the medium.
EnglishIncompressible, initial-stress, anisotropic, shear-wave, magnetic field.INTRODUCTION
Problem of shear waves in an orthotropic elastic medium is been very important for the possibility of its extensive application in various branches of Science and Technology, particularly in Optics, Earthquake science, Acoustics, Geophysics and Plasma physics. The term “Initial stress” is meant by stresses developed in a medium before it is being used for study. The earth is an initially stressed medium. Due to presence of external loading, slow process of creep and gravitational field, considerable amount of stresses (called pre-stresses or initial stresses) remain naturally present in the layers. These stresses may have significant influence on elastic waves produced by earthquake or explosions and also in the stability of the medium. The propagation of surface waves is well documented in the literature, Abd-Alla and AboDahab [1] investigated time-harmonic sources in a generalized magneto-thermo-viscoelastic continuum with and without energy dissipation. Abd-Alla [2] studied the effect of initial stress and orthotropy on the propagation waves in a hollow cylinder. Abd-Alla et al. [3] presented Rayleigh waves in a magnetoelastic half-space of orthotropic material under an influence of initial stress and gravity field. Abd-Alla and Mahmoud [4] solved the magneto-thermoelastic problem in rotating a non-homogeneous orthotropic hollow cylindrical under the hyperbolic heat conduction model, and investigated the effect of the rotation on propagation of thermoelastic waves in a nonhomogeneous infinite cylinder of isotropic material. Abd-Alla et al. [5] Kakar [16] has investigated surface wave in non-homogeneous, general magneto thermo, viscoelastic Media. The propagation of Rayleigh waves in granular medium was given by many authors such as Bhattacharyya [7], El-Naggar [8], Ahmed [9], and others. In [10], Ahmed discussed the influence of gravity on the propagation of Rayleigh waves in granular medium. The Edge wave propagation in an incompressible anisotropic initially stressed plate of finite thickness has been studied by Dey et al. [11]. Addy et al. [12] have studied Rayleigh waves in a viscoelastic half-space under initial hydrostatic stress in presence of the temperature field. Liu et al. [13] have demonstrated the propagation characteristics of converted refracted wave and its application in static correction of converted wave. Moczo et al. [14] provided mathematical modeling of seismic wave propagation using the FiniteDifference time-domain method. Huber [15] has explained the physical meaning of a nonlinear evolution equation of the fourth order relating to locally and non-locally supercritical waves in his work. Duan1 et al. [16-17] have investigated heterogeneous fault stresses from previous earthquakes and the effect on dynamics of parallel strike-slip faults and non-uniform pre-stress from prior earthquakes and the effect on dynamics of branched fault systems. Zhou and Chen [18] have studied the influence of seismic cyclic loading history on small strain shear modulus of saturated sands. Sharma et al. [19] discussed about the wave velocities in a pre-stressed anisotropic elastic medium. Selim et al. [20] have demonstrated the propagation and attenuation of seismic body waves in dissipative medium under initial and couple stresses. Seismology is the study of progressive elastic wave. But most of these studies and investigations do not include very important factor viz, the influence of initial stress, anisotropy and non-homogeneity present in the body. In this paper, the propagation of shear waves in a non-homogeneous anisotropic incompressible initially stressed medium under the influence of magnetic field is discussed. The frequency equation that determines the velocity of the shear wave has been obtained. The dispersion equations have been obtained, and investigated for different cases. Also, when the non-homogeneity are neglected, the frequency equation is in well agreement with the corresponding classical result.
RESEARCH METHODOLOGY
This paper aims to present an account of the theory of wave propagation in non-homogeneous elastic media. The treatment necessarily involves considerable mathematical analysis. The pertinent mathematical techniques are, however, discussed at some length. The basic equations are the problem is dealing with magnetoelasticity. Therefore the basic equations will be electromagnetism and elasticity. The Maxwell equations of the electromagnetic field in vacuum are
where H, B, E, J , and D denote the magnetic field intensity, magnetic induction, electric field intensity current density vector and displacement current vector respectively, c is the velocity of light in vacuum. The Gaussian units have been used.
where = the incremental stress components, = the components of the displacement vector of the solid,
Where and are the components of the rotational component .
FORMULATION OF THE PROBLEM
Most materials behave as incompressible media and the velocities of longitudinal waves in them are very high Initial stress arises in the earth due to factors like external pressure, slow process of creep, difference in temperature, manufacturing processes, nitriding, pointing etc., of rocks. Owing to the variation of elastic properties and the presence of these initial stresses, the medium becomes isotropic as well. We consider an unbounded incompressible anisotropic medium under initial stresses 11 and 22 along the x, y directions, respectively. When the medium is slightly disturbed, the incremental stresses 11, 12 and 22 are developed, and the equations of motion in the incremental state become from (**) and (*)
Where's is the magnetic permeability and H0, the intensity of the uniform magnetic field, parallel to x-axes, also, is incremental stresses the rotational component about z-axis. The incremental stress-strain relation for an incompressible medium may be taken as
Since the problem is treated in x-y plane where = , eij is an incremental strain component, and N and Q are the rigidities of the medium. The incompressibility condition exx + eyy = 0 is satisfied by
Substituting from equations (3) and (4) in equations (1) and (2), we get
Assuming non-homogeneities as
Substituting from equation (7) in equations (5) and (6), we get (8)
Eliminating τ from equations (8) and (9), we get
SOLUTION OF THE PROBLEM For propagation of sinusoidal waves in any arbitrary direction, we take the solution of equation (10) as
Where is the angle made by the direction of propagation with the x-axis, and c1 and k are the velocity of propagation and wave number, respectively. Using equation (11) in equation (10) and equating real and imaginary parts separately, we get
ANALYSIS OF PROBLEM IN HOMOGENEOUS MEDIUM (i) Analysis of equation (12) obtained by equating the real part of equations of motion: Case I : In this case Q is homogeneous (a ? 0) i.e., rigidity along vertical direction is constant
The velocity along x-direction (cos ? = 1, sin ??= 0, c1 = c11) as
Equation (16) depends on the initial stress and magnetic field. To obtain the velocity of propagation along y-direction Put cos ??= 0, sin ??= 1 and c1 = c22 in equation (14), we get
Case II : In this case N is homogeneous (b ??0) i.e., rigidity along horizontal direction is constant
Equation (19) depends on depth and magnetic field. The velocity of propagation along ydirection (cos ? = 0, sin ??= 1, c 1 = c11), is given by
For P > 0, the velocity along y-direction may increase considerably at a distance from free surface and the wave becomes dispersive.
Case III : In this case N, Q and ? are homogeneous (a ??0, b ??0, c ??0)
In the absence of initial stress the velocity equation becomes
In x-direction (cos ??= 1, sin ??= 0, c1 = c11), the velocity is given by
and in y-direction (cos ??= 0, sin ??= 1, c1 = c22), the velocity is given by
(ii) Analysis of equation (13) obtained by equating imaginary parts of equation of motion.
In absence the initial stress P in equation (13), following three cases have been analyzed.
Case I : In this case Q is homogeneous (a ??0) i.e., rigidity along vertical direction is constant
This allows that velocity of shear wave is always damped. The velocity of wave along x-direction (cos ??= 1, sin ??= 0, c 1 = c11) is obtained as
This shows that actual velocity in x-direction is damped by (4N0 b/Q0 c), and no damping takes place along y-direction.
Case II : In this case N is homogeneous (b ??0), i.e., rigidity along horizontal direction is constant.
The velocity of wave along x-direction (cos ??= 1, sin ??= 0, c 1 = c11) is given by
The existence of negative sign shows that damping does not take place along x-direction for (b ??0). The velocity along y-direction is given by
Indicating that a damping of magnitude (2a/c) takes place along y-direction. Case III : In this case N and Q are homogeneous (a ? 0, b ? 0) but density is linearly varying with depth :
i.e. no damping takes place.
NUMERICAL ANALYSIS AND DISCUSSION To get numerical information on the velocity of shear wave in the non-homogeneous initially stressed medium we introduce the following nondimensional parameters:
Using these parameters in the equation (2), we obtain
Various graphs are plotted with the help of MATLAB by taking the parameters as
a = 4; c = 0.7; p = 0.5; N = 2.5; H = 0.3; b = 0, 1, 6
The effect of a non-homogeneous anisotropic incompressible, magnetic field and initially stressed respectively on shear wave velocity c with respect to depth b is as shown in figures [1-4].
It is obvious that shear wave velocity increases with the increasing of the depth b. The velocity of propagation also depends on the inclination of the direction of propagation; an increase in the inclination angle decreases the velocity in the beginning, takes a minimum value before increasing
CONCLUSIONS
1. The anisotropy, magnetic field, inhomogeneity of the medium, the initial stress, the direction of propagation and the depth have considerable effect on the velocity of propagation of shear wave. 2. The velocity of the shear waves depends on the parameters associated with anisotropy. 3. The velocity of the shear waves increases with the increase in magnetic field and vice versa. 4. The shear wave velocity decreases with the increase of initial stress.
ACKNOWLEDGEMENTS
The authors are thankful to the referees for their valuable comments.
Englishhttp://ijcrr.com/abstract.php?article_id=1527http://ijcrr.com/article_html.php?did=15271. Abd-Alla, A.M. and Abo-Dahab, S.M. 2009. Time-harmonic sources in a generalized magneto- thermo viscoelastic continuum with and without energy dissipation. Applied Math Model, 33(5): 2388-402.
2. Abd-Alla, A.M. 1999. The effect of initial stress and orthotropy on the propagation waves in a hollow cylinder. Applied Math Computation, 106(3): 237-44.
3. Abd-Alla, A.M., Hammad A.H., and AboDahab 2004; SM. Rayleigh waves in a magneto elastic half-space of orthotropic material under influence of initial stress and gravity field. Applied Math Computation 154(2): 583-97.
4. Abd-Alla, M and Mahmoud, S.R. (2010). Effect of the rotation on propagation of thermoelastic waves in a non-homogeneous infinite cylinder of isotropic material, International Journal of Mathematical Analysis 4 : 34-45.
5. Abd-Alla, A.M., Hammad A.H., and AboDahab 2004. Rayleigh waves in magnetoelastic half-space of orthotropic material under influence of initial stress and gravity field, Applied Mathematics and Computation, 154 : 583–597.
6. Kakar, R. and Kakar, S., 2012 Surface wave propagation in non homogeneous, general magneto-thermo, visco-elastic media IJIEASR 1: 45-49.
7. Bhattacharyya, R. K. 1965. Rayleigh waves in granular medium, Pure Applied .Geophysics, 62 (3): 13–22.
8. El-Naggar, A.M. 1992. On the dynamical problem of a generalized thermoelastic granular infinite cylinder under initial stress. Astrophysics Space Science, 190 (2): 177– 190.
9. Ahmed, S. M. 1999. Influence of gravity on the propagation of waves in granular medium Applied Mathematics and Computation,154(2) : 269–280
10. Ahmed, S. M. 2000. Rayleigh waves in a thermoelastic granular medium under initial stress. International Journal of Mathematical Science. 23 (9): 627–637.
11. Dey, S. and De, P. K. 2009. Edge wave propagation in an incompressible anisotropic initially stressed plate of finite thickness, International Journal of Computational Cognition, 7(3): 55-60.
12. Addy, S. K. and Chakraborty ,N. R., 2005. Rayleigh waves in a viscoelastic half-space under initial hydrostatic stress in presence of the temperature field. International Journal of Mathematics and Mathematical Sciences, 24: 3883–3894
13. Liu, Y. and Wei , X. C. 2008. Propagation characteristics of converted refracted wave and its application in static correction of converted wave, Science in China Series D: Earth Sciences, 51(2): 226-232.
14. Moczo, P., Robertsson, J.O.A. and Eisner, L. 2007. The Finite-difference time-domain method for modeling of seismic wave propagation, Advances in Geophysics, 48: 421-516.
15. Huber, A. 2010. The physical meaning of a nonlinear evolution equation of the fourth order relating to locally and non-locally supercritical waves, International Journal of Engineering, Science and Technology, 2: 70- 79.
16. Duan1, B. and Oglesby, D.D., 2006. Heterogeneous fault stresses from previous earthquakes and the effect on dynamics of parallel strike-slip faults. Journal of Geophysical Research, 111: B05309.
17. Duan1, B. and Oglesby, D.D., 2007. Nonuniform prestress from prior earthquakes and the effect on dynamics of branched fault systems, Journal of Geophysical Research, 112: B05308.
18. Zhou, Y. and Chen, Y. 2005. Influence of seismic cyclic loading history on small strain shear modulus of saturated sands. Soil Dynamics and Earthquake Engineering, 25(5): 341-353.
19. Sharma M. D. 2005. Effect of initial stress on the propagation of plane waves in a general anisotropic poroelastic medium. Journal of Geophysical Research, 110(B11): B11307.1- B11307.14
20. Selim. M. M. and Ahmed. M. K., 2006. Propagation and attenuation of seismic body waves in dissipative medium under initial and couple stresses. Applied Mathematics and Computation, 182,(2): 1064-1074.
21. Pargamaon, and London, Bland, D.R. 1960. “The Theory of Linear Viscoelasticity”
22. Mcgraw-Hill, W.M. Ewing, W.S. Jardetzky, and F. Press, 1957. “Elastic waves in layesed media”, New York.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241424EnglishN-0001November30TechnologyASSESSMENT OF QUALITY NEEDS FOR NON FORMAL SERVICE SECTOR
English140144Mohit TripathiEnglishThe aim of this research is to find the quality needs for improvement of non-formal organization/service sector’s productivity. The non-formal organization or unorganized sector consists of all unincorporated private enterprises owned by individuals or households engaged in the sale and production of goods and services operated on a proprietary or partnership basis. Many parameters are responsible for increasing the productivity of the organization like public utility, selection of area, organized committee, finance and publicity. For deciding priorities and accessing the enhancement the quality of any non-formal organization, a questionnaire was prepared according to review of literatures. A survey was conducted with contacting 121 peoples/organizations and 26 people were interviewed in which 46 sample data collected from non-formal organization. SPSS 17.0 versions (statistical analysis software) used to analyze the sample data, which was received from the various peoples/organizations. As result of this study public utility was ranked highest followed by the selection of area, organizing committee, finance and publicity. After the application of this methodology to an event management group it is observed that they are highly managed and serving the best to the public.
EnglishNon-Formal Service Sector, organizing committee, Quality Assessment, selection of area, SPSS.INTRODUCTION In the recent cost-effective environment and in the globalization process the companies facade many challenges in all sectors; Unorganized/ Informal sector: The unorganized sector consists of all unincorporated private activity owned by folks or households betrothed in the sale and production of goods and services control on a proprietary or partnership foundation and with less than ten total workers (Rao, et.al. 2012). Informal sector is also divided into two broad categories: traditional domestic based informal sector and modern informal sector (Ranis and Stewart (1999). Traditional informal sector is differentiate as very small size, squat capitalization, stumpy labour productivity, stockstill technology and household based production unit. Modern informal sector is characterized as larger in size, capital demanding and more dynamic in technology (Indrajit.et.al.2010). The informal service organization is the intertwining social structure that governs how people work together in practice. It is the aggregate of behaviors, interactions, norms, personal and proficient connections through which work gets done and relationships are built among people who share a common organizational affiliation or cluster of affiliations. It consists of a vibrant set of personal relationships, social networks, communities of common interest, and arousing sources of motivation. The informal organization evolves organically and spontaneously in response to changes in the work milieu, the flux of people through its porous boundaries, and the intricate social dynamics of its members. Tended effectively, the informal organization complements the more explicit structures, plans, and processes of the formal organization: it can pick up the pace and enhance responses to unanticipated events, foster innovation, enable populace to solve problems that require alliance across boundaries, and create footpaths showing where the formal organization may someday need to pave a way (Michael et.al.1956). The informal organization, which is never explicitly stated. It encompasses all the acquaintances and relationships that aren't on the association chart but communicate to how people throughout the organization actually complex to get the job completed. The formal side of an organization establishes an overarching structure, but it's the informal organization that fills in the gaps of what the formal isn't doing. Unfortunately, most managers leave the informal organization to instinct or chance. Individuals need to comprehend their informal networking prospect—and to learn how to plot a course in those networks. Frontline and mid-level workers can be educated to be more valuable at operational in and through the informal network, while upper-level managers can learn to be more effective at seminal, using, and integrating it with the ceremonial organization. By mobilizing the power of the informal organization, companies will benefit from faster decision-making and improved execution, as well as from having more highly motivated workforce whose behaviors are better aligned with directorial goals and strategies. The end result is better performance (Goldsmith's,2012) .
INFORMAL SERVICE SECTOR
"The informal organization is a very useful and potentially powerful supplement to the formal," "When you get them jumping together, you gain, because the formal organization provides for alignment, scale, and consistency. The informal organization provides for motivation, emotional commitment, responsiveness, and flexibility." (Katzenbach et.al.2012) Benefits of the informal organization Although informal organizations create unique challenges and potential problems for management, they also provide a number of benefits for the formal organization. Blend with formal system Formal plans, guiding principle, procedures, and principles cannot solve every predicament in a dynamic organization; therefore, informal structure must intermingle with formal ones to contract work done. "Informal kindred in the organization serve to preserve the organization from the self-destruction that would result from literal obedience to the formal policies, rules, regulations, and procedures." No college or university could function purely by everyone following the "letter of the law" with respect to written document and procedures. Faculty, staff, and student informal groups must oblige in fulfilling the” spirit of the law" to effectuate an organized, sensibly run enterprise. (Robert Dubin, 1951) Lighten management workload Managers are less inclined to check up on workers when they know the informal organization is cooperating with them. This encourages delegation, decentralization, and greater worker support of the manager, which suggests a probable improvement in performance and overall productivity. When a professor perceives that students are conscientiously working on their term papers and group projects, there are likely to be fewer "pap tests" or impromptu progress reports. Fill gaps in management abilities For instance, if a manager is weak in financial planning and analysis, a subordinate may informally assist in preparing reports through either suggestions or direct involvement. ' Act as a safety valve. Employees experience frustration, tension, and emotional problems with management and other employees. The informal group provides a means for relieving these emotional and psychological pressures by allowing a person to discuss them among friends openly and candidly. In faculty lounge conversations, frustrations with the dean, department head, or students are "blown off" among empathetic colleagues. Encourage improved management practice Conceivably a restrained benefit of informal groups is that they give confidence to managers to prepare, plan, organize, and control in a more skilled approach. Managers who figure out the supremacy of the informal organization be acquainted with that it is a "check and balance" on their use of clout. Revolutionisation and plan are introduced with more careful thought and consideration, knowing that the informal organization can easily kill a poorly planned project. Understanding and Dealing with the Environmental Crisis The hierarchical ineffectiveness and how to triumph over, it could not passably understand the ecological crisis, or how to initiate tolerable. solutions. It argued that what was required and widespread introduction of informal set of connections or Information course-plotting Groups which were essentially a description of societal networking services prior to the internet.
FORMULATION
Major contents of the questionnaire
Finance
Organizing committee
Selection of area
Publicity
Public utility
Successfulness of event
SCALING TECHNIQUE
Scaling technique where a hefty number of objects that are proclamation of viewpoint or target are generated. Each item is arbitrator according to whether it reflects a encouraging and unfavorable attitude towards the object in questions.
CONCLUSION
This study explores the effect of finance, organizing committee, selection of area publicity, public utility on Successfulness of Event based on survey among Indian organizations. Moreover, the study shows that finance, organizing committee, selection of area, publicity, public utility gives significant effect on Successfulness of Event. The salient feature of this study is that, these finding are derived Int J Cur Res Rev, Dec 2012 / Vol 04 (24) Page 144 from a broad range of Indian organizations, representing service firms from private sectors. Finally, the finance, organizing committee, selection of area, publicity, public utility strengthen the way i.e. the Successfulness of Event. Results show that, an improved understanding of communication, organizing committee work‘s, finance management handling, cooperation .It is also found that when finance, organizing committee, selection of area, publicity, public utility are established with the organization, they work toward the collaboration or organizational integration from the broad range of non-formal organization, representing quality and service firms from private and public sectors. A conclusion section must be included and should indicate clearly the advantages, limitations, and possible applications of the paper. Although a conclusion may review the main points of the paper, do not replicate the abstract as the conclusion. A conclusion might elaborate on the importance of the work or suggest applications and extensions.
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