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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21General SciencesTHE IMPACT OF FOUR PESTICIDES ON THE EARTHWORM LUMBRICUS TERRESTRIS (ANNELIDA; OLIGOCHAETA)
English0105Sherwan Taeeb AhmedEnglishThe influence of four pesticides (Cyren, Ridomil, Triplen and Mamba) on Lumbricus terrestris earthworm for 4 weeks was studied in the laboratory. Results indicate that there are loss of weight in all cultures, signs and symptoms of toxicity such as coiling, selling of the body swollen, sluggish movements and discharge of coelomic fluid. Significant decrease in total sperm numbers was observed at the end of study period. The present study indicates that among the four pesticides tested Cyren is the most toxic to earthworm Lumbricus terristris causing high mortality, while Triplen and Mamba are moderately toxic and Ridomil was the least toxic pesticide.
EnglishToxicity, Lumbricus, weight, sperm.INTRODUCTION
Earthworms are more important organisms of the soil invertebrate fauna, they are considered as ecosystem engineers as they produce pronounced effects on soil structure due to their burrowing activities, ingestion of soil and production of castings (Latif et al., 2009). Pesticides, that are applied in agriculture ?elds, may affect the non-target soil organisms including earthworms and signi?cantly damage the ecosystem (Lavelle and Spain 2002). Pesticides, are either directly applied to soil to control soil borne pests or are deposited on soil as run off from foliar applications. Whatever the source, earthworms are exposed to pesticides through (a) skin contact and (b) by feeding on contaminated litter in soil. The effect of pesticides on earthworm may be either due to soil/foliar application at high concentrations or slow accumulation of low levels of persistent pesticide residues (Edwards 1990; Correia and Moreira 2010).
Since earthworms are preferred as food by amphibians, reptiles, birds and mammals there is a possible risk of these pesticides reaching higher trophic levels (Marino et al. 1992). Several researchers have advocated the use of earthworms as ecotoxicological model for risk assessment and bioassay of pesticides ( Edwards and Bohlen 1992; Cikutovic, et al. 2010).
In the present study experiments were made to evaluate the effects of four pesticides on the night crowling earthworm Lumbricus terrestris. This species is widely distributed in the Kurdistan region of Iraq and is considered as an ecologically important soil organism for its role in increasing soil fertility and for its potential of being used in the production of vermicompost (Nassri 1989). The pesticides tested in the present study include two herbicides (Mamba and Triplen), one insecticide (Cyren) and one fungicide (Ridomil).
MATERIALS AND METHODS
During February and April 2011, adult Lumbricus terristris worms were obtained from three local gardens in Erbil city (Kurdistan, Iraq) that have never been used for any agricultural purpose and pest control. The specimens were brought to the
laboratory and were cultured in small earthen pots (1liter containers). Finely grinded soil (collected from the same gardens) and a dry mass mixture of organic potting mixed in the ratio of 4:1 were used as the culture medium (Ismail 1997). The cultured earthworms were acclimated to laboratory conditions for 72 hrs and maintained at ≤ eight worms/liter, moistened with 200-220 ml distilled deionized water/kg in an environmental chamber set at 25-30°C. 65-70% moisture was maintained by adding nonchlorinated water into the medium. The culture pots were covered with ?ne meshed cloth nets (Reinecke and Reinecke 2007) .
The recommended doses of the four pesticides [1-Cyren (insecticide): Chlorpyriphos 500 g/l, Cypermethrin 50 g/l, 2 - Ridomil (fungicide): Mefenoxam 4 g/l, Mancozeb 64 g/l, 3 - Triplen (herbicide): Trifluralin 480 g/l, 4 – Mamba (herbicide): Glycophosate: 480 g/l ] (which are used by local farmers as pest control) were administered in to the test cultures by spraying overeach of the containers for one time only. The experiment was set up with two replicates for each pesticide and control and then incubated in their chamber. Observations were made every 24 hrs, those individuals who showed no response to apparent sign of life , even when poked with a needle, were considered dead and were removed (Yasamin and Dsouza 2010).
Animals were placed in ethanol solution (5%) and dissected to extract the male reproductive organs, located between the prostomium and the clitellum. Seminal vesicles were separated and placed in Petri dishes containing 1 ml of PBS (pH 7.4) and cut in small pieces to allow the liberation of the spermatozoa and perform sperm counts using a Neubauer chamber. Counts were expressed as number of spermatozoa per animal (Espinoza and Bustos 2004).
The pesticides used in present study along with source of obtaining and recommended agricultural doses were supplied by Agricultural Research Center/ Ministry of Agriculture and Water Resources-Erbil/Iraq
Statistics: Earthworm weight and sperm count were analysed over time using Analysis of Variance (ANOVA) and means separated using Duncan’s Multiple Range Test at p≤0.05 (SPSS, Windows 11.5).
RESULTS
The data presented in Table 1 clearly show that earthworm weight was significantly reduced by exposure to the four pesticides and, after 4 weeks exposure earthworm weight differed from the control in all treatments, There was a remarkable loss of weight in all cultures with noting that all individuals which were treated with Cyren (insecticide) died after three days post treatment.
The animals showed progressive signs and symptoms of toxicity ranging from visibly undetectable marks to coiling (Figure 1), curling, extrusion of coelomic fluid, segmental constriction and swelling. In several animals the swollen portion burst causing bloody lesions, limp and ultimately death (Table 1).
During the 4-week period of the test the results also showed that the number of sperms were reduced significantly at the end of the study period in all treatments as presented in Table 2.
DISCUSSION
The symptoms produced after exposure of L. terrstris to pesticide were specific in nature and so may help in recognizing the pesticide, e.g. coiling , curling (Ridomil), mucus secretion, sluggish movements (Triplen), lifting of the body, extrusion of coelomic fluid (Cyren), globular swelling, segmental constriction, white band (Mamba) (Chakravorty and Kaviraj 2010).
Many investigators have reported a high toxicity of Chlorpyrifos and Cypermethrin insecticides on many species of earthworms in different countries, the effects ranging between moderate mortality to Perionyx exacavtus (Chakravorty and Kaviraj 2010) and decrease in body weight of Eisenia
fetido (Yasamin and Dsouza 2010). Booth et al. 2000 observed loss of weight of Aporrectodea caliginosa when treated with organophosphate pesticides in field and laboratory also. (Faheem and Farhanullah Khan 2010) reported that predictable signs and symptoms of Imidacloprid poisoning on Pheretima posthuma including tiredness, twitching, cramps, and muscle weakness also including the muscles essential for breathing. Data presented in the study by Farrukh and Ali 2011 clearly showed that dichlorovos caused a decrease in the weight of all groups of earthworms, when they were exposed to different concentrations of dichlorovos fumigant insecticide.
This study showed that there was a significant decrease in sperm numbers of animals treated with the four pesticides, Sophie et al. (1995) showed that dieldrin at relatively low concentrations caused structural damage, especially to the nucleus of the sperm which may cause several changes in morphology, motility, and sperm density.
A significant decrease in sperm numbers were found at 15 and 30 days in the dose of 600 mg of malathion for kg of soil (Espinoza and Bustos 2004). This decrease of the sperm count indicates that the insecticide has been degraded to its active metabolites malaoxon and isomalathion, which could also alter spermatogenesis (ATSDR 2000). In another study when three different concentrations of benomyl were applied for one week there were abnormalities in the ultrastructure of the spermatogonia, spermatids, and spermatozoa of the earthworm Eisenia fetid (Sorour and Larink 2001). Xiao et al. (2006) mentioned that sperm count of the earthworm E. fetida depended on the duration and concentration of acetochlor (herbicide) exposure. After 5 days of exposure, number of sperm per mg of body did not change significantly when earthworms were treated with different concentrations of acetochlor. Low and middle concentrations showed higher sperm count. After 15 days of exposure, sperm count decreased when earthworms were treated with increasing concentration of acetochlor.
CONCLUSION
Based on the observations of the present study and previous studies, it can be concluded that the growth and reproductive parameters of earthworms exposed to pesticides seem to be useful bioindicators of soil pollution. Research should be extended to ecologically relevant species of earthworms, and also to other soil fauna to get a comprehensive knowledge on the malfunction in the soil biological processes due to pesticide pollution. Numerous studies indicate negative impact of pesticides on earthworm growth and reproduction. So, there is a need to acquire more knowledge on the chemical nature, mode of action, and means of degradation of pesticides in soil.
ACKNOWLEDGMENT
The author would like to express sincere appreciation to Miss Shelan for providing the pesticides and Department of biology, Collage of Science, University of Salahaddin / Erbil for their financial support.
Englishhttp://ijcrr.com/abstract.php?article_id=1034http://ijcrr.com/article_html.php?did=1034
ATSDR (Agency for Toxic Substances and Disease Registry),eds. Malathion; Resumen técnico químico para profesionales de la Salud Pública. Atlanta, Georgia. U.S.A., 2000.
Booth LH, Heppel VJ, Halloran K. Growth, Development and Fecundity of The Earthworm Aporrectodea Caliginosa After Exposure to Two Organophosphates. New- zealand Plant Protection 2000; 53: 221-225.
Chakravorty RD, Kaviraj A. Studies on Relative Toxicities of Six Insecticides on Epigeic Earthworm, Perionyx exacavatus. Bulletin of Environental Contamination and Toxicology 2010; 85 : 83-86.
Cikutovic MA, Fitzpatrick LC, Venables BS, Goven A J. Sperm count in earthworms as a biomarker for environmental toxicology: Effect of cadmium and chlordane, Environmental pollution 2010; 81(2): 123-125.
Correia FV, Moreira JC. Effect of glyphosate and 2,4-D on earthworms Eisenia foetida, Bulletin of Environental Contamination and Toxicology 2010; 85(3): 264-8.
Edwards CA, Bohlen P J. The effects of toxic chemicals on earthworms. Review of Environental Contamination and Toxicoogyl 1992; 125: 23-99.
Edwards CA. The impact of insecticides on soil ecosystem criterion. Review of Plant Science 1990; 8:145-171.
Espinoza NO, Bustos OE. Sublethal doses of malathion alter male reproductive parameters of Eisenia foetida. Inernational Journal of Morphology 2004; 22(4): 297-302.
Farrukh S, Ali AS. Effects of Dichlorovos Organophosphate on Growth, Reproduction,and Avoidance Behavior of Earthworm Eisenia foetida. Iranian Journal of Toxicology 2011; 5(14): 495-501.
Ismail SA. Vermicology - the biology of earthworms. Orient Longman 1997; p. 90
Latif R, Ezzatpanah S, Malik M, Parsa H. Earthworms of the Central Elburz Mountains, Iran. Iranian Journal of Animal Biosystematics 2009; 5(2):1-5.
Lavelle P, Spain AV. Soil ecology. Kluwer, Dordrecht 2002.
Marino F, Ligero A, Cosin DJ. Heavy metals and earthworms on the border of a road next to Santiago. Soil Biology and Biochemistry 1992; 24: 1705-1709.
Nassri NH. Effect of Some Pollutants on earthworm Lumbricus terristris (Annelida;Oligochaeta) MSc Thesis.University of Salahaddin/Iraq, 1989.
Reinecke SA, Reinecke AJ. The impact of organophosphate pesticides in orchards on earthworms in the Western Cape, South Africa. Ecotoxicology and Environmental Safety 2007; 66: 244-251.
Sophiè AR, Adriaan JR, Moya LF. The effects of dieldrin on the sperm ultrastructure of the earthworm Eudrilus eugeniae (Oligochaeta). Environmental Toxicology 1995; 14: (6):961-965.
Sorour J, and Larink O. Toxic effects of Benomyl on the ultrastructure during Spermatogenesis of the earthworm Eisenia fetida. Ecotoxicology and Environmental Safety 2001;50(3):180-188.
Yasamin S, Dsouza D. Effects of Pesticides on the Growth and Reproduction of Earthworm: A Review. Applied and Environmental Soil Science 2010; 9 pages.
Xiao NW, SongY, Ge F, Liu XH, Ou-Yang ZY. Biomarkers responses of the earthworm Eisenia fetida to acetochlor exposure in OECD soil .Chemosphere 2006; 65:907-912
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareELLIS VAN CREVELD SYNDROME WITH COMPLETE AV CANAL DEFECT - LATE RECOGNITION STILL REPAIRABLE
English0612ArumugamEnglish AashishEnglish Arun PrasathEnglishEllis Van Creveld syndrome (EVC) or chondroectodermal dysplasia is a rare congenital disorder of autosomal inheritance. It is commonly seen in Amish population of Pennslyvania in USA with the prevalence of 1/5,000 live births. In non- amish population the prevalence is 7/1,000,000 live births. It is caused by mutation in the EVC gene located on chromosome 4p16 and also mutation of EVC2 gene located close to EVC gene in a head to head configuration. It is characterized by bilateral postaxial polydactyly of hands, dysplasia of teeth and nails, short limbed dwarfism and congenital heart disease. This case report describes a 19 year old year Indian female born to a consanguineous marriage with the classical features of Ellis Van Creveld Syndrome with complete AV canal defect with relatively asymptomatic childhood with classical goose neck deformity in left ventricular angiogram
EnglishEllis van creveld syndrome, polydactyly, chondroectodermal dysplasia, complete AV canal defect, goose neck deformityINTRODUCTION
Robert Ellis and Simon Van Creveld in 1940 defined a syndrome termed chondro- ectodermal dysplasia comprising of certain type of chondrodysplasia, bilateral polydactyly of hands, small and dysplastic teeth and nails, congenital heart defects.(1) It is now referred to as Ellis Van creveld syndrome. It is most prevalent in the Amish population of Pennsylvania in USA occurring in 1 / 5,000 live births. In non- amish population birth prevalence is 7 / 1,000,000 live births, making it quite a rare occurrence in Indian subjects.
It is an autosomal recessive disorder caused by mutations in the EVC gene located on chromosome 4p16 and also mutation in EVC2 gene located close to EVC gene in a head to head configuration. Of the 300 cases reported ectodermal dysplasia is present in upto 93%. Five different mutations have been associated with this syndrome.(2) There is no male or female predeliction.
It usually presents as a characteristic tetrad (3)
Bilateral postaxial polydactyly of hands. Polydactyly of the feet is present in only 10% of the patients. Frequently the patient cannot make a tight fist.
Disproportionate dwarfism due to chondrodysplasia of the long bones and an exceptionally long trunk.
Presence of multiple frenulae tethering the upper and lower lip to the gingiva. Ectodermal dysplasia with dystrophic, small nails, thin sparse hair and hypodontic and abnormally formed teeth.
Congenital heart defects in 50- 60% of cases, mostly a single atrium and a Ventricular septal defect. Patient’s intelligence is usually normal. Liver and central nervous system abnormalities are rare. It is impossible to radiographically differentiate Ellis Van Creveld syndrome from similar chondrodystrophies.(2) Other skeletal anomalies such as genu valgum (knock knees) also can be seen. CASE REPORT A 19 year old young female presented to the outpatient department with complaints of exertional dyspnea of 1 year duration which has progressive from NYHA class 2 to NYHA class 3 within the past 2 months. There was no history of orthopnea or paroxysmal nocturnal dyspnea. She also had complaints of easy fatigability and occasional chest pain. She was told that she has some cardiac problem at birth but never had follow up due to long asymptomatic period. She had frequent upper respiratory tract infection in the past and was relatively asymptomatic throughout her childhood and early adolescence. She was born to a consanguineous marriage, attained menarche at the age of 13 years and has normal menstrual cycles. Her school performance was average. She had short stature and was born with six fingers in each hand. Her siblings and parents were normal and had no significant illness. On examination she was short statured with a height of 135cm and well nourished. She had six fingers in both the hands (Figure 2) (extra finger in each hand on the ulnar side), small and brittle nails in the hands and toes (dysplastic nails). Oral cavity examination revealed peg teeth with multiple frenulae in the lower lip and high arched palate. Cardiovascular examination: S1 heard normally, S2 widely split, pansystolic murmur in mitral area, no added sounds. Other systems were normal. Investigations revealed haemoglobin of 9 g/dl otherwise normal. Chest xray showed cardiomegaly. Ultrasound abdomen was normal. Electrocardiogram showed normal sinus rhythm, first degree heart block, biatrial enlargement, right ventricular hypertrophy (Figure 5) Echocardiography showed COMPLETE ATRIOVENTRICULAR CANAL DEFECT- large ostium primum Atrial septal defect amounting to single atrium, two separate atrioventricular valves with concominant regurgitation, small ventricular septal defect closed by septal leaflet of tricuspid valve, right atrium and right ventricle dilated, mild pulmonary artery hypertension. (Figure 6).
Catheterization study- classical Goose Neck deformity (Figure 7) due to elongated left ventricular outflow tract in left ventricular angiogram. The saturation run showed significant step up in right atrium with QP/QS- 5.05. Mean pulmonary artery pressure was recorded as 26mm Hg.
DISCUSSION
EVC syndrome belongs to a the short rib polydactyly group (SRP’s) which includes Verma – Naumoff syndrome, Jeune dystrophy, Mekusick- Kaufman syndrome and Weyers syndrome, Beemer- Langer syndrome, Saldino- Noonan syndrome and Ellis Van Creveld syndrome. These short rib polydactyly group are usually among the differential diagnosis in the pernatal and postnatal period.(5)
The parents are the carriers of the mutation and there is 25% chance of further pregnancies resulting in a child with a similar problem.(5) Our patient was born to a consanguineous marriage with no similar illness among the siblings or her parents.
Chondrodysplasia means disproportionate dwarfism i.e., normal trunk with symmetrical shortening of distal extremities. Thoracic dysplasia leads to frequent respiratory infections.(3) Our patient had frequent chest infections primarily due to acyanotic heart disease with left to right shunt and was a dwarf (Figure 1) with a height of 135cms. There was no lumbar lardosis or genu valgum or pectus carinatum in the patient which could also be seen as a result of chondrodysplasia.
She had classical polydactyly (Figure 2) of Ellis Van Creveld syndrome involving both the hands on the postaxial side. There was no polydactyly of the foot which is also present in 10% of the patients. There was no syncarpalism or synmetacarpalism(3) in her which could also be possible. She could not make tight fist3 like other patients of Ellis Van Creveld syndrome.
Ectodermal dysplasia in this patient lead to multiple frenulae connecting the lower lip to the gingiva(Figure 3), peg teeth(Figure 4) and high arched palate.(3) There was no natal or congenitally missing teeth but they were microdontic in nature.(4) She had dysplatic nails in both hands and feets (Figure 2) as seen in classical patient.
Cardiac manifestations are seen in 50-60% of cases.(5) Patient had a complete atrioventricular canal defect which is the most common congenital abnormality seen in 40% of cases followed by a ventricular septal defect or a patent ductus arteriosus.(3)
Liver and Central nervous system abnormalities could also occur rarely in Ellis Van Creveld syndrome. Other genitourinary anomalies like renal agenesis, renal tubular dilatation, nephrocalcinosis, megaureters, vulvar atresia.
50 % patients with Ellis Van Creveld syndrome usually die at infancy due to recurrent respiratory infections.(3) Those without any cardiac abnormality may have a normal life expectancy. This patient who has a complete atrioventricular canal defect has survived till 19 years without any significant pulmonary artery hypertension is quiet uncommon.
CONCLUSION
Ellis van Creveld syndrome is a rare disease in Indian population. This case report describes a 19 year old young female with Ellis van Creveld syndrome with complete atrioventricular canal defect who had a relatively asymptomatic childhood who presented in her late adolescence without any severe symptoms whose defect is still repairable.
CONFLICT OF INTEREST
None.
Englishhttp://ijcrr.com/abstract.php?article_id=1035http://ijcrr.com/article_html.php?did=1035
Ellis RW, van Creveld S. A syndrome characterized by ectodermal dysplasia, polydactyly, chondro-dysplasia and congenital morbus cordis. Arch Dis Childhood 1940;15:65- 79.
K Kurian , Shanmugam S , Harsh Vardha T, Gupta S. Chondroectodermal dysplasia (Ellis van Creveld syndrome): A report of three cases with review of literature. Indian J Dent Res 2007;18:31-4.
Ikramullah K, Syed A, Kiren M. Ellis van Creveld syndrome: A case report. Journal of Pakistan Association of Dermatologists 2006;16:239-242.
Cahuana et al. Oral manifestations in Ellis van Creveld syndrome: report of five cases. Pediatric Dentistry 2004;26:3:277-279.
Baujat G, Le Merrer M. Ellis van Creveld syndrome: Review. Orphanet Journal of Rare Dis 2007;2:27 1-5.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareA CROSS-SECTIONAL STUDY ON BREAST FEEDING PRACTICES IN A RURAL AREA OF NORTH KARNATAKA
English1318Bhavana R. HiremathEnglish M.M.AngadiEnglish Vijaya SorganviEnglishObjective: To elicit the breastfeeding practices prevalent in this rural backward area Methods: A community based cross sectional study wherein 236 mothers were interviewed regarding their place of delivery and breast feeding practices followed by them. Results: 236 mothers all of whom had a normal delivery were interviewed. 80.5% mothers had delivered in an institution. Only 5.1% mothers initiated breast feeding within half hour of delivery. 66.1% mothers gave prelacteal feeds and 72% gave colostrums to their neonates. Exclusive breast feeding was practiced by 27.1% mothers while 91.1% practiced demand feeding. Conclusion: It is often said that breast feeding is the foremost natural immunisation a baby receives and it saves more lives than any other preventive intervention. Such is the importance of breast feeding and this should be communicated to every woman using the appropriate medium.
EnglishColostrum, prelacteal feeds, demand feeding.INTRODUCTION
Breastfeeding is an unequalled method of providing ideal nutrition for the healthy growth and development of infants. It is a fundamental right of every child. Infants suffer from malnutrition if they do not receive adequate nutrients. Colostrum is the thick yellowish mammary secretion produced immediately after delivery. It protects the infant against infection and lays foundation for the immune system. It is often said that colostrums is the first immunisation that a newborn receives.
Baby Friendly Hospital Initiative was launched by WHO & UNICEF in 1991 as a part of global effort to protect, promote and support Breast feeding.1 Early and Exclusive Breast feeding are components of Essential Newborn Care introduced by World Health Organisation. (2) Government of India introduced Essential Newborn Care under Child Survival and Safe Motherhood Programme in 1992 and it has been a part of RCH programme since 1997.(3)
Breast feeding in India is universal and prolonged but several traditional practices are prevalent which vary among the different regions and communities. Ignorance, lack of awareness regarding importance of breast feeding and deep rooted cultural practices has been passed on for generations. Therefore, this study was undertaken with the objective of eliciting the breastfeeding practices prevalent in this rural backward area.
MATERIALS AND METHODS
A community based cross sectional study was conducted at Shivanagi village which is a rural area in Bijapur, Karnataka. All women who delivered from 1st January 2011 to 31st December 2011 were interviewed at their homes using a pre-
designed proforma. Those mothers who lost their child or not willing to participate were excluded from the study. Total sample size was 242 mothers of whom 6 did not show interest to participate in the study. Hence, 236 mothers were interviewed.
The data was compiled, tabulated and analysed using the Statistical Software SPSS version 16. Statistical tests like mean ± SD, percentages were used to analyze the data. Chi-Square tests were applied wherever necessary. The p - value less than 0.05 was considered statistically significant.
RESULTS
Of the 236 mothers in the present study, majority were in the age group of 21-25 years (67.8%), followed by ≤ 20 years (17.4%) and > 25 years (14.8%). Mean ± S.D. of mothers’ age was 23.11 ± 2.78 years. Out of 236 mothers in the present study, it was seen that 32.2% mothers were illiterate while 3.8% had education up to PUC and a mere 1.3% held a degree. With regards to occupation of the mother, 53.4% were housewives and remaining 46.6% worked as agriculture labourers. (Table 1)
Regarding place of delivery, 80.5% mothers delivered in hospital while remaining 19.5% delivered at home. No complications were noted in any delivery.
Breast feeding practices in this area are very disturbing. Many harmful practices are prevalent which should be addressed at the earliest. Initiation of breast feeding within half hour of delivery was practiced only by 5.1% mothers while 39.4% mothers waited beyond 4 hours. Most mothers (66.1%) were influenced by the traditional practice of giving prelacteal feeds to the neonate. Sugar water was the most common prelacteal feed (49.6%) as it is the most easily available sweetened food. Colostrum was discarded by 28% mothers. (Table 2)
It was discouraging to find that only 27.1% mothers practiced exclusive breast feeding though majority (91.1%) mothers practiced demand feeding. This beneficial practice of demand feeding can be attributed to the notion of rural women that a baby cries only when hungry and the only way to pacify such a child is by feeding him/her. Among 35.6% mothers who had a problem while breast feeding, lack of milk was the most common in 18.6% followed by painful breasts in 17%. (Table 3)
It was distressing to note that hygienic practice of cleaning breasts before feeding the baby was not followed by any mother as they were totally unaware of its importance.
Among 190 institutional deliveries, 81.1% mothers gave colostrums to their neonate and 61% gave prelacteal feeds. Of the 46 home deliveries, 30.4% mothers gave colostrums to their neonate and 86.9% gave prelacteal feeds. The practice of feeding colostrums is higher among mothers who had delivered in an institution compared to home. Harmful practice of giving prelacteal feeds was higher among those mothers who delivered at home. Both these finding were statistically significant. (Table 4)
DISCUSSION
India is a country where breastfeeding is a cultural norm, with every mother fostering a favourable positive attitude towards it. Early initiation was defined as breast feeding within half to one hour of delivery. In this study 42.8% mothers initiated breast feeding within 1hr of delivery which is higher than results of other studies in Uttar Pradesh (36.6% and 37.5% respectively) (4) (5) but low compared to study done in Western Nepal (57.9%).(6)
39.4% mothers delayed breast feeding initiation beyond 4 hours owing to the practice of giving prelacteal feeds to the neonate preferably a sweetened feed. Some also believed the initial milk to be harmful to the baby thereby discarding it and later breastfeeding the baby. Among some mothers initiation of breast feeding was delayed until both the mother and neonate were bathed as a belief of purifying them post delivery. Prelacteal feeds is the main source of infection to the
newborn which was given to 66% newborns in this study which is high compared to studies done in Bangalore (19%)(7) and Western Nepal (23.3%)(6) but low compared to studies done in a rural area of South India (71.8%)(8) and Uttar Pradesh (68%).(5) Lack of hygienic practices among mothers can also lead to infection. Infection leads to malnutrition which forms a vicious cycle endangering the life of the infant. Malnutrition may also be due to poor infant feeding practices, lack of exclusive breast feeding, discarding colostrums, improper posture while feeding and poor maternal knowledge on importance of breast feeding. 72% newborns were given colostrums in this study but this is low compared to studies done in Uttar Pradesh (86.1%),(5) Western Nepal (84.6%)(6) and Bangalore(81%).(7)
The National Guidelines on Infant and Young Child Feeding recommend exclusive breastfeeding for the first six months of life and then supplemented breastfeeding up to the age of two years or beyond.9 It was discouraging to note that exclusive breast feeding was practiced only in 27.1% newborns which is low compared to studies done in Bangalore (40%)(7) and Kanpur (51%). (10)
According to the recently developed child growth standards of WHO, 39% of children below 6months of age are underweight. (11) This finding indicated problems while feeding children below 6months of age. 35.6% mothers faced problems while breast feeding like lack of milk (18.6%), pain and tenderness in breasts (17%). In a study conducted in Andhra Pradesh, 65.6% mothers cited insufficient milk production as the main problem. (12)
86.9% mothers who underwent home delivery gave prelacteal feeds to their neonates compared to 61% mothers with institutional delivery. This highlights the importance of focussing on improving number of institutional deliveries. It was tragic to note that inspite of institutional delivery, 18.9% mothers did not give colostrums to the newborns. The health care services and advice given to mothers by the health professionals especially in rural areas should be enhanced in order to uproot these traditional practices. Health education should focus on ridding the community of such harmful practices and encourage institutional delivery and appropriate breast feeding practices. It is rightly said that breast feeding saves more lives than any other preventive intervention.
CONCLUSION AND RECOMMENDATIONS
Behavioural Change Communication (BCC) is essential for appropriate breast feeding practices. Counselling sessions should be directed towards women especially in rural areas so as to improve the breast feeding practices as well as infant and young child feeding practices. Hygienic practices should be encouraged among these women. Breast feeding programs and health workers should take into account traditional beliefs and concepts when communicating with families and emphasize the value of breastfeeding for mothers as well as children. Peer counselling and peer support groups should be developed in these areas.
ACKNOWLEDGEMENT
I would like to take this opportunity to thank all the mothers who consented to participate in this study. I also extend my gratitude to the anganwadi workers and ASHA workers who accompanied me to the houses of the participants. I would also like to thank my department faculty and institution who supported me during the course of this study.
Englishhttp://ijcrr.com/abstract.php?article_id=1036http://ijcrr.com/article_html.php?did=1036
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Takalkar Anant A, Saiprasad G S, Tarun Kumar, Madhekar Narendra S. Breastfeeding Practices in Rural Community of Andhra Pradesh; Indian journal of Maternal and Child Health; 12 (2)
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareA RARE CAUSE FOR HUGE ABDOMEN
English1922Govindarajalu GanesanEnglish Ganesh babuEnglishBoth intraabdominal cystic lymphangioma and chylolymphatic mesenteric cyst present as huge abdominal mass and both have chyle as their content. Hence the only way to differentiate between these two conditions is by histopathological examination which is extremely important as lymphangiomas are more invasive and relapsing than mesenteric cyst. Here we report a rare case of huge abdomen due to cystic lymphangioma arising from lesser omentum that did not have recurrence for more than six years after surgical excision.
Englishintraabdominal cystic lymphangioma, lesser omentum, chyle, recurrenceINTRODUCTION
Lymphangiomas is of three types- capillary, cavernous and cystic lymphangiomas (1-3). Cystic lymphangiomas are most commonly found in head and neck and axilla of young children (1-8).
But intraabdominal lymphangiomas are extremely rare and the incidence is only in 1 per 100000 individuals (2, 9) While occurring intraabdominally, lymphangiomas occur most frequently in the mesentery (2 - 6, 9). But it is extremely rare to find intraabdominal lymphangioma arising from lesser omentum (10, 11). Hence an extremely rare patient of cystic lymphangioma arising from lesser omentum and presenting as huge abdominal mass is reported here.
CASE REPORT
A 29 year old female presented with a huge painless soft, smooth, nontender, mobile mass occupying umbilical and hypogastric regions extending on either sides to both lumbar region and both iliac fossa for a period of two months. Ultrasound abdomen showed a large thin walled cyst occupying abdomino-pelvic region with septations suggestive of lymphatic cyst. Intravenous pyelogram showed normal function and drainage of both kidneys.
On 11th July 2007, the patient underwent laparotomy by midine incision. A huge cyst was arising from lesser omentum extending upto pelvic region. (fig.1).Cyst was excised in total and sent for biopsy.Patient had an uneventful post-operative period and discharged on 8th post-operative day.
The cyst was found to contain more than 1 litre of chyle as its content. Biopsy report showed cyst wall lined by flattened endothelium. The cyst wall showed fibro-collagenous tissue, smooth muscle bundles and aggregates of lymphocytes suggestive of cystic lymphangioma. (fig.2).Hence this patient is a case of huge intraabdominal chylous cystic lymphangioma arising from lesser omentum.
DISCUSSION
Pathologically, lymphangiomas consist of three groups :1) capillary lymphangiomas composed of small lymphatics, 2) cavernous lymphangiomas
composed of larger lymphatics and 3) cystic lymphangiomas composed of large macroscopic lymphatic spaces containing collagen and smooth muscle (1). Cystic lymphangiomas contain serous fluid or chyle as its content (2,4,5) Cystic lymphangiomas having chyle as its content can be called as chylous cystic lymphangiomas. Histopathologically cystic lymphangiomas are lined by a single row of flat endothelial cells and contain fibrous tissue, aggregates of lymphoid tissue and smooth muscles in the cyst wall (7).
But mesenteric cysts which are often confused with intraabdominal cystic lymphangiomas (12-14) do not contain smooth muscles in the cyst wall in histology (14). Chylolymphatic mesenteric cyst is a type of mesenteric cyst which has chyle as its content and can present as huge abdominal mass (14). Intraabdominal cystic lymphangiomas commonly has chyle as its content and can also present as huge abdominal mass (4). Hence it is extremely important to differentiate between these two conditions.
There are no blood tests to confirm the diagnosis of these two lesion (4). Radiological investigations like ultra sound or computed tomography are very sensitive in diagnosing intraabdominal cysts but are not very specific and cannot differentiate between these two conditions (4, 6, 15). Hence the only way to differentiate between these two conditions is by histopathological examination (12-14). The differentiating histologic feature is the presence of smooth muscles in the cyst wall of intraabdominal cystic lymphangiomas (1-9,12)which are absent in the cyst wall of chylolymphatic mesenteric cyst (14).
An exact histological diagnosis is extremely important as lymphangiomas are more invasive, aggressive and relapsing than mesenteric cyst (3,6,12,13,15,16).
Our patient is on regular follow up for 6 years and she did not have any evidence of recurrence for more than six years after surgical excision.
CONCLUSION
Though intraabdominal chylous cystic lymphangioma and chylolymphatic mesenteric cyst are exactly similar to one another clinically, radiologically and intraoperatively, they are two entirey different lesions histologically. Histologically smooth muscles are found in the cyst wall of chylous cystic lymphangioma, but smooth muscles are absent in the cyst wall of chylolymphatic mesenteric cyst. This histological differentiation is extremely important as lymphangiomas are more invasive and relapsing than mesenteric cyst. But our patient with cystic lymphangioma arising from lesser omentum did not have any evidence of recurrence for more than six years after surgical excision and hence is reported here.
ACKNOWLEDGEMENT
We are extremely thankful to Professor Dr. N. Anantha Krishnan for his valuable guidance which has helped us greatly to prepare this article. We are also extremely thankful to Dr. Nilotpal Chowdhury, the pathologist, who has helped us greatly in preparing the photomicrograph of the slide of the patient.
Englishhttp://ijcrr.com/abstract.php?article_id=1037http://ijcrr.com/article_html.php?did=1037
Okizaki A, Shuke N, Yamamoto W, Usui K, Koyano S, Miyokawa N, Tokusashi Y, Aburano T. Protein-loss into retroperitoneal lymphangioma: demonstration by lymphoscintigraphy and blood-pool scintigraphy with Tc-99m-human serum albumin.Ann Nucl Med. 2000 Apr;14(2):131-4
Rana Ajay, Katzman Philip J., Pegoli Walter, Qualia Cary.An Unusual Cause of Abdominal Pain: Duodenal Cystic Lymphangioma.Gastroenterology and Hepatology;Mar2013, 9 (3):192
Mousavi SR, Moradi A, Sobhiyeh MR, Jabbehdari S, Azimi B, Lotfollahzadeh S, et al. A patient with cystic lymphangioma in
pancreas. Gastroenterol Hepatol Bed Bench 2013;6(3):159-164.
Akwei Solomon, Neil Bhardwaj, and Paul D. Murphy. "Benign mesenteric lymphangioma presenting as acute pancreatitis: a case report." Cases journal 2009; 2(1): 9328.
ChungJ. H., Suh Y. L., Park I. A., Jang J. J., Chi J. G., Kim Y. I., and Kim W. H. .A pathologic study of abdominal lymphangiomas. J Korean Med Sci, 1999;14 (3), 257-262.
Sohn BK, Cho CH, Chae HD.Cystic lymphangioma of the pancreas.J Korean Surg Soc. 2011 Aug;81(2):141-5.
Kshirsagar A. Y., Wader J. V., Suleman F., and Pujari S.. Intra abdominal cystic lymphangioma in an adult. Medical Journal Armed Forces India,2009; 65(3), 270-271.
Hornick JL, Fletcher CD. Intraabdominal cystic lymphangiomas obscured by marked superimposed reactive changes: clinico pathological analysis of a series. hum pathol 2005 April:36(4) ;426-32.
Hisham Fayad Aly.Abdominal Cystic Lymphangioma in Children.Annals of Pediatric Surgery, April 2009:5[2] ;132-136.
Martin- perez E, Tejedor D, Brime R, Larranaga E, cystic lymphangioma of lesser omentum in an adult. Am J Surg 2010 Feb 199(2): 20- 22.
Sakurai Y, Taniguchi K, Uyama I, inaba K, Furuta S, Sunagawa R et al, laparascopic excision of the cystic lymphangioma occurred in the lesser omentum: report of a case and review of literature. Surg Laparose Endose Percutan Tech. 2009 Feb;19(1):e11-4.
Geof Allen J, Taylor Sohn Riall, John L. Cameron, Frederic B. Askin, Ralhb H.Hruban, kurtA.Campbell. Abdominal lymphangiomas in adults .J Gastrointestinal Surg 2006; 10:746-51.
Takiff H, Calabria R, Yin L, Stabile BE.Mesenteric cysts and intra-abdominal cystic lymphangiomas. Arch Surg. 1985 Nov; 120(11):1266-9.
Rattan K. N., Nair V. J., Pathak M., and Kumar S. Pediatric chylolymphatic mesenteric cyst-a separate entity from cystic lymphangioma: a case series. Journal of medical case reports, 2009 ;3(1):111.
Lörken M, Marnitz U, Manegold E, Schumpelick V.Intra-abdominal lymphangioma.Chirurg. 2001 Jan; 72(1):72-7.
Granata C, Lonati L, Scarsi PL, Mattioli G, Michelazzi A. Abdominal cystic lymphangiomas and mesenteric cysts: the clinical considerations. Pediatr Med Chir.1994 May-Jun;16(3):277-9.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareEFFECTS OF EXTREMELY LOW-FREQUENCY ELECTROMAGNETIC FIELD EXPOSURE DURING THE PRENATAL PERIOD ON BIOMARKERS OF OXIDATIVE STRESS AND PATHOLOGY OF OVARIAN TISSUE IN F1 GENERATION
English2329Hamideh GharamalekiEnglish Kazem ParivarEnglish Jafar Soleimani RadEnglish Leila Roshangar Mehrdad ShariatiEnglishObjective: In recent years, numerous reports indicate of the negative effects of electromagnetic fields on biological system. To evaluate the effects of 50Hz electromagnetic fields on parameters of oxidative stress in pregnant rats and its effects on ovarian tissue in F1 generation rats during puberty. Methods: In treatment group pregnant Wistar rats were exposed 3mT EMF for 21 days, 4 hours per day. Pregnant rats under same condition of treatment group, but off the field as a Sham group intended and pregnant rats were used as control in the room. After delivery the blood sample of mothers for biochemical analyze of MDA and SOD provided. For investigation of ovarian tissue pups, they were kept until maturity. Then adult female ovary of F1 generation were removed, fixed and prepared for light microscopy studies. Results: Biochemical analysis showed that MDA was significantly increased in the treated group in comparing with the controls, but no significant differences in SOD levels were observed between the groups. Microscopic results of the follicles F1 generation of treated group, in comparison with the control and Sham, showed that granulosa cells have interspaced from the basement membrane and in this group narrow and irregular in zona pellucida, vacuolization in ooplasm, detachment of granulosa cells was observed. Conclusion: The results suggest that pregnant maternal exposure in magnetic field cause of increases some of parameters of oxidative stress and also adverse effect on ovarian follicles in F1 generation during maturation and may impact on fertility.
EnglishElectromagnetic field, Oxidative stress, Pathology, Ovary, prenatalINTRODUCTION
The presence of electromagnetic fields (EMFs), and extremely Low-frequency electromagnetic field (ELF-EMF) are part of today life due to the increasing usage of electricity. (1) The EMF is produced by different home appliances devices such as televisions, computers, mobile phones and other life devices.(2, 3)
Byus et al (4) have reported a decrease in the activity of c-AMP independent protein kinas in
response to Radio Frequency (RF) fields amplitude-modulated at extremely low frequencies (ELF). In biological systems, undesired effects, started or supported by EMF, trigger the cascade of events that end with adverse results.(5) Three mechanisms have been suggested to explain the effects of EMF on biological systems: magnetic induction, magneto mechanical effects and electronic interaction.(6,7)
Some epidemiological studies have showed that low frequency EMFs produced by 50 and 60 Hz electricity could increase malfunction of circulatory system, Central Nervous System (CNS) and even could increase the prevalence of neoplastic disorders in peoples living near the electric poles.(8) Interesting researches are performed in related with effects of magnetic fields on cellular stress, reactive oxygen species (ROS) and free radicals, reproductive and fertility.(9)
Recent studies have shown that ELF-EMF by affecting biochemical or biophysical processes in the cell could alter cellular behavior. EMF could affect chemical bonds between neighboring atom and could also change the direction of electron spin and by this way it could affect the reactions between biological molecules. This mechanism would result in concentration and life span free radicals.(10) EMF result in excessive formation of ROS which would result in irreversible tissue damage.(11,12) ROS can easily damage DNA, Lipid and proteins of the membrane.(12,13)
Living organisms can defense against free radicals by producing antioxidant enzymes such as: Catalase (CAT), Glutathione peroxides (GPX) and Superoxide dismutase (SOD).(10) SOD is the most important antioxidant enzymes which is involved in removal of superoxide and H2O2 Since lipid peroxidation is increased by increasing of ROS, Malondialdehyde (MDA) that indicate lipid peroxidation is used as a marker oxidative stress. (9,14)
EMF also affect reproductive system and could lead to sub fertility, implantation disorder and congenital malformations.(15)
It has been reported that EMF and Radio Frequency Radiation (RFR) have detrimental effects fertility and reproductive in females.(16,17) Most of In-Vitro studies suggest that low-frequency magnetic field EMF could affect cellular metabolism, proliferation such effects many result in abnormalities in embryonic development.(18) Previous studies of female newborn rats to EMF of 10 kV/m for 24- hours/ day during developmental and neonatal period resulted in delayed puberty and some histopathological changes on reproductive organs.(19)
Since Stem cells are fully active in embryos, every physico-chemical factors could affect embryonic development including their reproductive organs. The evidence suggests that special attention must be taken in preventing embryos and neonates from EMFs. (20)
The aim of the present study is to investigate the effect of EMF on biomarkers of stress oxidative such as MDA and SOD in pregnant rats exposed to EMF and on the ovary of the F1 generation during adulthood.
MATERIALS AND METHODS
Animals
In the present research, 18 female Wistar rats weighting 200-250g with 2-3 month age were studied. The rats were supplied from animal house of the histology Department Faculty of Medicine, Tabriz University of Medical Sciences. The rats were housed in plastic cages and kept under 12h light / dark condition under 20-220C, 50-60% humidity and free access to food and water. The rats were mated and pregnancy was determined by detection of vaginal plagues. The pregnant rats were divided into 3 groups of 6 rats in each group, including: experimental, sham and Control.
Study design
The rats in treatment group randomly were exposed to 3mT EMF produced by 50Hz and the rats were exposed for 4 hours/day during the pregnancy period. The sham groups were kept in a similar condition without exposure to EMF. The control group were kept in standard condition.
After delivery, all rats were bleeding from the eye angle and the blood and sera were kept in -800C freezer for biochemical analysis and detection of MDA and SOD. For study of ovarian tissue the neonates were kept up to adolescence and at that time anesthetized using chloroform and their ovaries were removed, fixed in 10% formalin, embedded in paraffin and 5µm sections were stained with H and E and studied with light microscope.
MDA was measured on the basis of reaction thiobarbituric acid (TBA) and measuring absorbance spectrophotometer and calculated as nmol/ml. (21)
SOD was determined using RANSOD kit (obtained from RANDOX company of England) as U/ml, according to Sun et al.(22)
Statistical analysis
The data were analyzed and compared with control and sham group with SPSS v.19 software by using T-test and PEnglishhttp://ijcrr.com/abstract.php?article_id=1038http://ijcrr.com/article_html.php?did=1038
Sun j. Does exposure to Computers affect the routine parameters of semen quality. Asian Journal of Andrology 2005; 7 (3): 263-266.
Chan Gye Myung and Jin Park Chan. Review Effect of electromagnetic field exposure on the reproductive system. Clin Exp Repord Med 2012; 39 (1): 1-9.
Moussa S.A. Oxidative Stress in rats Exposed to microwave Radiation. J Biophysics 2009; 19 (2): 149-158.
Byus CV, Lundak RL, Fletcher RM, Adey WR. Alterations in kinas' activity following exposure of cultured human lymphocytes to modulated microwave fields. Bioelectromagnetics 1984; 5: 341– 351.
Repacholi MH, Greenebaum B. Interaction of static and extremely low frequency electromagnetic fields with living systems: health effects and research needs. Bioelectromagnetics1999; 20: 133–160.
Adey WR. Biological effects of electromagnetic fields. J Cell Biochem 1993; 51:410–416.
Cleary SF, Cau G, Liu LM. Effects of isothermal 45 GHz microwave on the mammalian cell cycle: comparison with the effects of isothermal 27 MHz radiofrequency radiation exposure radiation. Bioelectrochem Bioenerg 1996; 39: 167–173.
Kula Boguslaw, Sobczak andrzej and kuska Rafal. Effects of electromagnetic field on field on free radical. Journal occup Health 2002; 44: 226-229.
Saad El- Din Islam Mohammad. Effects of electromagnetic field on some physiological Parameters in Rat 2007; A Thesis submitted to Zagazig university for the degree of master of Veterinary Medical Science.
Ciejka E, Kleniewska P, Skibska B, Goraca, A. Effects of Extremely Low frequency Magnetic field on Oxidative Balance in brain of Rats. Journal of physiology and pharmacology 2011; 62 (6) : 657-661.
Canseven Gulnihal Ayse, Coskun Sule and Seyhan Nesrin. Effects of various extremely low frequency magnetic fields on the free radical processes, natural antioxidant system and respiratory burst system activites in the heart and liver tissues. Indian journal of biochemistry and Biophysics 2008; 45: 326-331.
Ferniekim J and Reynoldajames. The Effects of electromagnetic fields from power lines Avian Reproductive Biology and Physiology. Journal of Toxicology and Enviromental Health. Part B 2005; 8: 127-140.
Hardell Lennart and Sage Cindy. Biological effects from electromagnetic field exposure and public exposure standards. Biomedicine and pharmacotherapy 2008; 1-6.
Somi, M.H, Hajipour B, Asi, N.A, Estakhri.R, Azar A.N, Zade M.N, Haghjou A.G and Vatankhah A.M. Pioglitazone Attenuates Ischemia/Reperfusion- Induced liver. Transplantation proceedings 2009; 41: 4105-4109.
Chernoff N, Rogevs JM, Kavet R. A review other literature on potential reproductive and developmental toxicity of electric and magnetic fields. J Toxicology 1999; 14, PP: 91-125.
Huuskonen H, juutilainen J, Komulainen H. J Effects of Low frequency magnetic fields on fetal development in rats. Bioelectro magnetic 1993; 14: 205-213.
Behari jitendra and Rajamani Paulraj. Electromagnetic field exposure effects (ELF-EMF and RFR) on fertility and Reproduction. BioInitiative working Group 2012.
Juutilainen Jukka J. Effects of Low-frequency magnetic fields on embryonic development and pregnancy. Environ Health 1991; 17:149-158.
Exponent. EMF and Health. Health Science practice. Comprehensive Review and Update of the Scientific 2012.
Bellieni Carlo V. Fetal and Neonatal Effects of EMF 2012; Section 19.
Kaya H Sezik. Lipid peroxidation at various estradiol Concentrations in human circulation during ovarian stimulation with exogenous gonadotropins 2004; 36: 693-2004.
Sun Y and Oberley Li Y. A Simple method for clinical assay of Superoxide dismutase 1988; 34: 497-500.
Uzar Ertugral, Yilmaz H. Ramazan, Yilmaz Mustafa, Uz Efkan, Yurekli Vedat, Dundar Bumin, Koyuncuoglu Hasan Rifat, Comlekci Selcuk. Effects of 50Hz electric field on malondyaldehide and nitric oxide levels in Spinal cord of rats at prenatal plus postnatal period. Turk J Med Sci 2011; 1 (1): 65-72.
Markkanen Ari. Effects of electromagnetic fields on Cellular Responses to Agents causing oxidative Stress and DNA Damage 2009.
Martinez –Samano Jesus, Torres-Duran Patricia V, Juarez-Oropeza Marco A, Elias-Vinas David and Verdugo-Diaz Leticia. Effects Of Acute electromagnetic field exposure and movement restraint on antioxidant System in liver, heart, kidney and plasma of Wistar rats. Journal Radiat Biol 2010; 86: 1088-1094.
Guler G, Turkozer Z, Seyhan N. Electric field effects on guinea pig serum. The role of free radicals. ElectromagenBiol Med 2007; 26: 207-222.
Tilley JL, Kawalski KL, Schomberg DW and Hsueh AJ, Endocrinol. Apoptosis in atretic ovarian follicles is associated with selective decrease in messenger ribonucleic acid transcripts for gonadotropin receptors and cytochrome p450 aromatase1992; 131: 1670-1676.
Kheradmand A, Roshangar L, Taati M, Sirotkia AV. Popho, etrical and intra cellular changes in rat ovaries following chronic administration of ghrelin. Tissue and cell 2009; 41: 511-517.
Roshangar Leila and Soleimanirad Jafar. Ultrastructural Alteration and occurrence of Apoptosis in Developing follicles exposed to Low frequency Electromagnetic field in Rat ovary. Pakistan journal of Biological Sciences 2007; 1 (24): 4413- 4419.
Cecconi Sandra, Gualtieri Giancaterino, Di Bartolomeo Angela, Troiani Giulia, Grazia Cifone Maria and Canipari Rita. Evolution of the effects of extremely low frequency electromagnetic fields on mammalian follicle development. Human Reproduction 2000; 15 (11): 2319-2325.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareDERMATOGLYPHICS IN DENTISTRY -A REVIEW
English3033Ceena Denny E.English Junaid AhmedEnglish Nandita ShenoyEnglish Almas BinnalEnglishDermatoglyphics deals with the study of fine patterned dermal ridges on volar surfaces of soles, palms and ridges. The volar pads are mound shaped elevations on each finger above the proximal end on the distal metacarpal bone. It is unique for each person, and is not same even in monozygotic twins, studying them can be helpful in diagnosing certain genetic disorders, oral diseases and also in forensic science.
EnglishDermatoglyphics, Palmarglyphics, Oral diseases, Genetic disordersINTRODUCTION
The palms of the hands and the soles of the feet are covered with two totally distinct classes of marks. The most conspicuous are the creases or folds of the skin which interest the followers of palmistry. These folds or creases could be an indicator of certain congenital abnormalities. Scientifically the term palmistry means dermatoglyphics (derma-skin; glyphics-carvings).1 The term was coined in 1926 by Cummins and Midlo,2 although Harold Cummins is considered to be the father of dermatoglyphics.1
Dermatoglyphics deals with the study of fine patterned dermal ridges on volar surfaces of soles, palms and ridges. The volar pads are mound shaped elevations on each finger above the proximal end on the distal metacarpal bone. The size and position of these pads are responsible for the ridge patterns to an extent.3,4 Towards the end of the 19th century, Galton put forth a rule called ‘proof of no change’, which states that an individual’s dermatoglyphics remain unchanged throughout his/her lifetime. Since it is unique for each person, and is not same even in monozygotic twins, studying them can determine a number of parameters which could be helpful in diagnosing and treatment of examined individuals. Thus, it is considered to be an important tool in assessing the genetic trait, evaluation of children with suspected genetic disorders and also in forensics. It is noted that subjects with chromosomal abnormalities had unusual ridge formations.5The ridges are influenced by blood vessel-nerve pairs at the border between the dermis and epidermis during prenatal development and factors, such as inadequate oxygen supply, unusual distribution of sweat glands and alterations of epithelial growths could influence the ridge patterns.6The ridged skin is considered to be a sensitive indicator of intrauterine dental anomalies because it originates from the foetal volar pads as the teeth which also originates from the same ectodermal layer in the 6th-7th week of embryonic life. Hence, when an intra-uterine dermal damage occurs, a tooth anomaly can be expected.7 In a similar way development of dermal ridges and congenital deafness seems to be interlinked as they develop at around the same time.8
CLASSIFICATION OF FINGERPRINTS
The basic characteristic pattern of finger print was classified in 1892 by Sir Francis Galton.9 He
classified the patterns into three types: arches, loops and whorls, based on the degree of curvature of the ridges. This classification enables almost any pattern to be sorted under one or other of the above three heads. There are a few patterns, which are nondescript and rare. Arches are formed when the ridges run from one side to the other of the bulb of the digit without making any backward turn or twist. Loops, when there is a single backward turn, but no twist. Loops can be further subdivided according to ridge opening as radial(towards the thumb on the radial side) and ulnar (away from the thumb on ulnar side).1 Whorls are said to be present, when there is a turn through at least one complete circle; they are also considered to include all duplex spirals.10 The whole of the human palm shows certain other features such as ATD angle [This angle is formed by lines drawn from the digital triradius (a) to the axial triradius (t) and from this triradius to the digital triradius (d)], H-loop, IV loop, and triradius. (Triradii is a point of convergence for three regions that separate almost parallel ridges)11
ADVANTAGES
The major advantages of dermatoglyphics is that scanning or recording is cost effective, rapid and can be done in the clinics without hospitalisation and without causing any trauma. It also requires minimum equipments and data collected can be preserved for lifelong.12
INDICATIONS
Clinically, dermatoglyphics is used in diagnosing various conditions like mental retardation, autism, schizophrenia, Alzheimer disease and even in predicting appearances of addiction diseases such as alcoholism. It can also be used to determine genetic predispositions for dyslexia or hyperactivity and also as clinical markers for various types of trisomy.4It is also used as a Biometric identifier.13 Many researchers have investigated dermatoglyphics in various fields such as forensic medicine, genetics and anthropology.14
DERMATOGLYPHICS IN DENTISTRY
Dermatoglyphics has drawn attention in the field of dentistry and has been used to unveil oral diseases like dental caries, oral cancer, bruxism, malocclusion, anomalies of teeth, cleft lip, cleft palate, periodontal disease, dental fluorosis and also in unveiling truth with forensic odontology.
Periodontal disease
M. Atasu et.al (2005)15 In their comparative study between periodontally healthy and patients suffering from periodontitis, noticed that there was decreased frequency of twinned and transversal ulnar loops on all fingers of the patients with juvenile periodontitis(JP), a decreased frequency of double loops on all fingers and an increased frequency of radial loops on the right second digits of the patients with rapidly progressing periodontitis(RPP), and the increased frequencies of concentric whorls and transversal ulnar loops on all fingers of the patients with adult periodontitis(AP), an increased frequency of t″ triradii on the palms of the patients with JP, the increased frequencies of IV and H loops and tbtriradii on the palms of the patients with RPP and an increased frequency of e triradii on the soles of the patients with JP were found.
Dental caries
Padma et al. (2011)8 in their study evaluated the dermatoglyphic peculiarities and caries experience of deaf and mute children and found an increased frequency of whorl pattern in caries group and the frequency of loops were more in caries free group.
Sharma A andSomani R (2009)16 found highly significant difference in loops between the subject (Caries) and control groups, and also observed significant difference between subject and control groups for microbial growth.
Malocclusion
Tikare S et al.(2010)17 assessed the relationship between fingerprints and malocclusion among a group of 696 high school children aged 12-16
years and it revealed a statistical association between whorl patterns and classes 1 and 2 malocclusion.
Squamous cell carcinoma, Leukoplakia
ElluruVenkatesh et.al.(2008)2 in their study to determine the dermatoglyphic pattern in subjects with leukoplakia and oral squamous cell carcinoma found that among 30 patients diagnosed with leukoplakia, 30.70% had whorls,6.30% had loop and arch type of finger print respectively and in oral squamous cell carcinoma patients it was found that 60. 70% had loop, 32.30%had whorl, and 7.0% had arch pattern of fingerprints.
Bruxism
Increased frequency of whorls and a decrease in frequency of ulnar loops were seen in patients with bruxism than the controls. They also demonstrated a lower frequency of angle than controls.18
Cleft lip and palate
R.S Balgir (1992)19 in his study among 69 cases with cleft lip with or without cleft palate observed, that there was an increased frequency of ulnar and radial loops than arches and whorls.
Oral Tumors
Polat HM et al. (2004) 20Among 29 patients with oral tumors who were investigated for their dermatoglyphic patterns found that there was an increased frequency of arch pattern on their fingertips.20
Forensic odontology
In a comparative study among100 children (50-healthy, 50-mentally challenged) an increased frequency of loops and transverse palmar crease line among the mentally challenged children were observed.12
CONCLUSION
Dermatoglyphics is an upcoming integral part of medicine and forensic science. The correlation of dermatoglyphics with dental abnormalities is still in its nascent stages and presently it is safe to say that the various finger print patterns can be considered as an indicator for the occurrence of congenital abnormalities. Dermatoglyphics has moved from obscurity to acceptability as a diagnostic tool. In the future it may serve as an important tool that can predict the future health of a person.
Englishhttp://ijcrr.com/abstract.php?article_id=1039http://ijcrr.com/article_html.php?did=1039
Nidhi Madan, Arun Rathnam, Neeti Bajaj. Palmistry: A tool for dental caries predilection. IJDR 2011;22(2):213-218.
ElluruVenkatesh, AnjanaBagewadi,Vaishali K and Arvind S. Palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma patients. JIAOMR July-Sept 2008; 20 (3):94-99.
Kimura S. Embryologic development of flexion creases. Birth defects Orig Artic Ser 1991; 27:113-29.
MiodragStošljevi, MilosavAdamovi. Dermatoglyphic characteristics of digito-palmar complex in autistic Boys in Serbia.Vojnosanit Pregl 2013; 70(4): 386–390.
Kamboj. Dermatoglyphics, letter to editor. British Dental Journal.2008; 204 (2),51.
ImeneNamouchi.Anthropological significance of dermatoglyphic trait variation: an intra-Tunisian population analysis. Int. J. Mod. Anthrop. 2011, 4: 12 – 27.
Atasu M, Akyuz S. Congenital hypodontia: a pedigree and dermatoglyphic study. J. Clin.Pediatr. Dent. 1995; 19(3): 215-24.
Padma K. Bhat, Bhumika Kamal Badiyani, Aruna C.N., SandhyaChengappa, NithinN.Bhaskar. Dermatoglyphics-A New Diagnostic Tool in Detection of Dental Caries among Deaf and Mute Children. IJCDS • 2011,2(4):80-84.
Galton F. Finger prints London;McMillan:1982.
http://www.BiometricBits.htm.
Vineet Gupta, Puneet Kumar, RoshniDupare, Sonia SoodDatta.Dermatoglyphics and dental caries: A review Indian Journal of Forensic Odontology.2011e 4 (3-4):33-37.
Kiran.K, KavithaRai, Amitha M Hegde.Dermatoglyphics as a noninvasivediagnostic tool in predicting mental retardation J. Int Oral Health 2010, 2 (1):95-100.
Maltoni D., Maio D., Jain A.K., Prabhakar S., 2003. Handbook of Fingerprint Recognition. Springer Verlag. New York.
Matsuyama N, Ito Y. The frequency of fingerprint type in parents of children with trisomy 21 in Japan.J PhysiolAnthropol2006 25: 15-21.
M. Atasu, B. Kuru, E. Firatli, H. Meriç.Dermatoglyphic findings in periodontal diseases International Journal of Anthropology January – June 2005, 20(1-2): 63-75
Sharma A andSomani R.Dermatoglyphic interpretation of dental caries and its correlation to salivary bacteria interactions: an in vivo study. J Indian SocPedodPrev Dent. 2009 Jan-Mar;27(1):17-21.
S Tikare, G Rajesh, KVV Prasad, V Thippeswamy and SB Javali. Dermatoglyphics – A marker for malocclusion? International Dental Journal (2010) 60(4):300-304.
Polat MH, Azak A, Evlioglu G, et al. The relation of bruxism and dermatoglyphicsJClinPediatr Dent 2000; 24(3) :191-4.
BalgirRS. Dermatoglyphics in cleft lip and cleft palate anomalies.IndianPediatr. 1993;30(3):341-6.
PolatHakan M., Evlio?luGülülmser, KarayazganBanu.Dermatoglyphic findings in patients with oral cancers.Balkan Journal of Stomatology.2004, 8 (2): 105-108.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareCAUSES OF DEARTH OF MEDICAL TEACHERS IN SOME SPECIALITIES : A CROSS- SECTIONAL OBSERVATIONAL STUD
English3439Lopamudra Dhar ChowdhuryEnglish Ranjan BasuEnglish Avijit HazraEnglish Tanmoy BiswasEnglishObjective: At present there is a deficit of 30-40 % medical teachers in the existing 345 medical colleges in India. This study was done to find out the percentage of medical students who desire to opt for medical teaching, the subjects chosen for their future career and the major factors which influence their decision making were assessed to explore the possible causes of dearth of medical teachers in some specialities. Settings and Design: The study was a cross sectional observational study, done among the medical students and junior doctors in IPGME andR , Kolkata. Methods and Material: A cross sectional questionnaire based study was done on students, interns and house officers of Institute of Post Graduate Medical Education and Research, Kolkata. The answers were treated as confidential and their views and opinions were analyzed statistically. Data obtained was analysed and presented in counts and percentages and chi square test or Fisher’s Exact Probability test as applicable. Results: Data collected revealed that out of 149 medicos, 146 (97.99%) were willing to do post-graduation, 3 (2.01%) were undecided; 61(40.9%) wanted to opt for medical teaching, 47 (31.58 %) did not while 41 (27.52 %) were undecided. Regarding the subjects chosen for post-graduation, Surgery, Medicine and Pediatrics held the priority followed by Orthopedics and GandO. Pre and para-clinical subjects were chosen by 4.02%. 132 wanted pre-PG subject counseling. The major drawbacks of the present medical education system were found to be, lack of exposure to clinics in pre and para-clinical subjects, inadequate teaching infrastructure and students not reciprocating the contributions of a teacher. Conclusions: Various factors influence the ultimate career choice of medical students. Exploring and sorting out the deterring factors which hold them back from medical teaching specially the dearth subjects could perhaps help to tide over the present crisis of dearth of teachers.
Englishmedical teacher, dearth , specialityINTRODUCTION
The demand of medical colleges in India is ever increasing, though the student: teacher ratio in the Medical Education System is disheartening. At present as on July, 2013, there are 381 medical colleges in India, to provide MBBS course to 50068 medical students (1,2). There is about 30-40% deficit of Medical Teachers in various
specialities (3). So, we cannot expect a turn-out of good doctors to serve the community in the present scenario of deficit of inspiring teachers. At present, the student: teacher ratio is 2:1 to 3:1 whereas according to MCI norms, 1:1 is the target (3). Many of the students in the medical profession are keen in clinical practice rather than treating medical teaching as a good career option. Various factors influence the ultimate career choice of the students at the time of admission to the course (4,5) . As some career options are overlooked by the students (6), the deterring factors which hold them back from opting for medical teaching can be sought for to tide over the present crisis.
MATERIALS AND METHODS
A questionnaire based cross sectional survey was done. Two hundred structured questionnaires were distributed among students of various semesters, interns and house officers of IPGMEandR, medical college of Kolkata , West Bengal after obtaining ethical clearance from the institutional ethical committee. The participants were assured that the answers would be treated as confidential and taken with their consent. The questionnaire requested their personal choice regarding post graduation, their preference for teaching and the drawbacks which they consider are a hindrance to teaching. The answered questionnaires were collected and the properly filled up, valid answer sheets (n= 149) were analyzed statistically for significance.
Statistical Analysis
The data were entered into an MS Excel worksheet. Categorical demographic variables, their subject choice of post graduation, the preference for teaching, the drawbacks considered as a hindrance to teaching were presented in counts and percentages and compared using the Chi-square and Fisher exact tests as applicable.
RESULTS
Out of 149 medicos, 146 (97.99%) were willing to do post-graduation, 3 (2.01%) were undecided; 61(40.9%) wanted to opt for medical teaching, 47 (31.58 %) did not while 41 (27.52 %) were undecided (Figure-1). The demographical distribution of different classes of medical students and junior doctors regarding age and sex were found statistically significant (Table –1)
Regarding the subject choice for post graduation, Surgery, Medicine and Pediatrics were chosen by the majority, followed by Orthopedics and Gynecologyand Obstetrics. Pre and Para clinical subjects were chosen by only 4.02% (Figure –2) .
Regarding option for teaching, subjects like Medicine, Surgery held the priority followed by Pharmacology, Pediatrics and Physiology. Subjects like Skin, Anesthesiology, Radiotherapy and Gynecology and Obstetrics were not chosen for teaching (Figure -3). The disparity in teaching subject choice is perhaps due to non exposure to some subjects in undergraduate years.
The drawbacks associated with teaching as a career were analyzed and it was found that lack of exposure to clinics in preclinical and para clinical subjects, inadequate teaching infrastructure and students not reciprocating the contributions of a teacher were responded by majority (Table -2).
DISCUSSION
The number of medical colleges in India over the past 15 years has more than doubled but the human resource in the form of medical teachers has not kept pace in fulfilling the MCI criteria . The gross deficit of medical teachers has led to unethical practices during MCI inspection (7) . With the present criteria, over 2000 teachers are required in Medicine, surgery and community Medicine; 1600-2000 teachers for Anatomy, Physiology, Pathology andAnaesthesiology; 1000-1500 for Pharmacology, Paediatrics, Ortopaedics , Gynaecology and Obstetrics, Radiology. As teachers are required for both undergraduate and postgraduate courses, the deficit of medical
teachers should be urgently sorted out. In 1997, the MCI guidelines were modified to give a clear direction towards small group teaching. For small group teaching–learning activity, the teacher requirement would exceed the minimum numbers prescribed by the MCI. Hence, the whole issue of human resources in the form of medical teachers requires a thorough reappraisal on an urgent basis if the system is not to fail (7) . Considering the large number of faculty required, there is an acute shortage of teaching manpower in medical colleges both in the long standing and newly started ones. This shortage is in the region of 20%–25% in most departments and as high as 33% in some departments. The shortage is mainly attributable to non-availability of qualified personnel willing to take up employment in medical colleges on the current terms and conditions (7) . The crisis is so acute that MCI has undertaken some strategies like re-employing retired teachers, extending the age of retirement of teachers, even decreasing the experience required for faculty posts to tide over the present crisis (3) .
In this study participants were from various semesters as well as interns and house-officers. It has been seen that the preclinical and clinical training period can be used to influence the speciality preference in future years.(8,4). Moreover, career preferences change dynamically as the students progress through the course and are exposed to different specialities (9). There are various factors which influence the ultimate turn-out of medical teachers in various specialities. A recent survey shows that some subjects like Anatomy, Biochemistry, Physiology, Forensic Medicine and Pathology had no takers. This study shows that choices have changed. It is also likely that their choices would change in subsequent years (10). As many post-graduate seats in the pre/para - clinical subjects remain vacant over the years, it implies that deficit of medical teachers in these specialities would be bound to occur in the near future (11). Some career options are overlooked by students (10). A proper career counselling of medical students could perhaps open up newer avenues for the upcoming post graduates. In this study, 88.5% of participants had voted for pre-PG subject counselling for appropriate subject choice for future career. It has been seen that students who opt for subjects without proper prospective knowledge of the subject may not have much passion for, or commitment to the subject, resulting in mediocrity and frustration (12) . In addition, understanding of factors that influence their career decisions is also important (13). Hence screening of the factors, which actually deter the candidates from opting for a teaching career should be sorted out at an early stage. In previous studies it was seen that factors like career stability, reputation, lifestyle and income influenced career choice of students of India and abroad (14). In this study, other drawbacks specially of the medical education system, were placed before the participants for their opinion. Sorting out the underlying factors and proper career counselling could perhaps avoid either overcrowding or scarcity of postgraduates in different specialities (15,9) . Thereby, the valuable post-graduate seats would be utilized rather than being wasted bringing hope for better turn-out of medical teachers in at least certain specialities. Up gradation of the present teaching infrastructure, involvement of pre and para clinical medical teachers in clinics perhaps initiation of integrative teaching would attract many students towards teaching.
Career choices are dynamic and likely to change over time, however if the disinclination towards some subjects persist, there is likely to be a scarcity of teachers in pre and para clinical departments (16,17) .
CONCLUSION
As this study was carried out on a small groups of students of various category of a single teaching institution, further multicentric studies involving more participants specially of final semesters or interns would perhaps bring out more information
regarding the causes of deficit of medical teachers in some specialities. Further studies involving exploration of the underlying causes which keep away students from selecting some subjects for their future career and measures to make these subjects attractive should be undertaken urgently to achieve the target of attaining student: teacher ratio of 1:1 for all subjects.
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=1040http://ijcrr.com/article_html.php?did=1040
en.Wikipedia.org/wiki/list_of_Medical_Colleges_in_India
List of MCI recognised and permitted colleges for MBBS course searched in all state, all universities , all colleges as accessed on 15/07/2013 . URL: http://www.mciindia.org/InformationDesk/CollegesCoursesSearch.aspx.
Ananthakrishnan N.Medical Education in India: Is it still possible to reverse the downhill trend?. The National Medical Journal of India 2010; 23; 156-60.
Wright B , Scout I, Wolochuk W.Brennies F, Bradley J. Career choice of new medical students at three Canadian universities; Family medicine versus speciality medicine. CMAJ 2004;170; 1920-4.
Wright B, Scott I, Powis D, Wodochuk W, Henry R, Turnbull D, et al. Career preferences of new medical students at four Australian universities; Rural family medicine versus the rest . Aust J Rural Health 2006; 14; 229-30.
Mutha S, Takayama JL, O’Neil EH. Insights into medical students’ career choices based on third and fourth –year students’ focus- group discussions. Acad Med 1997; 72; 635-40.
Ananthkrishnan N. Acute shortage of teachers in medical colleges; Existing problems and possible solutions. The National Medical Journal of India 2007; 20; 25-9.
Harris MG, Gavel PH, Young JR. Factors influencing the choice of speciality of Australian medical graduates. Med J Aust 2005;183:295-300.
Khader Y, Al-Zoubi D, Amarin Z, Alkafagei A,Khasawneh M, Burgan S et al. Factors affecting medical students in formulating their speciality preferences in Jordan.BMC Med Educ 2008;8:32
Huda N, S, Career preferences of final year medical students of Ziauddin Medical University; Educ Health (Abingdon) 2006;19;345-53.
Kumar R, Dhaliwal U. Career choices of undergraduate medical students. The National Medical Journal of India 2011; 24; 166-69.
Shah SU. The medical students’ dilemma; Which postgraduate specialty to pursue? J Postgrad Med 2009;55:294-95.
Ranta M, Hussain SS, Gardiner Q.Factors that inform the career choice of medical students: Implications for otolaryngology. J Laryngeal Otol 2002;116:839-41.
Buddeberg,Fischer B, Klaghofer R, Abel T,Buddeberg C.Swiss residents’ speciality choices- impact of gender, personality traits, career motivation and life goals.BMC Health Serv Res 2006;6:137.
Soethout MB,Heymans MW,Ten Cate OJ.Career preference and medical students’ biological characteristcs and academic achievement. Med Teacher 2008:30;e 15-e22.
Anand MK, Raibagkar CJ, Ghediya SV, Singh P. Anatomy as a subject and career option in view of medical students in India.J Anat Soc India 2004;53:10-14.
Anantraman V, Kanya R. MBBS students observations on pre and paraclinical subjects. J Anat Sci 1995;14:31-3.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareHEAT STRESS AND MUSCLE HYPERTROPHY: EFFECTS AND MECHANISMS
English4046Medha KapoorEnglish Laxmi Prabha SinghEnglishMaintenance of skeletal muscle integrity is a very important concern for certain occupational workers such as athletes, sportsmen and military personnel. A number of published reports suggest that heat stress in a potent activator of muscle hypertrophy and can be used as a powerful tool to prevent muscle atrophy during conditions of bed rest due to injury or illness as well muscle inactivity due to any other reason. Therefore, application of heat to muscle can be very beneficial not only for soldiers and athletes, but patients during habilitation for gaining muscle mass and force generation. This review attempts to summarize the recent advances in understanding of mechanisms by which heat stress causes skeletal muscle hypertrophy with an emphasis on the signal transduction pathways that play detrimental roles in regulating muscle hypertrophy in response to heat stress.
EnglishHeat stress, Muscle hypertrophy, mTOR, Satellite cells, ThermotherapyINTRODUCTION
The skeletal muscle comprises of approximately 50% of total body weight. It is the largest tissue in the human body and controls body functions such as breathing, force generation and movement. Heat stress in one of the prominent stimuli in addition to exercise, overloading, vascular occlusion and vibration for induction of muscle hypertrophy. The enhanced proliferation of muscle specific stem cells, the satellite cells, and their subsequent differentiation into mature muscle cells is one of the major contributors to muscle hypertrophy, apart from protein synthesis [1, 2, 3, 4]. The expression of the developmental (embryonic and neonatal) Myosin Heavy Chain (MHC) isoforms in adult skeletal muscle indicates a state of generation of new muscle fibers. Therefore, at the time of muscle hypertrophy, an enhanced expression of the developmental isoforms is observed [5].There are various signaling pathways regulating protein synthesis for induction of hypertrophy and Akt/mTOR stands out as the most significant and extensively studied pathway amongst all. We attempt to summarize the literature pertaining to effect of heat stress on muscle hypertrophy and understanding of the signal transduction pathways that underlie muscle hypertrophy in response to heat stress.
The role of satellite cells and protein synthesis in muscle hypertrophy
The skeletal muscle specific stem cells called as satellite cells as well as protein synthesis are the major contributors to the skeletal muscle mass. The satellite cells have the potential to proliferate and subsequently fuse and differentiate to form myofibers under conditions of cellular stress. Myogenic precursor cells expressing specific transcriptional factors such as MyoD and Myf5 differentiate into myoblasts, which proliferate and fuse to form myotubes, the immature multinucleated skeletal muscle cells. These develop into mature skeletal muscle cells at the time of embryonic development. The histopathological examination of muscles following an injury has revealed an increase in the satellite cells numbers and their subsequent differentiation into myotubes and myofibers [5, 6]. Muscles without satellite cells have been found to lack any regenerative potential [7, 8]. An increase in muscle protein content, which results from increased muscle protein synthesis and/or reduction in muscle protein catabolism contributes to skeletal muscle hypertrophy. However, the molecular mechanisms, which mediate the sensing of stimuli for muscle hypertrophy still remain unknown [9].
Induction of muscle hypertrophy via heat stress
The application of thermotherapy to damaged or atrophied muscles is a standard practice to achieve muscle regeneration. Heat application not only leads to the proliferation of satellite cells [3] but also enhances the supply of infiltering phagocytes to the injured muscle and ensuing removal of the damaged cells [10]. Pan et al., 2012 investigated the role of the oxidative stress response in preconditioning heat stimulation in Rat skeletal muscle. In this study, Fluctuating Local Somato Thermal Stimulation (LSTS) between 37-44°C was applied to the left quarter ventral abdomen muscle of male Sprague-Dawley rat for 27 minutes. The concentration of Reactive Oxygen Species (ROS), Nitric Oxide (NO) metabolites, malonaldehyde, dismutase, catalase and glutathione were measured 0, 5,15, 30 and 60 minutes post LSTS with the 0 minute readings serving as baseline(without LSTS). A significant increase in the concentration of ROS, NO metabolites, malonaldehyde was observed 5 minutes after LSTS. On the other hand the dismutase activity was found to be the least after 5 minutes post LSTS. The catalase and glutathione activity was recorded to be the least after 15 minutes post LSTS. Also it was shown that the inhibition of NO synthesis using NO synthase inhibitor L- N-nitro-L-arginine methyl ester resulted in a decrease in HSP 70 expression [11]. The possible explanation is the partial involvement of NO in HSP 70 production. There are reports highlighting that the ROS can also stimulate other pathways for upregulation of Heat Shock Proteins (HSPs) [12].
Heat stress attenuates skeletal muscle atrophy in hindlimb unweighted rats. Niato et al., 2000 developed a muscle atrophy rat model employing 8 day hind limb unweighting. For the study, 40 rats were divided in a 4 groups with 10 rats in each, namely sedentary control(group 1) heat stress(group 2) hind limb unweighting(group 3) and heat stress(group 4) prior to hind limb unweighting. The second and third groups were subjected to heat stress at 41°C for 60 minutes in a heat chamber. The third and fourth groups were subjected to hindlimb unweighting for 8 days. At the end of the 8th day, soleus muscle was removed and HSP72 and total protein concentration were measured. There was a difference of 32% in the muscle weight loss between group 3 and group 4, with group 3 exhibiting greater loss. Also, group 3 exhibited greater protein loss compared to group 4. The HSP 72 levels were significantly higher in group 2 and 4 compared with control values. These results strongly suggest that thermotherapy can reduce the rate of immobilization and disuse induced muscle atrophy [4]. A study by Booth et al., 1997 suggested that hindlimb unweighting induced atrophy follows a typical course wherein the protein synthesis shows a rapid reduction (peaking 7th day post unloading) whereas the protein degradation takes place at a relatively slower pace (peaking 15th day post unloading) [13]. Protein degradation induced by muscle atrophy is accompanied by oxidative injury in myocytes. This is due to the fact that oxidatively modified proteins are susceptible to proteolytic attack. HSP 72 acts as a chaperon and binds to the oxidatively modified proteins assisting in protein refolding. Hence HSP 72 plays a very crucial role in preventing protein degradation [14].
Signaling pathways regulating muscle hypertrophy
The response of the skeletal muscles to various physiological stimuli is mediated via the following fundamental steps: Interaction of extracellular stimuli with plasma membrane receptors, activation of intracellular signaling pathways, changes in gene transcription and protein synthesis and ultimately, the muscle remodeling. The IGF-1/PI3K/Akt signaling pathway has been found to play a key role in muscle hypertrophy. It influences the critical hypertrophic processes such as protein degradation and synthesis. The Akt family comprises of three members: Akt1, Akt2 and Akt3, out of which Akt1 and Akt2 isoforms are predominantly expressed in skeletal muscle. The Akt is activated upon phosphorylation, which is stimulated by the action of growth factors, cytokines and hormones in a PI3K dependent manner. Another very prominent stimulator of this pathway is mechanotransduction, which pertains to the transition from mechanical signal into a biochemical event and is a key regulator of induction of protein synthesis. Thus hypertrophy can be induced independent of IGFI and PI3K via mechanotransduction. The Akt induces two independent pathways which play very critical roles in inducing muscle hypertrophy via regulation of transcription, protein synthesis and degradation: mTOR (mammalian target of rapamycin) and GSK3β (glycogen synthase kinase-3β) pathways. The mTOR upon activation influences protein synthesis via the action of three downstream molecules: p70s6k, 4E-BPI and eEF2. Muscle hypertrophy is also induced via the phosphorylation of GSK-3β, which inactivates GSK3β, which in turn inactivates eIF2B resulting in protein translation. A third mechanism by which Akt regulates skeletal muscle hypertrophy is the inactivation of Forkhead Transcription Factors (FOXO or FKHR), which regulate gene transactivation of the proteolytic system components, constituting the ubiquitin-proteasome system. The FOXO isoforms (1, 2 and 3) are active when located in the nucleus and induce transcription of genes involved in muscle atrophy such as atrogin-I/MAFbx and MuRF, which are the components of ubiquitin proteasome system. Upon phosphorylation mainly by Akt protein, these FOXO proteins migrate to cytosol, and are rendered inactive where they can no longer transcribe the atrophy inducing genes [15].
Kakigi et al., 2011 attempted to evaluate the role of mTOR signaling in heat stress related muscle hypertrophy. The study involved 8 human volunteers who performed two sessions of acute resistance exercise separated by three weeks rest period. During the first session, the subjects performed one leg knee extension exercise whereas during the second session, the same exercise was performed using contralateral leg with belly of the Vastuslateralis muscle subjected to heat stress with the help of microwave therapy unit. The Vastuslateralis muscle biopsies were taken from the non-exercising leg to serve as control samples and from the exercise leg 5 and 60 minutes post exercise. The muscle biopsies were analyzed for the expression levels of myosin heavy chain isoforms, eEF2, 4E-BP1, AMPK, p38, ERK ½, Akt, mTOR, S6K1 and S6. The Akt and mTOR phosphorylation were observed to increase significantly after the second session where exercise was combined with heat stress. There was no significant increase in the Akt and mTOR phosphorylation after first session, where exercise was not coupled with heat stress.4E-BP1 phosphorylation significantly decreased immediately after exercise performed in both the sessions but was found to increase 1-hour post exercise post second session. S6K1 phosphorylation was significantly increased at both time points (5 minutes and 1 hour post exercise) for session 2 compared to session 1. ERK1/2 and p38 phosphorylation also showed significant elevation 1-hour post exercise in session 2 compared to session 1. This provides very clear-cut evidence that heat stress increases the phosphorylation of the mTOR signaling molecules in human skeletal muscle. This in turn results in an increased muscle protein synthesis leading to muscle hypertrophy. However, the study suffered with certain major limitations with lack of a group representing the effect of heat stress alone, independent of exercise on mTOR signaling. Physiological changes such as blood flow were not measured which could have aided in clarification of the mechanism of activation of mTOR signaling molecules [16].
Yoshihara et al., 2013 investigated the role of hyperthermia in stimulating the Akt/mTOR signaling pathway in skeletal muscles of rats. 42 male Wistar rats were employed for the study and they were divided into 6 groups with 7 rats in each. One group served as control, and the other groups served as thermal stress groups with temperatures 37, 38, 39, 40 and 41 °C. Rats in all the groups fasted over night after which both their legs were emerged in hot water with temperatures as specified for 30 minutes under the influence of anesthesia induced via sodium pentobarbital administration. This was followed by immediate removal of the soleus and plantaris muscle from each leg. Akt and P70S6K phosphorylation was found to be significantly increased at 41 °C in both soleus and plantaris muscle. The increase in Akt and P70S6K phosphorylation was found to increase in a temperature dependent fashion in both muscles indicating that temperature itself may be a fundamental stimulator of Akt/mTOR signaling [17].
HSPs and MHC isoforms: Effect on muscle hypertrophy
Touchberry et al., 2012 investigated the effect of HSPs induction upon heat shock pretreatment on the events of early remodeling and signaling (2 hours and 48 hours) in soleus muscle following a bout of downhill running. The male Wistar rats were divided into 3 groups. Group 1(control) did not receive any exercise or heat treatment, Group II(eccentric exercise group) conducted eccentric exercise and the third group (Heat shock group) was subjected to heat shock treatment 48 hours prior to the exercise. The soleus muscle was removed 2 and 48 hours post exercise and blood was drawn. Muscle damage, regeneration markers and intracellular signaling was evaluated. Muscle damage was analyzed using Creatine Kinase (CK) and mono-nucleated immune infiltration as markers. Muscle regeneration was analyzed by estimating total protein and MHCneo as markers. Akt/ p70S6K and MAPKs intracellular signaling was evaluated. The average CK level was observed to increase in eccentric exercise group 2 and 48 hours post exercise whereas for the heat stress group CK level was not significantly elevated 2 Hours post exercise compared to control and was significantly less compared to eccentric exercise group and returned to baseline level 48 hours post exercise. Quantitative analysis of mono-nucleated immune infiltration revealed an increased number of immune cells infiltering the muscle in both eccentric exercise and heat stress groups but the number of immune cells in heat stress group was significantly less compared to eccentric exercise group. Protein content was found to be elevated in heat stress group 48 hours post exercise compared to control and eccentric exercise group. MHCneo content was found to be significantly elevated 2 hours and 48 hours post exercise compared to the control and eccentric exercise groups. No significant difference was observed in activation of Akt/p70S6K and MAPKs intracellular signaling 48 hours post exercise in heat stress group compared to control or eccentric exercise group suggesting that Akt/p70S6K may not be crucial for heat shock induced muscle regeneration. These observations are contradictory to the observations made by Kakeki et al., 2011. The possible mechanism for the increase in muscle protein concentration and MHCneo content has been postulated to occur by the recruitment of satellite cells [18].
Frier et al., 2007 conducted a study with an aim to determine the extent to which HSPs accumulation resulting from a single heat stress may influence the early events associated with skeletal muscle hypertrophy. To achieve this, 24 hours prior to overloading of 1 plantaris muscle by surgical removal of the gastrocnemius muscle, Sprague-Dawley rats were subjected to heat stress at 42 °C for 15 minutes. HSP 25, HSP 72, MHC 1, muscle mass, total muscle protein contents were measured for both control (contralateral plantaris muscle) and heat stressed and/or overloaded plantaris muscle over the course of 7 days after gastrocnemius muscle was removed. For animals subjected to overloading without heat stress,
muscle mass, total muscle protein, MHC I, HSP 25, HSP 72 were found to increase significantly upon overloading. In the heat stress and overloading group, the expression level of HSP72 was significantly higher than that of the overloading group without heat stress and muscle mass, total muscle protein and MHC I were comparatively diminished suggesting the inhibitory role of heat induced HSP expression to these parameters, which is contrary to many published reports included in this review [19].
CONCLUSION
A vast body of literature establishes heat stress as a potent inducer of muscle hypertrophy. It is also known that satellite cells’ proliferation and subsequent differentiation into mature muscle cells coupled with protein synthesis results in muscle hypertrophy. Various signaling pathways such as Akt/mTOR have been found to play critical roles in inducing muscle hypertrophy but the mechanisms of activation of these pathways are still incompletely understood. The understanding of the molecular phenomenon underlying the activation of various signal transduction pathways in response to heat stress is crucial for design of measures to combat and treat the conditions of muscle atrophy.
Future perspectives
Although a significant body of literature exists on signaling pathways that regulate muscle hypertrophy in response to heat stress, the precise understanding of the mechanisms of activation of these pathways is still lacking. Therefore, further research initiatives are required to understand the exact mechanism by which heat stress activates key signal transduction pathways associated with muscle hypertrophy. The precise understanding of the regulation of muscle hypertrophy via heat stress at the level of signal transduction involved will facilitate the design of modalities to combat conditions of muscle atrophy. Application of heat stress to induce hypertrophy will serve as a very economical, practical and easy to use alternative compared to the existing mechanical stress application to alleviate muscle atrophy observed under the conditions of injury, illness, unloading and immobilization.
Englishhttp://ijcrr.com/abstract.php?article_id=1041http://ijcrr.com/article_html.php?did=1041
Cochrane DJ. Vibration exercise: the potential benefits. Int J Sports Med.2011 Feb;32(2):75-99.
Kawada S, Ishii N. Changes in skeletal muscle size, fibre-type composition and capillary supply after chronic venous occlusion in rats. Acta Physiol (Oxf). 2008 Apr;192(4):541-9.
Kojima A, Goto K, Morioka S, Naito T, Akema T, Fujiya H et al. Heat stress facilitates the regeneration of injured skeletal muscle in rats. J Orthop Sci. 2007 Jan;12(1):74-82.
Naito H, Powers SK, Demirel HA, Sugiura T, Dodd SL, Aoki J. Heat stress attenuates skeletal muscle atrophy in hindlimb-unweighted rats. J Appl Physiol.2000 Jan;88(1):359-63.
Roy RR, Talmadge RJ, Fox K, Lee M, Ishihara A, Edgerton VR. Modulation of MHC isoforms in functionally overloaded and exercised rat plantaris fibers. J Appl Physiol. 1997 Jul;83(1):280-90.
Bischoff R. The satellite cell and muscle regeneration. In: Engel A, Franzini-Armstrong C, editors. Myology. New York: McGraw-Hil; 1994. P. 97-118.
Kuang S, Chargé SB, Seale P, Huh M, Rudnicki MA. Distinct roles for Pax7 and Pax3 in adult regenerative myogenesis. J Cell Biol. 2006 Jan 2;172(1):103-13.
Wang YX, Rudnicki MA. Satellite cells, the engines of muscle repair. Nat Rev Mol Cell Biol. 2011 Dec 21;13(2):127-33.
Goto K, Ohno Y, Goto A, Ikuta A, Suzuki M, Ohira T, et al. Some aspects of heat stress on the plasticity of skeletal muscle cells. JPFSM. 2012;1(2):197-204.
Tidball JG, Wehling-Henricks M. Macrophages promote muscle membrane repair and muscle fibre growth and regeneration during modified muscle loading in mice in vivo. J Physiol. 2007 Jan 1;578(Pt 1):327-36.
Pan PJ, Hsu CF, Tsai JJ, Chiu JH. The role of oxidative stress response revealed in preconditioning heat stimulation in skeletal muscle of rats. J Surg Res. 2012 Jul;176(1):108-13.
Banerjee Mustafi S, Chakraborty PK, Dey RS, Raha S. Heat stress upregulates chaperone heat shock protein 70 and antioxidant manganese superoxide dismutase through reactive oxygen species (ROS), p38MAPK, and Akt. Cell Stress Chaperones. 2009 Nov;14(6):579-89.
Booth FW, Criswell DS. Molecular events underlying skeletal muscle atrophy and the development of effective countermeasures. Int J Sports Med. 1997 Oct;18 Suppl 4:S265-9.
Kondu H, Itokawa Y. Oxidative stress in muscle atrophy. In: Sen CK, Packer L, Hanninen O, editors. Exercise and Oxygen Toxicity. Amsterdam: Elseveir, 1994,p 319-342.
Tiago Fernandes, Úrsula P.R. Soci, Stéphano F.S. Melo, Cléber R. Alves and Edilamar M. Oliveira (2012). Signaling Pathways that Mediate Skeletal Muscle Hypertrophy: Effects of Exercise Training, Skeletal Muscle - From Myogenesis to Clinical Relations, Dr. Julianna Cseri (Ed.), ISBN: 978-953-51-0712-5, InTech, DOI: 10.5772/51087. Available from: http://www.intechopen.com/books/skeletal-muscle-from-myogenesis-to-clinical-relations/signaling-pathways-that-mediate-skeletal-muscle-hypertrophy-effects-of-exercise-training
Kakigi R, Naito H, Ogura Y, Kobayashi H, Saga N, Ichinoseki-Sekine N,Yoshihara T, Katamoto S. Heat stress enhances mTOR signaling after resistance exercise in human skeletal muscle. J Physiol Sci. 2011 Mar;61(2):131-40.
Yoshihara T, Naito H, Kakigi R, Ichinoseki-Sekine N, Ogura Y, Sugiura T, Katamoto S. Heat stress activates the Akt/mTOR signaling pathway in rat skeletal muscle. Acta Physiol (Oxf). 2013 Feb;207(2):416-26.
Touchberry CD, Gupte AA, Bomhoff GL, Graham ZA, Geiger PC, Gallagher PM. Acute heat stress prior to downhill running may enhance skeletal muscle remodeling.Cell Stress Chaperones. 2012 Nov;17(6):693-705.
Frier BC, Locke M. Heat stress inhibits skeletal muscle hypertrophy. Cell Stress Chaperones. 2007 Summer;12(2):132-41.
Abbreviations
Myosin Heavy Chain (MHC)
Fluctuating Local Somato Thermal Stimulation (LSTS)
Reactive Oxygen Species (ROS)
Nitric Oxide (NO)
Heat Shock Proteins (HSPs)
Creatine Kinase (CK)
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareOSSIFICATION OF ANTERIOR LONGITUDINAL LIGAMENT IN THORACIC VERTEBRAE - A CASE REPORT
English4749Nagaraj MallashettyEnglish B.M. BannurEnglish Preetish EndigeriEnglish O.B. PattanashettyEnglish Pramod SangolgiEnglishDuring the routine examination of dry and processed bones, it was observed that the bodies’ thoracic vertebrae were fused due to the ossification of anterior longitudinal ligament. The posterior longitudinal ligament, ligamentum flavum and intervertebral disc were spared. The ossification of anterior longitudinal ligament is considered as a part of diffuse idiopathic skeletal hyperostosis – DISH( Forestier’s disease), most common in the age group of 40 and more who are obese leading to mild to moderate restriction of joint movement, low back pain and stiffness.
Englishossification, longitudinal ligament, forestiers disease, vertebraeINTRODUCTION
The human vertebral column consists of 33 vertebrae. 7- cervical, 12 - thoracic, 5 - lumbar, 5 - sacral, and 4 - coccygeal. Among these five sacral vertebrae fuse to form sacrum and 4 coccygeal bones fuse to form one coccyx.
The vertebrae are held together by muscles and strong ligaments like anterior longitudinal and posterior longitudinal ligaments. Anterior longitudinal ligament extends from atlas to sacrum and it is a flat strong band found along the anterior surface of vertebral bodies. 1
In the present study the bodies of upper ten thoracic vertebrae were fused due to ossification of anterior longitudinal ligament.
CASE REPORT
During the routine examination of dry and processed bones in the department of Anatomy, Shri B.M.Patil Medical College, we observed that the bodies of upper ten thoracic vertebrae were fused due to ossification of anterior longitudinal ligament.
A clear space was noted between the mass and the vertebral bodies. The intervertebral disc space was found to be maintained and zygoapophyseal joints were found to be free. The intervertebral foraminae and vertebral canal appeared normal.
DISCUSSION
The present observation of ossification of anterior longitudinal ligament on the anterior aspect of thoracic vertebral bodies, with maintained disc space, favor the diagnosis of Forestier’s disease, otherwise known as Diffuse Idiopathic skeletal hyperostosis (DISH).
DISH commonly involves the thoracic and lumbar vertebrae. Foresteir’s disease most commonly affects obese men who are more than 40 years old. The prevalence of the disease has been estimated to range between 12 and 22% in men and 12 to 13% in women. Most patients have mild to moderate restriction of spine movements, low back pain and stiffness in the lumbosacral region.3
The Forestier’s disease is diagnosed and differentiated from ankylosing spondylitis, on the basis of certain radiological criteria. Calcification and ossification along the anterolateral borders of vertebral bodies and preservation of the integrity
of the intervertebral disc, without diminution of disc spaces and facet joints remain unaffected1.
The ossification pattern of DISH involves the anterior ligament, the lateral portion of the annulus fibrosis, and the adjacent vertebral bodies.
Ankylosing spondylitis is a genetic disease with identifiable marks and involvement of organs. DISH has no genetic link and no organ involvement.4
DISH is an abnormality in which abnormal ossification occurs along the ligaments.5 The incidence of this disease is about 6-12% and most common in males. Usually occurs in elder people after 50 years of age. But coakely et al., had observed it in paediatric cases.6
The cacification and ossification is most common in right side of spine than left. In patients with dextrocardia this calcification occurs on left side, which confirms the role of the descending thoracic aorta in preventing the physical manifestation of DISH on one side of spine4
The exact etiology is unknown. Mechanical factor, dietary and long term use of antidepressants may be correlated with DISH. The disease is not fatal however some complications may lead to death such as paralysis, dysphagia and pulmonary infections due to fusion of rib cage.
Ossification of posterior longitudinal ligament has been well recognized as Japanese disease and it is a well documented cause of cervical spine stenosis. It occurs after the age of 40years and most commonly affected region is cervical spine, although thoracic and lumbar regions are not exempt. the frequency of involvement decreases as the level descends as follows: cervical 70-75%,thoracic 15-20% and lumbar 10%. most of the cases are asymptomatic. Some may present with cervical radiculomyopathy along with spastic palsy of extremities which depends on thickness ossification of ligament.7
CONCLUSION
In the present study it was observed that, there was fusion of the bodies of thoracic vertebrae due to ossification of anterior longitudinal ligament and it is a part of Diffuse Idiopathic Skeletal Hyperostosis which should be differentiated from ankylosing spondylitis as both have different etiology and treatment.
ACKNOWLEDGEMENT
Authors acknowledge the 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. . 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=1042http://ijcrr.com/article_html.php?did=1042
Sinnatamby C S (1999) Last’s Anatomy – Regional and applied. 10th edition. UK; Churchil Livingstone. 414-421.
KhoziamN, Grays(2009) Diffuse Idiopathic Skeletal Hyperostosis, e- medical Radiology /article/388973- overview
Burkus JK, Denis F(1994) Hyperextension injuries of thoracic spine in Diffuse Idiopathic Skeletal Hyperostosis; J Bone Joint Surg Am, 76; 237-24
Forestier,j Lagier R(1951).Ankylosing hyperostosis of the spine.:clin.orthop.;74-75
Mccafferty RR,HarrisonMJ,(1991) ossification of anterior longitudinal ligament and forestiers disease:an analysis of seven cases.J Neurosurg,85:524-525
Coakley FV, vive J,(1995)childhood ossification of anterior longitudinal ligament of cervical spine.clin radiol,50:115-116
M Khalid,(2000) ossification of posterior longitudinal ligament presenting as cervical myelopathy:In J Radiology and imaging.10:253-254
Maheshwari J(2005) Essential Orthopedics Text Book, 3rd Edition, New Delhi; Mehta publications Pvt Ltd. 248-249.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareSTUDY OF TRANSVERSE AND SAGITTAL DIAMETERS OF LUMBAR PEDICLES IN RELATION TO TRANS-PEDICULAR SCREW FIXATION USING MRI IN RAJASTHAN POPULATION
English5055Meghna BhaumikEnglish Neelam BapnaEnglish Uday BhaumikEnglish K. PrabhakaranEnglishIntroduction: The technique of inter-pedicular screw fixation for the purpose of spinal fixation has gained enormous importance in the recent years. The choice of screw for the procedure is determined by the minimum (transverse) diameter of the pedicle .Morphometric data on the diameters of the pedicles are therefore useful in preoperative planning and in designing pedicle screws.Most of the previous study of the morphometry of pedicle is based on white population using x-rays and CT scans. Therefore the present study was conducted in the Western region of India in state of Rajasthan to measure the morphometry of pedicles in relation to trans-pedicular screw fixations as well as to distinguish differences in the morphometry of pedicles in men and women of different age groups using MRI technique. Aims and Objectives: To evaluate the sexual differences in transverse and Sagittal diameters of lumbar vertebral pedicle. Also to determine the difference of diameter in the pedicles of different age groups and finally to determine the morphometry of pedicles in relation to trans- pedicular screw fixation in the region of Rajasthan. Materials And Methods: MRI scan of 1000 patients (both males and females) between the age group of 20 to 60 years, with the history of low back pain reporting to the outpatient department of Neurosurgery, Orthopedics, Rehabilitation and inpatients admitted in various wards for complaints of disc protrusion, disc extrusion, spondolysthesis (not associated with gross vertebral body collapse) of S.M.S. hospitals, Jaipur formed the material for the current study. Results: There is a cranio–caudal increase of transverse and sagittal diameters from L1 toL5 vertebrae. Dimensions of male population are significantly higher than female population with respect transverse diameter and sagittal diameter. With the above parameters the size of the screw for transpedicular screw fixation can be derived.
Englishlumbar vertebra, lumbar pedicle, trans-pedicular screw fixationINTRODUCTION
The technique of inter-pedicular screw fixation for the purpose of spinal fixation has gained enormous importance in the recent years.
Stefee et al1 and Zindric2 described the screw fixation procedure as the method of choice for stabilization of the lumbo-sacral spine. Many types of pedicle screw systems have been developed; basically they all entail the insertion of screws through the pedicle from the posterior aspect into the vertebral bodies. The success of the technique depends upon the ability of the screws to obtain and maintain balance within the vertebral body2 .This is determined among other factors by the accuracy of choice of screw, size of the pedicle and the quality of the bone of the pedicle.
The choice of screw for the procedure is determined by the minimum (horizontal) diameter of the pedicle3,4 .Morphometric data on the diameters of the pedicles are therefore useful in preoperative planning and in designing pedicle screws.
Most of the previous study of the morphometry of pedicle is based on white population5-10
Almost all the previous workers have reported the data on morphometry of the pedicle based on a common pool of vertebrae where male and female vertebrae were pooled together5,6,2,7. However, recently Amonoo Kuofi10 has reported statistically significant sex differences in pedicle morphometry.
Thus according to Kragman3, as the racial variations in skeleton are well known the morphometry of pedicle may vary population to population, even within the same population, the anatomical variations have been reported in the shape, size and angulations of the pedicles by Weinstein et al4.
C.T. scans or M.R.I. sections represent a new approach to vertebral morphometry allowing certain measurements to be measured for the first time.
Morphometric studies of the pedicles have demonstrated variations in pedicle shape, size and angulations. Carefully taken routine radiographs, CT scans and MRI scans can help in determine about the diameter, length and angulations of the pedicle. This is critically important, particularly in placing screws in rotated vertebrae and deformed spines like in patient with scoliosis or spondylolisthesis.
Anatomic variations may prevent placing a screw in a particular pedicle or necessitate using a smaller screw than originally planned.
Risks of neural damage can be minimized by thorough knowledge of the anatomy of vertebral column as well as practicing on anatomical specimens. Therefore the present study was conducted in the Western region of India in state of Rajasthan to measure the morphometry of pedicles in relation to trans-pedicular screw fixations as well as to distinguish differences in the morphometry of pedicles in men and women of different age groups.
AIMS AND OBJECTIVES
To evaluate the sexual differences in transverse and
Sagittal diameters of lumbar vertebral pedicle.
To determine the difference of diameter in the pedicles of different age groups.
To determine the morphometry of pedicles in relation to trans- pedicular screw fixation in the region of Rajasthan.
MATERIALS AND METHODS
MRI scan of 1000 patients (both males and females) between the age group of 20 to 60 years, with the history of low back pain reporting to the outpatient department of Neurosurgery, Orthopedics, Rehabilitation and inpatients admitted in various wards for complaints of disc protrusion, disc extrusion, spondolysthesis (not associated with gross vertebral body collapse) of S.M.S. hospitals, Jaipur formed the material for the current study. Only Patients who were natives of Rajasthan State (born and brought up in Rajasthan) were included in the study.
Whereas Patients suffering from congenital spinal deformities like Achondroplasia, Tethered cord syndrome, spinal dysraphism, spilt cord malformation etc. and Patients affected with spinal tuberculosis, spinal meningitis and even Patients coming with spinal trauma along with bony injuries, were excluded from the study. Also Patients below 20 years of
age and above 60 years of age who were not natives of Rajasthan were excluded from the present study. The study design is mainly of descriptive type.
The measurement of the lumbar pedicles of one thousand patients was recorded with the magnetic resonance imaging (M.R.I. scanning).
The measurements of angles in MRI scans were measured using diacom software.
Student’s t test was used for statistical analysis.
DISCUSSION
Transverse diameter of pedicle – The transverse diameter of pedicles are showing a steady increase from first to fifth lumbar vertebrae. The value of transverse diameter of pedicle is 9.01 mm at L1 vertebra and 18.00 mm at vertebra L5, while in females the minimum value is 8.10 mm at L1 vertebra and the maximum value is 16.01 mm at L5 vertebra. P value is highly significant for L1, L3, L4 and L5 vertebrae (PEnglishhttp://ijcrr.com/abstract.php?article_id=1043http://ijcrr.com/article_html.php?did=1043
Steffee AD, Sitkowski DJ, Topham LS. Total vertebral body and pedicle arthroplasty. Clin Orthop Relat Res. 1986; Feb;(203):203-8
Zindrick MR. The role of transpedicular fixation systems for stabilization of the lumbar spine. Orthop Clin North Am. 1991; Apr;22(2):333-44.
Krag MH, Beynnon BD, Pope MH, Frymoyer JW, Haugh LD, Weaver DL. An internal fixator for posterior application to short segments of the thoracic, lumbar, or lumbosacral spine. Design and testing. Clin Orthop Relat Res. 1986; Feb;(203):75-98
Weinsten JN, Rydevik BL, Rauschning W. Anatomic and Technical considerations of pedicle screw fixation. Clinical Orthopaedics and related research 1986; 248:34-46.
Saillant G. Anatomical study of the vertebral pedicles. Surgical application. Rev Chir Orthop Reparatrice Appar Mot. 1976 Mar;62(2):151-60.
Roy Camiller R, Saillant G, Lapresle P, Mazel C. A secret in spine surgery. The pedicle, 51st meeting of the American Academy of Orthopaedic Surgeons. Atlanta, Georgia, 1984.
Berry JL, Moran JM, Berg WS, Steffee AD. A morphometric study of human lumbar and selected thoracic vertebrae. Spine. 1987; May;12(4):362-7
Scoles PV, Linton AE, Latmimer B, Levy ME, Diglovanni BF. Vertebral body and posterior element morphology: The normal spine in middle life. Spine 1988;13:1082-1086.
Olsewski JM, Simmon EH, Kallen FC, Mendel FC, Severin CM, Berens DL. Morphometry of lumbar spine, Anatomical perspectives related to transpedicular screw fixation. Journal of bone and joint Surgery 1990;72A: 541-549.
Amonoo-Kuofi HS. Maximum and minimum lumbar interpedicular distances in normal adult Nigerians. J Anat. 1982; Sep;135(Pt 2):225-33.
Mitra SR, Datir SP, Jadhav SO. Morphometric study of the lumbar pedicle in the Indian population as related to pedicular screw fixation. Spine. 2002; Mar 1;27(5):453-9.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareA CADAVERIC STUDY ON ANATOMICAL VARIATIONS OF SCIATIC NERVE IN RELATION TO PYRIFORMIS MUSCLE IN ANDHRA PRADESH REGION
English5660Prathiba K.English Seema MadanEnglish Udaya Kumar P.English Dharmendar P.English NishaEnglishIntroduction: The sciatic nerve is the largest nerve of the body. Not only does it have the largest number of nerve fibers, but it also supplies a vast region. Compression of sciatic nerve any where during its course may contribute to clinical conditions like sciatica and pyriformis syndrome. Anomalous sciatic nerve and its branches can often be damaged by wrongly placed intra-muscular injections and during pelvic and total hip replacement surgeries. The present study was conducted to highlight different variations in course and branching pattern of the sciatic nerve in Andhra Pradesh population. Materials and Methods: The present study was carried out on gluteal regions of 100 lower extremities of 50 embalmed cadavers during routine dissection practices for undergraduates in the dissection hall of Gandhi medical college and Osmania medical colleges of Andhra Pradesh, India. Results and Conclusion: In the present study 92 out of 100 specimens sciatic nerve passed below pyriformis into gluteal region then descended downwards in the back of thigh, which terminated in to common peroneal nerve and tibial nerve in the popliteal fossa as usual. In 3% cases common peroneal nerve pierced pyriformis and tibial nerve passed below the muscle. Common peroneal nerveand tibial nerve passed above and below the pyriformis respectively in 4% cases. Unsplit sciatic nerve piercing the piriformis is found in 1 case only.
EnglishSciatic nerve, Tibial nerve, Common peroneal nerve, Pyriformis, Pyriformis syndromeINTRODUCTION
The sciatic nerve is the largest nerve of the body. Not only does it have the largest number of nerve fibers, but it also supplies a vast region. It is the continuation of the upper band of the sacral plexus. It is formed by ventral rami of L4, L5, S1, S2, and S3. It passes out of the pelvis through the greater sciatic foramen below the piriformis. Then it descends between the greater trochanter of the femur and the tuberosity of ischium and along the back of the thigh. It divides in the lower 1/3rd of the thigh into two large terminal branches named tibial and common peroneal nerves.
Compression of sciatic nerve any where during its course may contribute to clinical conditions like sciatica and piriformis syndrome. Anamolous sciatic nerve and its branches can often be damaged by wrongly placed intra-muscular injections and during pelvic and total hip replacement surgeries.
The present study was conducted to highlight different variations in course and branching
pattern of the sciatic nerve in Andhra Pradesh population. A knowledge of the variations of the sciatic nerve could help Anesthetists, Neurosurgeons and Orthopaedicians to avoid surgical errors.
MATERIALS AND METHODS
The present study was done on gluteal regions of 100 lower extremities of 50 embalmed cadavers during routine dissection practices for undergraduates in the dissection hall of Gandhi medical college and Osmania medical colleges of Andhra Pradesh, India. Skin incision was given, gluteus maximus muscle was identified, incised and reflected as per the instructions in Cunningham’s manual of practical anatomy 15th edition. Sciatic nerve was identified and its relation to the pyriformis muscle was noted. The sciatic nerve was then traced down till its division into common peroneal and tibial branches. All the observations were meticulously tabulated and compared with previous studies
OBSERVATIONS
In the present study 92 out of 100 specimens showed normal pattern of sciatic nerve. i.e. sciatic nerve passed below pyriformis into gluteal region then descended downwards in the back of thigh, which terminated into common peroneal nerve and tibial nerve in the popliteal fossa. The variationsvof the nerve in relation to pyriformis are shown in the table no 1.
DISCUSSION
The sciatic nerve is the largest nerve arising from lumbosacral plexus. It innervates 28 muscles of the lower limb. Normally it leaves the pelvis through the greater sciatic foramen and runs below the pyriformis to enter the gluteal region. Variations in its relationship with the piriformis have been observed by several workers. Entrapment of the nerve within the piriformis muscle is one of the reasons of its compression, the condition being called ‘pyriformis syndrome’. A large number of cases of sciatic nerve injuries have been recorded due to intra-muscular injections been given in the gluteal region. The chances of damaging the sciatic nerve in children are higher, more so in neonates and malnourshied infants. Therefore the possibility of variations of its course should be consider seriously, which otherwise would lead to unwanted consequences.
Initial studies on the sciatic nerve and its variations started late back in nineteenth century. Several authors reported that the sciatic nerve divides in the pelvic region itself, even before it enters the gluteal region. Beaton L E, et al2 in 2250 lower limbs and Lee c. s. et al6 in 168 lower limbs observed that the common peroneal nerve, as it enters the gluteal region, pierced the piriformis muscle in 11.7% and 19.6% respectively while tibial nerve passed below the muscle. Chiba S3 dissected 514 lower extremities and observed that in 34% of cases common peroneal nerve pierced through the piriformis muscle. Gabrielli, et al5, Ewa Okrazeweska, et el4, Anne M R Agur, et al1, Ronald A Bergman et al12, Pokorny D, et al11, Vincenti EJD, et al14 and Mustafa Guvencer, et al10 observed the same in 11.2%, 2%, 12.2%, 12 %, 14.3%, 15% and 16% of cases respectively. Machado, F.A., et al8, performed the same study on 100 foetuses and showed that in 16% of cases, common peroneal nerve pierced the pyriformis muscle.
In the present study of 100 lower limbs, 3% were seen to have this type of variation.
Beaton L E, et al2, Gabrielli, et al5, Ewa Okraszweska, et al4, Machado, et al8, Pokorny D, et al11, Mustafa Guvencer, et al10 in their individual studies, observed that the common peroneal nerve passed above the pyriformis and the tibial nerve below the pyriformis after dividing in the pelvis, in 3.3% 2.5% 5.5% 2% 4.4% 8% in of cases respectively.
During the present work the common peroneal nerve and tibial nerve were found to pass above and below the piriformis muscle respectively in 4% of limbs.
There were studies which reported a rare type of variation, that the sciatic nerve enters the gluteal region unsplit and piercing through the pyriformis muscle.
Beaton L E, et al2 observed that in 0.8% of cases entire sciatic nerve pierced the piriformis muscle. Ewa okraszweska, et al4, Pokorny D, et al11, Ronald A. Bergman, et al12, observed the same in 8.3%, 2.2% and 2.25% cases respectively. The present worker found this type of variation in 1 case only.
M. A. Babinski, et al7 reported a rare variation of the high division of the sciatic nerve surrounding superior gamellus muscle In the common peroneal nerve passed between piriformis and the superior gamellus muscle and the tibial nerve passed below the superior gamellus muscle. Another case of high division of sciatic nerve was observed by Md Hassan Ali et al7 in which the right side sciatic nerve divided just 1cm below the piriformis muscle and on the left side division of sciatic nerve was seen 2cm below the piriformis. However on both sides the sciatic nerve divided above the superior gamellus muscle. Sateesha Naik, et al observed trifurcation of sciatic nerve in the middle of popliteal fossa. No such variations were observed in the present study.
SUMMARY AND CONCLUSION
It has been observed during clinical practice that the commonest causes of sciatic nerve injuries could be either intra muscular injections given in the gluteal region or the posterior dislocation of the hip joint. Such injuries are more common in malnourished infants and neonates due to lack of subcutaneous tissue and less muscle mass. When unsplit nerve or any of its division passes through the piriformis, a painful condition resembling sciatica called piriformis syndrome can occur. Compression of nerve fibers during the maximum contraction of pyriformis muscle could be the cause of pain. So the knowledge of the variations of sciatic nerve will help Anesthetists, Neurosurgeons and Orthopedic surgeons to avoid surgical errors.
Author wishes to continue the study in a larger group of individuals by adopting advanced radiological methods to detect variations in the sciatic nerve.
Competing Interests
The authors declare that we have no competing interests
Ethical committee clearance
As the study included only human cadavers, ethical committee clearance was not taken into consideration. Authors will take the responsibility of any further allegations regarding ethical clearance that arise from the study.
ACKNOWLEDGEMENTS
I thank Dr. Ashok Kumar, Professor of Dept of Anatomy and my colleagues for their precious suggestions and support during the study. I extend my gratitude to all the scholars / authors / editors / publishers whose articles, journals are reviewed, cited and included in the references of this manuscript.
Englishhttp://ijcrr.com/abstract.php?article_id=1044http://ijcrr.com/article_html.php?did=1044
Anne M. R. Agur, Arthur F. Dally; Relationship of sciatic nerve to piriformis. Grant’s atlas of anatomy, 11th edition, page-372, 5.26B, lippincott Williams and wilkins, 2005.
Beaton L.E, Anson B.J; The relation of sciatic nerve and its sub divisions to the piriformis muscle.Anat. Rec. 70:1-5, 1937 (cited by W. Henry Hollinshed, Anotomy For Surgeons; Volume 3, 2nd edition, page-687, 1958, Paul B. Hoeber inclu.)
Chiba S; multiple positional relationships of nerves arising from sacral plexus to the piriformis muscle in humans. Acta Anat. Nipon 67: 691-724. 1992.
Ewa Okraszewska, tukasz Migdalski, kazimierz S. Jedrzejewski, Wojciech
Bolanowski; Sciatic nerve variations in some studies on the polish population and its stastical significance. Folia Morphol. Vol. 61, No. 4, pp. 277-282, 2002.
Gabrielli, Carla, Olave, Enrique, Mandiola, Eduardo et al. Inferior gluteal nerve cource associated to the high division of the sciatic nerve. Rev. chil. Anat., 1997, Vol.15, no.1, p. 79-83.
Lee C S, T Sai T L; The relation of the sciatic nerve to the piriformis muscle. J. Formasan Med. Assoc. 73: 75-80, 1974. (Cited by Zeliha Kurtoglu, M. Haluk Ulutuku; A combined variation in the gluteal region. Tr. J. of Medical Sciences, 29 (1999) 579-581.
M.A. Babinski, F.A. Machado, W.S. Costa; A rare variation in the high division of sciatic nerve surrounding the superior gamellus muscle. European Journal of Morphology 2003, Vol. 41, No. 1, pp. 41-42.
Machado, F.A. et al. Anatomical variations between sciatic nerve and piriformis muscle during fetal period in human. Int. J. Morphol. 2003, Vol. 21, n.1., pp. 29-35
Md Hassan Ali, Mohamed Hassan Eweidah+, A case of unilateral unusual genicular branch of the common peroneal nerve with bilateral high division of sciatic nerves and unusual bilateral thickness of peroneal communicating nerve. International Journal of Anatomical variations (2010)3: 33-35.
Mustafa Guvencer, Cihan Iyem, Pinar Akyer, Suileyman Tetic, Sait Naderi; Variations in the high division of sciatic nerve and Relationship between the sciatic nerve and the piriformis. Turkish Neurosurgery 2009, Vol: 19, No: 2, 139-144.
Pokorny D, Jahoda D, Veigl D, Pinskerova V, Sosna A; Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relavance to palsy after total hip arthroplasty. Surgical and Radiologic Anatomy, Volume 28(1)/March, 2006.
Ronald A. Bergman, Adel K. Afifi, Ryosuke Miyauchi; Sciatic nerve. Illustrated encyclopedia of human anatomic variation: Opus 111: Nervous system: Plexuses. 2006.
Satheesha nayak, An unusual case of trifurcation of sciatic nerve. Neuroanotomy (2008)5: 8-7.
Vicente EJD; Viotto MJS; Barbosa CAA; Vicente PC; Study on anatomical relationships and variations between the sciatic nerve and piriformis muscle. Rev. bras. Fisioter. Vol.11(3) Sao Carlos May/June 2007dol:10.1590/s1413-35552007000300009.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareUNILATERAL VARIATION IN THE TERMINATION OF MUSCULOCUTANEOUS NERVE
English6164Sirisha V.English Reshma MohammadEnglish Udaya Kumar P.English Chandra Mohan M.EnglishNerve variations are always a great challenge to the surgeons, anaesthetists and neurologists. The precise knowledge of variations may help to avoid injuries during surgical and anaesthatic procedures in the region of axilla, arm and forearm. Musculocutaneous nerve is a branch of lateral cord of brachial plexus. It pierces the corachobrachialis muscle and runs in between the biceps and brachialis muscles. After giving off muscular branches, the nerve pierces the deep fascia about 2-3cm above the elbow and continues as lateral cutaneous nerve of forearm. We observed that the lateral cutaneous nerve of forearm is found to be arising from the median nerve. The musculocutaneous nerve terminated after supplying the muscles of the arm without giving any communicating branch to the median nerve. The reminding of this type of variation is also important while performing the surgeries on the forearm.
EnglishMusculocutaneous nerve, Median nerve, Lateral cutaneous nerve of forearm, Variation, Brachial plexus.INTRODUCTION
Musculocutaneous nerve (MCN) is derived from the lateral cord of brachial plexus and conveys the fibres from C5, C6, and C7. The MCN initially accompanies the third part of axillary artery and pierces the coraobrachialis muscle and supplies it. Then passes across the front of the arm in between the biceps brachii and brachialis muscles. It supplies both the heads of biceps muscle and medial major part of the brachialis muscle. Through the nerve to the brachialis it gives articular twigs to the elbow joint and a nutrient branch to the humerus.
The knowledge of the anatomical variation of the peripheral nerves in the upper extremities is important as the nerves could be injured during anaesthetic and surgical procedures and variation may explain unusual clinical symptoms.
CASE REPORT
Present variation was noticed in the Department of Anatomy, Mamata Medical College, Khammam, during routine educational dissection for medical undergraduates. We observed a variation in the termination of MCN in right upper limb of 60 years old female cadaver. After piercing coracobrachialis muscle, MCN supplied biceps muscle and brachialis muscle and terminated by giving articular twig to the elbow joint. The LCNF has been observed arising from the lateral side of MN [fig-1] in the lower 1/3 of the arm, passed beneath biceps brachii and pierced the deep fascia above the elbow to supply the skin of the anterolateral region of forearm as far distally as the base of the thenar eminence [fig-2]. In this case we also noticed atrophy of long head of biceps brachii muscle. Other than this the left sided MCN and courses of all other major nerves like median, ulnar, axillary and radial were normal.
DISCUSSION
In the present case, anatomical variation occurred in the termination of MCN in the right upper limb of 60 years old female cadaver. Variations in the course and termination of MCN have been reported by many authors. Choi D et al5 (2002) and Budhiraja V et al3 (2011) has worked extensively on the variations of the MCN. They reported variations like absence of MCN, communication between MCN and MN and fusion of MCN with MN. The present case does not correlates with their findings. Chitra4 (2007) and Suseelamma8 (2013) has reported communication between MCN and MN, but no such communication is observed in the present case report. Le Minor7 (1992) classified these variations into five types.
Type 1: No communication between MN and MCN.
Type 2: The fibers of the medial root of the MN pass through the MCN and join the MN in the middle of the arm.
Type 3: The fibers of the lateral root of the MN pass through the MCN and after some distance leave it to form the lateral root of the MN.
Type 4: The MCN fibers join the lateral root of the MN and after some distance the MCN arise from the MN.
Type 5: The MCN is absent and all the MCN fibers pass through lateral root of MN; fibers to the muscles supplied by MCN branch out directly from MN. In this type, the MCN does not pierce the coracobrachialis muscle.
Venieratos and Anangnostopoulou9 (1998) suggested another classification in relation to the coracobrachialis muscle.
Type I: Communication is proximal to the coracobrachialis muscle.
Type II: Communication is distal to the muscle.
Type III: Neither the nerve nor the communicating branch pierce the muscle.
The present finding does not fit into any of the above classifications. Bergman1 (1988) described the short MCN and LCNF arising from MN. The present case report correlates with his description. Bhattarai, et al2 (2009) described a variation in the MCN in his study which is similar to the present variation excepting for the communication between the MCN and MN.
According to Larson WJ6 as quoted by Yogesh AS10 (2011) the motor axons, which enter the base of the limb bud, join with each other to form the brachial plexus in the upper limb. The guidance of the developing axons is regulated by the expression of chemoattractants and chemorepulsant in highly coordinated site-specific fission. Tropic substances such as brain-derived neurotropic growth factor, c-kit ligand, neutrin-1, neutrin-2, etc. attract the correct growth cones or support the viability of the growth cones that happen to take the right path. The significant variations in nerve pattern may be the result of altered signaling between the mesenchymal cells and the neuronal growth cones or circulatory factors at the time of fission of brachial plexus cords.
The MCN can be damaged by a number of mechanisms but isolated injury is rare when compared to other peripheral nerves. It may be injured in the axilla or more distally where just the sensory branch (LCNF) is affected resulting only in an altered sensation.
CONCLUSION
The present case report gives us an idea that the lateral cutaneous nerve of forearm (LCNF) also arises from the MN without any communication between the MCN and MN.
Meticulous knowledge of possible variations of the MCN and the MN may endow us with valuable help in the management of upper limb injuries, specifically during anaesthetic and orthopaedic procedures.
Englishhttp://ijcrr.com/abstract.php?article_id=1045http://ijcrr.com/article_html.php?did=1045
Bergman RA, Thompson SA, Afifi AK Saadeh FA – Compendium of Human anatomical variations. Munich. Urban and Schwarzenberg. 1988 11,108-114, 139-141.
Bhattarai C, Poudel PP – Unusual variations of musculocutaneous nerves. Kathmandu University Medical Journal, 2009, 7: 408-410.
Budhiraja V, Rastogi R, Asthana AK, Sinha P, Krishna A, Trivedi V – Concurrent variations in median and musculocutaneous nerves with clinical correlation-a cadaveric study, Ital. J Anat Embryol., 2011; 116(2):67-72
Chitra R – Multiple bilatreral neuranatomical variations of the nerves of the arm, Neuroanatomy, 2007(6): 43-45.
Choi D, Rodriguez NM, Vazquez T, Parkin I, Sanudo JR – Patterns of connection between musculocutaneous and median nerves in the axilla and in arm. Clinical Anatomy. 2002, 15: 11-17.
Larson WJ – Development of Peripheral nervous system, 3rd ed., Pennsylvania, Churchill Livingstone, 2001, Human Embroyology, pg 115-116.
Le Minor JM – A rare variant of Median and Musculocutaneous nerves in man, Archives Anatomy Histology Embryology. 1992, 73, 33-42.
Suseelamma D, Krishna chaitanya K, Sharada HR, Deepthi S – Radix formation between MN and MCN: embryological, morphological and clinical correlation, Int J Res Med Sci. 2013; 1 (3):222-225.
Venieratos D, Anaqnostopoulo S – Classification of communications between musculocutaneous and median nerves, 1998, Clinical Anatomy, 11 (5): 327-331.
Yogesh AS, Marathe RR, Pandit SV – Musculocutaneous nerve substituting for distal part of radial nerve: A case report and its embryological basis, J Neuroscience, 2011,2[1]: 74-76.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcarePSYCHIATRIC MORBIDITY IN PATIENTS OF ATTEMPTED SUICIDE ADMITTED IN A RURAL AREA HOSPITAL OF NORTHERN ANDHRA PRADESH
English6569Srikrishna NukalaEnglish Ravinder EdamEnglish M. DattatreyEnglishWorld Health Organization estimates about one million people die of suicide each year. Approximately one suicide occurs every minute, and a suicidal attempt every 3 seconds. In India the rate of suicide is 12 per lakh and more than 100,000 people die of suicide every year. Aims and Objectives: To study the demographic profiles and other related details of attempted suicides in rural area. To investigate for the presence of any physical or psychiatric morbidity in the subjects. To assess increase in psychosocial stress, in any specific area, preceding the event Material and methods: Fifty patients who have survived the attempt and as defined by Dorpat and Boswell (1963) and Morgan (1975) were taken up for study after taking informed consent. All the subjects were subjected to detailed psychiatric interview and are assessed on different scales. Results: In the present study, the most common Psychiatric disorders are depressive disorder 42% followed by Alcohol abuse 14% and Anxiety disorders 8%, No psychotic disorders were noted . 68% of the subject?s common mode of Attempt was organo-phosphorous, and 60% of the attempts were impulsive in nature Conclusion: In a country like ours, where literacy is low and poverty is high, the biggest challenge will be to dispel the stigma and superstitions associated with mental illness and explode the myths shrouding „suicide?.
EnglishAttempted suicide, Psychiatric morbidity, Suicidal ideation, StressINTRODUCTION
Global mortality due to suicide has increased by about 60% in the last five decades. According to World Health Organization estimates about one million people die of suicide each year. Approximately one suicide occurs every minute, and a suicidal attempt every 3 seconds [1]. In India the rate of suicide is 12 per lakh and more than 100,000 people die of suicide every year. Though 70 to 90% of suicide cases have a treatable underlying psychiatric illness, only less than 10% seek mental health care, because ‘attempted suicide’ continues to be a punishable offence in our country [2].
AIMS AND OBJECTIVES
To study the demographic profiles and other related details of attempted suicides in a rural setting.
To investigate for the presence of any physical or psychiatric morbidity that led the subjects to the extreme step.
To assess increase in psychosocial stress, in any specific area, preceding the event that could be contributive to the attempt.
METHODOLOGY
Hospital based study, 50 patients between 15years and 65 years are included. Variables related to Socio-demographic features, family dynamics, suicide characteristics, Psychiatric morbidity were studied. All the subjects who attempted suicide as defined by Dorpat and Boswell (1963) [3] and Morgan (1975) [4] were taken up for study, Dorpat and Boswell’s definition of attempted suicide includes all willful, self-inflicted, life threatening acts which have not led to death. Morgan’s definition which is restricted to self poisoning includes all the deliberate, nonfatal acts done in the knowledge that it was potentially harmful and the amount taken was excessive in the case of drug over dosage.
Tools
Structured Pro forma for collecting demographic data and details of suicide attempts.
Socio-economic scale by O.P Aggarwal.
Alcohol use disorders identification test (AUDIT).
Becks depression inventory (BDI).
Hamilton Anxiety rating scale (HARS).
Brief Psychiatric Rating Scale (BPRS).
Family Interaction Scale - NIMHANS Scale I-Bhatti (1982).
Family and Social Integration Schedule - Venkoba Rao (1989).
Presumptive Stressful Life Event Scale Gurmeet singh, Dalbir Kaur and Harsharan Kaur (1981). DISCUSSION
Socio- Demographic Features
Peak occurrence of suicides was observed in the age group of 15 to 25yrs, the youngest and the oldest being 15yrs and 70yrs respectively. Nagendra Gouda, Sambaji (2008) showed similar results [5]. Female predominance of 64% in the sample is in conformity with the earlier studies reported on attempted suicides. WHO studies hold unmarried, divorced, widowed and single people at a high risk than married people. But in the present study 74% of the subjects were married. This may be due to the nature of the institution of marriage in India, which is more of a social obligation, performed by elders, irrespective of the individual’s preparedness for it. Marital partners in India are virtually strangers to each other, and so are the families. Hence, several adjustment problems can arise after marriage. The study of Nagendra Gouda, Sambaji M Rao (2008) [5] also reported similar results. As most of the studies in India are from Hindu residential areas it is very difficult to make any observation from the religious perspective. Majority of the sample in this study had only school education, while in the study of Nagendra Gouda, Sambji (2008) [5] majority had college level and above education. Different domiciliary backgrounds of the samples could be a reason for this observation. Underdeveloped rural
background with low educational and employment opportunities could be a reason for the poor socio economic status
Features of suicide Attempt
60% of the suicides were impulsive in nature in the present study and it is in accordance to the study done by Kretman (1975) [6]. The commonest method was ingestion of organo-phosphorous compounds, followed by self poisoning with over dosage of drugs and other substances. The area of study being agrarian, the subjects have an easy access to these compounds both at home and at local markets. This could be the reason for the high choice of this method. Diurnal variation is observed in this study. In general, planned and highly motivated attempts occur in solitude and nights and it in accordance to the study done by B.S. Chavan, Gurvinder pal singh (2008) [7]. In the present study suicidal ideation was observed in 40% of the subjects. Suicidal ideation is a high risk factor and dependable indicator. Paykel reported 8.9 % [8] in his study In the present study 8% of the subjects had past history of suicide attempt, it in similar line with the study done by B.S. Chavan, Gurvinder pal singh(2008) [7] who had 8.9% Suicidal behaviour in the past is a very high risk factor in the predictability of future attempts.
Current psychopathology
On Beck Depression Inventory (BDI) 42% of the sample were found to be suffering from depressive disorder. The result in the present study is comparable with those of Barraclough et al (1974) [9], A Roy et al. [10]. Hamilton Anxiety Rating Scale (HARS) was used to assess anxiety. In contrast to the present study, T.Pettri, Taraja k. Melartin (2003)[11] reported 63 %. Indians, more so the villagers take life in their stride with a philosophical fortitude and hence have a high threshold to anxiety. This might have reflected as low anxiety levels in the present study Brief Psychiatric Rating Scale (BPRS) was used to evaluate psychotic disorders. In the present sample none had psychosis. However few subjects scored high on depression related questions of BPRS. Brain A. Palmer (2005) [12] in a Meta analysis reported a life time prevalence of 4.9% in schizophrenia. Assessment of subjects was done using Alcohol Use Disorders Identification Test (AUDIT). In this study 14% were found to be having alcohol use disorder. B.S.Chavan, Gurvinder Pal singh (2008) [7] noted 23.7 % H. Gethinin noted 12% [13].
Other observations
On Gurmeeth singh’s Presumptive Scale of Life Events, the subjects in the present study scored a total of 189 life events during the past one year and 115 life events during the life time. The corresponding mean scores are 3.78 and 2.3 while the standard deviations are 2.38 and 2.18 respectively. These results show that subjects had increased psychosocial stress preceding the attempt. Failures in the examination, frustration in love affairs were the common causes in the 15-25 year age group. In married females persecution in the family topped the list. Financial problems were the cause of stress in the male subject. Only 14% of the samples were aware of the ensuing legal complications beforehand. This can be explained on the basis of low education level in the rural area.
CONCLUSION
By and large ingestion of pesticides, indigenous substances and drugs in excess is the commonest method of attempt in the rural areas, perhaps due to their easy availability. A free access to these substances poses a great threat to the villagers. Conducting awareness programmes regarding the use and safety of these substances may help prevent suicides to a greater extent in the rural areas. In our country, where people can freely purchase drugs of any quality and quantity without an authorized prescription, it is high time the Government impose strict rules making the prescription of a Medical practitioner mandatory for dispensation of drugs. Total prevention of suicides is never possible. In a country like ours, where literacy is low and poverty is high, the biggest challenge will be to dispel the stigma and superstitions associated with mental illness and explode the myths shrouding ‘suicide’. This is possible with a multi dimensional and well concerted approach under a National Community Health Program.
Limitations
As the study was conducted in a rural area and the sample size being small the study results cannot be generalized to the overall population though personality disorders carry a substantial risk for suicide, personality was not assessed for the current sample.
ACKNOWLEDGEMENTS
I sincerely thank all the participants for their contribution to the study. I extend my thanks to Dr. Lakshmi Naresh, M.D, Dr. Rajesh, M.D for their valuable suggestions.
Ethical Issues
Institutional ethical clearance was obtained for the study. Confidentiality of participant’s personnel information was maintained throughout the study.
Englishhttp://ijcrr.com/abstract.php?article_id=1046http://ijcrr.com/article_html.php?did=1046
Preventing suicide. World Health Organization, Geneva-2006.
vijay kumar, lakshmi. Suicide and mental disorders- A maze Indian journal of Medical research, Oct 2006
Dorpat T and Boswell J: An evaluation of suicidal intent in suicide attempts. Comprehensive Psychiatry. 4:117-1259(1963).
Morgan H G, Burns cox CJ, Pocock H and Pottle S; deliberate self harm: clinical and socio demographic characteristics of 368 patients: BJP 127:567-574(1975)
Factors related to attempted suicide in Davanagere, MR Nagendra Gouda, Sambabi Rao, Indian journal of community Medicine vol. 33, No 1, January 2008.
Kreitman N, psychaitric aspects of the problem of drug over dosage in Bricken Bridge A M (Ed) “Topics in therapeutics”.Pitman, London 1975
B.S.Chavan, Gurvinder Pal Singh, Jaspreet Kaur: psychological autopsy of 101 suicides from Noth West Region of India. Indian Journal Of Psychiatry vol.50 No 1 Jan-March-2008
Paykel, E S Myers J. K Lindenthal j. j et al (1974) Suicide feelings in the general population: A prevalence study. Br J Psychiatry 124:460-469.
Barraclough, B, Bunch, J, Nelson, B, and Sainsbury, P (1974) A Hundred cases of suicide: Clinical aspects.Br J Psychiatry, 125,355-373.
A Roy: Risk factors for suicide in psychiatric Patients: Arch Gen Psychiatry, vol.39 no 9. 1982.
T.Petttri sokero,Taraja k . Melartin, Heikki j, Rytsala, Ulla S. Leskela, Paula S , Lestela- Mielonen and Erkki T, Isomesta: Prospective study of risk factors who attempted suicide among patients with DSM-IV major depressive disorder.
Brain A Palmer, MD, MS, MPH; V Shane Pankratz, PHD; John Michael Bostwick, MD. The life time risk of suicide in schizophrenia Arch. Gen Psychiatry 2005; 62:247-253.
H.gethin, Christopher j, burns cox, Helen pocock b.a and susan pottle: Deliberate Self Harm: clinical and socio-economic characteristics of 368 patients.Br J Psychiatry (1975) 127: 564-574.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareHISTOPATHOLOGICAL PATTERN OF OVARIAN NEOPLASMS AND ESTROGEN AND PROGESTERONE RECEPTOR EXPRESSION IN PRIMARY EPITHELIAL TUMOURS AND THEIR HISTOPATHOLOGICAL CORRELATION
English7077Summyia FarooqEnglish Reyaz TasleemEnglish Naila NazirEnglish Ruby ReshiEnglish Zhahid HassanEnglishBackground: Ovarian neoplasm is one of the most complex tumours of women in terms of histogenesis, clinical behaviour and malignant potentiality and is the third most common cancer of female genital tract. Estrogen and progesterone hormones and their receptors are thought to be involved in process of tumour genesis in ovarian cancers. The objective of this study was to evaluate histopathology of ovarian neoplasms and evaluate the expression of estrogen and progesterone receptors in primary epithelial tumours. Material and Methods: The study included a total of 144 consecutive cases of ovarian tumours. Sections of 4μm from 50 epithelial tumours were taken from paraffin embedded tissue blocks for immunohistochemistry (IHC) for ER and PR. Statistical analysis was done using chi square test. Results: Among 144 cases 75% were benign 3.48% were borderline and 21.52% were malignant. Surface epithelial tumours were most common 69.44% followed by germ cell tumours 22.22%. ER and PR had higher expression in serous tumours 37.14% and 51.42% as compared to mucinous tumours 6.67% and 13.3%. ER and PR had lower expression in benign tumours 20% and 30% as compared to borderline 50% and 50% and malignant 61.53% and 84.6%. ER and PR had higher expression in older age women 78.57% and 75%. ER and PR expression in grade 3 tumours was 75% and 87% and in advanced stage was 100% each. Conclusion: Surface epithelial tumours were most common type of tumours both benign as well as malignant. Estrogen and Progesterone showed higher expression in serous tumours, older age group and higher grade of tumours. So estimation of Estrogen and Progesterone receptor status may help to select the women with ovarian malignancy for hormonal therapy, which is more likely to improve the response rate as well as prognosis.
EnglishOvarian tumours, Molecular profile, ER, PR, Histopathology.INTRODUCTION
Ovarian tumours are one of the major health problems and the most complex tumours of women and are the third most common cancer of the female genital tract1,16. Ovarian cancers account for 15.0% - 25.0% of all primary malignancies in female genital tract and are common cause of death from gynaecological malignancies1. It is estimated that about 1 in every 70 women have a life time risk of developing ovarian cancer18. The most significant risk factor for developing ovarian cancer is age. Ovulation, growth factors, cytokines, and environmental agents may play a role in the initiation and progression of ovarian cancer22. Familial predisposition has been noticed in approximately
5-10% of cases6,10. The risk for developing ovarian cancer is increased four fold in women with affected first degree relative. Estrogen and progesterone are important hormones secreted by ovary acting through specific receptors19. Both the hormones and their receptors are thought to be involved in the process of tumour genesis in ovarian cancers14. Immunohistochemical ER and PR assays have added the advantage that the distribution in tumour tissues as well as normal surrounding can be evaluated9. Hormone receptor determination in malignant ovarian neoplasms can aid in selection of patients for endocrine therapy in a manner similar to that already established for certain hormone dependent cancers5.
The present study is an effort addressing the frequency of ovarian tumours, their histological subtypes and hormonal status in epithelial ovarian tumours observed over a period of two years in our valley. The study also aims at studying the correlation between histopathology and hormonal receptor status (ER and PR status), so that patients can be subjected to hormonal therapy.
MATERIAL AND METHODS
After obtaining the ethical board approval, a two year prospective study was carried out from January 2011 to February 2013 on 144 patients in the post-graduate department of pathology, Government medical college Srinagar. All ovarian neoplasms except functional ovarian cysts received in department were included in study. Complete clinical data of patients was recorded. The received respected specimen was put in 10% formalin for fixation overnight. The specimen was then grossed findings like appearance, size were recorded and multiple tissue pieces from representative areas 1 cm apart were taken with a knife, put in stainless steel cassettes, labelled and again kept in fixative for 2-4 hours. The tissue blocks were thoroughly washed with distilled water three to four times to remove excess formalin. The tissue was then dehydrated by passing through ascending grades of ethanol and the tissue was then embedded in molten wax, which was maintained in an oven at melting point of wax. Wax blocks of embedded material were prepared by using Leukhart’s ‘L’ blocks, these blocks were marked and labelled for further processing. Then the sectioning of tissue blocks was done by rotatory microtome and 3-5 micron sections were obtained. A thin film of Mayer’s albumin was spread over clean glass slides and sections were placed on these slides using hot water bath. After de-waxing the staining of sections was done routinely with Haemtoxylin and Eosin. Then slides were studied and tumours were classified according to WHO classification. Histological subtypes, differentiation (grade) of malignant tumours were studied. Immunohistochemical expression for ER and PR was studied in 50 epithelial tumours which included all malignant (20), borderline (5) and 25 randomly selected (table of random numbers) benign epithelial tumours. Immunohistochemical staining was done using rabbit monoclonal anti-human estrogen receptor antibody (clone SP1Biocare) and anti-human progesterone receptor antibody (clone SP2 Biocare) by microwave antigen retrieval technique, in a standard avidin- biotin immunoperoxidase method. Diaminobenzidine (DAB) with hydrogen peroxide was used as chromogen substrate and sections were counterstained by Mayer’s Haematoxylin. For immunohistochemical staining, positives control sections were from breast carcinoma and negative controls sections were provided by omission of primary antibody. Grading of ER and PR staining was performed using H-scoring system obtained by multiplying the epithelial cell intensity ( graded as 0 negative, 1+ weak, 2+ as moderate and 3+ as strong) by percentage of positive cells. This index ranges from 0-300; 300 indicates, 100% of tumour cells stained strongly (3+). H-score of 0-9 is taken as negative and > 9 as positive. Statistical analysis was done using Chi Square test. SPSS software was used for data analysis.
RESULTS
The age of the patients ranged from 15 – 70 years with an average of 43.6 years. Among 144 cases 108 (75%) were benign, 5 (3.48%) were borderline and 31(21.52%) were malignant. In present study out of 144 cases 131(90.97%) cases were unilateral and 13(9.03%) were bilateral. Adopting WHO classification the surface epithelial tumours were maximum accounting to 100 (69.44%) cases followed by germ cell tumours 32 (22.22%), sexcord stromal tumours 9(6.25%) and metastatic tumours 3(2.09%). The surface epithelial tumours were maximum (100) cases out of them 75 (75%) were benign 5 (5%) borderline and 20 (20%) were malignant (Table 1).
Out of 144, IHC for ER and PR was done on 50 primary epithelial tumours, which included 20 primary malignant 5 borderline and 25 randomly selected benign tumours. Out of 50 epithelial tumours estrogen positivity was seen in 14 (28%) and progesterone positivity was seen in 20 (40%) of cases. Out of 14 ER positive cases 13 were serous tumours and only one was mucinous. Out of 20 PR positive cases 18 were serous and two were mucinous. Out of 35 serous tumours estrogen receptors were expressed in 13 (37.14%) and progesterone receptors were expressed in 18 (51.42%) cases. Out of 15 mucinous tumours estrogen receptor positivity was seen in only 1(6.67%) and progesterone receptor positivity was seen in 2 (13.3%) cases. Out of 35 serous tumours 13(37.14%) were both ER PR positive and 17(48.57%) were both receptors negative. Out of 15 mucinous, only one (6.67%) was both receptors positive and 13 (86.6%) were both receptor negative. So both ER and PR showed statistically significant higher expression in serous tumours (37.15%/ 51.42%) as compared to mucinous tumours 6.67% /13. In serous tumours estrogen receptors were expressed in 8 (61.53%) malignant tumours. 1( 50%) borderline and 4 (20%) of benign tumours, and progesterone receptors were expressed in 11 (84.6%) of malignant 1 (50%) borderline and 6 (20%) benign tumours. In mucinous tumours estrogen receptors were expressed in only 1(14.28%) malignant tumour and progesterone receptors were expressed in 1(33.3%) borderline and 1(14.28%) malignant tumour. Among 35 serous tumours 17 (48.57%) tumours were both ER/PR-, none was ER+/PR-, 5 (14.28%) were ER-/PR+ and 13 (37.14%) were both ER+/PR+. Among 15 mucinous tumours 13 (86.6%) were both ER-/PR-, 1(6.67%) was ER+/PR+ and 1(6.67%) was ER-/PR+. Table 2, 3 and 4 depict the correlation between the age, histological type and tumour grade with ER/PR status respectively.
DISCUSSION
Ovarian neoplasm is the most fascinating tumour of women in terms of histogenesis, clinical behaviour and malignant potentiality. Many of ovarian neoplasms cannot be detected early in their development, they account for a disproportionate number of fatal cancers, being responsible for almost half of deaths from cancer of female genital tract4. The present study was carried out on 144 cases of ovarian neoplasms. Two main aspects considered in the study were histopathological type as per WHO classification and estrogen and progesterone receptors expression in primary epithelial ovarian neoplasms and their correlation with histopathology, age and differentiation (grade) of tumour.
The maximum number of tumour occurred in 31-40 years 50(34.73%) followed by 21-30 years 45 (31.25%), 41-50 years 22 (15.28%). Similar age range was reported by other studies7,15,21.
The epithelial tumours on which immunohistochemistry for ER and PR was done, 35 were serous and 15 mucinous tumours as no other epithelial tumour type was found in present study. Estrogen positivity was seen in 14 cases (28%) and Progesterone receptor positivity was seen in 20 cases (40%) of 50 epithelial tumours. Scambia et al (1998)5 reported that 56% and 35% cases of ovarian cancers were positive for ER and PR respectively. Tangjitgamol et al (2009)20 in their
study found that ER positivity was 39.6% and PR positivity was 33.0% of total 106 cases of ovarian tumours. Both ER and PR showed higher expression in serous tumours 37.14% and 51.42% as compared to mucinous tumours 6.67% and 13.4%. H. Arias-pulido et al (2009)8 reported that 66% of serous tumours were ER positive and 54% were PR positive, in mucinous tumours 13% were ER positive and 20% were PR positive. Sylvia et al (2012)11 showed 72% of serous tumours were ER positive and 57.7% were PR positive, Mucinous tumours were negative for ER and 14.28% were positive for PR In present Estrogen receptor showed higher expression in malignant tumours 61.53% as compared to benign (20%) and borderline 50%. In present study Progesterone receptor expression was 30% in benign, 50% in borderline and 81% of malignant tumours. Our observations were similar to Agarwal et al13 who reported progesterone receptor positivity in 8 (88.9%) in malignant tumours but no receptor positivity was seen in benign tumours but in present study PR positivity in benign tumours is 30%, which is in close to Sylvia et al11 who showed 40% benign tumours expressed PR. In present study out of 14 ER positive cases only 1 (7.14%) was < 40 years, 2 (14.28%) were between 40-50 years and 11(78.57%) were more than 50 years of age. Out of 20 PR positive cases 2 (10%) were 50 years of age. Our observations are similar to Sylvia et al11, Hahnel et al17 and Agarwal et al13. In present study Estrogen receptors were mostly expressed in poorly differentiated (grade III) and moderately differentiated 50% each as compared to well differentiated 37.5% and progesterone receptors were expressed as 62.5% in well differentiated 50% in moderately differentiated and 62.5% in poorly differentiated. Our study is in contrast to Buchynska et al (2009)3 who demonstrated that higher grade tumours have low estrogen receptor positivity. Lau et al (1999) demonstrated that progesterone receptor decreases with increasing grade this is in contrast to our observation. We could not find significant association between PR positivity and grade. In present study ER was expressed as 100% in stage IV, 50% in stage III, 50%in stage II and 30% in stage III. PR was expressed as 50% in stage I, 50% in stage II, 75% in stage III and 100% in stage IV tumours. Hogdall E V et al (2007)12 reported that ER positivity in ovarian cancers increases with increasing FIGO stage. Agarwalet al13 reported that receptor positivity increases with stage of tumour. Similar observations were made by Sylvia et al11. Slotman et al2 reported 64% and 60% of stage III and IV were positive for ER and PR respectively as compared to 43.7% and 56% of stage I and II tumours.
CONCLUSION
In the current study benign tumours were more common than malignant tumours in all age groups. Estrogen and Progesterone showed higher expression in serous tumours, older age group, higher grade and in advance stage of tumour. So estimation of Estrogen and Progesterone may help to select the women with ovarian malignancy for hormonal therapy, which is more likely to improve the response rate as well as prognosis.
ACKNOWLEDGEMENTS
We thank Dr. Sheikh Bilal, Dr. Ambreen and Dr. Mahnaaz for helping us in compiling the data.
Englishhttp://ijcrr.com/abstract.php?article_id=1047http://ijcrr.com/article_html.php?did=1047
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BerendJ. Slotman., RadkaKuhnel., B Ramanath Rao., Gerard. H., Jan De Graaff and Johannes. Importance of steroid receptors and aromatase activity in the prognosis of ovarian cancer: High tumour progesterone receptor levels correlate with longer survival. Gynaecologic oncology 33,76-81(1988).
Buchynska LG, Iurchenko NP, Grinkevych VM, Nesina IP, Chekhun SV, Svintsitsky VS. Expression of the estrogen and progesterone receptors as prognostic factor in serous ovarian cancers. ExpOncol 2009; 31:48-51.
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Hugo Arias-Pulido, Harriet O. Smith, Nancy E.Joste, Therese Bocklage, Clifford R. Qualis, Allison Chavez, Eric R. Prossnitz, Claire F, Verschraegen. Estrogen and progesterone receptor status and outcome in epithelial ovarian cancers and low malignant potential tumour. Gynaeologic oncology 114;2009:480-485.
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MR. Cardillo. E. Petrangeti. N. Aliotta. L Salvatorv, L Ravenna1, C. Chang*, C. Casiagna Androgen Receptors in Ovarian Tumours: Correlation with Oestrogen and Progesterone Receptors in an immunohistochemical and Semi quantitative Image Analysis Study. J. Exp. Clin. Cancer Rev. 17.2, 1998.
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Tangjitgamol S, Manusirivithaya S, Khunnarong J, Jesadapatarakul S, Tanwanich S Expressions of estrogen and progesterone receptors in epithelial ovarian cancer: a clinicopathologic study Int J Gynecol Cancer. 2009 May; 19(4):620-7.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareCOMMUNICATIONS IN ORAL BIOFILM
English7882Snophia SureshEnglish Satya NarayanaEnglishMolecular analysis of oral microbial communities has indicated that the human mouth provides a habitat for approximately 700 species of bacteria.The oral cavity is somewhat unique, since it provides hard, nonshedding surfaces (teeth) that are accessible for microbial colonisation. Oral microorganisms live in biofilm. Biofilms are composed of microbial cells encased within a matrix of extracellular polymeric substance such as polysaccharides, proteins and nucleic acids. In a biofilm, bacteria have the capacity to communicate with each other by the process called quorum sensing.
Englishoral biofilm, quorum sensing, bacterial communicationINTRODUCTION
Oral diseases like dental caries and periodontal diseases are usually associated with ecologic imbalance in oral microbial biofilm.[1] Periodontal disease is caused by complex microbial community which consists of several hundred different bacterial species. The dental biofilm is a microbial community that forms at high density on tooth and tissue surfaces of oral cavity. Biofilms are composed of microbial cells encased within a matrix of extracellular polymeric substances such as polysaccharides, proteins and nucleic acids. This microbial community is one of the most complex and pathogenic biofilm that exist in humans. In nature the bacteria rarely find life very easy. The major struggle faced by bacteria lies in obtaining sufficient nutrients to support growth. Human oral cavity consists of physiologically diverse organisms which coexist and thrive by adapting and responding to other organism in their local environment. The oral organisms express intraspecies and interspecies communication which favors the coordinated response by microbial community to environmental flux.
Communication of Bacteria
The bacteria within the biofilm have the capacity to communicate with each other and to other species by the process called quorum sensing. Quorum sensing allows the bacteria to sense one another and to regulate variety of physiological activities like symbiosis, virulence, motility, antibiotic production, and biofilm formation. Autoinducers are chemical signaling molecules which help in the process of bacterial communication. Quorum sensing plays a role in expressing genes for antibiotic resistance and in encouraging the growth of beneficial species to the biofilm and discouraging the growth of competitors.
Quorum sensing relies upon the interaction of a small diffusible signal molecule with a sensor or transcriptional activator to initiate gene expression for coordinated activities. The bacterial communication through signaling molecule was first demonstrated from studies of marine organism vibrio fischeri. Quorum sensing systems in bacteria have been generally divided into three classes like LuxI/LuxR–type quorum sensing in Gram-negative bacteria, oligopeptide-two-component-type quorum sensing in Gram-positive bacteria and luxS-encoded autoinducer 2 (AI-2) quorum sensing in both Gram-negative and Gram-positive bacteria.
The signal molecules for Gram-negative bacteria are acyl-homoserine lactones (AHL) and the sensory mechanism that responds to signal consists of two proteins designated as LuxI and LuxR. LuxI protein is responsible for the synthesis of acyl homoserine lactones. AHL activates the transcription regulator LuxR and induces expression of luciferase operon and other quorum sensing related genes. AHLs freely diffuse across the cell membrane and increase in concentration in proportion to cell density. A cognate LuxR-like protein is responsible for recognition of the AHL and when bound to the AHL, LuxR-like protein binds to specific promoter DNA elements and activates transcription of target genes. The LuxI-like enzymes produce a specific AHL by coupling the acyl-side chain of a specific acyl-acyl carrier protein (acyl-ACP) from the fatty acid biosynthetic machinery to the homocysteine moiety of S-adenosylmethionine (SAM). This intermediate lactonizes to form acyl-HSL, releasing methylthioadenosine. (Figure-1)
Two types of quorum-sensing systems identified in gram – positive bacteria. In the first type, quorum-sensing systems generally consist of three components, a signalling peptide known as autoinducing peptide (AIP) and a two-component signal transduction system (TCSTS) that specifically detects and responds to AIP.[2] Gram-positive bacteria normally produce a signal peptide precursor, which is cleaved from the double-glycine consensus sequence and the active AIP is then exported through a peptide-specific ABC transporter into their environments. Detection of signalling peptides in Gram-positive bacteria is mediated by a two-component signal transduction system, which consists of a membrane-associated, histidine kinase protein sensing the AIP, and a cytoplasmic response regulator protein enabling the cell to respond to the peptide via regulation of gene expression.[3](Figure-2)
Bassler laboratory reported that the luciferase operon of vibrio harveyi was regulated by another quorum sensing system encoded by luxPQ genes which responded to an autoinducer designated as autoinducer 2 (AI-2).[4] AI-2 allows for inter-species communication, so it is called a “universal language”. This system is highly distributed among gram positive and negative bacteria. Autoinducer 2 produced by LuxS enzyme that functions in the activated methyl cycle and contributes to the turnover of S-adenosyl homocysteine into homocysteine and 4,5-dihydroxy-2,3-pentanedione (DPD) which undergoes intramolecular cyclization and hydration to generate R and S stereoisomers of 2,33,4- tetrahydroxymethyltetrahydrafuoran, the precursor of AI-2.Autoinducer 2 bound by perplasmic protein LuxP which interacts with sensor kinase LuxQ initiates a signal transduction cascade that flows through phosphorelay protein LuxU, a F54 dependent response regulator LuxO and a series of small regulatory RNAs in concert with the chaperone Hfq, modulate the expression of LuxR, the master regulator of the quorum sensing regulon. (Figure-3)
Quorum Sensing Inhibitors
Quorum sensing system of bacteria relies on signaling activities for their activity. So, any compounds that block these signaling molecules might inhibit bacterial quorum sensing. The use of quorum-sensing inhibitors block bacterial communication and control biofilm formation by increasing biofilm susceptibility to antibiotics and the susceptibility of the pathogens to host defenses and these compounds named as quorum quenchers.[5] Blocking of quorum sensing can be achieved through enzymatic degradation of the signal molecule, blocking the signal generation and blocking the signal reception. The acyl homoserine lactones which are the signaling molecules released by gram negative bacteria may be inactivated at alkaline PH and by the enzyme lactonases which hydrolyzes the ester bond of homoserine lactone ring.
Halogenated furanones produced by red seaweed are found to be powerful signal antagonists for prevention against bacterial colonization by interfering with acyl-homoserine lactone signalling system.[6] . Furanones inhibit bacterial colonization and biofilm formation through interference with acyl-HSL quorum-sensing pathway in Gram-negative bacteria.[7] They also interfere with AI-2 signalling systems in both Gram-negative and Gram-positive bacteria.
Numerous studies have described the application of AHL analogs or signal peptide analogs to achieve inhibition of quorum-sensing circuits in some bacteria. Zhu and Lau have recently reported a competence-stimulating peptide analog, CSP1-E1A, which inhibits competence development and reduces expression of pneumococcal virulence factors, such as choline binding protein D and autolysin A in vitro.[8]
DISCUSSION
Dental biofilm is a dynamic microbial community which forms high cell density on the tooth and tissue surfaces. This microbial community adhere to the acquired dental pellicle which favours the successive bacterial colonization. Most periodontal pathogens produce autoinducer-2 which is responsible for interspecies communication of bacteria. The widespread distribution of LuxS in both gramnegative and gram-positive bacteria has led to the suggestion that autoinducer-2 represents a universal quorum sensing system that mediates interspecies communication. In periodontal pathogens the important physiologic processes, such as the stress response, the acquisition of iron or hemin, and the development of structured biofilms, have been shown to be linked to autoinducer-2 signaling. Current data suggest that N-acyl homoserine lactone-dependent quorum sensing systems may not be common among organisms that populate the dental biofilm and are not present in several of the well-characterized pathogens associated with periodontitis. So the autoinducer-2 quorum sensing system may represent targets for the development of new therapies to control periodontal pathogen population and biofilm growth.
CONCLUSION
The biofilm has major impact on human health. Community behaviour of bacteria in oral biofilm imparts pathogenicity and antibiotic resistance. Quorum Sensing Inhibitors (QSI) have been found to increase the susceptibility of bacterial biofilms to existing antibiotics both in vitro and in vivo, thereby, increasing the success of antibiotic treatment of biofilm infections. The challenge of targeting autoinducer-2 quorum sensing arises from
the widespread distribution of LuxS and autoinducer- 2 among bacteria and the possibility that autoinducer- 2 may also be beneficial for establishment of the commensal community in the oral cavity. Better understanding of autoinducer-2 mechanism in oral bacteria and identifying the cellular components may be viable targets for therapeutic intervention of biofilm-associated oral diseases.
ACKNOWLEDGEMENT
Authors acknowlege 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1048http://ijcrr.com/article_html.php?did=1048
Marsh PD. Dental plaque as a biofilm and a microbial community - implications for health and disease. BMC Oral Health 2006: 6 (Suppl.1): S14.
Miller ST, Xavier KB, Campagna SR, Taga ME, Semmelhack MF, Bassler BL, Hughson FM. Salmonella typhimurium recognizes a chemically distinct form of the bacterial quorum-sensing signal AI-2. Mol Cell 2004: 15: 677–687.
Dunny GM, Leonard BA (1997). Cell-cell communication in Grampositive bacteria. Annu Rev Microbiol 51:527-564.
Bassler BL, Wright M, Showalter RE, Silverman MR. Intercellular signalling in Vibrio harveyi: sequence and function of genes regulating expression of luminescence. Mol Microbiol 1993: 9: 773–786.
Costerton, W.; Veeh, R.; Shirtliff, M.; Pasmore, M.; Post, C.; Ehrlich G. The application of biofilm science to the study and control of chronic bacterial infections. J. Clin. Invest. 2003, 112, 1466–1477.
Hentzer, M.; Givskov, M. Pharmacological inhibition of quorum sensing for the treatment of chronic bacterial infections. J. Clin. Investig. 2003, 112, 1300–1307.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21HealthcareDIAGNOSIS OF IRON DEFICIENCY OF CHRONIC KIDNEY DISEASE : VALIDITY OF IRON PARAMETERS, RETICULOCYTE HEMOGLOBIN CONTENT(CHR) AND HYPOCHROMIC RED CELLS IN INFLAMMATORY STATE
English8391Vidyashankar P.English Alan F. AlmeidaEnglish Niwruti K. HaseEnglish Arun HalankarEnglish Harinakshi RaiEnglish Sadanand BhusariEnglishIntroduction: Diagnosis of iron deficiency is difficult in presence of uraemia. The validity of these tests in the presence of inflammation has not been studied, and it formed the basis of this enquiry. Methods: On hundred and twenty two consecutive chronic kidney disease (CKD III, IV, V-non dialysis) patients were enrolled. Complete hemogram, iron studies, Reticulocyte hemoglobin content (CHr) and percent hypochromic red cells (%Hypo), high sensitive CRP (hs-CRP) levels were done. In the study group of 122 patients screened, 103 patients were found to be iron deficient by Kidney Dialysis Outcome Quality Initiative (KDOQI) criteria. In the iron deficient patients, intra venous iron (i.v iron sucrose 1000mg) was administered in divided doses followed by erythropoetin and the tests were repeated after 4 weeks of completing i.v iron therapy. If the rise in Hb> 1gm%, at the end of 4 weeks, the patient were grouped into responders (iron deficient subjects). The rest were grouped as non responders(Iron replete).The value of the tests, individually or in combination, was determined in the subgroups and categorized based on hs-CRP levels (EnglishIron deficiency, iron studies, Reticulocyte hemoglobin content (CHr), Hypochromic red cells (Hypo %), Inflammation.INTRODUCTION
Diagnosing iron deficiency with currently available tests is rendered difficult in patients with chronic kidney disease due to presence of inflammatory state associated with uremia [1,2,3,4,10]. The accurate diagnosis of iron status is essential in avoiding iron overload, which increases morbidity and mortality. Serum ferritin and transferrin saturation (TSAT) are commonly and easily available tests [12,13,14] for diagnosis. However, serum ferritin is an acute phase reactant, and is raised in the anemia of chronic disease and uremic state, hence these values could be unreliable [3,12,13,33,34].
Newer markers like CHr and hypochromic red cells have been currently introduced to guide iron therapy [18,19,20,26,38,39]. European best practice guidelines 2005 [8,17,27] and K/DOQI 2006 guidelines have recommend these newer parameters, Reticulocyte hemoglobin content (CHr) and Hypochromic red cells (Hypo %) as marker of iron deficiency status. [7,8,9,21,22,23]. But these tests have not been validated in the presence of inflammation ,which is often found in azotemic and hemodialysis patients [11,12,32].
CHr and hypochromic red cells has been shown promising evidence in studies by Fishbane S et al and Cullen P [18,20,22,35,41]. Their validity in inflammatory state have not been evaluated.
There is no single test or in combination have good validity in diagnosis of iron deficiency (34). Hence, poor response to intravenous iron is considered as the gold standard in the diagnosis of iron deficient state (32,33,40,43,50)
SUBJECTS AND METHODS
Patients and study protocol
A Prospective study was conducted at King Edward VII Memorial Hospital affiliated to Seth GS medical college, Mumbai, India. We included 122 (70 males and 52 females) consecutive patients with chronic kidney disease (Stage 3, 4 and 5 not on dialysis) attending the Nephrology outpatient services. Institution ethical committee approval and informed consent were taken before enrollment. Patients with age < 18 years, recent blood transfusions (Preceding 2 months), with active infection, bleeding, malignancy and active liver disease were excluded. After a wash out period of seven days (on oral iron preparation) and for 14 days (on intravenous iron preparation), fasting blood sample was collected and tested for the following parameters . Iron studies including serum iron, TIBC, transferrin saturation and ferritin. Reticulocyte parameters like absolute reticulocyte count (ARC), reticulocyte percentage, corrected reticulocyte index (CRI), reticulocyte hemoglobin content (CHr) and hypochromic red cells (Hypo%). High sensitive C - Reactive Protein (hs-CRP). Blood urea nitrogen, Serum creatinine, Serum electrolytes, urine examination, urine culture, liver function tests. The patients were diagnosed to have iron deficiency if they have one of the following as per Kidney Dialysis Out come Quality Initiative (K/DOQI) criteria (Transferrin saturation (TSAT)< 20 % or Serum ferritin 5 mg/dl respectively [40,43].
Laboratory methods
The samples for the complete blood count, CHr and hypochromic red cells was processed within 3 hrs of collection. The reticulocyte parametres like CHr absolute reticulocyte count, reticulocyte percentage was processed by ADVIA 120 automated hematology analyzer (Bayer’s diagnostics) at Ranbaxy research laboratory [37, 42]. The reticulocytes were stained with RNA stain oxazine 750 and analyzed by flow cytometric principle with proper standardization. Serum ferritin was tested by Enzyme Linked Iimmuno Sorbant Assay technique, iron studies done by colorimetric methods using SESOMEM analyzer. C - Reactive Protein was be measured by immunonephelometric method at the Immunology laboratory department of pathology. Blood urea nitrogen, serum creatinine, serum electrolytes, urine examination, urine culture, liver function tests, viral markers were done at hospital central clinical laboratory.
Statistical analysis
Statistical analysis was performed using the computer software package of social science (SPSS 13.1, 2005: SPSS Inc, IL, USA.) The data was expressed as mean ± Standard Deviation. Comparison of data for responders and non responders were performed by using the t-test or Mann-Whitney U-test as applicable. The inter group comparison was made by analysis of variance test (ANOVA). The sensitivity and specificity, positive and negative predictive values were calculated using appropriate formula. A p value of less ? 0.05 was considered as statistically significant.
RESULTS
There were 64 males with mean age of 45.32?12.23 years and 39 females with mean age of 41.23?10.34 years were iron deficient. A total of 103 patients were iron-deficient by KDOQI criteria (TSAT < 20% or Serum ferritin Englishhttp://ijcrr.com/abstract.php?article_id=1049http://ijcrr.com/article_html.php?did=1049
Konijn AM, Hershko C: Anemia of inflammation and Chronic Disease, in iron in immunity, cancer and inflammation, edited by De Souza M, Brock JH, Chechister, John Wiley and sons,:111-143. 1989
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Allan B Schartz, Vinod prasad,Jaslot Garcha.Anemia of chronic Kidney Disease: A combined effect of marginal iron stores and erythropoeitin deficiency. Nephrol Dialysis and Transplantation. Vol 33 No 12, pp 758-767,Dec 2004.
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Clinical practice guideline for management of anemia of chronic kidney disease. K/DOQI update 2006,Am J kid disease 47:855-924, 2006.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21TechnologyDOMAIN PAIRS OF THE FERROIC SPECIES OF LANGBEINITE FAMILY OF CRYSTALS
English9295G. SireeshaEnglish S. Uma DeviEnglishIn this paper we have taken the Langbeinite family ? ? + 2 3 2 2 4 3 A M so ? ? of crystals with
A = NH4, K, Rb, Cs, Ti and M = Mg, Ca, Mn, Fe, Co, Ni, Zn and Cd. The Langbeinite family of
crystals which is exhibiting different higher order physical properties at various phase transition
temperatures. Here we calculated ferromagnetoelectric (aev2) domain pairs of the crystal at different phase transition temperatures with the help of group theoretical methods of studying the effect of symmetry on some physical properties.
EnglishPrototypic point group, ferroic point group, coset decomposition, Domain pairs, ferromagnetoelectric property.INTRODUCTION
Physical properties of crystals generally express the relation between the two quantities. These may be scalars and vectors. These properties differ from one another by their transformation properties. A ferroic crystal contains two (or) more equally stable domains, volumes of the same homogeneous bulk structure of these domains in a polydomain sample are referred to as domain states. The analysis of domains of a ferroic crystals can be found using coset decomposition of point group (Aizu, 1970; Janovec,1972). Here the number of distinct right or left cosets and coset representatives are F- operations that change one orientation state to another. The ferroic crystal with A = NH4, K, Rb, Cs, Ti and M = Mg, Ca, Mn, Fe, Co, Ni, Zn and Cd which is exhibiting different physical properties at various phase transition temperatures. In this chapter we have taken this crystal and found its physical property like ferromagnetoelectric domain pairs at different phase transition temperatures with the help of group theoretical methods of studying the effect of symmetry on the physical properties.
Coset Decomposition
Let H be a subgroup then the left (right) cosets of H in G provide a decomposition of G as a sum of mutually disjoint left (right) cosets. i.e. G = This is known as coset decomposition of G with respect to H. The arbitrary element ai of each left (right) coset is called a representative of coset.
The concept of coset decomposition of a group with respect to one of its subgroup has wide application in crystallography and solid-state physics. The points of any crystallographic orbit are in a one-to-one correspondence with the cosets of the coset decomposition of the crystallographic group with respect to the site symmetry group of one of its points (wondratschek, 1983). Coset decomposition has been applied in the analysis of domains of ferroic crystals using coset decomposition of point groups and space groups (Aizu, 1970 ; Janovec, 1972). Here the number of distinct domains of ferroic crystals are equal to the
number of distinct right (or) left cosets and the coset representatives are F - operations that change one orientation state to another.
Domain
A phase transition of a crystalline structure from a phase of higher symmetry G to a phase of lower symmetry F of ferroic materials consists of homogeneous regions called domain.
Representative Domain Pairs
Consider a ferroic phase transition of a crystalline structure from a phase of higher symmetry G to a phase of lower symmetry F of ferroic materials consists of homogeneous regions called domains, the interior bulk structures of the domains are called domain states and in the continum description differ only in orientation. The properties of domain states are described by the property of tensors. By using the coordinate system components, in which the properties of the tensors that distinguish between the domains of magnetic domains which differ solely in the two domains by change in the sign.
Two domain states that have different spontaneous magnetization vector are denoted as a ferromagnetic domain pairs. Consider a phase transition between phases of symmetry G & F. The crystal splits into n = [G/F] single domain states denoted by S1, S2 … Sn. Let Si & Sj be two arbitrary orientation states of ferroic crystals. They are identical (or) an antimorphism in structure. This means that mathematically Sj is said to be obtained by performing a certain operation of G upon Si. We refer to this operation as an F – operation from Si to Sj of the ferroic crystal. In particular, when Si and Sj (or) Si itself is just an element of the point group of Si. In general there is more than one F operation from Si to Sj. Let a ferroic crystal have q orientation states in all and let S be one of those operation states. We refer to a set of q – F operations each from S to each orientation state as a “Set of representative F operation on S” of the ferroic crystals. In general, there are more than one set of representative F operation on S. These can be obtained by the coset decomposition of G with respect to F. For the given group G and subgroup F one writes the left coset decomposition of G with respect to F symbolically written as G = F + g1F + g2F + …. + gnF. Where gi F denote the subset elements of G obtained by multiplying each element of the subgroup F from the left side of the elements gi of G. Each subset of elements of gi F. i = 1, 2 ….. n of G are called left coset representatives of the left coset decomposition of G with respect to F.
The subset of elements of G in each coset of the left coset decomposition of G with respect to F is unique but the coset representatives are not unique. A coset representative gi can be replaced by the element gi f where f is an arbitrary element of a subgroup F. Si = gi S1 i.e the orientation of the ith domain Si is related to the orientation of the domain S1 by the element gi of this coset decomposition for i = 1, 2 …. N. The symmetry group Fi = gi F i.e the groups F and Fi are conjugate groups. Two domain states Si and Sj form a domain pair (Si, Sj) if Si = gij Sj where gij is element of G. Here we calculated ferromagnetoelectric domain pairs for the ferroic species by using coset decomposition.
Ferromagnetoelctric domain pairs for Langbeinite family in the state 23F1 :
Consider the ferroic species 23F1. Where 23 is a prototypic point group and 1 is a ferroic point group. The number of distinct domain pair classes are 6.
The coset decomposition of 23 with respect to the group 1 is given by-
Ferromagnetoelctric domain pairs for the ferroic species 23F2 :
Consider the ferroic species 23F2. Where 23 is a prototypic point group and 2 is a ferroic point group. It has 3 domain pairs. The coset decomposition of 23 with respect to the group 2 is given by . The coset elements .It has six coset elements and hence they form three domain pairs.
Ferromagnetoelctric domain pairs for the Ferroic species 23F3 :
Consider the ferroic species 23F3. Where 23 is a prototypic point group and 3 is a ferroic point group. The number of distinct domain pair classes are 2. The coset decomposition of 23 with respect to the group 3 is given by .
The coset elements gi’s are E, . Domain pairs of 23F3 are
Consider the ferroic species 23F222. Where 23 is a prototypic point group and 222 is a ferroic point group. It has 2 domain pairs. The coset decomposition of 23 with respect to the group 222 is given by . The coset elements are.
CONCLUSION
Due to the phase transitions of the crystals A2+ M22+ (so43-)3 with A = NH4, K and M = Mg, Ca, Mn & Cd, cubic structure P213(T group) which is the prototypic point group is changed at high temperature as trigonal structure R3 (C3 group), orthorhombic P212121 (D2 group),mono clinic structure P21 (C2 group) and triclinic structure P1 (C1 group) with different temperatures. Consider P213(T group) as prototypic point group and R3, P212121, P21 and P1 are taken as ferroic point groups. The first three involve improper ferroelectric transitions. The change of phase from P213 to P212121 involves a ferroelastic transition. While considering ferromagnetoelectric property, ordinary point group 23 is taken as prototypic point group and 222, 2,3 and 1 are taken as ferroic point groups. In this paper ferromagnetoelectric domain pairs of Langbeinite family of crystals at different temperatures are calculated by using group theory techniques and the results are tabulated.
Englishhttp://ijcrr.com/abstract.php?article_id=1050http://ijcrr.com/article_html.php?did=1050
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241521EnglishN2013November21TechnologyUNSTRUCTURED PEER - TO - PEER NETWORKS USING OPTIMIZING OVERLAY TOPOLOGIES
English9699M. ArulrajaEnglish K. UmasankarEnglish S. ManikandanEnglishIn its simplest form, a peer-to-peer (P2P) network is created when two or more PCs are connected and share resources without going through a separate server computer. A P2P network can be an ad hoc connection-a couple of computers connected via a Universal Serial Bus to transfer files. A P2P network also can be a permanent infrastructure that links a half-dozen computers in a small office over copper wires. Or a P2P network can be a network on a much grander scale in which special protocols and applications set up direct relationships among users over the Internet.
EnglishSerial bus, protocols, copper wiresINTRODUCTION
The initial use of P2P networks in business followed the deployment in the early 1980s of free-standing PCs. In contrast to the mini mainframes of the day, such as the VS system from Wang Laboratories Inc., which served up word processing and other applications to dumb terminals from a central computer and stored files on a central hard drive, the then-new PCs had self-contained hard drives and built-in CPUs. The smart boxes also had onboard applications, which meant they could be deployed to desktops and be useful without an umbilical cord linking them to a mainframe.
Many workers felt liberated by having dedicated PCs on their desktops. But soon they needed a way to share files and printers. The obvious solution was to save files to a floppy disk and carry the disk to the intended recipient or send it by interoffice mail
MATERIALS AND METHODS
That practice resulted in the term "sneaker net." The most frequent endpoint of a typical sneaker net was the worker who had a printer connected to his machine. While sneaker nets seemed an odd mix of the newest technology and the oldest form of transportation, the model is really the basis for today's small P2P work groups. Whereas earlier centralized computing models and today's client/server systems are generally considered controlled environments in which individuals use their PCs in ways determined by a higher authority, a classic P2P workgroup network is all about openly sharing files and devices. In general, office and home P2P networks operate over Ethernet (10M bit/sec.) or Fast Ethernet (100M bit/sec.) and employ a hub-and-spoke topology. Category 5 (twisted-pair) copper wire runs among the PCs and an Ethernet hub or switch, enabling users of those networked PCs access to one another's hard drives, printers or perhaps a shared Internet connection.
BOTH CLIENT AND SERVER
In effect, every connected PC is at once a server and a client. There's no special network operating system residing on a robust machine that supports special server-side applications like directory services (specialized databases that control who
has access to what). In a P2P environment, access rights are governed by setting sharing permissions on individual machines.
For example, if User A's PC is connected to a printer that User B wants to access, User A must set his machine to allow (share) access to the printer. Similarly, if User B wants to have access to a folder or file, or even a complete hard drive, on User A's PC, User A must enable file sharing on his PC. Access to folders and printers on an office P2P network can be further controlled by assigning passwords to those resources.
TRENDS AND IMPACT
The first appearance of open source systems such as Napster in 1999 radically changed file-sharing mechanisms. The traditional client-server file sharing and distribution approach using protocols like FTP (File Transfer Protocol) was supplemented with a new alternative — P2P networks. At the time, Napster was used extensively for the sharing of music files. Napster was shut down in mid-20012 due to legal action by the major record labels.
The shutting of Napster did not stop the growth of P2P applications. A number of publicly available P2P systems have appeared in the past few years, including Gnutella, KaZaA, WinMX and BitTorrent, to name but a few. From analysis of P2P traffic in 2007, BitTorrent is still the most popular file sharing protocol, accounting for 50-75% of all P2P traffic and roughly 40% of all Internet traffic3.
P2P technology is not just used for media file sharing. For example, in the bioinformatics research community, a P2P service called Chinook4 has been developed to facilitate exchange of analysis techniques. The technology is also used in other areas including IP-based telephone networks, such as Skype5, and television networks, such as PPLive6. Skype allows people to chat, make phone calls or make video calls. When launched, each Skype client acts as a peer, building and refreshing a table of reachable nodes 7 in order to communicate for chat, making phone calls or video calls. PPLive shares live television content. Each peer downloads and redistributes live television content from and to other peers8.
GOVERNANCE AND REGULATIONS
In the U.S., a number of politicians have raised concerns about possible threats to national security due to P2P network technology. The possibility of accidental leaks of classified information by government officers to foreign governments, terrorists or organized crime via P2P file sharing programs has prompted a view that “new laws and rules should be enacted to protect personal information held by federal agencies and other organizations”. The proposal does not restrict P2P networks as a whole, but attempts to strike “a balance that protects sensitive government, personal and corporate information and copyright laws”9.
A P2P network itself is only a form of technology, and is not related to disputes over content and intellectual property rights. However, there have been court cases in Hong Kong against illegal P2P activities. In 2005, a Hong Kong resident was convicted of Peer-to-peer Network Page 7 of 14
breaching the Copyright Ordinance by uploading illegal copies of copyrighted works to the Internet using the BitTorrent peer-to-peer file sharing program, and making files available for download by other Internet users10.
SECURITY THREATS
A P2P network treats every user as a peer. In file sharing protocols such as BT, each peer contributes to service performance by uploading files to other peers while downloading. This opens a channel for files stored in the user machine to be uploaded to other foreign peers. The potential security risks include:
1. TCP ports issues
Usually, P2P applications need the firewall to open a number of ports in order to function
properly. BitTorrent, for example, will use TCP ports 6881-6889 (prior to version 3.2). The range of TCP ports has been extended to 6881-6999 as of 3.2 and later16. Each open port in the firewall is a potential avenue that attackers might use to exploit the network. It is not a good idea to open a large number of ports in order to allow for P2P networks.
2. Propagation of malicious code such as viruses
As P2P networks facilitate file transfer and sharing, malicious code can exploit this channel to propagate to other peers. For example, a worm called VBS. Gnutella was detected in 2000 which propagated across the Gnutella file Peer-to-peer Network Page 10 of 14
sharing network by making and sharing a copy of itself in the Gnutella program directory17.
Algorithm 1: Building Hierarchical Summaries
1. for each peer
2. for each document
3. Generate its vector vd by VSM
4. Generate peer weighted term dictionary vp
5. for each document vector vd
6. transform it into D(vp) dimensionality
7. generate high-dimensional point for vd by SVD
8. Pass vp to its super peer
9. for each super peer
10. Generate group weighted term dictionary vs
11. for each vp
12. transform it into D(vs) dimensionality
13. generate high-dimensional point for vp by SVD
14. Pass vs to other super peers
15. Generate global weighted term dictionary vn
16. for each vs
17. Transform it into D(vn) dimensionality
18. Generate high-dimensional point for vs
RESULT AND DISCUSSION
While P2P networks open a new channel for efficient downloading and sharing of files and data, users need to be fully aware of the security threats associated with this technology. Security measures and adequate prevention should be implemented to avoid any potential leakage of sensitive and/or personal information, and other security breaches. Before deciding to open firewall ports to allow for peer-to-peer traffic, system administrators should ensure that each request complies with the corporate security policy and should only open a minimal set of firewall ports needed to fulfil P2P needs. For end-users, including home users, care must be taken to avoid any possible spread of viruses over the peer-to-peer network.
Englishhttp://ijcrr.com/abstract.php?article_id=1051http://ijcrr.com/article_html.php?did=1051
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