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In this study, finite element (FE) analysis of underground structure is carried out, which is subjected to the internal blast loading and the structure is surrounded with soil media. Three different methods to analyze the effect of blast loading on structure, i.e. ConWep, smooth particle hydrodynamics (SPH), and couple Eulerian-Lagrangian (CEL) are used for the simulation of blast loading using ABAQUS/ExplicitⓇ. Concrete damage plasticity (CDP), Mohr–Coulomb, Johnson–Cook (JC) plasticity model, Jones–Wilkins–Lee (JWL) equation of state and ideal gas are utilized for defining behavior of concrete, soil, steel, explosive and air, respectively. FE analysis is performed to compare the behavior of structure under different blast modelling methods. The effect of different explosive weights is considered to see the impact of the blast load on the structure. For parametric analysis, three explosive weights, 3kg, 5kg, and 10kg of TNT (trinitro toluene), and three concrete grades, M30, M35, and M40 are considered to see the stability of the structure. The effect of varied explosive weights and varied concrete grades is compared in terms of stress, pressure, and displacement at critical locations of the structure. The outcome of this shows that the change in explosive weight and concrete grade considerably affects the stability of the structure. As the explosive weight increases, damage to the structure increases, and with the increase in the concrete grade, the blast load resistance capacity of the structure increases. It is observed that buried part of the structure is more resistant to blast load compared to the structure visible above ground. [ABSTRACT FROM AUTHOR]

Sandwich structure is one of the blasts protecting and energy absorbing materials with different types of light weight cores. This article aimed at investigating blast response of hexagonal honeycomb sandwich structure having perforations along the cell height of core over conventional honeycomb cores. The study discussed the mechanics of deformation behavior of perforated sandwich structure to improve the energy absorption characteristics of the bare honeycomb core sandwich structure. Detailed numerical analysis is conducted to accurately produce the deformation process with finite element analysis using explicit software LS-DYNA®. Blast load resulting from 1 kg TNT on the sandwich structure is applied using Conventional Weapons Effects Program (ConWep) function available in LS-DYNA. Several different parameters consisting of varying sizes of perforation by changing d/l ratio, shape, number of perforations and different facesheet and backsheet thicknesses, and different scaled distances are investigated in detail. The results indicated that both size and shape and number of perforations have significant influence on reduction of blast impulse. The variation of facesheet and backsheet thicknesses without changing the overall thickness of the structure also has evident effect in blast resistance capability of perforated honeycomb sandwich structure. The blast mitigation and energy absorption capacity of honeycomb core sandwich structure can be improved with the provision of perforations and optimizing the arrangement of holes. The perforated honeycomb core is further investigated based on analytical formulation developed using single degree of freedom (SDOF) system analysis approach. Optimization study is done further to get the best configuration based on different design variable limits. [ABSTRACT FROM AUTHOR]

Doors are the most critical part in any structure as they may eventually fail first when subjected to extreme loads such as blasts. Blast resistant doors in a structure work as effective barriers against blast pressure thus making the entire structure safe. Accordingly, the need to provide blast resistant doors arises in important structures to endure blast pressure. Herein, the comparative performance of a three-hinged five-latched double leaf composite door subjected to blast loading is investigated using finite element analysis software LsDyna. The composite door consists of front and rear steel plates composed of armor steel and three different infill materials, i.e., polyurethane (PU) foam, aluminum syntactic foam with 200 μm cenosphere (Al200), or plain cement concrete (PC) are explored in this investigation. Comparative studies of these composite doors are performed by varying the thicknesses and types of infill material and blast-scaled distances. The peak deflection, permanent deflection, internal energy, and total energy are compared among the doors considered herein. Weight and cost analysis of the door are also considered to determine the most cost-effective solution. The numerical results show that the polyurethane core door illustrates better performance for 150 mm of core material. However, the plain concrete infill door and cenosphere aluminum alloy core door demonstrate enhanced performance for 100 mm core thickness at 0.15, 0.2, 0.3, and 0.4 m/kg1/3 scaled distances. [ABSTRACT FROM AUTHOR]

An innovative sacrificial system consisting of hollow metal tubes as the energy-absorbing core was analyzed through three-dimensional (3D) finite-element analysis. The Johnson-Cook (J-C) plasticity model along with the J-C failure criterion were incorporated to model metallic parts under high-strain-rate loading, whereas the concrete damage plasticity (CDP) model was used to predict the behavior of concrete. Dynamic increase factors (DIFs) were used for concrete to understand the effect of high-strain-rate conditions. Finally, blast resistance performance of a square RC panel with dimension and thickness equals to 1,250 and 225 mm, respectively, with or without an innovative sacrificial system was analyzed under blast loading. From numerical simulation results, it is observed that sacrificial systems with thin sections of hollow metallic tubes performed better than thick sections irrespective of the same weight of the sacrificial system. Further, discussion was reported for the energy-dissipation curve of the system, and it is useful in defining the efficiency of the sacrificial system under blast loading. [ABSTRACT FROM AUTHOR]

Basalt fiber is commonly used as reinforcement in various civil engineering structures such as concrete panels, domes, bridges, and tunnels. Dynamic characterization of basalt fiber–reinforced concrete (BFRC) using a split Hopkinson pressure bar (SHPB) is carried out in the present investigation. Concrete with characteristic compressive strength of 30 MPa is considered herein to study its static and dynamic behavior. For this purpose, plain concrete (PC) and BFRC with a fiber content of 1% and 2% are investigated. For dynamic behavior, two different diameters, i.e., 76 and 54 mm samples, are prepared with varying slenderness ratios of 0.3 and 0.5. The behavior of PC and BFRC is experimentally studied at different strain rates ranging from 164 to 796/s, with gas gun pressures up to 0.38 MPa. Based on this investigation, it is observed that the strength of the concrete increases with the increasing strain rates, and the dynamic increase factor (DIF) is found to be varying from 0.91 to 3.58. [ABSTRACT FROM AUTHOR]

Metal foams has shown their usage in variety of industrial applications. Such foams are used for protective packaging to prevent the damage in case of impact due to various accidental reasons. Many equipment needs to be transferred from one place to another for several reasons. This may lead to damage of the equipment if being improperly handled or packed. Excessive accelerations during impact may damage the equipment thus indicating the importance of properly chosen packaging material. The present investigation aims for the study of applicability of aluminum foam for protective packaging of delicate equipment in comparison with the commonly used polymeric foams. In the present investigation a circuit board, packed in foam material, is dropped at an angle onto a rigid surface. The mathematical model of packaging, foam and circuit board is developed in finite element software and it is subjected to a simulated drop from a given height to assess the level of protection. The main aim is to assess whether these foam packaging are adequate to prevent circuit board damage when the board is dropped from a particular height. [ABSTRACT FROM AUTHOR]

The present investigation examines the interaction of shock waves with closed cell aluminum foam samples in a conventional shock tube. The effect of the sample thickness on shock wave attenuation and/or enhancement and the use of the foam in the sandwich structure is studied. Results in terms of incident and reflected shock pressures are obtained, and the effectiveness of the samples with and without the foam is compared. It is demonstrated that the foam density and thickness, as well as the placement of cover plates of the same material in front of and behind the foam have the most significant effect on the reflected shock pressure. It is concluded that the closed cell aluminum metal foam can be effectively used as a sacrificial layer in blast protection of structures. [ABSTRACT FROM AUTHOR]

Abstract: The Müller glial cells exhibit stem cell properties and express neuronal markers following experimentally induced retinal injury. However, it is not known whether Müller glia respond similarly to degenerative neuronal loss caused by genetic mutation. Here, we asked whether Müller cells dedifferentiate and express neuronal proteins in rd1 mouse, a naturally occurring mutant model of inherited retinal degeneration. Using immunohistochemistry and Western blotting, we studied expression patterns of glial fibrillary acidic protein (GFAP), nestin, rhodopsin, protein kinase C alpha (PKCα), β-III-tubulin and recoverin in Müller glia. Reverse transcriptase-polymerase chain reaction (RT-PCR) was carried out to detect any rhodopsin mRNA in the rd1 mouse retina. We found that Müller cell processes in rd1 mouse hypertrophied and overexpressed GFAP as early as postnatal day (P)-14, features that were maintained throughout development and in the adult stage. Furthermore, Müller cells continued to express nestin, a progenitor cell marker, up to 6months of age, raising the possibility that they remain undifferentiated for several months in rd1 mouse. We did not find nestin expression in Müller cells in 1-year-old rd1 mouse. Interestingly, Müller cell processes in rd1 mouse also expressed rhodopsin, a rod-specific protein. The rhodopsin expression in Müller cells was evident at P-21, and remained so up to at least 1year of age. The expression of rhodopsin by Müller cells was further supported by our finding of the rhodopsin transcript in the 9-month-old rd1 mouse retina. We did not find the expression of PKCα, β-III-tubulin or recoverin in Müller cells in adult rd1 mouse. These results suggested that Müller cells in rd1 mouse express proteins specific to retinal neurons that are the primary targets of the mutation in this mouse. Although the functional significance of rhodopsin expression by Müller cells is unclear, these results have implications for novel therapeutic strategies for retinal degeneration. [Copyright &y& Elsevier]

The emerging and re-emerging diseases are posing a great health risk for the last few years. One such category of diseases is viral haemorrhagic fevers (VHFs), which have emerged in the new territories, worldwide. Crimean Congo Hemorrhagic Fever (CCHF) cases, for the first time in India, were reported from Gujarat, in January 2011. The emergence of diseases not reported earlier, pose great economic and social challenge, burden health system, and create panic reaction. Nonetheless, with recent experience in control of epidemic diseases, and advances in basic scientific knowledge; the public health community is better prepared for these unexpected events. This review provides information to physicians on CCHF for managing outbreak, and identifies public health measures to prevent emergence and re-emergence of VHFs (including CCHF) in future. The authors suggest that though, there are a few challenging and unanswered questions, the public health preparedness still remains the key to control emerging and re-emerging diseases. The countries where virus activities have been reported need to be prepared accordingly. [ABSTRACT FROM AUTHOR]

Reservoir management involves allocating available water among multiple uses and users, minimizing the risks of water shortages and flooding and optimizing the beneficial use of water. Irrigation demands from a reservoir, which are generally computed by using the design cropping pattern and average rainfall conditions, may vary over the years depending on the actual cropping pattern and meteorological conditions. This study demonstrates the utility of remote sensing inputs and geographic information system (GIS) environment for determining realistic irrigation demands from a reservoir. Remote sensing data are used to map the actual cropping pattern in the command area while the GIS is used for integrating the field-level irrigation demands up to the canal system head. Ten daily irrigation demands in the command area of Samrat Ashok Sagar Reservoir in Madhya Pradesh, India have been estimated and the reservoir operation policy has been derived. Through the simulation analysis with 29 years of inflow data, rule curves have been derived for the operation of reservoir so that water deficit (if any) can be distributed in time much in advance and severe crop failure can be avoided. Inferences drawn from the analysis can guide the system operator in using the available water in a scientific and judicious manner. [ABSTRACT FROM AUTHOR]

Studies the crystal structure of the complex of meso-tetrasulfonatophenylporphyrin with jack fruit agglutinin. Transformations being undergone by residues involved in rendering galactopyranoside specificity to jacalin; Mediation of porphyrin binding by replicating the hydrogen-bonding network of mannpyranoside through the sulfonate atoms in the case of ConA.

Teleoperated robots in harsh environments have a significant likelihood of failures. It has been shown in previous work that a common type of failure such as that of a joint "locking up," when unidentified by the robot controller, can cause considerable performance degradation in the local behavior of the manipulator even for simple point-to-point motion. The effects of a failure become more critical for a system with a humanism the loop, where unpredictable behavior of the robotic arm can completely disorient the operator. In this experimental study involving teleoperation of a graphically simulated kinematically redundant manipulator, two control schemes, the pseudoinverse and a proposed failure-tolerant inverse, were randomly presented under both nonfailure and failure scenarios to a group of operators. Based on performance measures derived from the recorded trajectory data and operator ratings of task difficulty, it is seen the failure-tolerant inverse kinematic control scheme improved the performance of the human/robot system. [ABSTRACT FROM AUTHOR]

The article studies civic competence through survey data to a major new area, India. Civic competence feelings are also very strongly related to formal education, the higher the educational level, the more efficacious the person is likely to feel. Education and competence feelings in India are not accompanied by higher voter turnout rates or by feelings of loyalty and patriotism. The task of drawing and administering a representative sample in an underdeveloped and polyglot country like India is horrendous, because of social customs and communication difficulties characteristic of Indian society. Women are not easily accessible to an interviewer; social convention and caste restrictions prevent their being interviewed by an outsider, especially a male. The more traditional and rural the family, the stronger these restrictions. Lack of adequate communication facilities further compounds the problem. Some rural areas lie in remote regions making physical access difficult. Civic competence or political efficacy differs from the traditional definitions which highlighted anomie, cynicism, and loss of values or like feelings.

Dynamic response of shallow buried tunnel with three different cross sections subjected to surface blast loading using LS-DYNA version R10.1.0 is investigated. Multimaterial arbitrary Lagrangian Eulerian (MM-ALE) is employed for this study. Strain softening of concrete is incorporated in terms of tensile cracking. Whereas, strain rate dependent behavior of reinforcement is defined using visco-plastic formulation. The main objective is to investigate the nonlinear behavior of reinforced concrete that constitutes the tunnel lining under a surface blast. Extensive parametric analysis has been performed to determine the effects of change in explosive charge weight, lining thickness, and cover depth on the behavior of tunnel under blast loading. Further, a comparative study based on the degree of blast resistance has been carried out considering three tunnel cross sections, namely, horseshoe, box, and circular. Finally, the blast damage assessment of tunnel with varying geometry, explosive charge weight, and cover depth has been investigated to arrive at the most vulnerable blast scenario. [ABSTRACT FROM AUTHOR]

Aim To report the successful clinical and radiographic outcome of a regenerative endodontic treatment. Summary A 16-year-old male patient presented with a discoloured, maxillary left lateral incisor with a necrotic pulp. Radiographic examination revealed an incompletely developed root with an open apex. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the necrotic pulpal remnants were removed. The canal was disinfected without mechanical instrumentation with 5.25% Na OCl solution and dried with sterile paper points. A triple antibiotic (metronidazole, ciprofloxacin and minocycline) mixed with distilled water was packed in the canal and left for 28 days. Ten millimetres of whole blood was drawn by venipuncture from the patients antecubital vein for preparation of platelet-rich plasma ( PRP). After removal of the antibiotic mixture, the PRP was injected into the canal space up to the cementoenamel junction level. Three millimetres of white MTA was placed directly over the PRP clot. Two days later, the tooth was restored with permanent filling materials. The patient was recalled for 3, 6, 12, 24 and 36 months clinical/radiographic follow-up. A 3-year follow-up radiograph revealed resolution of the periapical lesion, increased thickening of the root walls, further root development and continued apical closure of the root apex. The tooth was not responsive to cold tests; however, sensitivity tests with an electric pulp tester ( EPT) elicited a delayed positive response. Key learning points Regeneration is a viable treatment modality that allows continued root development of immature teeth with open apices and necrotic pulps., Platelet-rich plasma appears to be a suitable scaffold for regeneration of vital tissues in teeth with a necrotic pulps and an associated periapical lesion., Regenerative endodontic procedures may offer an effective treatment option to save teeth with compromised structural integrity. [ABSTRACT FROM AUTHOR]

Introduction: Minimal invasive surgery has proven its advantages over open surgeries in the perioperative period. Food and Drug Administration approved da Vinci robot in 2000. The latest version, da Vinci Xi system has a mobile tower-based robot with several modifications to improve the functionality, versatility, and operative ease. None of the centers have reported exclusively on hepatobiliary oncology using the da Vinci Xi system. We report our initial experience.Aims and Objectives: To study the feasibility, advantages, and discuss the operative technique of da Vinci Xi system in hepatobiliary oncology.Materials and Methods: Data were analyzed retrospectively from a prospectively maintained database from June 2015 to October 2016. Twenty-five patients with suspected or proven hepatobiliary malignancies were operated. Total robotic technique using da Vinci Xi system was used. Demographic details and perioperative outcomes were noted.Results: Of the 25 surgeries, 14 patients had a suspected gallbladder malignancy, 11 patients had primary or metastatic liver tumor. Median age was 53 years. The average duration of surgery was 225 min with a median blood loss 150 ml. The median postoperative stay was 4 days. The median nodal yield for radical cholecystectomy was seven. Five patients required conversion. Two of these developed postoperative morbidity.Conclusion: Robotic surgery for hepatobiliary oncology is feasible and can be performed safely in experienced hands. Increasing experience in this field may equal or even prove advantageous over conventional or laparoscopic approach in future. A cautious approach with judicious patient selection is the key to establishing robotic surgery as a standard surgical approach. [ABSTRACT FROM AUTHOR]

Cerebral radiation necrosis is a complication following radiation treatment to the brain. It is hypothesized that radiation treatment causes vascular injury, leading to tissue ischemia and then radiation necrosis. Radiation necrosis is a delayed phenomenon, occurring several months to years after the completion of radiation therapy. Radiation necrosis can be difficult to diagnose as it appears similar to tumor progression on standard magnetic resonance imaging (MRI). The ability to distinguish the two is important for further treatment strategies, and there is no current guideline on which imaging modality should be used. Various imaging modalities have been studied as an alternative to MRI, including, but not limited to, MR perfusion techniques (MRP), MR spectroscopy (MRS), single photon emission computed tomography (SPECT), and positron emission tomography (PET). We aim to review the existing literature and perform a diagnostic meta-analysis comparing these different imaging modalities to differentiate radiation necrosis from tumor progression. A systematic review adherent to PRISMA guidelines was performed using Scopus and PubMed databases. Sensitivities and specificities were pooled using the inverse-variance method, and 95% confidence intervals were calculated. To compare modalities, Euclidean distances are calculated as the absolute distance from the point (1.0, 1.0) of a theoretical ideal classifier on a graph of sensitivity vs. specificity. For evaluation of Euclidean distance, the lower the value, the closer the test is to optimal, which would be a sensitivity and specificity of 1. The analysis includes 113 studies with a total of 200 imaging data points, including the following imaging modalities: MRI (n = 13), MRS (n = 21), MRP (n = 12), Dynamic Contrast Enhanced (DCE) MRI (n = 4), Dynamic Susceptibility Contrast MRI (n = 20), MR arterial spin labeling (ASL) (n = 3), Diffusion Weighted Imaging (n = 11), Diffusion Tensor Imaging (DTI) (n = 2), PET (n = 88), and SPECT (n = 26). MRS had the highest pooled sensitivity at 0.92 (95% CI: 0.84 - 0.96), followed by DCE MRI (0.88; 95% CI: 0.70 - 0.96) and then SPECT (0.88; 95% CI: 0.82 - 0.93). The highest pooled specificities were DTI at 0.90 (95% CI: 0.69 - 0.98), SPECT at 0.88 (95% CI: 0.83 - 0.92), and DCE MRI at 0.85 (95% CI: 0.71 - 0.93). For Euclidean distances, SPECT had the lowest at 0.163 (95% CI: 0.106 - 0.248), followed by MRS (0.167; 95% CI: 0.100 - 0.275), and DCE MRI (0.185; 95% CI: 0.077 - 0.414). MRI had the highest Euclidean distance at 0.373 (95% CI: 0.238 - 0.542). The results from this diagnostic meta-analysis evaluating pooled sensitivities, pooled specificities, and Euclidean distances indicate that SPECT and MRS appear to be promising imaging modalities for the differentiation of radiation necrosis from tumor progression. This study may have implications in the formation of imaging guidelines for this purpose. [ABSTRACT FROM AUTHOR]

Bladder cancer (BC) is one among the most common and lethal urothelial malignancies worldwide. The expression of cancer-testis (CT) antigens in some tumours and restricted expression among normal tissues make CT antigens as attractive vaccine targets. In this context, we evaluated Centrosomal protein 55 kDa (CEP55), which is specifically expressed in normal human testis and various malignancies. Until the expression pattern of CEP55 in transitional cell carcinoma (TCC) of human urinary bladder and its clinical significance are not known. The aim of the present study is to evaluate mRNA/protein expression of CEP55 in TCCs of urinary bladder and correlate its expression with the clinicopathological characteristics of BC patients. In this study, the methods of quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) were used to investigate mRNA/protein expression of CEP55 in TCC. Independent Student's t test, ANOVA and Chi-square (χ²) were used to analyze the data statistically. We observed CEP55 mRNA overexpression in testis and 48.7% of BC patients. Relative mean fold expression of CEP55 mRNA was found to be significantly (p < 0.01) higher in muscle-invasive bladder cancer (MIBC) as compared to non-muscle-invasive bladder cancer (NMIBC) patients (7.88 ± 3.88 vs. 4.75 ± 2.30, p = 0.01). CEP55 protein expression was evaluated using IHC and cytoplasmic staining pattern was recorded in formalin fixed, paraffin-embedded (FFPE) bladder tumour tissues. No significant difference was observed in protein expression of CEP55 between the two groups (NMIBC and MIBC patients) (72.2% vs. 69.0%, p = 0.774). No significant protein expression of CEP55 was observed among adjacent noncancerous tissues (ANCTs) and benign prostatic hyperplasia (BPH) used as control. Our study results suggest that CEP55 mRNA/protein expression was observed is specific to TCC of human urinary bladder and might be used as a diagnostic biomarker and vaccine target in development of BC specific immunotherapy. [ABSTRACT FROM AUTHOR]

Coexistence of tuberculosis (TB) and palatal malignancy is a rare phenomenon and it has never been reported. Here, we present a case of hard palate carcinoma with TB in a 60-year-old male patient who was successfully managed by three pronged approaches by combining antitubercular therapy with chemotherapy and radiotherapy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aim of this study was to investigate the prognostic significance of CD3+ TILs in infiltrating ductal carcinoma (IDC) of the breast. MATERIALS AND METHODS: Immuno-histochemistry was done with CD3 antibodies in tissue sections of 127 breast cancer patients, and CD3+ intra-tumoral and stromal TILs were counted in relation to clinico-pathological variables. RESULTS: Intra-tumoral and stromal CD3+ TILs were significantly associated with positive lymph node status (P = 0.006, P = 0.043, respectively) without significant association with age, menopausal status, family history, and hormonal status. The higher CD3 intra-tumoral and stromal counts both showed significant association with good prognosis (P = 0.039, P = 0.044, respectively). The intra-tumoral count was higher than stromal count and was independently associated with disease-free survival in stage I and II cancer (P = 0.021). CONCLUSIONS: CD3+ TILs may serve as independent marker of good prognosis in IDC breast. The findings of this study need further validation on a larger sample size. [ABSTRACT FROM AUTHOR]

Purpose: This trial was undertaken to compare the rates of resectability between patients treated with neoadjuvant concurrent chemoradiation vs. boosted radiotherapy alone. Materials and methods: Patients with clinically unresectable rectal cancer were randomized to receive external beam radiation therapy (EBRT) to pelvis (45 Gy) with concurrent oral Capecitabine (CRT group; Arm 1) or EBRT to pelvis (45 Gy) alone followed by 20 Gy dose of localized radiotherapy boost to the primary tumor site (RT with boost group, Arm 2). All patients were assessed for resectability after 6 weeks by clinical examination and by CT scan and those deemed resectable underwent surgery. Results: A total of 90 patients were randomized, 46 to Arm 1 and 44 to Arm 2. Eighty seven patients (44 in Arm 1 and 41 in Arm 2) completed the prescribed treatment protocol. Overall resectability rate was low in both the groups; R0 resection was achieved in 20 (43 %) patients in Arm 1 vs. 15 (34 %) in Arm 2. Adverse factors that significantly affected the resectability rate in both the groups were extension of tumor to pelvic bones and signet ring cell pathology. Complete pathological response was seen in 7 and 11 %, respectively. There was greater morbidity such as wound infection and delayed wound healing in Arm 2 (16 vs. 40 %; p = 0.03). Conclusion: Escalated radiation dose without chemotherapy does not achieve higher complete (R0) tumor resectability in locally advanced inoperable rectal cancers, compared to concurrent chemoradiation. [ABSTRACT FROM AUTHOR]

Arachnoiditis involving optic nerve and the optic chiasm can occur as a complication of tuberculous meningitis (TBM). This study evaluates the clinical features, cerebrospinal fluid (CSF) and laboratory parameters and imaging findings of optochiasmatic arachnoiditis (OCA) and also tried to identify any factors which can predict this complication in patients with TBM. Patients admitted with TBM in the neurology wards of a tertiary care teaching hospital over a period of 6 years formed the material for this study. Student's 't' test and univariate analysis were done to identify any predictors for this complication and the variables found to be significant were further analyzed by multivariate logistic regression analysis. One hundred sixty-three patients with TBM, admitted over a 6-year period, were studied. Twenty-three (14%) patients developed OCA. Eighteen out of 23 (78%) developed this complication while on antituberculous treatment (ATT) and 5/23 (22%) were newly diagnosed cases of TBM. Of those already on treatment, 12/23 (52%) were receiving only ATT, the remaining 6/23 (26%) had received steroids along with ATT in varying doses and duration. The average period from diagnosis of TBM to visual symptoms was 6.4 months. On the multivariate logistic regression analysis, female sex (P < 0.037), age less than 27 (P < 0.008) years and protein content in the CSF > 260 mg% (P < 0.021) were the factors predisposing toward this complication. At 6 months follow-up, on treatment with steroids and ATT, 17% had improvement and no further deterioration was noted in visual acuity in 52%. OCA can develop even while on treatment with ATT. Young women with a high CSF protein content seem to be more prone for this complication. [ABSTRACT FROM AUTHOR]

Background: The exact pathogenesis of pregnancy associated cerebral venous thrombois is still unsettled. Aims: To identify possible inherited and acquired prothrombotic risk factors and also identify the factors associated with mortality in pregnancy associated CVT. Settings and Design: Prospective cohort study to identify prothrombotic risk factors and case control study of influence of local traditional practice of puerperal water restriction on postpartum CVT. Materials and Methods: Consecutive patients with pregnancy associated CVT seen over a period of three years. Thrombotic workup included genetic markers, protein assays, and other factors. Statistical Analysis: Univariate and chi-square analysis. Results: Of the 41 patients studied during the study period, 71% of patient had a single and 34% had multiple prothrombotic risk factors. Methylene tetrahydro-folate reductase (MTHFR) heterozygosity (19.5%) and factor V Leiden heterozygous (7.3%) were the commonest genetic markers. Hyperhomocysteinemia (34%) and elevated factor VIII levels (14.6%) were the other important risk factors. In this cohort the mortality was 17%. Mortality increased by odds of 1.3 for every additional prothrombotic marker. The factors associated with increased mortality included: status epileptics (P = 0.05, OR 13.2, 95% CI 1.002 - 173), deep venous system involvement (P = 0.016, OR 9.64, 95% CI 1.53 - 60.6), presence of midline shift (P = 0.012, OR 24.7, 95% CI 2.05 - 29.8) and diffuse cerebral edema (P = 0.006, OR 14.5, 95% CI 2.18- 96.4). The traditional practice of decrease intake of water during puerperium was significant in woman with pregnancy associated CVT when compared to control subjects (P < 0.02). Conclusion: In patients with pregnancy associated CVT, prothrombotic markers can be multiple and are associated with increased odds of mortality. Deep venous system involvement, presence of midline shift and diffuse cerebral edema increased mortality. Peuperial water restriction may be a modifiable risk factor. [ABSTRACT FROM AUTHOR]

BACKGROUND: Free radical Injury is associated with cancer, but how the extent of oxidative stress correlates with the FIGO (International Federation of Gynecology and Obstetrics) stage in Carcinoma Cervix (Ca Cx), and its significance as a prognostic marker, is not clear and needs an in-depth study. AIM: To correlate the blood levels of Lipid Peroxidation (LPO), Reduced Glutathione (GSH), Superoxide Dismutase (SOD), and Vitamin A and E levels with the clinical stage in Ca Cx. SETTINGS AND DESIGN: This is a Prospective Case Control Study. MATERIALS AND METHODS: LPO, SOD, reduced GSH were estimated by Bio Chemical Assays and Vitamins by High Performance Liquid Chromatography (HPLC). STATISTICAL ANALYSIS: The cases and controls were compared using One Way ANOVA and different stages over different time periods were individually compared by Repeated Measure Analysis of Variance. RESULTS: The results indicated a statistically significant increase of LPO vis-a-vis the FIGO stage of Ca Cx and control, while the antioxidant status as depicted by GSH and SOD decreased. Vitamin A and E levels were significantly lower in cancer cases as compared to the control. CONCLUSION: Increased LPO and reduced antioxidant levels may be taken as associated predictive markers, thus suggesting that Ca Cx cases should get nutritive supplements to contain the blood LPO level and maintain a positive balance of antioxidants for a better outcome in terms of delayed recurrence and better Quality of Life (QOL). [ABSTRACT FROM AUTHOR]

Acute coronary syndromes result in a global impairment of coronary blood flow with nonculprit artery blood flow being associated with culprit artery flow and vice versa. Improvements in nonculprit artery flow are related to improvements in culprit artery flow after percutaneous intervention; nonculprit arteries with abnormal flow sustain greater improvements in their flow after culprit artery intervention. [ABSTRACT FROM AUTHOR]