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A prospective study was undertaken in 459 cases, undergoing open heart surgery which necessitated media sternotomy, to see the frequency of brachial plexus and peripheral nerve related complications in the upper limbs. Seven cases (1.53) had such complications. These included lower trunk injury (3 cases), ulnar neuropathy at the elbow (3 cases), and radical neuropathy at the level of radical groove (one case). The youngest patient was aged 12 years and the remaining 6 patients were more than 30 years of age. There was no relation between the type of heart disease and these complications. The difference between patients with or without preparation of the internal mammary artery for graft was not significant. All the complications occurred on the left side. Ulnar and radical nerve palsy could be due to the positioning of the left limb. The barchial plexus injury was related to retraction of the sternum during operation. AA : Y.

Background: In the era of declining HIV/AIDS prevalence, low penetration of Information Education and Counseling (IEC) activities, particularly among the rural community is still a matter of concern for public health officials. Integrated Counseling and Testing Centers (ICTC’s) are key entry points for a wide range of interventions in HIV awareness, prevention and care in India. Objective: The objective of current study was to assess the socio-demographic profile and risk behavior of attendees who tested seropositive at our ICTC clinic. Methodology: A prospective questionnaire based study from August 2009 to December 2013 was conducted in the ICTC attached to Microbiology department of SGPGIMS to enumerate the socio-demographic and risk behavior pattern of HIV positive cases. Result: Among 16038 attendees investigated during the study, 298(1.86%) tested positive for HIV with a male to female ratio of 2.24:1. Maximum seropositivity (35.6%) was found in the age group of 31-40 years followed by 21-30 years age group (26.8%). Most of the study individuals were married (86.6%) and belonged to rural community. Unprotected heterosexual route was found to be the commonest (71.1%) mode of infection. The majority of the subjects had received education up to primary (36.2%) and secondary level (31.9%). Conclusion: The rural population and the sexually active and economically productive age group dominated among the HIV seropositives presenting at this centre. Heterosexual route is still the predominant mode of transmission among seropositives. Recommendation: The planning and designing of IEC activities should be based on socio-demographic profile and risk behavior pattern of a particular area.

Sequencing of the human genome and the evidence correlating specific genetic variations to diseases have opened up the potential of genomics to more effective and less harmful interventions of human diseases. A wealth of pharmacogenomics knowledge is in place for the practice of precision medicine. However, this knowledge is not fully realized in clinical practice. One reason for this impasse is the lack of in-depth understanding of the potential of pharmacogenomics among the healthcare professionals. Pharmacists are the point-of-care providers and are expected to advise clinicians on matters relating to the implementation of pharmacogenomics in patient care. However, current pharmacogenomics instruction in pharmacy schools fails to produce pharmacists with the required knowledge or practical training in this discipline. In this perspective, we provide several strategies to overcome limitations faced by pharmacy schools. Once implemented, pharmacy schools will produce precision medicine-ready pharmacists.

A simple and efficient, Lewis acid catalysed reductive etherification strategy for the stereoselective synthesis of cis-2,6-disubstituted morpholines and 1,4-oxathianes starting from readily available 1,5-diketones has been developed. The strategy is used in the total synthesis of morpholine-based natural products (+/-)-chelonin A and formal total synthesis of (+/-)-chelonin C.

Previously we found the structural integrity of the aortic endothelium was maintained after the administration of endotoxin in type 1 interleukin-1 (IL-1) receptor knockout mice. In this study, we investigated further the integrity of pulmonary vascular endothelium, airway epithelial, pulmonary microvasculature, and neutrophil infiltration into the microvasculature and respiratory air spaces. Adult male C57BL/129J wild-type mice and C57BL/129J knockout mice possessing a homozygous deletion of the type 1 IL-1 receptor received the following intraperitoneal injections; 1) Escherichia coli endotoxin (ENDT) (10 mg/kg), 2) ENDT (2 mg/kg given for 4 days), or (3) saline vehicle. Wild-type and knockout control animals receiving saline vehicle showed normal endothelial and epithelial ultrastructure with intact membranes. Pulmonary endothelial cell damage was found only in wild-type mice given a single 10 mg/kg endotoxin dose. Airway epithelial damage was found only in wild-type mice given a repetitive dose of endotoxin (2 mg/kg for 4 days). Neutrophil infiltration increased only in mice given a single dose of endotoxin (10 mg/kg) with the wild-type increasing by 32% and the knockouts by 6% compared with the saline control for that group respectively. Serum IL-6 and nitric oxide (indicators of septic shock severity and lethality) significantly increased only in the mice given 10 mg/kg of endotoxin. The maintenance of pulmonary endothelial and epithelial cell integrity and the decrease of neutrophil infiltration in the IL-1 knockout mice suggest that IL-1 contributes significantly to the severity of endotoxin-induced sepsis.

Evaluation of specific energy consumption was carried out during convective-microwave and convective drying of Ashwagandha root in a developed laboratory scale microwave dryer. The specific energy consumption in convective drying at 60oC of air temperature and 1.0 m/s air velocity was estimated as 2.27 ± 0.12) MJ/kg of water evaporated. The increase in air velocity increased the energy consumption. The specific energy consumption at 6 W/g of microwave power level, 60oC air temperature and 1.0 m/s air velocity was 0.396 ± 0.047) MJ/kg of water evaporated, resulting in about 82% energy saving as compared to convective drying processes. The drying time increased with increase in air velocity in convective - microwave drying process as a reverse trend that was observed in convective drying process of Ashwagandha roots.

BACKGROUND Several devices are available for transcatheter occlusion of patent ductus arteriosus. Most of these devices either require complicated intracardiac maneuvering, have not been tried in humans, or need a large-sized sheath for implantation of the device. METHODS AND RESULTS During a 26-month period ending November 1992, 14 patients underwent transcatheter closure of patent ductus arteriosus with an adjustable buttoned device delivered via a 7F sheath under an institutional review board-approved custom-made device protocol. The children were 15 months to 8 years of age with weight range of 7.2 to 19 kg. The patent ductus arteriosus measured from 2 to 7.5 mm (median, 3 mm) at the narrowest diameter and was conical, short, or tubular. They were occluded with devices measuring 15 to 20 mm. The ratio of pulmonary to systemic flow decreased (P < .01) from 1.9 +/- 0.6 (mean +/- SD; range, 1.3 to 3.2) to 1.05 +/- 0.1 (1 to 1.3). Continuous murmur of patent ductus arteriosus disappeared in all except 1 patient. Small residual shunts were detected by color Doppler studies in 4 of 14 patients (29%). All patients were followed for 1 to 24 months (mean, 6 +/- 7 months). The device was intact in all patients, and no breakage of the wires was noted. No shunts were seen in 12 of 14 patients (86%), and minute residual shunts were seen in 2 children. No major complications were encountered. CONCLUSIONS It is concluded that transcatheter closure of patent ductus arteriosus with the adjustable buttoned device is feasible and effective and can be accomplished via small 7F sheaths; a 7F sheath is adequate for all ductal sizes; and the adjustable length of the loop accommodated all types of patent ductus arteriosus. Clinical trials on a larger number of patients are warranted.

This article presents a new algorithm for the solution of the combined heat and power economic dispatch problem, encountered in systems having simple cycle co-generation units with quadratic cost functions. An explicit formula is developed for computing the system-wide incremental costs corresponding to the optimal dispatch. The novelty of the proposed dispatch procedure is that it avoids the use of iterative search schemes for this crucial step. The method is illustrated using the test cases taken from the literature as well as some new ones.

This paper presents an alternative interpretation of the relation used for computing the bus admittance matrix (Y-BUS) of electrical networks. We show that this alternate view permits the development of a new algorithm for computing the Y-BUS. The most important feature of the proposed algorithm is that it enables us to handle mutually coupled elements in a network in a manner almost identical to the simple method widely used for elements with no mutual coupling. The new algorithm is illustrated with a detailed example. (c) 2006 Elsevier Ltd. All rights reserved.

Background Abnormalities of arterial pulse and limb growth after retrograde femoral arterial catheterization have been well documented. However, the magnitude of such complications after transfemoral artery balloon dilatation has not been thoroughly investigated. This study sought to evaluate the prevalence of these abnormalities in children who have undergone transfemoral artery balloon dilatation. Methods and Results Data on 43 consecutive patients (1 day to 15.5 years old at the time of balloon dilatation) seen on follow-up (42±23 months) (group 1) were compared with those of 35 patients undergoing retrograde femoral arterial catheterization (group 2) and 47 control patients. Interventional ankle/control ankle blood pressure index (AAI), ratio of interventional/control lower limb length (LLI), and leg length difference (LLD) were measured. Ages and weights at study were similar in all three groups, as were the ages and weights at intervention and duration of follow-up in groups 1 and 2. The AAI was lower ( P =.023) in group 1 (0.95±0.13) than in groups 2 (1.0±0.1) and 3 (1.01±0.09). The prevalence of subjects with AAI ≤0.9 was higher ( P =.003) in group 1 than in the other two groups. The LLI and LLD were similar ( P >.1) in all three groups. AAI and LLD in the balloon group are not significantly associated with age and weight at intervention, duration of follow-up, or size of the balloon or balloon catheter shaft. Conclusions Transfemoral artery balloon dilatation procedures produce superficial femoral artery compromise, but there was no significant limb growth retardation at a 3.5-year mean follow-up, which may be related to development of collateral circulation. Study of a larger number of children at a longer follow-up interval may be necessary to further confirm these observations.

Cost-effective programmes for the prevention of disabilities in leprosy require active involvement of the patients and their families as well as an integrated team approach. This paper presents the views and recommendations of a group of 35 experienced leprologists who met at a workshop, reviewed the current scenario and worked out specific objectives, strategies and the reorganization required in the existing infrastructure. Three tiers of workers are suggested: village volunteer; paramedical worker; and the professionals at the base hospital. All three levels should work together at the start of a programme as well as for periodic monitoring and evaluation.

Mixed ligand phenolate Schiff base complexes of ruthenium (II) of the types [Ru(pap)(2)L]ClO4, [pap = 2-(phenylazo) pyridine; L = deprotonated form of HL ligand, HO-C6H4-CH=N-C6H4-(R), where R = H, Me, OMe, Cl, NO2] and [Ru(bpy)(2)L(2)]ClO4H2O (where bpy = 2,2'-bipyridine) have been synthesised and characterised. The complexes are diamagnetic and in acetonitrile solution they behave as 1:1 electrolyte. All the complexes show strong MLCT transitions in the visible region 400-800 nm. The redox properties of all these complexes have also been studied.

A total of 26 clinically diagnosed adult patients, with active untreated lepromatous leprosy, with a Bacteriological Index of 4+ or more, were admitted to the hospital of the Central Leprosy Teaching and Research institute, Chengalpattu, India, between 1989 and 1991. After prescribed investigations, the patients were randomly allocated in groups of 3 to 3 treatment regimens, namely: 1, clofazimine 50 mg daily and 300 mg once in 4 weeks + dapsone 100 mg daily (AA); 2, (AA)+ofloxacin 400 mg daily (BB); and 3, (AA)+ofloxacin 800 mg daily (CC). The drugs were administered for 56 days continuously under supervision. Sequential biopsy results on day 0, 7, 14, 28 and 56 in normal mouse footpad revealed no growth by day 28 and 56 in all patients treated with CC and BB regimens, respectively. Calculation of the proportion of viable Mycobacterium leprae through analysis of median infectious dose (ID50) showed significant differences on day 7 in the percentage of kill between the ofloxacin-containing regimens and the other. Moderate to marked clinical improvement has been observed in a significantly higher proportion of patients treated with ofloxacin-containing regimens. All the 3 regimens were well tolerated. No severe complications or side-effects to the drugs were noticed with any of the regimens that required any suspension of treatment or the administration of steroids. Addition of ofloxacin to the standard WHO recommended MDT regimen for multibacillary patients may reduce the present duration of therapy. Ofloxacin may also be considered as an alternative drug in rifampicin-resistant cases or where rifampicin is contraindicated.

A comparison of the profile of monolesional cases among new PB cases detected in a Government Leprosy Control Unit (GLCU) and the field area of a Central Leprosy Teaching and Research Institute (CLTRI), both located in South India, demonstrates that the proportion of monolesional cases among new cases detected between 1987 and 1991 was higher in children than adults, higher in females than males (only in the CLTRI)--over 95% were the tuberculoid type. A significantly increasing trend in this proportion could be seen in the GLCU but not in the CLTRI; an explanation of this is based on the difference in operational aspects in case detection methodology adopted by the 2 areas--e.g. intersurvey interval and mode of case detection. Such studies, focusing on single skin lesions, help us in understanding the role of various possible operational factors in influencing the behaviour of the disease.

Anomalous drainage of the right superior vena cava (RSVC) to the left atrium was diagnosed in a 4-month-old infant with cyanosis. Surgical repair was undertaken at 26 months of age; we report the surgical technique used to correct this uncommon defect. In the immediate postoperative period we used a noninvasive technique, contrast echocardiography, to assess the adequacy of the surgical repair. Contrast echocardiography is a simple technique which can exclude the presence of postoperative right-to-left shunting.