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Background: Tuberculosis (TB) remains a major global health problem. The first line anti-tubercular drugs are hepatotoxic. Despite adequate knowledge, we are still unable to predict antitubercular drug induced liver injury (DILI) before initiation of treatment. Methods & Materials: This case-control study was nested in a cohort of patients from Christian Medical College, Vellore who were newly diagnosed to have tuberculosis and started on treatment. It was carried out from April 2013 to May 2014. All patients who present with suspected ATT related hepatotoxicity were also enrolled in the study. All patients on treatment were clinically assessed for symptoms of hepatitis at every visit until completion of treatment. The risk factors for ATT induced hepatitis were identified by bivariate analysis and logistic regression analysis with odds ratio and 95% confidence interval. Results: A total of 393 patients were eligible for our study which included 5 patients presenting with DILI. Patients on DOTS regimen had lower rates of HIV infection and disseminated disease but had greater under nutrition when compared with patients on daily regimen. 43 patients out of 393 patients developed DILI. The incidence of anti-tubercular drug induced liver injury was 9.7% (95% C.I 7-13.2%) with lower incidence among patients on DOTS regimen (14% Vs 3.5%). HIV infection, daily regimen, disseminated disease, hypoalbuminemia and chronic liver disease were independent risk factors for development of DILI. A prediction score of > 5 based on the above risk factors will predict DILI with a sensitivity and specificity of 74% and 67% respectively. All cause mortality in DILI was 4.7% (2 patients). 36 patients (84%) had complete resolution of hepatitis. Rechallenge by both ATS and BTS guidelines had similar successful rechallenge rates. Conclusion: The incidence of anti-tubercular DILI was 9.7%. The study suggests that the combination of risk factors of extensive TB disease, HIV infection and undernutrition increase the vulnerability to DILI particularly with daily TB treatment regimen, emphasizing the role of acquired risk factors in the development of DILI. The predictive scoring system proposed from our study needs to be validated by a well designed prospective study. [ABSTRACT FROM AUTHOR]

The transconductance of SiC metal-oxide-semiconductor field-effect transistors (MOSFETs) is typically much lower in devices fabricated on the 4H-SiC polytype compared to 6H. It is believed that this behavior is caused by extreme trapping of inversion electrons due to a higher density of traps D[sub it] at the SiC/SiO[sub 2] interface in 4H-SiC. Here we present an approach for profiling D[sub it] versus energy in the band gap using a modified capacitance-voltage technique on large-area MOSFETs. We find that D[sub it] increases towards the conduction band edge E[sub c] in both polytypes, and that D[sub it] is much higher in 4H- compared to 6H-SiC for devices fabricated in the same process lot. © 2000 American Institute of Physics. [ABSTRACT FROM AUTHOR]

To understand the mechanisms that control the cell-specific visual pigment gene transcription, the Xenopus rhodopsin 5' regulatory region has been characterized in vivo using transient transfection of Xenopus embryos and transgenesis. The principal control sequences were located within -233/+41, a region with significant conservation with mammalian rhodopsin genes. DNase footprinting indicated seven distinct regions that contain potential cis-acting elements. Sequences near the initiation site (-45/+41, basal region) were essential, but not sufficient, for rod-specific transcription. Two negative regulatory regions were found, one between -233 to -202, with no apparent similarity to known elements, and a second Ret-1-like CAAT (-136/-122) motif. Deletion of either sequence led to a 2-3-fold increase in expression levels, without a change in rod specificity. Sequences between -170 to -146, which contain an E-box motif, were necessary for high level expression in transgenic tadpoles but not in transient transfections. Sequences between -84 and -58, which contained an NRE-like consensus were found to be necessary for high level expression in both assays. Although expression levels were modulated by various proximal sequences in the rhodopsin promoter, none of the tested sequences were found to be necessary for rod specificity. Promoter constructs with a consensus BAT-1 sequence in conjunction with an NRE-like element upstream of the basal promoter directed low level green fluorescent protein expression in the central nervous system in transgenic tadpoles. These results suggest that rod cell-specific expression of rhodopsin is controlled by redundant elements in the proximal promoter.

Routine operative angiography was performed during a 14 1/2-year period ending June 1982, during which 603 consecutive carotid endarterectomies were performed. For the purpose of standardization, a functional classification of stroke in terms of severity was established: class I--minimal, class II--moderate, class III--marked, class IV--severe, and class V--coma or death. Patients were analyzed to determine the cause of the stroke, the severity of the stroke, and the efficacy of routine operative angiography in reducing the incidence of perioperative stroke caused by technical error. Perioperative stroke occurred in 18 patients (2.9%), with only one having been caused by technical error. Fifteen patients underwent revision of the endarterectomy before wound closure because of unsatisfactory operative angiography results. None of the patients developed permanent neurologic deficits. Permanent perioperative neurologic deficits resulted from embolization (six patients), hypertensive episodes with cerebral hemorrhage (three patients), conversion of ischemic to hemorrhagic infarcts (two patients), spontaneous thrombosis (one patient), clamp ischemia (two patients), and other factors (three patients). Nine patients died, two of myocardial infarction and seven of stroke, for a combined mortality and morbidity rate of 3.3%. There were three class II, five class III, two class IV, and eight class V strokes that were determined to be related to the procedure. In this series stroke may have been prevented in 15 patients who underwent revision of the endarterectomy because of an unacceptable technical error demonstrated on operative angiography.

A patient with Dyke-Davidoff-Masson Syndrome had a lifelong history of spatial disorientation and visual-spatial cognitive defects demonstrated by psychological tests. We suggest that the abnormalities of behavior and test performance may be related atrophic lesions demonstrated by pneumoencephalography and computerized axial tomography. We consider several explanations to account for the lack of compensation for these cognitive defects.