PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-25 (29)
 

Clipboard (0)
None

Select a Filter Below

Year of Publication
1.  Identifying barriers to chronic disease reporting in Chicago Public Schools: a mixed-methods approach 
BMC Public Health  2014;14(1):1250.
Background
Chronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses.
Methods
A mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process.
Results
The three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse.
Conclusions
These findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students’ chronic conditions. A parent-focused intervention informed by these results has been completed.
Electronic supplementary material
The online version of this article (doi:10.1186/1471-2458-14-1250) contains supplementary material, which is available to authorized users.
doi:10.1186/1471-2458-14-1250
PMCID: PMC4265490  PMID: 25481628
Asthma; Food allergy; Chronic disease; Schools nurses; Parents; Reporting; Barriers
2.  Correlation between Epidurographic Contrast Flow Patterns and Clinical Effectiveness in Chronic Lumbar Discogenic Radicular Pain Treated with Epidural Steroid Injections Via Different Approaches 
The Korean Journal of Pain  2014;27(4):353-359.
Background
Epidural steroid injections are an accepted procedure for the conservative management of chronic backache caused by lumbar disc pathology. The purpose of this study was to evaluate the epidurographic findings for the midline, transforaminal and parasagittal approaches in lumbar epidural steroid injections, and correlating them with the clinical improvement.
Methods
Sixty chronic lower back pain patients with unilateral radiculitis from a herniated/degenerated disc were enrolled. After screening the patients according to the exclusion criteria and randomly allocating them to 3 groups of 20 patients, fluoroscopic contrast enhanced epidural steroids were injected via midline (group 1), transforaminal (group 2) and parasagittal interlaminar (group 3) approaches at the level of the pathology. The fluoroscopic patterns of the three groups were studied and correlated with the clinical improvement measured by the VAS over the next 3 months; any incidences of complications were recorded.
Results
The transforaminal group presented better results in terms of VAS reduction than the midline and parasagittal approach groups (P < 0.05). The epidurography showed a better ventral spread for both the transforaminal (P < 0.001) and the paramedian approaches (P < 0.05), as compared to the midline approach. The nerve root filling was greater in the transforaminal group (P < 0.001) than in the other two groups. The ventral spread of the contrast agent was associated with improvement in the VAS score and this difference was statistically significant in group 1 (P < 0.05), and highly significant in groups 2 and 3 (P < 0.001). In all the groups, any complications observed were transient and minor.
Conclusions
The midline and paramedian approaches are technically easier and statistically comparable, but clinically less efficacious than the transforaminal approach. The incidence of ventral spread and nerve root delineation show a definite correlation with clinical improvement. However, an longer follow-up period is advisable for a better evaluation of the actual outcom.
doi:10.3344/kjp.2014.27.4.353
PMCID: PMC4196501  PMID: 25317285
epidural steroid injection; fluoroscopy; midline interlaminar; parasagittal interlaminar; transforaminal
3.  Postspinal hypotension in elderly patients undergoing orthopedic surgery, prophylactic ephedrine versus polygeline 3.5% 
Context:
Perioperative fluid management in elderly poses considerable challenge to the anesthesiologist. The conventional crystalloid loading may not be a preferred regime in this subgroup of patients since an exaggerated hemodynamic response is expected due to blunted sympathetic response and compromised cardiorespiratory system.
Aims:
This study was designed in the elderly patient for comparing efficacy, side-effects and limitations of prophylactic ephedrine 30 mg (intramuscular [i.m.]) versus polygeline 3.5% 500 ml (intravenous [i.v.]) for the maintenance of blood pressure after subarachnoid block (SAB).
Settings and Design:
The sample size of 100 elderly (age > 50 years) patients undergoing orthopedic surgeries was administered SAB using bupivacaine 0.5% heavy. The primary outcome of this study was the attenuation of hypotension due to SAB using ephedrine or polygeline 3.5%.
Materials and Methods:
A total of 100 patients were randomly allocated to receive ephedrine 30 mg i.m. 10 min before the institution of SAB in Group I and preloading with 500 ml of polygeline 3.5% i.v. over 10 min prior to SAB in Group II. Patients in both groups were closely monitored for pulse rate, systolic blood pressure; any hypotension, requirement of rescue therapy and adverse effects.
Statistical Analysis Used:
Results were interpreted using Student's t-test for parametric and Chi-square tests for nonparametric data.
Results:
The incidence of hypotension and requirement for rescue therapy was statistically less in Group I compared with Group II (P < 0.05). Heart rates were better maintained in Group I than Group II, with few hemodynamic adverse effects in both groups.
Conclusions:
Ephedrine 30 mg i.m. given as pretreatment before SAB in elderly patients was more effective for the prevention of post-SAB hypotension.
doi:10.4103/0259-1162.143132
PMCID: PMC4258975
Ephedrine; elderly; hypotension polygeline 3.5%; subarachnoid block
4.  Enhanced Photoacoustic Gas Analyser Response Time and Impact on Accuracy at Fast Ventilation Rates during Multiple Breath Washout 
PLoS ONE  2014;9(6):e98487.
Background
The Innocor device contains a highly sensitive photoacoustic gas analyser that has been used to perform multiple breath washout (MBW) measurements using very low concentrations of the tracer gas SF6. Use in smaller subjects has been restricted by the requirement for a gas analyser response time of <100 ms, in order to ensure accurate estimation of lung volumes at rapid ventilation rates.
Methods
A series of previously reported and novel enhancements were made to the gas analyser to produce a clinically practical system with a reduced response time. An enhanced lung model system, capable of delivering highly accurate ventilation rates and volumes, was used to assess in vitro accuracy of functional residual capacity (FRC) volume calculation and the effects of flow and gas signal alignment on this.
Results
10–90% rise time was reduced from 154 to 88 ms. In an adult/child lung model, accuracy of volume calculation was −0.9 to 2.9% for all measurements, including those with ventilation rate of 30/min and FRC of 0.5 L; for the un-enhanced system, accuracy deteriorated at higher ventilation rates and smaller FRC. In a separate smaller lung model (ventilation rate 60/min, FRC 250 ml, tidal volume 100 ml), mean accuracy of FRC measurement for the enhanced system was minus 0.95% (range −3.8 to 2.0%). Error sensitivity to flow and gas signal alignment was increased by ventilation rate, smaller FRC and slower analyser response time.
Conclusion
The Innocor analyser can be enhanced to reliably generate highly accurate FRC measurements down at volumes as low as those simulating infant lung settings. Signal alignment is a critical factor. With these enhancements, the Innocor analyser exceeds key technical component recommendations for MBW apparatus.
doi:10.1371/journal.pone.0098487
PMCID: PMC4043749  PMID: 24892522
5.  Assessment of Anti-Plasmodial Activity of Non-Hemolytic, Non-Immunogenic, Non-Toxic Antimicrobial Peptides (AMPs LR14) Produced by Lactobacillus plantarum LR/14 
Drugs in R&d  2014;14:95-103.
Background and Objectives
Lactobacillus plantarum strains are known to exhibit an antimicrobial property against bacteria and fungi. In the present investigation, AMPs LR14, antimicrobial peptides produced by L. plantarum strain LR/14, were tested against a protozoan system, Plasmodium falciparum and its non-toxic nature was envisaged on a mammalian system.
Methods
Human erythrocytes infected with chloroquine-sensitive and -resistant strains of P. falciparum were treated with purified AMPs LR14. The loss in cell viability was assessed by monitoring the incorporation of [3H]-hypoxanthine in the nucleic acid of the parasite. The hemolytic activity of AMPs LR14 was monitored at different concentrations and the investigations into the in vivo toxicity of AMPs LR14 were carried out on a mammalian system (Wistar rat). The level of toxicity in the tissues was visualized by histopathological studies conducted on the liver and kidney of the test and control rats. A study was also undertaken to see the production of antibodies in an animal (rabbit) after it was immunized with AMPs LR14.
Results
A loss in cell viability was observed in both test strains of P. falciparum. However, the dose required for inhibition of the chloroquine-resistant strain was ~2 times the dose required for the chloroquine-sensitive strain. At these concentrations, no hemolysis of human erythrocytes was observed. The studies conducted on in vivo toxicity of AMPs LR14 suggest that the lethal dose (LD50) is beyond 1,000 mg/kg body weight, suggesting its safe use against microbes and protozoans. Antibodies were also not detected against these peptides, indicating a non-immunogenic nature.
Conclusion
The data indicate that AMPs LR14 are non-toxic, potent anti-plasmodial peptides causing growth inhibition of P. falciparum without causing hemolysis. These results pave the way for the development of bioactive peptides as therapeutics.
doi:10.1007/s40268-014-0043-y
PMCID: PMC4070454  PMID: 24797399
6.  Assessment of Anti-Plasmodial Activity of Non-Hemolytic, Non-Immunogenic, Non-Toxic Antimicrobial Peptides (AMPs LR14) Produced by Lactobacillus plantarum LR/14 
Drugs in R&D  2014;14(2):95-103.
Background and Objectives
Lactobacillus plantarum strains are known to exhibit an antimicrobial property against bacteria and fungi. In the present investigation, AMPs LR14, antimicrobial peptides produced by L. plantarum strain LR/14, were tested against a protozoan system, Plasmodium falciparum and its non-toxic nature was envisaged on a mammalian system.
Methods
Human erythrocytes infected with chloroquine-sensitive and -resistant strains of P. falciparum were treated with purified AMPs LR14. The loss in cell viability was assessed by monitoring the incorporation of [3H]-hypoxanthine in the nucleic acid of the parasite. The hemolytic activity of AMPs LR14 was monitored at different concentrations and the investigations into the in vivo toxicity of AMPs LR14 were carried out on a mammalian system (Wistar rat). The level of toxicity in the tissues was visualized by histopathological studies conducted on the liver and kidney of the test and control rats. A study was also undertaken to see the production of antibodies in an animal (rabbit) after it was immunized with AMPs LR14.
Results
A loss in cell viability was observed in both test strains of P. falciparum. However, the dose required for inhibition of the chloroquine-resistant strain was ~2 times the dose required for the chloroquine-sensitive strain. At these concentrations, no hemolysis of human erythrocytes was observed. The studies conducted on in vivo toxicity of AMPs LR14 suggest that the lethal dose (LD50) is beyond 1,000 mg/kg body weight, suggesting its safe use against microbes and protozoans. Antibodies were also not detected against these peptides, indicating a non-immunogenic nature.
Conclusion
The data indicate that AMPs LR14 are non-toxic, potent anti-plasmodial peptides causing growth inhibition of P. falciparum without causing hemolysis. These results pave the way for the development of bioactive peptides as therapeutics.
doi:10.1007/s40268-014-0043-y
PMCID: PMC4070454  PMID: 24797399
7.  Sinus arrest with intrathecal dexmedetomidine 
Indian Journal of Anaesthesia  2014;58(2):227-228.
doi:10.4103/0019-5049.130851
PMCID: PMC4050954  PMID: 24963202
8.  The Adoption of New Endodontic Technology by Indian Dental Practitioners: A Questionnaire Survey 
Aim: To ascertain the adoption of new endodontic technology in general dental practice in India in 2011.
Methodology: A postal questionnaire survey comprising 26 questions was sent to 700 general dental practitioners. The questions covered professional activity, root canal preparation and instrumentation, choice of irrigants and intracanal medicaments, choice of obturation techniques and other aspects of endodontics. The data were analyzed using descriptive statistics and the Chi-square (χ2) test at 0.05 level of significance.
Results: The overall response rate was 88%. The results showed that rubber dams were used by 27% of dental practitioners in India. The most widely used irrigant was sodium hypochlorite, which was used by 33% of the respondents. Thirty nine percent of the practitioners were still incorporating only hand files during the cleaning and shaping phase of treatment. The technique of choice was both step back and crown down (35%). Calcium hydroxide was found to be the most frequently used (62%) intracanal medicament. Lateral condensation with guttapercha (61%) was the most common method used for obturation. Majority used zinc oxide eugenol as a sealer (55%). The post obturation restoration was done mostly by composite material (46%). Most of the respondents placed crowns after root canal treatment. Digital radiography was reported as being used by 17% of the respondents. There was no difference between males and females with respect to the incorporation of new technologies in dentistry. They had been incorporated significantly more by respondents who held postgraduate qualifications and had professional activities of <5 years.
Conclusion: The results indicated that new endodontic technology and materials are slowly being incorporated in clinical practice of endodontics in India. This survey shows the importance of continuing dental education for practitioners to update their knowledge.
doi:10.7860/JCDR/2013/5817.3628
PMCID: PMC3879893  PMID: 24392420
Survey; Endodontics; General dental practitioner; Root canal treatment; Ni-Ti instruments; Obturation
9.  Foreign body blocking closed circuit suction catheter: An unusual cause of retained tracheal secretions in a mechanically ventilated patient 
Closed circuit suction system (CCSS) has become a standard of care for the tracheal suctioning of mechanically ventilated patients. The advantages of CCSS over the open suction system include decreased environmental, personnel and patient contamination, preservation of lung volumes and oxygenation especially in the severely hypoxemic patients. On the other hand, CCSS has lower efficacy in removal of secretions and it may have certain other disadvantages due to the invisibility of its tip. We report an unusual case of an airway foreign body causing blockage of the CCSS leading to retained secretions and deterioration of patient. Timely changing over to open suction system helped in its detection and improvement of patient.
doi:10.4103/2229-516X.125696
PMCID: PMC3931216  PMID: 24600580
Catheter; closed circuit suction system; foreign body; suction
10.  Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature 
Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.
doi:10.4103/0259-1162.128923
PMCID: PMC4173580
Asystole; bradycardia; cardiac arrest; spinal anesthesia
11.  Non-Surgical Management of Mandibular Molar with Multiple Intra–oral Sinus Tracts: A Case Report 
Multiple intra–oral sinus tracts of dental origin are an uncommon condition. Patients with this condition may undergo surgical extraction, biopsies and antibiotic regimens, but all of them fail with the recurrence of the sinus tract. A proper diagnosis and management are important, to avoid any complications. This case report has described the conventional root canal treatment of a patient who had three distant intra–oral sinuses which had occurred due to an intact tooth with pulp necrosis, who had a history of accidentally biting on a hard food object and having a periapical radiolucency which indicated a chronic periradicular abscess. At follow up examination, the tooth was found to be asymptomatic and radiographically, it showed repair of the lesion.
doi:10.7860/JCDR/2013/5953.3535
PMCID: PMC3843443  PMID: 24298540
Sinus tract; Periapical abscess; Root canal treatment; Mandibular molar
12.  In vitro evaluation of the effect of two finishing and polishing systems on four esthetic restorative materials 
Aim:
To determine the surface roughness of esthetic restorative materials after finishing and polishing.
Materials and Methods:
All 60 specimens were divided into four groups. Group I: Nanocomposite, Z 350 XT (3M ESPE, USA); Group II: Microhybrid composite, Z 250 (3M ESPE, USA); Group III: Compomer, Dyract XP (LD Caulk/Dentsply, USA); and Group IV: Resin modified glass ionomer cement (GIC), Fuji II LC (GC, Japan). Each group was again divided into three subgroups. Subgroup A: Sof-Lex (3M ESPE); Subgroup B: Super-Snap Rainbow finishing and polishing kit (Shofu INC, Japan); and Subgroup C: Control Mylar strip. Surface roughness was determined by Perthen Perthometer S6P profilometer.
Result:
Filtek Z350 XT showed minimum surface roughness followed by Filtek Z250, Dyract XT and Fuji II LC. Super-Snap exhibited less surface roughness than Sof-Lex polishing systems.
Statistical Analysis:
One-way analysis of variance (ANOVA) followed by multiple post hoc comparisons using least square difference method and unpaired t-test was used.
Conclusion:
Filtek Z350 XT with Mylar strip exhibited least surface roughness.
doi:10.4103/0972-0707.120946
PMCID: PMC3842729  PMID: 24347895
Composite; finishing; glass ionomer cement; polishing; surface roughness
13.  Nucleobindin 1 Caps Human Islet Amyloid Polypeptide Protofibrils to Prevent Amyloid Fibril Formation 
Journal of Molecular Biology  2012;421(2-3):378-389.
Many human diseases are associated with amyloid fibril deposition, including type 2 diabetes mellitus (DM) where human Islet Amyloid Polypeptide (hIAPP) forms fibrils in the pancreas. We report here that engineered, soluble forms of the human Ca2+-binding protein Nucleobindin 1 (NUCB1), prevent hIAPP fibril formation and disaggregate pre-existing hIAPP fibrils. Scanning transmission electron microscopy (STEM) and atomic force microscopy (AFM) indicate that NUCB1 binds to and stabilizes heterogeneous prefibrillar hIAPP species. The NUCB1-stabilized prefibrillar species were isolated by size-exclusion chromatography and analyzed by STEM, dynamic light scattering (DLS) and multi-angle light scattering (MALS). The stabilized prefibrillar species show a size-range of 2–6 million Da and have other similarities to hIAPP protofibrils, but they do not progress to become mature fibrils. The effects of NUCB1 are absent in the presence of Ca2+. We postulate that the engineered forms of NUCB1 prevent hIAPP fibril formation by a mechanism where protofibril-like species are “capped” to prevent further fibril assembly and maturation. This mode of action appears to be different from other protein based inhibitors, suggesting that NUCB1 may offer a new approach to inhibiting amyloid formation and disaggregating amyloid fibrils.
doi:10.1016/j.jmb.2012.04.017
PMCID: PMC3398247  PMID: 22542527
amylin; islet amyloid polypeptide; Type-2 diabetes mellitus; amyloid; Nucleobindin 1; NUCB1; protofibril; fibril
15.  Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study 
BMC Pediatrics  2012;12:52.
Background
Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak.
Methods
A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14). Classrooms were systematically assigned to an intervention or control group by grade (cluster design). Hand hygiene facilities (sanitizer and soap) were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs.
Results
Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days). Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P = 0.002, P < 0.001, respectively). This difference peaked during the influenza season (when intervention began) and declined in the following months. Teachers (n = 23) agreed that hand hygiene is not performed properly among students and reported time constraints as a barrier to frequent hand washing.
Conclusions
Adding hand hygiene instruction to existing hand hygiene practices improved attendance at public elementary schools during the flu season. Standardized and brief repetitive instruction in hand hygiene holds potential to significantly reduce absenteeism.
doi:10.1186/1471-2431-12-52
PMCID: PMC3470997  PMID: 22587432
Hand hygiene; Education; Elementary school; Illness
16.  Comparative evaluation of sealing properties of different obturation systems placed over apically fractured rotary NiTi files 
Aim:
To evaluate sealing properties of different obturation systems placed over apically fractured rotary NiTi files.
Materials and Methods:
Forty freshly extracted human mandibular premolars were prepared by using Protaper (Dentsply-Maillefer, Ballaigues, Switzerland) or the RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) systems (n=20 for each), after which half of the specimens were subjected to instrument separation at the apical level. Roots with and without apically separated instruments (n=5) were filled with the two obturation systems i.e. Thermafil and lateral compaction technique. The modified glucose penetration setup was used to assess the microleakage. The leakage data was statistically analyzed.
Results:
The amount of leakage was significantly lower in specimens containing fractured instruments, regardless of the obturation method used. Roots obturated with Thermafil displayed significantly less leakage than cold lateral compaction technique, both, in the presence and absence of separated instruments. There was no significant difference among specimens prepared with ProTaper and RaCe when Thermafil obturation was done. But with cold lateral compaction technique, RaCe system showed less leakage as compared to ProTaper system.
Conclusion:
The type of obturation may play more important role than the type of instrument or retained/non-retained instrument factor.
doi:10.4103/0972-0707.92604
PMCID: PMC3284011  PMID: 22368333
File separation; fracture; microleakage; NiTi instrument; obturation
17.  Molecular Mining of Alleles in Water Buffalo Bubalus bubalis and Characterization of the TSPY1 and COL6A1 Genes 
PLoS ONE  2011;6(9):e24958.
Background
Minisatellites are an integral part of eukaryotic genomes and show variation in the complexity of their organization. Besides their presence in non-coding regions, a small fraction of them are part of the transcriptome, possibly participating in gene regulation, expression and silencing. We studied the minisatellite (TGG)n tagged transcriptome in the water buffalo Bubalus bubalis across various tissues and the spermatozoa, and characterized the genes TSPY1 and COL6A1 discovered in the process.
Results
Minisatellite associated sequence amplification (MASA) conducted using cDNA and oligonucleotide primer (TGG)5 uncovered 38 different mRNA transcripts from somatic tissues and gonads and 15 from spermatozoa. These mRNA transcripts corresponded to several known and novel genes. The majority of the transcripts showed the highest level of expression either in the testes or spermatozoa with exception of a few showing higher expression levels in the lungs and liver. Transcript SR1, which is expressed in all the somatic tissues and gonads, was found to be similar to the Bos taurus collagen type VI alpha 1 gene (COL6A1). Similarly, SR29, a testis-specific transcript, was found to be similar to the Bos taurus testis-specific Y-encoded protein-1 representing cancer/testis antigen 78 (CT78). Subsequently, full length coding sequences (cds) of these two transcripts were obtained. Quantitative PCR (q-PCR) revealed 182-202 copies of theTSPY1 gene in water buffalo, which localized to the Y chromosome.
Conclusions
The MASA approach enabled us to identify several genes, including two of clinical significance, without screening an entire cDNA library. Genes identified with TGG repeats are not part of a specific family of proteins and instead are distributed randomly throughout the genome. Genes showing elevated expression in the testes and spermatozoa may prove to be potential candidates for in-depth characterization. Furthermore, their possible involvement in fertility or lack thereof would augment animal biotechnology.
doi:10.1371/journal.pone.0024958
PMCID: PMC3174239  PMID: 21949806
19.  A comparison of Epidural Butorphanol and Tramadol for Postoperative Analgesia Using CSEA Technique 
Background:
Post operative analgesia in patients undergoing lower limb surgery is very essential for immediate postoperative pain relief which can be provided by oral or parentral medication, epidural analgesia, local blocks etc.The study was designed to evaluate the efficacy of epidural butorphanol and tramadol for postoperative pain relief.
Patients & Methods:
This was randomized, prospective, double blind study was conducted on 60 patients, ASA grade I&II, age 18-60 undergoing lower limb surgeries after approval from hospital ethics committee. Group allocation - Group I I (n=30) received 2 mg butorphanol as bolus epidurally, 1 mg for top up dose. Group II (n=30) received 100mg tramadol as bolus, 50 mg for top up. All the drugs were diluted to 10 ml normal saline & the observer was blinded to the drugs given. Postoperatively VAS, sedation score, vitals & side effects were observed. Top ups were given on achieving VAS>4. Diclofenac 75mg was given as rescue analgesia.
Results:
Duration of analgesia was 5.35±0.29 hr and 6.25±1.58 hrs in Butorphanol and Tramadol groups respectively and the difference was found to be statistically significant. Pain scores were also significantly lower statistically in Group I as compared to Group II. Sedation scores were significantly higher in butorphanol group, whereas nausea vomiting was seen in tramadol group only (4 patients).No other side effects were observed.
Conclusions:
Both butorphanol and tramadol were effective for relieving postoperative pain, however quality of analgesia & patient satisfaction was more with butorphanol.
PMCID: PMC3141111  PMID: 21804703
Epidural; Tramadol; Butorphanol; Post-operative Pain
22.  Prematurity, Chorioamnionitis and the Development of Recurrent Wheezing: a Prospective Birth Cohort Study 
Background
Prematurity (<37 weeks) has been inconsistently associated with asthma and wheezing. Chorioamnionitis may promote both prematurity and inflammatory pathways in infants’ airways.
Objective
To investigate the relationship of prematurity and chorioamnionitis with the development of early childhood recurrent wheezing.
Methods
The Boston Birth Cohort (n=1096) were followed prospectively from birth to a mean age of 2.2±2 years. Perinatal and postnatal clinical data and placental pathology were collected. The primary outcome was recurrent wheezing (≥2 physician documented episodes). Secondary outcomes included physician diagnosed asthma, food allergy and eczema. Preterm children were grouped by gestational age into moderately (33-36.9 weeks) and very preterm (<33 weeks) with and without chorioamnionitis, and compared to term children without chorioamnionitis (reference group). Chorioamnionitis was diagnosed either by intrapartum fever or by placental histology findings. Logistic regression models were preformed to investigate the independent and joint associations of degree of prematurity and chorioamnionitis.
Results
Prematurity was associated with recurrent wheezing (OR:1.7, 95%CI:1.2-2.6). However, when subjects were grouped by degree of prematurity with or without chorioamnionitis, the highest risk of wheezing (OR:4.0, 95%CI:2.0-8.0) and physician diagnosed asthma (OR:4.4 95%CI:2.2-8.7) was present in the very preterm children with chorioamnionitis. The effect on both wheezing (OR:5.4, 95%CI:2.4-12.0) and asthma (OR:5.2, 95%CI:2.3-11.9) was greater in African Americans. Neither prematurity nor chorioamnionitis were associated with food allergy or eczema.
Conclusions
We found a strong joint effect of prematurity and chorioamnionitis on early childhood wheezing. This effect was stronger in African Americans.
Clinical Implications
Chorioamnionitis may increase the risk of recurrent wheezing in very low birth weight infants.
doi:10.1016/j.jaci.2008.01.030
PMCID: PMC2993062  PMID: 18313129
Chorioamnionitis; prematurity; recurrent wheezing
23.  Strategies for Extracting Structural Information from 2D IR Spectroscopy of Amyloid: Application to Islet Amyloid Polypeptide 
The journal of physical chemistry. B  2009;113(47):15679-15691.
The 37-residue human islet amyloid polypeptide (hIAPP or amylin) self-assembles into fibers, the assembly of which has been associated with the disease mechanism of type II diabetes. Infrared spectroscopy in conjunction with isotope labeling is proving to be a powerful tool for studying the aggregation process of hIAPP and other amyloid forming proteins with residue specific structure and kinetic information, but the relationship between the spectroscopic observables and the structure is not fully established. We report a detailed analysis of the linear and 2D IR spectra of hIAPP fibers isotope labeled at seven different residue positions. The features of the 2D IR spectra, including the frequencies, linewidths, intensities, and polarization dependence of the diagonal and cross-peaks, rely heavily on the position of the isotope labeled residue. In order to understand how these measured parameters depend on fiber secondary and tertiary structure, we have simulated 1D and 2D IR spectra utilizing idealized structural models in addition to a recently published solid-state NMR based model of the amyloid fibril. The analysis provides a more rigorous foundation for interpreting the infrared spectra of amyloids. In addition, we demonstrate that 2D IR spectra can be employed to distinguish between residues in β-sheets versus those in turn regions, and that transitional residues between secondary structures can be identified by the suppression of their cross-peaks in 2D IR spectra. This latter approach is not limited to amyloid fibrils and will be generally useful in identifying regions of secondary structure in proteins using 2D IR spectroscopy and isotope labeling.
doi:10.1021/jp9072203
PMCID: PMC2901919  PMID: 19883093
24.  The state of pediatric asthma in Chicago's Humboldt Park: a community-based study in two local elementary schools 
BMC Pediatrics  2010;10:45.
Background
Pediatric asthma is a serious public health problem in Chicago and has been designated a high priority concern by residents of Chicago's Humboldt Park, a diverse community area with a large number of Puerto Rican, African American, and Mexican American families.
Methods
In May 2009, following the principles of community-based participatory research, a cross-sectional asthma screening survey was administered to adult caregivers of children attending two Humboldt Park elementary schools. Data were analyzed to determine the prevalence of diagnosed and probable asthma as well as the degree of asthma control among affected children; associations between asthma outcomes and mutable triggers were evaluated.
Results
Surveys from 494 children were evaluated. Physician-diagnosed asthma was reported for 24.9% of children and probable asthma identified in an additional 16.2% of children. Asthma was poorly or moderately controlled in 60.0% of diagnosed children. Smoking occurred inside 25.0% of households and 75.0% of caregivers reported idling of vehicles in their community. Report of general stress among caregivers, stress due to community crime, and/or an inability to cope with everyday life were significantly and positively associated with poor asthma morbidity and control among affected children.
Conclusions
Despite high prevalence rates and poor asthma morbidity and control in Humboldt Park, the association of these measures with mutable variables is promising. A community-based asthma intervention to address the issues identified in this study is needed to affect positive change.
doi:10.1186/1471-2431-10-45
PMCID: PMC2912879  PMID: 20576150
25.  The Protective Effect of Community Factors on Childhood Asthma 
Background
Asthma burden in the US is not evenly distributed. Although asthma prevalence varies widely across urban neighborhoods, little attention has been paid to the community as a key contributor.
Objective
To determine the effect of positive socio-environmental community factors on childhood asthma prevalence in Chicago.
Methods
From 2003–2005, an asthma screening survey was conducted among children attending Chicago Public/Catholic K-8 schools. One hundred five schools participated, yielding a stratified representation of 4 race-income groups. Positive community factors, such as social capital, economic potential and community amenities, were assessed using the Metro Chicago Information Center’s Community Vitality Index.
Results
Of the surveys returned, 45,177 (92%) were geocoded into 287 neighborhoods. Neighborhoods were divided into quartile groups by asthma prevalence (mean: 8%, 12%, 17%, 25%). Community vitality (54% vs. 44%, p<0.0001) and economic potential (64% vs. 38%, p<0.0001) were significantly higher in neighborhoods with low asthma prevalence. Neighborhood interaction (36% vs. 73%, p<0.0001) and stability (40% vs. 53%, p<0.0001) were significantly higher in neighborhoods with high asthma prevalence.
Overall, positive factors explained 21% of asthma variation. Childhood asthma increased as the Black population increased in a community (p<0.0001). Accordingly, race/ethnicity was controlled. In Black neighborhoods, these factors remained significantly higher in neighborhoods with low asthma prevalence. When considered alongside socio-demographic/individual characteristics, overall community vitality as well as social capital continued to contribute significantly to asthma variation.
Conclusion
Asthma prevalence in Chicago is strongly associated with socio-environmental factors thought to enrich a community. A deeper understanding of this impact may lend insight into interventions to reduce childhood asthma.
doi:10.1016/j.jaci.2009.03.039
PMCID: PMC2754178  PMID: 19450873
asthma; prevalence; community; neighborhood; childhood; environment; social capital; disparity

Results 1-25 (29)