Postural orthostatic tachycardia syndrome (POTS) is an autonomic disturbance which has become better understood in recent years. It is now thought to encompass a group of disorders that have similar clinical features, such as orthostatic intolerance, but individual distinguishing parameters--for example, blood pressure and pulse rate. The clinical picture, diagnosis, and management of POTS are discussed.
Objective:Methicillin-resistant Staphylococcus aureus (MRSA) ranks top among the nosocomial pathogens. Nasal formulation of mupirocin is found to eradicate MRSA from colonized individuals, but the emergence of resistant strains is a matter of concern.Methods:Nasal swabs were collected from 200 health care workers (HCWs) who were screened for MRSA. Kirby–Bauer disc diffusion method was used to perform antibiotic susceptibility test. MRSA detection was done using a cefoxitin 30 µg disc and interpreted according to the Clinical and Laboratory Standards Institute guidelines. Determination of mupirocin resistance was performed using Epsilometer test (E-test).Findings:About 14% of HCWs showed nasal carriage of MRSA. Nursing orderlies were the predominant carriers. E-test showed four mupirocin resistant isolates. The antibiogram of the MRSA isolates revealed the higher resistance to antibiotics as compared to methicillin-sensitive Staphylococcus aureus. All the MRSA isolates were sensitive to linezolid.Conclusion:HCWs in our hospital showed high nasal carriage rate of MRSA, particularly the nursing orderlies which is statistically significant. It is advisable to detect mupirocin resistance among the isolates obtained from the HCWs so that in case of resistance, alternative treatment should be sought.
Obstructive Sleep Apnea Syndrome (OSAS) has been recognised as a major cause of morbidity and mortality in developing countries like India. There is still a paucity of Indian studies regarding the prevalence of OSAS. The current single centre prospective cross-sectional study was undertaken to know prevalence estimates for key symptoms and features that can indicate the presence of OSAS in an Indian population. A survey was conducted on subjects with age groups ≥25 years at King George's Medical University, Lucknow, Uttar Pradesh, India from August 2009 to July 2011. Data was recorded during the interview on the basis of Berlin Questionnaire (BQ). Risk factors for OSAS were also evaluated. Risk group categorization for OSAS was done with the help of a questionnaire and overnight polysomnography was performed in each group to measure apnea and hypopnea index (AHI). Out of 1816 subjects, 1512 (response rate 83.3%) finally participated in the survey with mean age 42.6±11.2 years, males 67.9% and females 32.1%. Of them 6.2% were found to be at high-risk OSAS; 12.2% were obese (Body Mass Index ≥30 kg/m 2 ) and 33.5% of the obese population were at high-risk OSAS. Among high-risk patients with OSAS, 62.4% had hypertension. Statistically significant and independent risk factors found for OSAS were obesity, large neck size, alcoholism and use of sedatives/tranquillizers. Highrisk category predicted an AHI ≥5 with a sensitivity of 86.3% (95% CI 73.1-93.8), specificity of 93.1% (95% CI 89.1-95.7), positive and negative predictive values of 70.9% (95% CI 57.9-81.4) and 97.2% (95% CI 94.1-98.8) respectively. It can be concluded that BQ questionnaire can still be used as a pre-assessment tool for predicting persons at risk for OSAS in clinical practice. Further studies on estimation of prevalence of OSAS by applying BQ are warranted in near future from other regions of India.
The present investigation was designed to determine whether supplementation of different level of vitamin E for 12 months to arsenic exposed goats (50 ppm as sodium arsenite) affords protection against the blood hemato-biochemical parameters caused by the metalloid. A total of 24 crossbred (Alpine×Beetal) lactating goats were assigned randomly into 4 equal groups (control, T1, T2 and T3) of 6 in each, on the basis of average body weight (36.10±0.11 kg) and milk yield (1.61±0.04 kg/d). The animals in T1, T2 and T3 were given 50 ppm arsenic, while in T2 and T3, additionally; vitamin E at the rate of 100 IU and 150 IU/kg dry matter (DM) respectively was additionally supplemented for the period of 12 months. Hemoglobin (Hb), total leukocyte (TLC) and blood lymphocyte % were decreased (p<0.05) in arsenic fed groups and vitamin E supplementation in the experimental group showed a protective potential. Significant increases (p<0.05) in aspertate transaminase (AST) and alanine transaminase (ALT) activities among arsenic supplemented groups were recorded, however vitamin E supplementation at higher doses showed a protective effect (p<0.05) against AST but in the case of ALT no ameliorating effect was found in either of the doses. Plasma total protein was decreased (p>0.05) but creatinine level was periodically increased in all As supplemented groups and vitamin E supplementation did not produce any protective effect. It can be concluded that arsenic exposure resulted in varying degree of changes in hemato-biochemical parameters and activities of antioxidant enzymes in goats but concomitant treatment with Vitamin E is partially helpful in reducing the burden of arsenic induced effect.
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