Termansenhorowitz0441

Determination of ethanol levels in aircraft accident victims constitutes an important part of investigation. However, postmortem production of alcohol by microbial fermentation is known to interfere with the results. Distinguishing postmortem produced alcohols from antemortem ingested is very important in interpretation of results. Ratio of 5-hydroxytryptophol (5-HTOL) and 5-hydroxyindole-3-acetic acid (5-HIAA) metabolites of serotonin, has known to provide a convenient, rapid, and reliable solution as antemortem ethanol leads to an elevation in the 5-HTOL/5-HIAA ratio after ingestion of alcohol (5-HTOL/5-HIAA = >15 pm/nm).

Triple quadruple (QQQ) liquid chromatography-mass spectrometry (LC-MS) with electrospray ionization positive mode has been used for development of single tube multiple reaction monitoring (MRM) method for simultaneous quantification of 5-HTOL and 5-HIAA in urine. Deglucuronidation of 5-HTOL glucuronide in urine by beta-glucuronidase followed by simple sample preparation has been adopted. Examination of the ratio on urine samples from 15 individuals after consumption of 60 and 90ml of whiskey has been carried out at different time interval.

A single method for analysis of both the analytes was developed with sensitivity of 50ppb and recovery of around 80-90%. Examination of the ratio on urine samples revealed that the ratio was >15 in all groups consuming 60ml and 90-ml whiskey up to 12h after alcohol ingestion.

This is a unique highly sensitive single LC-MS method, which has been developed for simultaneous estimation of both 5-HTOL and 5-HIAA on same instrument for proving antemortem alcohol ingestion with high degree of sensitivity and specificity.

This is a unique highly sensitive single LC-MS method, which has been developed for simultaneous estimation of both 5-HTOL and 5-HIAA on same instrument for proving antemortem alcohol ingestion with high degree of sensitivity and specificity.

Airway hyperresponsiveness (AHR) is a characteristic feature of bronchial asthma and is diagnosed using direct and indirect bronchoprovocation tests. The diagnosis of AHR is a challenge in symptomatic patients with a normal baseline prebronchodilator spirometry and postbronchodilator spirometry. Exercise-induced asthma or exercise-induced bronchoconstriction (EIB) is a distinct form of AHR. There is no single test that is sufficient to exclude AHR in symptomatic military personnel with normal spirometry. This study was conducted to compare the diagnostic value of indirect bronchoprovocation test using inhaled adenosine monophosphate (AMP) and exercise challenge test (ECT) in the diagnosis of EIB.

A crossover study was conducted with consecutive sampling of patients presenting with symptoms suggestive of asthma and with normal spirometry results who were subjected to both ECT and bronchoprovocation test using inhaled AMP on separate days.

Forty participants were recruited (the mean age 25 yrs, 100% male). The commonest presentation was breathlessness on exercise (55%). With exercise alone, 40% tested positive for AHR, while with AMP alone, the positivity increased to 53%, and the difference was statistically significant (p= 0.03). Exercise alone failed to detect 8 cases that tested positive for AHR by inhaled AMP challenge.

Indirect bronchoprovocation test using inhaled AMP may be used to diagnose AHR in conditions in which exercise challenge testing is not available or the patient is unable to complete ECT.

Indirect bronchoprovocation test using inhaled AMP may be used to diagnose AHR in conditions in which exercise challenge testing is not available or the patient is unable to complete ECT.

Intravascular devices have significant potential for producing iatrogenic diseases resulting in catheter-related blood stream infections (CRBSIs). A study was undertaken to find the prevalence of CRBSI amongpatients in acute wardsand to analyze the associated risk factors, causative pathogens with their antibiotic susceptibility (ABST) patterns.

Randomly ten days per month were chosen, for a period of two years. All the acute wards patientswho were on indwelling blood catheters were identified. Those fulfilling the CRBSI criteriawere further worked up for confirmation of diagnosis by differential time to positivity. The catheter tip was cultured by Maki's semiquantitative method. ABST of the isolates obtained was performed by Kirby-Bauer disk diffusion method.

The prevalence of CRBSI was found to be 39.25% with the most common organism isolate being

(23.81%). The immunocompromised status of the patients and catheterisation time were significant risk factors. Methicillin resistance was found to be 33.33% in coagulase-negative staphylococci. The resistance to vancomycin amongthe

isolates was found to be 33.33%. Amongthe gram negatives, resistance to aminoglycosides, fluoroquinolones and third-generation cephalosporins was high.

The study highlights the importance of regular surveillance programs, an efficient infection control program, strict adherence to antiseptic measuresand use of a rational antibiotic policy for the early diagnosis and better management of CRBSI.

The study highlights the importance of regular surveillance programs, an efficient infection control program, strict adherence to antiseptic measures and use of a rational antibiotic policy for the early diagnosis and better management of CRBSI.

The tobacco epidemic is one of the biggest public health threats the world has ever faced. World Health Organization has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about 7 million people across the world each year. The objective of the study was not only to find the effect of group intervention on tobacco cessation but also to describe certain epidemiological factors associated with tobacco cessation and make suitable recommendations to tackle this epidemic.

A randomized controlled trial was carried out among male employees who were tobacco users in health-care setting in Western Maharashtra. In the study, 60 subjects each in intervention and control arm were taken. Pretested validated questionnaires were used for the study. The intervention comprised of two sessions delivered 5 weeks apart. Control arm received self-help material (Booklet) immediately after baseline data collection. The outcomes were measured using structured interview schedule. The data were analyzed using SPSS, version 20.

Overall, 13.3% of the study subjects had quit tobacco use post intervention. In the intervention group 21.7% of the participants had quit tobacco since past one month and 5% in the control group (relative risk (RR) = 4.33). Low to moderate nicotine dependence (p = 0.023, RR = 6.46) and stage of contemplation (p = 0.018) were found to be important predictors of abstinence.

Community-based group intervention for tobacco cessation is the way forward to tackle the tobacco epidemic.

Community-based group intervention for tobacco cessation is the way forward to tackle the tobacco epidemic.

The purpose of the present study was to determine the airway changes in skeletal class II division 1 malocclusion patients with mandibular retrognathism, treated with Twin-Block (TB) appliance.

Airway assessment was carried for twelve patients (mean age 11.7±1.1 years) who underwent myofunctional therapy using TB appliance for correction of skeletal class II division 1 malocclusion with mandibular retrognathism. Acoustic pharyngometry (AP) was used to assess and quantify the comparative changes in the upper airway, pretreatment and posttreatment.

Data acquired was subjected to appropriate statistical analysis. The paired '

' test was used to compare pre-treatment (T0) and after the positive pterygoid response (T1). TB appliance increased mean minimum airway area by 0.28±0.25cm

and mean airway by 0.47±0.44cm

with 95% CI. Posttreatment minimum airway and mean area changes were found to be statistically significant (

-value<0.01).

TB appliance therapy has a positive effect on upper airway and is beneficial for the treatment of sleep-related disorders associated with Class II division 1 malocclusion for achieving positive functional changes, esthetics, and healthier quality of life.

TB appliance therapy has a positive effect on upper airway and is beneficial for the treatment of sleep-related disorders associated with Class II division 1 malocclusion for achieving positive functional changes, esthetics, and healthier quality of life.

Antibiotic resistance in bacteria is a cause for concern, especially in hematopoietic stem cell transplant (HSCT) patients. Endogenous bowel microflora in HSCT patients get replaced by hospital multidrug resistant flora and pose risk of serious bacterial infection during the pre-engraftment stage. For decades, many methods to reduce the translocation of gut microbiota in HSCT patients have been attempted. Despite the logic, of using prophylactic antibiotics, there is no consensus on standard regimen. Personalized antibiotic prophylaxis-based on gut microbiota and clinical profile has been suggested by researchers. In this study, gut microbiota in HSCT recipients has been studied with antimicrobial susceptibility testing and detection of various antibiotic resistance phenotypes.

Seventy-six HSCT patients (2016-2018) were included. Stool surveillance cultures and antibiotic susceptibility testing were performed. Bacterial isolates were classified into various antibiotic resistance phenotypes.

This study revealed that 73.75% HSCT recipients had gut colonized with antibiotic resistance microbiota which included extended-spectrum β-lactamase-, multidrug- and extensively drug-resistant phenotypes.

This study reiteratesthe importance of individual profiling of gut microbiota in HSCT patients.

This study reiterates the importance of individual profiling of gut microbiota in HSCT patients.

We present our experience of ABO-incompatible renal transplant using immunoadsorption (IA) columns. We have compared efficacy of two commercially available columns.

This single-center prospective study was conducted at Army Hospital Research and Referral, Delhi. All consecutive ABO-incompatible renal transplants from January 2014 to February 2018 were analyzed. Of 30 patients who underwent transplantations, 28 underwent antibody depletion with immunoadsorption columns. Of them, 14 cases were in the "Glycosorb group," while 14 in the "Adsopak group."

The donors in the Adsopak group were older than those in the Glycosorb group (p<0.05). Both groups had spousal donors in majority. The cutoff for the antibody titer was 18. The median titer in the Adsopak group was 128 (range, 14 to 12048), while that in the Glycosorb group was 24 (range, 18 to 1128). All patients in the Glycosorb group had baseline titers ≤1128, while 13 patients in the Adsopak group had baseline titers ≤1512. Nil titer was achievable wi the use of immunoadsorption columns could effectively deplete antibody titers. Glycosorb columns were more efficient than Adsopak columns. Graft survival was better with Glycosorb. Posttransplant infections were a major cause of mortality.Spondylolysis is increasingly associated with specific sports, timely and effective management of which underpins successful return to sports. Hence, the main purpose of this systematic review of reviews [RoR] is to summarize data from published reviews exploring the return to play in athletes with spondylolysis managed conservatively or surgically, thereby providing for recommendations for future practice and research. A systematic review of review of articles published in English and since 2015 was conducted online using PubMed and Google Scholar, as per Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines. Predefined eligibility criteria were applied, and the data thus compiled were analyzed. AMI-1 nmr Study quality was assessed using the AMSTAR-2 checklist. A total of 7 systematic reviews and meta-analysis consisting of 51 primary studies were included in the review. The result of this RoR highlights the knowledge gap and limitations in RTP research post spondylolysis with existing heterogeneity in methods and reporting amid other factors within primary studies.