Phytochemical Screening, Antioxidant and Antifungal Activities of Aconitum chasmanthum Stapf ex Holmes Wild Rhizome Extracts

Aconitum chasmanthum Stapf ex Holmes, an essential and critically endangered medicinal plant from Kashmir Himalayas, was studied for its antioxidant and antifungal properties. The shade-dried powdered rhizome was extracted sequentially with hexane, ethyl acetate, and methanol. These subsequent fractions were evaluated for total phenolic content (TPC); total flavonoid content (TFC); antioxidant assays, such as 1,1-diphenyl 1-2-picryl-hydrazyl (DPPH); ferric-reducing antioxidant power (FRAP); superoxide radical scavenging (SOR); hydroxyl radical scavenging (OH) and antifungal activity using the poisoned food technique. Highest TPC (5.26 ± 0.01 mg/g) and TFC (2.92 ± 0.04 mg/g) were reported from methanolic extracts. The highest values of radical scavenging activities were also observed in methanolic extracts with IC₅₀ values of 163.71 ± 2.69 μg/mL in DPPH, 173.69 ± 4.91 μg/mL in SOR and 159.64 ± 2.43 μg/mL in OH. The chemical profile of ethyl acetate extract was tested using HR-LCMS. Methanolic extracts also showed a promising inhibition against Aspergillus niger (66.18 ± 1.03), Aspergillus flavus (78.91 ± 1.19) and Penicillium notatum (83.14 ± 0.97) at a 15% culture filtrate concentration with minimum inhibitory concentration (MIC) values of 230 μg/mL, 200 μg/mL and 190 μg/mL, respectively. Overall, the methanolic fractions showed significant biological potential, and its pure isolates might be used to construct a potential new medicinal source.

Workplace mistreatment and mental health in female surgeons in Pakistan

Background

Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower–middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being.

Methods

A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent to surgical programmes in Pakistan.

Results

A total of 146 women surgeons responded to the survey; 67.1 per cent were trainees and the rest attending surgeons. Overall, 57.5 per cent of surgeons reported experiencing harassment, most common being verbal (64.0 per cent) and mental (45.9 per cent), but this mostly went unreported (91.5 per cent). On multivariable analysis adjusted for age and specialty, workplace harassment (odds ratio 2.02 (95 per cent c.i. 1.09 to 4.45)) and bullying (odds ratio 5.14 (95 per cent c.i. 2.00–13.17)) were significantly associated with severe self-perceived burnout, while having a support system was protective against feelings of depression (odds ratio 0.35 (95 per cent c.i. 0.16 to 0.74)). The overwhelming majority (91.3 per cent) believed that more institutional support groups were needed to help surgeons with stress reduction (78.8 per cent), receiving mentorship (74.7 per cent) and work–life balance (67.8 per cent).

Conclusion

Workplace mistreatment, in particular harassment and bullying, has a damaging impact on the mental well-being of female surgeons, particularly trainees. The absence of support groups in Pakistan should be urgently addressed so that surgeons, especially trainees, may cope better with potentially harmful workplace stressors.

P89 Role of inflammation as a risk factor for atrial fibrillation in rheumatic mitral stenosis and its correlation with atrial late gadolinium enhancement (LGE) on cardiac MRI

Funding Acknowledgements

ICMR

Aims

Association of atrial fibrillation (AF) is a common cause of morbidity and mortality in patients with rheumatic heart disease (RHD). Association of Atrial Fibrillation with inflammation is well delineated in nonvalvular AF as compared to Rheumatic AF. This study evaluated the presence of atrial inflammation, in patients with AF and rheumatic mitral stenosis (MS), using cardiac MRI and its correlation with inflammatory markers.

Methods and Results

Twenty RHD patients with predominant mitral stenosis were recruited for the study. Ten patients had persistent AF, three had paroxysmal AF and seven were in sinus rhythm. Patients with AF had lower mitral valve areas. Cardiac MRI showed evidence of late gadolinium enhancement (LGE) in the atrial wall in 61.54% (8/13) of patients with AF as compared with only 20% (1/5; p < 0.05) of patients in sinus rhythm. Mean levels of IL-6 were also significantly higher in patients with AF (10.62 ± 5.92 pg/mL versus 4.37 ± 2.68 pg/mL; P= 0.017). IL6 with a cutoff of ≥ 6.5 pg/mL was associated with a sensitivity of 76.92 % and specificity of 71.43 % for prediction of AF. There was also significant association between high IL-6 levels and LGE on MRI (13.13 ± 5.75 pg/mL vs 5.29 ± 3.23pg/mL; P < 0.05)

Conclusion

Patients with MS who developed AF show evidence of atrial inflammatory sequelae in the form of fibrosis as suggested by LGE on cardiac MRI. Systemic inflammation in the form of elevated IL-6 levels correlated significantly with atrial fibrosis and AF.

Table 1: MS patients with or without AF Clinical Features Rhythm P-Value NSR (n = 7) AF (n = 13) Mean Valve Area (cm2) 1.28 ± 0.35 0.83 ± 0.26 < 0.01 Mean Diastolic Gradient (mmHg) 6.29 ± 2.2 11.92 ± 5.65 <0.01 Wilkin Score 7 ± 0.816 8.46 ± 1.66 0.04 LVEF % (non indexed) 59.57 ± 1.13 58.77 ± 2.89 0.49 LA Volume with MRI (ml) 127.50 ± 51.32 284.33 ± 133.12 <0.01 Inflammatory Markers hs-CRP (mg/L) 5.59 ± 3.89 3.94 ± 3.47 0.34 IL6 (pg/mL) 4.37 ± 2.68 10.62 ± 5.92 0.017 sCD-40L (ng/mL) 3.72 ± 3.73 4.77 ± 2.80 0.48 Atrial LGE 0 (0%) 8 (61.5%) 0.04

Abstract P89 Figure. Image 1: Cardiac MRI showing LGE

Endoscopic Management of Vesicoureteral Reflux and Long-term Follow-up

OBJECTIVE

To report our experience with endoscopic management of vesicoureteral reflux (VUR) by injection of a tissue bulking substance - Dextranomer/ hyaluronic acid co-polymer at vesicoureteric junction.

DESIGN

Retrospective analyses of case records.

SETTING

Pediatric Surgery department in a tertiary care government Institute.

PARTICIPANTS

500 children (767 renal units) consecutively referred to the out-patient department with vesicoureteral reflux noted on micturating cysto-urethrogram (MCU) over a period of 13 years (2004-2016).

INTERVENTION

Preoperative VUR grading and renal scars on radionuclide scans were documented. Dextranomer hyaluronic acid copolymer was injected through a cystoscope at the vesicoureteral junction as a day care procedure under short anesthesia. Patients were followed (average duration 27.3 mo) with clinical assessment, periodic urine cultures and renal scans.

MAIN OUTCOME MEASURE

Cessation of VUR and symptomatic relief / clinical success postoperatively at 3 months.

RESULTS

Complete symptomatic relief was obtained in 482 (96.4%) patients. In 681 units where MCU was available, 614 (90%) units showed resolution of VUR.

CONCLUSIONS

Endoscopic injection of tissue bulking substances at vesicoureteric junction to stop VUR seems to be an effective intervention.

Antibacterial efficacy of a novel plasma reactor without an applied gas flow against methicillin resistant Staphylococcus aureus on diverse surfaces

The use of nonthermal plasma in the clinic has gained recent interest, as the need for alternative or supplementary strategies are necessary for preventing multi-drug resistant infections. The purpose of this study was to evaluate the antibacterial efficacy of a novel plasma reactor based on a high current version of sliding discharge and operated by nanosecond voltage pulses without an applied gas flow. This modification is advantageous for both portability and convenience. Bacterial inactivation was determined within a chamber by direct quantification of colony Jing units. Plasma exposure significantly inhibited the growth of Escherichia coli and Staphylococcus epidermidis following a 1-min application (p<0.001). S. epidermidis was more susceptible to the plasma after a 5-min exposure compared to E. coli. Temperature and pH measurements taken immediately before and after plasma exposure determined neither heat nor pH changes play a role in bacterial inactivation. Because of the notable effect on S. epidermidis, the effect of plasma exposure on several isolates and strains of the related opportunistic pathogen Staphylococcus aureus was quantified. While S. aureus isolates and strains were efficiently inactivated on an agar surface, subsequent testing on other clinically relevant surfaces demonstrated that the inactivation level, although significant, was reduced. This reduction appeared to depend on both the surface texture and the surface moisture content. These findings suggest this novel plasma source lacking an applied gas flow has potential application for surface bacterial decontamination.

Impact of method of application and concentration of potassium on yield of wheat

A field experiment was conducted to study the effect of different levels and methods of potassium application on yield, K uptake and forms of potassium in wheat crop at experimental field of Division of Soil Science, Sher-e-Kashmir University of Agricultural Sciences and Technology, Kashmir. The treatment consisted of 5 levels of potassium (0, 20, 40, 60 and 80 kg K2O ha(-1)) and two methods of application viz Single basal and split (1/2 basal+1/2 at tiller initiation stage). Out of various treatments, split application of potassium @ 80 kg K2O ha(-1) was found superior to single basal application in terms of grain yield (43.20 q ha(-1)) and K uptake (22.89 kg ha(-1)) by grains at harvest. However, it was at par with split application of 60 kg K2O ha(-1). All forms of potassium viz water-soluble, exchangeable, available, boiling HNO3 extractable and lattice increased with increasing levels of potassium and were found maximum (3.20, 62.80, 66.00 ppm 0.723 and 1.440% respectively) when potassium was applied @ 80 kg K2O ha(-1) in two equal splits except for lattice K which was maximum (1.440%) when potassium was applied @ 60 kg K2O ha(-1).

Comparison of the C-MAC videolaryngoscope with the Macintosh, Glidescope, and Airtraq laryngoscopes in easy and difficult laryngoscopy scenarios in manikins

The C-MAC comprises a Macintosh blade connected to a video unit. The familiarity of the Macintosh blade, and the ability to use the C-MAC as a direct or indirect laryngoscope, may be advantageous. We wished to compare the C-MAC with Macintosh, Glidescope and Airtraq laryngoscopes in easy and simulated difficult laryngoscopy. Thirty-one experienced anaesthetists performed tracheal intubation in an easy and difficult laryngoscopy scenario. The duration of intubation attempts, success rates, number of intubation attempts and of optimisation manoeuvres, the severity of dental compression, and difficulty of device use were recorded. In easy laryngoscopy, the duration of tracheal intubation attempts were similar with the C-MAC, Macintosh and Airtraq laryngoscopes; the Glidescope performed less well. The C-MAC and Airtraq provided the best glottic views, but the C-MAC was rated as the easiest device to use. In difficult laryngo-scopy the C-MAC demonstrated the shortest tracheal intubation times. The Airtraq provided the best glottic view, with the Macintosh providing the worst view. The C-MAC was the easiest device to use.

Facial tuberculoid leprosy: case report

Leprosy is a chronic, infectious, systemic disease caused by Mycobacterium leprae and is classified as paucibacillary and multibacillary types. It is contagious and has an insidious onset. Clinical presentation is characterised by hypopigmented skin lesions with reduced sensation. Presence of acid-fast bacilli in tissue specimens is regarded as a gold standard for diagnosis. Treatment is based on multi-drug regimens. We report a case of borderline tuberculoid leprosy in a 31-year-old woman.

Determination of the optimal stylet strategy for the C-MAC videolaryngoscope

The C-MAC videolaryngoscope is a novel intubation device that incorporates a camera system at the end of its blade, thereby facilitating obtaining a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. It retains the traditional Macintosh blade shape and can be used as a direct or indirect laryngoscope. We wished to determine the optimal stylet strategy for use with the C-MAC. Ten anaesthetists were allowed up to three attempts to intubate the trachea in one easy and three progressively more difficult laryngoscopy scenarios in a SimMan manikin with four tracheal tube stylet strategies: no stylet; stylet; directional stylet (Parker Flex-It); and hockey-stick stylet. The use of a stylet conferred no advantage in the easy laryngoscopy scenario. In the difficult scenarios, the directional and hockey-stick stylets performed best. In the most difficult scenario, the median (IQR [range]) duration of the successful intubation attempt was lowest with the hockey-stick stylet; 18 s (15-22 [12-43]) s, highest with the unstyletted tracheal tube; 60 s (60-60 [60, 60]) s and styletted tracheal tube 60 s (29-60 [18-60]) s, and intermediate with the directional stylet 21 s (15-60 [8-60]) s. The use of a stylet alone does not confer benefit in the setting of easy laryngoscopy. However, in more difficult laryngoscopy scenarios, the C-MAC videolaryngoscope performs best when used with a stylet that angulates the distal tracheal tube. The hockey-stick stylet configuration performed best in the scenarios tested.

Lack of influence of DNA repair gene OGG1 codon 326 polymorphisms of gastric cancer risk in the Kashmir valley

Damage to DNA may lead to carcinogenesis but is repaired through activation of pathways involving polymorphic enzymes, including human 8-oxoguanine glycosylase 1 (OGG1). The present study aimed to assess the role of genetic variants of DNA repair gene OGG1 Ser326Cys in susceptibility to gastric cancer in Kashmir valley. A case control study was performed in 303 subjects (108 gastric cancer and 195 healthy controls), all genotyped through the polymerase chain reaction (PCR). Data were statistically analyzed using the chi-square test and the logistic regression model. The distribution of OGG1 genotypes among controls and gastric cancer cases did not show any significant differences. Although smokers and high salted tea drinkers themselves were at higher risk for gastric cancer (OR=8.975, P=0.0001; OR=14.778, P=0.0001), interaction with OGG1 Ser326Cys did not further modulate the risk. In conclusion, our findings suggest that the OGG1 polymorphism does not influence either gastric cancer risk independently or by interaction with smoking or salted-tea consumption in the Kashmir valley.

Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation

BACKGROUND

The purpose of this study was to determine the potential for the Pentax AWS and the Glidescope to reduce the difficulty of tracheal intubation in patients at increased risk for difficult tracheal intubation, in a randomized, controlled clinical trial.

METHODS

Seventy-five consenting patients presenting for surgery requiring tracheal intubation, and who were deemed to possess characteristics indicating an increased risk for difficult tracheal intubation, were randomly assigned to undergo intubation using a Macintosh, AWS, or Glidescope laryngoscope (n=25 patients per group). All patients were intubated by one of three anaesthetists experienced in the use of each laryngoscope.

RESULTS

Both the Glidescope and the AWS significantly reduced the intubation difficulty score compared with the Macintosh. The rate of successful tracheal intubation was lower with the Macintosh (84%) compared with the Glidescope (96%) or the AWS (100%). There were no differences in the duration of tracheal intubation attempts between the devices. Both the Glidescope and the AWS significantly reduced the need for additional manoeuvres and improved the Cormack and Lehane view obtained at laryngoscopy, compared with the Macintosh. Tracheal intubation with the AWS but not the Glidescope reduced the degree of haemodynamic stimulation compared with the Macintosh laryngoscope.

CONCLUSIONS

The AWS and the Glidescope laryngoscopes reduced the difficulty of tracheal intubation to a similar extent compared with the Macintosh laryngoscope, in patients at increased risk for difficult tracheal intubation.

Nutrients as trophic factors in neurons and the central nervous system: role of retinoic acid

In multicellular organisms, death, survival, proliferation, and differentiation of a given cell depend on signals produced by neighboring and/or distant cells, resulting in the coordinated development and function of the various tissues. In the nervous system, control of cell survival and differentiation is achieved through the action of a distinct group of polypeptides collectively known as neurotrophic factors. Recent findings support the view that trophic factors also are involved in the response of the nervous system to acute injury. By contrast, nutrients are not traditionally viewed as potential trophic factors; however, there is increasing evidence that at least some influence neuronal differentiation. During development the brain is responsive to variations in nutrient supply, and this increased sensitivity or vulnerability of the brain to nutrient supply may reappear during neuronal repair, a period during which a rapid membrane resynthesis and reestablishment of synthetic pathways occur. To further evaluate the potential of specific nutrients to act as pharmacologic agents in the repair of injured neurons, the effects of retinoic acid, an active metabolite of vitamin A, and its role as a trophic factor are discussed. This literature review is intended to provide background information regarding the effect of retinoic acid on the cholinergic phenotype and the differentiation of these neurons and to explain how it may promote neuronal repair and survival following injury.

A one-step synthesis of cadmium selenide quantum dots from a novel single source precursor

A new approach to the one-step synthesis of cadmium selenide (CdSe) quantum dots is reported using the air stable complex cadmium imino-bis(diisopropylphosphine selenide); the ligand is readily prepared from elemental selenium and the precursor, quantum dots of comparable quality to those prepared by conventional methods are obtained.

Significance of thyrotrophin and thyroxine estimations in type 1 diabetes

OBJECTIVE

To investigate whether estimation of thyrotrophin (TSH) and thyroxine (T4) is significant to assess the thyroid status of diabetic patients.

MATERIALS AND METHODS

Fifty patients with type 1 diabetes (25 male and 25 female) aged 9-50 years were included. The mean duration of diabetes was 6.7 +/- 4.3 years. Clinically they were not suffering from any systemic disease or endocrine ailment. Twenty-six, age and sex matched, normal controls were also included. The TSH and and T4 were estimated in the sera of all the subjects using the commercially available ELISA kits.

RESULTS

The mean +/- SD concentration of TSH was raised significantly (p < 0.001) in the patients as compared to the controls, whereas the T4 concentration was comparable. Furthermore, 30% diabetics showed significantly elevated TSH concentration than the controls.

CONCLUSION

It is proposed that the estimation of TSH in the patients with type 1 diabetes may be useful in the early identification of thyroid dysfunction.

Cholinergic differentiation triggered by blocking cell proliferation and treatment with all-trans-retinoic acid

This study determined whether the effect of all-trans-retinoic acid (t-RA) on markers of cholinergic differentiation in a murine septal cell line, SN56.B5.G4, differed depending upon the cell's proliferative status. To develop a model of non-proliferating cells, aphidicolin, a DNA alpha-polymerase inhibitor, was used. Cessation of proliferation by aphidicolin increased intracellular choline and acetylcholine (ACh) levels in the absence of change to choline acetyltransferase (ChAT) activity and mRNA and vesicular ACh transporter (VAChT) mRNA. Importantly, the response to t-RA differed depending upon proliferative status. Consistent with previous reports, t-RA increased ChAT and VAChT mRNA, ChAT activity and intracellular ACh levels in proliferating SN56 cells with no effect on intracellular choline levels. When cells were treated with t-RA while undergoing proliferative arrest, an additive effect of combined treatment was observed on ACh levels; nevertheless, this was only accompanied by an increase in choline levels, VAChT and ChAT mRNAs, but not ChAT activity. Indeed, aphidicolin treatment completely suppressed the t-RA-induced increase in ChAT activity observed in proliferating cells. To explore the response to t-RA in post-mitotic cells, a sequential treatment of aphidicolin and t-RA was employed. t-RA treatment was ineffective in increasing ACh and choline levels, over and above that observed with the aphidicolin treatment alone. Comparable to the combined treatment, sequential treatment lead to an increase in ChAT mRNA without any increase in ChAT activity. In conclusion, both the magnitude and the mechanism(s) of action whereby t-RA enhances the cholinergic phenotype of SN56 cells is dependent upon the cell's proliferative status.

Outcome of cases of persistent diarrhea after discharge

After recovery from persistent diarrhea, some children have recurrent episodes of diarrhea and associated problems. We undertook this study to identify the risk factors responsible for this relapse. All patients reporting at 1 month follow up since discharge, with > 7 diarrheal days, or inadequate weight gain compared to the weight at discharge, constituted the failure group. All others constituted the non-failure group. Various risk factors were studied in 21 cases (failure group), and 42 controls (non-failure group). Univariate analysis revealed a significant association of hospital stay < 5 days (OR 10.6; 95% CI 3.13-36), working mothers (OR 8.5; 95% CI 2.5-27), poor socioeconomic status (OR 4.5; 95% CI 1.4-14) and presence of younger sibling (OR 3.69, 95% CI 1.1-12.6) with failed outcome. On logistic regression analysis, only hospital stay < 5 days (OR 11.7; 95% CI 1.02-134.68) and female children (OR 17.65; 95% CI 1.26-246) remained significant. We therefore conclude, that a short hospital stay, limited optimal contact and limited health education adversely affects the outcome. Pediatricians should be more cautious while managing female children.

Charge-transfer photochemistry of bis(diethyl-diselenocarbamato)copper(II)

The photochemical reactions of bis(diethyl-diselenocarbamato)copper(II), Cu(Et2dsc)2, complex have been studied in toluene, CH2Cl2, CHCl3 and chloroalkane/EtOH mixed solvents. Charge-transfer irradiation induces intramolecular oxidation of the ligand and reduction of copper(II) to copper(I) as evidenced by EPR and UV-Vis spectra of the complex as well as quantum yield results. When photolysis is carried out in CHCl3 or CH2Cl2 or in the solvent mixture CHCl3/EtOH resp. CH2Cl2/EtOH of lower than 1:1 EtOH content, the primary photoproduct CuI(Et2dsc) is further oxidised in a dark reaction with the chloroalkane producing the corresponding paramagnetic mixed-ligand CuII(Et2dsc)Cl complex in equilibrium with its chloride-bridged and EPR silent, dimeric form Cu2(Et2dsc)2Cl2. At low concentration of EtOH the equilibrium is shifted to the dimeric form whereas at higher than 1:1 EtOH content in the mixed solvent CHCl3/EtOH it is shifted to CuII(Et2dsc)Cl. A reaction mechanism is proposed and the role of ethanol is discussed.

Ventilatory function of healthy, urban, non smoking, Pakistani young adults aged 18-24 years

Age may have a different contribution to normal lung function values in those aged less than 25 years, as compared to older individuals. We report regression equations predicting ventilatory parameters in this age group, as none have been reported from Pakistan. The study was conducted on students of King Edward Medical College Lahore, Pakistan. Participants had never smoked and reported no respiratory symptoms. In addition to anthropometric data, forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flow at 50% of FVC (FEF50) were measured. Equations predicting normal values of these parameters were derived using SPSS (Chicago, Illinois, U.S.A.) P < or = 0.05 was treated as statistically significant. Of the students, 519 took part in the study. All four parameters correlated significantly (P < 0.001) and positively with height. FEF50 had a negative correlation with age in both sexes (P < 0.05). The correlation of other parameters with age was variable and not statistically significant. On multiple regression, height featured as an independent predictor in equations for all parameters. The contribution of age as an independent predictor of ventilatory function was, once again, variable. Independent variables were retained in the raw form as their transformation did not improve the goodness of fit of the derived equations. Only height and age emerged as independent predictors of ventilatory function. Values derived from the equations presented in this study were less than those for height and age matched white Caucasians. Such differences were greater than the 'Asian correction factors'.

Lead exposure in papier mâché workers

Lead exposure was assessed in a random cohort of 70 male papier mâché workers and compared with 35 age and sex matched controls. Blood-lead levels in workers were significantly higher than in controls (Mean 68.07 +/- 44.64 ug/dl vs 25.52 +/- 16.56 ug/dl respectively; P < 0.001). Urinary lead was also higher in workers (128.53 +/- 52.61 ug/l) compared to controls (91.18 +/- 27.06, P < 0.001), but excretion of urinary coproporphyrin in the two groups was not significantly different (102.78 +/- 153.42 vs 70.03 +/- 27.06 ug/l, P > 0.05). Blood levels bore a significant correlation with age but did not bear any correlation with the duration of exposure. Various modes of exposure to lead included hand mixing of paints, skin application of the paint to match shades and making point of the brush using lips and the tongue.

Asthma in chemical workers exposed to aliphatic polyamines

Following the identification of an index case of occupational asthma, we assessed the respiratory morbidity in 12 workers exposed to aliphatic polyamines in a chemical factory and in 60 unexposed workers in three other workplaces. Many amine workers reported symptoms of chronic cough (7/12), chronic phlegm (9/12), wheezing (4/12) and exertional breathlessness (3/12). These were significantly more frequent in exposed than in unexposed workers (P < 0.01). They also had significantly greater diurnal variation in peak expiratory flow rates (DV-PEFR) than the unexposed workers (P < 0.01). All four amine workers with wheezing reported onset of symptoms after employment at the factory, and all had DV-PEFR greater than 15%, compared to only one control worker (P < 0.01). A second case of occupational asthma was confirmed by bronchial challenge test. The study indicated a very high risk of asthma and chronic airways disease and a need for stringent measures to protect the health of industrial workers exposed to aliphatic amines in Singapore.

Significance of thyroid microsomal antibody in Graves' disease

Thyroid microsomal antibody (MsAb) was estimated in 48 patients with Graves' disease (15 newly diagnosed, 15 on drugs for about 4 weeks and 18 euthyroid with drug treatment) and twenty age and sex matched controls. The diagnosis of Graves' disease (GD) was based on clinical history, physical examination and thyroid function tests, viz. 131I uptake, thyroid scintigram and serum T3, T4 and TSH levels. MSAb was positive in 93.3% of newly diagnosed as well as hyperthyroid GD patients on drugs. Eighty-three percent euthyroid GD patients and 20% normal controls also showed MSAb positivity. The titres of newly diagnosed patients were significantly raised (P < 0.05) than those of euthyroid patients and controls indicating the diagnostic as well as prognostic significance of MSAb in Graves' disease.

Glycaemic index of Pakistani staple foods in mixed meals for diabetics

Glycaemic index of local staple foods was determined. In first phase, the post prandial blood glucose response of isocaloric portion of wheat chapati and gram flour (baisen) chapati, were compared in 11 type II diabetic patients as a part of mixed meal in fasting state, alternately. The glycaemic index of baisen chapati was 39 as compared with wheat chapati. In second phase of the study, 22 type II diabetic patients were given isocaloric portions of wheat chapati and boiled rice as a part of mixed meal alternately. The glycaemic index of rice was 98 as compared with wheat chapati. This study favours the belief that baisen chapati is better and refutes that rice is bad for diabetics. It also upholds that glycaemic index is useful for planning a diabetic diet.

Osteoblasts on hydroxyapatite, alumina and bone surfaces in vitro: morphology during the first 2 h of attachment

The morphological responses of individual osteoblasts as they attached and spread on hydroxyapatite, bovine bone, alumina with rough and polished surfaces, and tissue culture polystyrene in vitro were examined with scanning electron microscopy. Depending on the surface tested two different morphological sequences were observed during 2 h of adhesion. On alumina, both rough and smooth, bone, and tissue culture polystyrene the cells were round after 0.5 h, and spread radially during the next 1.5 h until they were almost flat, with a nuclear bulge. On hydroxyapatite, however, the cells were flat and circular at 0.5 h, and the edge of the cytoplasm was hardly discernable. This morphology did not change much during the subsequent 1.5 h. The observed cellular morphological response may be related to the bioreactivity of hydroxyapatite.

Reactive hypoglycemia and A-cell ('pancreatic') glucagon deficiency in the adult

Serum glucose, A-cell (IRGA) and total glucagon (IRGT), insulin, growth hormone, cortisol, triiodothyronine, and thyroxine values were measured in the fasting state and in response to oral glucose, intravenously administered arginine, and a meal of pan-broiled ground beef in 31 symptomatic patients and 11 normal subjects. Twenty-four patients and 11 control subjects had normal glucose tolerance (group 1); seven patients had reactive hypoglycemia (group 2). Under all conditions, serum IRGA value was significantly lower in group 2 than in group 1. Glucose, arginine, or meat increased serum IRGT levels. This response did not differ significantly in the two groups, nor did the secretion of the other measured hormones. We conclude that A-cell insufficiency can contribute to reactive hypoglycemia in the adult.

The Crystal Structure of [2,6-Bis(1-methyl-4-methylthio-5-thia-2,3-diazahexa-1,3-dienyl)-pyridine]dithiocyanatonickel(II), a Complex of a Potentially Pentadentate N3S2 Ligand, and a Comparison with Complexes of an N3O2 Ligand

The crystal structure of Ni(dapsm)(NCS)2 [dapsm is 2,6-bis(1-methyl-4-methylthio-5-thia-2,3-diazahexa-1,3-dienyl)pyridinel has been determined from three-dimensional single-crystal diffractometer X-ray data. Structure refinement was carried out by least-squares methods to a final R value of 0.059. The ligand dapsm is a potential N3S2 pentadentate, but it coordinates as a tetradentate, giving a planar N3S donor grouping. Rotation occurs about an N-N bond in dapsm, moving a potential donor sulfur atom away from the nickel(II) ion. The pyridine ring of the ligand, and the N3S donor grouping, are approximately coplanar. Two thiocyanate groups are coordinated to the nickel, giving a distorted octahedral structure. The structure and electronic spectrum of Ni(dapsm)- (NCS)2 are compared with those for seven-coordinate complexes with the related N3O2 ligand, 2,6-diacetylpyridine bissemicarbazone.

Abnormal calcium metabolism in normocalcaemic sarcoidosis

In studies of calcium metabolism in 13 unselected patients with untreated sarcoidosis all were normocalcaemic but five had hypercalcuria. All had normal renal function. Calcium absorption was indexed by a double isotope test. 45Ca hyperabsorption occurred in six patients. Ten kinetic studies were carried out with 47Ca and in six bone turnover was increased. 45Ca absorption correlated well with the calculated bone uptake rate of calcium, and with urine calcium excretion. These results suggest that in sarcoidosis abnormalities in calcium metabolism are fairly common although they rarely result in sustained hypercalcaemia.

Complexes of cobalt(II) and nickel(II) with some bidentate thiosemicarbazones

Some new, and some previously reported, bis-chelate complexes of bidentate thiosemicarbazones with a range of cobalt(II) and nickel(II) salts have been isolated, and they have been characterized by infrared and electronic spectra, and by magnetic measurements. The complexes are those of the thiosemicarbazones of acetone, diethyl ketone and cyclopentanone with nickel(II), and the thiosemicarbazones of acetone, ethyl methyl ketone, cyclopentanone and benzaldehyde with cobalt(II). They all have the composition M(tsc)2X2 (some being obtained with solvent of crystallization), and the influence of metal ion M, the thiosemicarbazone ligand tsc, and the anion X on the structures is examined. The non-aromatic thiosemicarbazones gave five-coordinate halo complexes of general type [M(tsc)2X] X (M = Co, Ni; X = halide). The nitrates appear to have formally six-coordinate structures of type [M(tsc)2(NO3)]NO3 involving one bidentate nitrate, although the electronic spectra suggest that the coordination environments of the metal ions resemble those of five- rather than six-coordinate complexes. The thiocyanato and perchlorato complexes are considered to be five-coordinate with cobalt and six-coordinate with nickel. Benzaldehyde thiosemicarbazone (bztsc) did not yield nickel(II) complexes, but gave tetrahedral complexes [Co(bztsc)2] X2 with X = halide, and a six-coordinate thiocyanato complex [Co(bztsc)2(NCS)2] whose reflectance spectrum may show the effects of tetragonal distortion.

Complexes of Pyridine-2-carbaldehyde S-Methylthiosemicarbazone with nickel(II) and copper(II)

New complexes of pyridine-2-carbaldehyde S-methylthiosemicarbazone (pmts) with nickel(11) and copper(11) are reported, together with magnetic moments, infrared and electronic spectra. The pale yellow bis-ligand complexes with nickel perchlorate, tetrafluoroborate and nitrate have the ionic structures [Ni(pmts)2] X2, with six-coordinate nickel(11) and tridentate ligands. Thiocyanate co-ordination and bidentate pmts appear to be present in the six-coordinate orange-brown complex Ni(pmts)2(NCs)2. The complexes, Ni(pmts)X2 (X = Cl, Br), are halogen-bridged and six-coordinate. The complexes Cu(pmts)X2 (X = Cl, Br, NO3) do not appear to be five coordinate, and may be six coordinate.

Prediction values for the ventilatory capacity in male West Pakistani workers in the United Kingdom

The ventilatory functions (forced vital capacity, forced expiratory volume in one second, and peak expiratory flow rate) of West Pakistani immigrants working near Manchester were measured. There were 198 `normal' healthy adult workers aged 25 to 60 years and 129 workers aged 16 to 24 years. The subjects were considered `normal' if they did not admit to persistent cough and phlegm. The regression equations on age and height for the two groups are presented together with the corresponding nomograms for the adult group.

Ventilatory function reached its maximum between the ages of 25 and 30 years; smokers and dust-exposed subjects did not differ significantly from non-smokers and non-dust-exposed subjects (P>0·1). This was probably due to their relatively light smoking habits and the short duration of dust exposure. The effects of age, in workers over the age of 25 years, and the predominant effects of height on the FVC, FEV_1·0, and PEFR are similar to those found in other studies.

The ventilatory capacity of the subjects was found to be somewhat lower than that of Caucasians, about equal to that of Negroes living in America, and higher than that of Indians of Asian origin living in Guyana or of Bantu Negroes in South Africa.

The predicted FEV_1·0/FVC% in the West Pakistani subjects is a little higher than any calculated from the results of other authors, but its regression on age is consistent with the findings of other studies and, therefore, can be used in clinical practice to assess the pulmonary conductance.