Context:Many advances have taken place in the detection of diabetic polyneuropathy with respect to examination scores, electrophysiological techniques and quantitative sensory testing.Aim:This study aims to evaluate the discriminative power of the Diabetic Neuropathy Examination Score (DNE), 10-g Semmes-Weinstein Monofilament Examination (SWME) and Quantitative Sensory Testing by Vibration Perception Threshold (VPT) in the diagnosis of diabetic polyneuropathy and seek an optimal screening method in diabetic clinic.Materials and Methods:Hundred consecutive patients with Type 2 diabetes were subjected to Diabetic Neuropathy Symptom Score, DNE score, Semmes-Weinstein monofilament examination, Vibration Perception Threshold and Nerve Conduction Studies; mean ± SD for the various characteristics were calculated. Sensitivity and specificity for the DNE, SWME and VPT were calculated, taking NCS as gold standard.Results:Seventy one of 100 subjects had evidence of neuropathy confirmed by Nerve Conduction Studies, while 29 did not have neuropathy. The DNE score gave a sensitivity of 83% and a specificity of 79%. The sensitivity of SWME was 98.5% and specificity was 55%. Vibration Perception Thresholds yielded a sensitivity of 86% and a specificity of 76%.Conclusions:A simple neurological examination score is as good as Vibration Perception threshold in evaluation of polyneuropathy in a diabetic clinic. It may be a better screening tool for diagnosis of diabetic polyneuropathy in view of the cost effectiveness and ease of applicability.
Members of the genus Curvularia are melanin-producing dematiaceous fungi of increasing clinical importance as causal agents of both local and invasive infections. This study contributes to the taxonomical and clinical knowledge of this genus by describing two new Curvularia species based on isolates from corneal scrapings of South Indian fungal keratitis patients. The phylogeny of the genus was updated based on three phylogenetic markers: the internal transcribed spacer (ITS) region of the ribosomal RNA gene cluster as well as fragments of the glyceraldehyde-3-phosphate dehydrogenase (gpdh) and translation elongation factor 1-α (tef1α) genes. The maximum likelihood phylogenetic tree constructed from the alignment of the three concatenated loci revealed that the examined isolates are representing two new, yet undescribed, Curvularia species. Examination of colony and microscopic morphology revealed differences between the two species as well as between the new species and their close relatives. The new species were formally described as Curvularia tamilnaduensis N. Kiss & S. Kocsubé sp. nov. and Curvularia coimbatorensis N. Kiss & S. Kocsubé sp. nov. Antifungal susceptibility testing by the broth microdilution method of CLSI (Clinical & Laboratory Standards Institute) revealed that the type strain of C. coimbatorensis is less susceptible to a series of antifungals than the C. tamilnaduensis strains.
Diclofenac is recently considered as one of the most devastating environmental pollutants, because of its biomagnification in the food chain which leads to potential harmful effects on non-targeted organisms. This study describes the optimized laccase mediated diclofenac transformation using response surface methodology (RSM) and cytotoxicity testing on mouse fibroblast 3T3-L1 preadipocytes. Three factors (laccase, syringaldehyde, reaction time) were used to optimize the diclofenac transformation. The optimum level of laccase, syringaldehyde and reaction time was found to be 1.91 U mL À1 , 187 mg and 51 min for diclofenac transformation (20 mg L À1 ). The cytotoxicity assessment on mouse fibroblast 3T3-L1 preadipocytes showed that a maximum of 67.9% cell death occurred at 72 h treatment with diclofenac (200 mg mL À1 ), while the cells treated with laccase treated diclofenac (LTD) showed less toxicity on the cells. These findings can be addressed for the removal of diclofenac toxicity.
Introduction:Women with epilepsy (WWE) have an increased risk for several endocrine disorders. Obesity and Polycystic Ovarian Syndrome (PCOS) are common side-effects of anticonvulsant drugs.Aim:To study the prevalence of Obesity, PCOS, Thyroid dysfunction in WWE on monotherapy with Carbamazepine (CBZ), Sodium Valproate (VAL) and Phenytoin (DPH)Material and Methods:Sixty WWE in the reproductive age group (13 – 45 yr) who are on atleast 6 months of monotherapy with either CBZ (20) or VAL (20) or DPH (20) are subjects of the study. Their Anthropometric data is recorded. They are interviewed and investigated for PCOS and thyroid dysfunction. Twenty healthy women in the reproductive age group served as controls. BMI>25 is taken as cut-off for Obesity. PCOS is defined as menstrual irregularity and/or clinical /biochemical hyperandrogenism with ultrasound evidence of PCO as per the Rotterdam criteria. TSH <0.1 and >4 is taken as evidence of thyroid dysfunction. Women are grouped according to the anticonvulsant drug received and the data analyzed in each group.Results:The mean BMI among VAL and CBZ users is significantly higher than among DPH users (23.3 & 23.4 vs 20.4). There is no significant difference in incidence of PCOS among WWE using either DPH or VAL or CBZ. Elevated TSH>4 is seen more often in WWE on VAL (9/20) compared to CBZ (6/20) and DPH (3/20). WWE on CBZ, VAL and DPH did not differ in mean BMI, Obesity, PCOS compared to healthy controls. As compared to healthy controls, more WWE on drug therapy had significantly elevated TSH (1/20 vs20/60).Conclusions:WWE on VAL and CBZ had significant weight gain compared to DPH users. Despite weight gain, there was no difference in the incidence of PCOS between the users of VAL, CBZ and DPH. As compared to healthy controls, more WWE on drug therapy had significantly elevated TSH, more so in the VAL group.
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