Hypocalcemia Presenting as Life Threatening Torsades de Pointes with Prolongation of QTc Interval

Torsades de pointes with prolonged QTc interval is a form of ventricular tachycardia. Many predisposing factors have been identified and hypocalcemia is among the rare ones. Our case illustrates that though rare, hypocalcemia might manifest as torsades de pointes with prolongation of QTc interval. Early diagnosis and management of dyselectrolytemia can prevent these patients from catastrophic torsades de pointes.     

Utility of P-SEP,sTREM-1 and suPAR as Novel Sepsis Biomarkers in SARS-CoV-2 Infection

The coronavirus disease 2019 is a highly contagious viral infection caused by SARS-CoV-2 virus, member of coronaviridae family. It causes life threatening complications due to complexity and rapid onset course of the disease. Early identification of high-risk patients who require close monitoring and aggressive treatment remains challengeable till date. Novel biomarkers which help to identify high risk patients at the early stage is high priority. Objective of this review to find utility of P-SEP, sTREM-1 and suPAR for diagnosis, risk stratification and prognosis of SARS-CoV-2 infected cases. Soluble receptors like, P-SEP, sTREM-1 and suPAR have been involved in immune regulation in SARS-CoV-2 infection and elevate more in severe cases. A comprehensive research of databases like PubMed, EMBASE, CNKI and Web of Science was performed for relevant studies. A total of nine out of fifteen research literature in initial screening were included for this review. Interestingly all studies have reported high levels of P-SEP, sTREM-1 and suPAR in SARS-CoV-2 infected cases and the biomarkers positively correlated with severity of infection. This implies that P-SEP, sTREM-1 and suPAR can be implemented as surrogate marker in blood profile for early diagnosis, risk stratification and prognosis in SARS-CoV-2 for better management in Indian population at the current situation.     

Customer value via an Intranet: A case application of B2E at HCL Technologies

The case study illustrates another genre of the B2E (business to employee) model, implemented at a large Indian IT organisation to engage its employees in order to create value for its customers. The main focus of the empirical analysis is the counterintuitive strategy to ensure customer loyalty and increased revenues by transforming the relationship between the management and the employees. A brief outline is presented of the B2E model and a case analysis of issues is derived.     

Acid base status in chronic obstructive pulmonary disease patients

348 patients of chronic obstructive pulmonary diseases (COPD) were studied for their acid base profile using ABL-3 blood gas analyser (Radiometer, copenhagan). 185 patients (53.1%) had simple disorders (respiratory acidosis—53%, respiratory alkalosis—25.4%, metabolic acidosis—11.3%, metabolic alkalosis—10.2%). Mixed disorders were present in 131 patients (34.9%) (respiratory acidosis and metabolic acidosis—75.2%, respiratory acidosis and metabolic acidosis—14%, metabolic acidosis and metabolic alkalosis—5.7%, metabolic alkalosis and respiratory alkalosis—4.9%). Hypoxemia without other acid base abnormalities was observed in early patients of GOPD (42 patients—12%). Chronic respiratory acidosis was the most common finding in advanced cases of COPD (98%). An almost equal number of such patients had a mixed disorder of respiratory acidosis with metabolic alkalosis (91%). Salt restriction, prolonged use of steriods and hypokalemia were often related to metabolic alkalosis in such patients.     

Classroom

In this section of Resonance, we invite readers to pose questions likely to be raised in a classroom situation. Wemay suggest strategies for dealingwith them, or invite responses, or both. “Classroom” is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to teaching and learning science.     

Combining Work and Learning in the Informal Economy: Implications for Education, Training and Skills Development

Although education is identified as a key determinant of economic development and poverty eradication, this relationship is only possible when educationists are able to provide a comprehensive picture of the educational process in working life. In this paper it is argued that if systems of education and training are to cater to both the formal and the informal labour markets, then they need to take into account the traditions and values of the system of vocational learning in working life, cater to the requirements of local development and be based on an understanding of the kinds of competencies people in the informal economy want, need and utilise, the socio-economic and cultural contexts within which they work, and how they cope and sustain their livelihood strategies.     

A preliminary report on the role of yoga asanas on oxidative stress in non-insulin dependent diabetes mellitus

Nineteen subjects of non-insulin dependent diabetes mellitus (NIDDM) between the age group of 30–60 yrs were studied to see the effect of specific yoga asanas on fasting and postprandial blood glucose (FBG, PPG), serum malondialdehyde (MDA) and glycosylated hemoglobin (HbA₁) in addition to drug treatment and diet control. The duration of diabetes ranged from 1–10 years. Patients with renal, cardiac and proliferative retinal diseases were excluded from the study. The same patients served as their own control. Subjects were called in the morning to the cardio-respiratory laboratory and were given training by a yoga expert. Yoga asanas included Suryanamskar, Tadasan, TriKonasan, Padmasan, Pranayam, Paschimottanasan, Ardhmatsyendrasan, Pavanmukthasan, Sarpasan and Shavasan. The asanas were done every day for 40 days for 30–40 min. FBG, PPG, serum MDA and HbA₁ were estimated before and after 40 days of yoga asanas regimen. Significant reduction was seen in FBG from 220 mg/dl to 162 mg/dl, PPG from 311 mg/dl to 255 mg/dl, MDA from 6 nmol/l to 3 nmol/l and HbA₁, from 8.8% to 6.4%. Subjects felt better and were relieved of their stresses and had an improvement in their day to day performance. The decrease was statistically significant (p<0.0001 for FBG and PPG, p<0.001 for MDA and for HbA₁).     

Serum apolipoproteins in the patients of myocardial infarction in different age groups

The level of serum cholesterol (Ch), serum-high density lipoprotein cholesterol (HDLc), serum-low density lipoprotein cholesterol (LDLc), serum very low density lipoprotein cholesterol (VLDLc), Triglyceride (Tg), Apolipoprotein A-1, B and ratio of Apolipoprotein A1/B were observed in 151 survivors of myocardial infarction in different age groups. A significant increase was found in the level of triglyceride, LDLc, apolipoprotein-B and a significant decrease in apolipoprotein-A1 and the ratio of apolipoprotein A1/B. No significant alteration was found in serum cholesterol, HDLc except in the age group of 31–40 years and 41–50 years and VLDLc. Thus, serum Apo A-1 and Apo-B may be considerably better markers for coronary artery disease than traditional lipid parameters.     

Assessment of oxidative stress and effect of antioxidant supplementation during radiotherapy in carcinoma of upper digestive tract

Oxidative stress was studied by estimating plasma levels of malondialdehyde (MDA), beta carotene, vitamin E and erythrocytic superoxide dismutase(E-SOD) activity in 50 cases of carcinoma of upper digestive tract which included carcinoma of oral cavity, pharynx and oesophagus. While plasma MDA level was found to be increased (3.5±1.0 nmole/ml), a significant decrease in beta carotene (81.2±14.5mg%), vitamin E (8.5±1.1 mg/L) level and E-SOD activity (657.0±80.6 U/G Hb) were observed in carcinoma of upper digestive tract. Patients were treated with radiotherapy which itself was toxic enough and produced its deleterious effects by generation of reactive oxygen species (ROS). As antioxdiants can detoxify ROS, beneficial effect if any, of antioxidant administration during radiotherapy was studied in two groups of patients, group A (n=5, supplemented with antioxidants) and group B (n=5, without antioxidant supplementation). Plasma MDA level was found to be elevated in both the groups but the increase in group B was significant, compared to pretreatment level. Further, body weight was found to be significantly decreased in group B patients, which was maintained in group A patients. Moreover, group A patients showed significant elevation in beta carotene concentration, thus showing beneficial effect of administration of antioxidants during radiotherapy without disturbing the desirable therapeutic effect of radiotherapy.