Primary lymphoma of CNS, mycophenolate mofetil and lupus

Lymphoproliferative disorders are known to complicate immunosuppressive therapy and two cases of primary lymphoma of CNS (PCNSL) have previously been described in association with mycophenolate mofetil (MMF) treatment. We report the third case of PCNSL in a patient with lupus nephropathy while on MMF treatment. PCNSL may be seen more frequently considering the increased use of MMF in immunosuppressant responsive conditions.

Leg Ulcers and Oedema: A Study Exploring the Prevalence, Aetiology, and Possible Significance of Oedema in Venous Ulcers

Oedema is commonly associated with venous leg ulcers, and is thought to discourage wound healing. However, little attention has been paid to the mechanism or significance of oedema in this condition. This study assessed the prevalence of oedema and lymphatic insufficiency and their influence on wound healing amongst 56 patients. Two populations were studied – community and hospital-managed, with an almost equal number of cases in each. The presence of oedema and lymphatic insufficiency was assessed clinically and, the duration of the current ulcer was used as an indicator of healing rate.

Oedema was present in 55% of patients, but its prevalence in the community-treated group was much greater than in the hospital-treated group. Lymphatic insufficiency was present in 22% of patients with an equal prevalence in the two groups. The presence of oedema was associated with a longer duration of ulcer whereas the use of diuretics was associated with a shorter duration. This suggests that oedema may be an important factor in discouraging the healing of ulcers.

Greater attention should be paid clinically to the prevention of oedema, as its presence suggests inadequate treatment and a failure to heal.

Immediate tangential excision accelerates wound closure but does not reduce scarring of mid-dermal porcine burns

Current evidence supports the use of excision to remove eschar from deep dermal and full-thickness burns. However, the role of excision of mid-dermal burns remains unclear. This study aimed to develop a porcine model that could produce reproducible middermal thermal burns that undergo tangential excision; and investigate the effects of immediate tangential excision (30 minutes postburn) on healing and scarring. An aluminum bar preheated in hot water (70°C) was applied for 20 or 30 s to produce a total of sixteen mid-dermal burns per pig on each of six pigs. Thirty minutes after burn creation, half of the burns were tangentially excised. Four partial- thickness wounds per pig were created as controls. Depth of burn injury (1 and 24 h), reepithelialization (7 and 10 d) and scar depth (28 d) were assessed microscopically. Total scar surface area was grossly evaluated on day 28. Exposure of porcine skin to a preheated aluminum bar at 70 °C for 20 or 30 sec resulted in reproducible mid-dermal burns, where immediate excision enhanced complete wound closure as judged by complete re-epithelialization, but did not reduce initial depth of injury, scar contraction and scar depth. Immediate surgical intervention is sufficient to enhance wound closure, but not to mitigate mid-dermal burn scar formation. This work provides a suitable animal model to evaluate novel therapies that may be used to inhibit burn progression, accelerate wound closure and decrease scarring, especially those therapies unable to penetrate burn eschar.

Effect of non-genetic factors on the prevalence of Stilesia globipunctata in the goat

Despite its high prevalence and pathogenicity, Stilesia globipunctata is a neglected cestode infection of ruminants in the tropics and sub-tropics. The present study reports the effect of sex, age, year and month on the prevalence of S. globipunctata in the goat. A total of 5208 eviscerated intestines of the goat carcasses were screened for a period of seven years, from January 2001 to December 2007. The overall prevalence of 36.6 % was significantly affected by the factors studied (P<0.05). Male goats were more susceptible to the S. globipunctata infection than that of female (P<0.05). Goat aged between 6 months and 1 year were found to be significantly more susceptible (P<0.05) which was followed by animals between 1 and 4 years of age and then more than 4 years of age. Morbidity was high (59 to 86 %) in animals of less than one year of age. The striking observation was that the prevalence peaked during monsoon and at nadir in May.

Evaluation of immunogenicity and protective efficacy of a liposome containing Brucella abortus S19 outer membrane protein in BALB/c mice

The use of liposome as an adjuvant and a vaccine carrier has been cited previously in the literature. It has also been shown to be effective in enhancing the immunogenicity of vaccine candidates. BALB/c mice immunized subcutaneously with outer membrane protein (OMP) of Brucella abortus S19 vaccine strain entrapped in a commercial cationic liposome (S19-OMP-liposome) for vaccine delivery, showed enhanced protection (P<0.05) compared to groups of mice inoculated with S19 OMP alone, S19 live B. abortus vaccine and liposome alone, when challenged intra-peritoneally with virulent B. abortus strain 544 at 30 days post-immunization (DPI). The S19-OMP-liposome preparation was found to be safer compared to the live B. abortus S19 vaccine at 15 days post challenge (DPC), as evidenced by the significant difference in spleen weight between S19-OMP-liposome, S19 OMP and S19 live as well as the liposome control groups (P<0.01). Antibody isotype response profiles of the experimental groups indicated that the immune response was Th1 cell mediated. The protective advantage conferred to mice immunized with S19-OMP entrapped in liposome over those immunized with the live B. abortus S19 version, could probably be related to the significantly different response of IgG2b at 30 DPI (P<0.01), IgG2a (P<0.01), IgG2b (P<0.01) and IgG3 (P<0.05) at the DPC stages, respectively.

An electron microscopy based method for the detection and quantification of nanomaterial number concentration in environmentally relevant media

Improved detection and characterization of nanomaterials (NMs) in complex environmental media requires the development of novel sampling approaches to improve the detection limit to be close to environmentally realistic concentrations. Transmission electron microscopy (TEM) is an indispensable metrological tool in nanotechnology and environmental nanoscience due to its high spatial resolution and analytical capabilities when coupled to spectroscopic techniques. However, these capabilities are hampered by the conventional sample preparation methods, which suffer from low NM recovery. The current work presents a validated, fully quantitative sampling technique for TEM that overcomes conventional sample preparation shortcomings, and thus enables the use of TEM for measurement of particle number concentration and their detection in complex media at environmentally realistic concentrations. This sampling method is based on ultracentrifugation of NMs from suspension onto a poly-l-lysine (PLL) functionalized TEM grid, using active deposition (by ultracentrifugation) and retention (by PLL interactions with NM surface) of NMs on the substrate, enabling fully quantitative analysis. Similar analysis with AFM was satisfactory in simple media but the lack of chemical-selectivity of AFM limits its applicability for the detection of NMs in complex environmental samples. The sampling approach was validated using both citrate- and PVP-coated AuNMs in pure water, which demonstrated an even distribution of NM on the TEM grid and high NM recovery (80-100%) at environmentally relevant NM concentrations (ca. 0.20-100 μg L(-1)). The applicability of the sampling method to complex environmental samples was demonstrated by the quantification of particle number concentration of AuNMs in EPA soft water (with and without Suwannee River fulvic acid) and lake water. This sample preparation approach is also applicable to other types of NMs with some modifications (e.g. centrifugation force and time) to insure full sample recovery. This TEM sampling method is key to the accurate quantification of NM number concentration, and therefore to improving our understanding of environmental fate, behavior, effects and dose of NMs.

Monitoring sessile droplet evaporation on a micromechanical device

A bulk acoustic mode micro-electro-mechanical dual resonator platform is utilised to study the evaporation of sub-microliter water droplets from the surface of the resonator. An analytical formulation for the observed frequency shift and the measure dependence of resonant frequency on the modes of evaporation which is consistent with the optically derived data. The resonators access only a thin layer of the liquid through shear contact and, hence, the response is not affected by the bulk mass of the droplet to first order. A relationship between the droplet contact area and the elapsed time was established for the evaporation process and is used to derive a value of the diffusion coefficient of water in air that is found to be in reasonable agreement with literature values. This work introduces a new tool for the electro-mechanical monitoring of droplet evaporation with relevance to applications such as biosensing in liquid samples of sub-microliter volumes.

Cysteine proteinase genes in Indian strain of Haemonchus contortus

The genes of microvillar cysteine proteinases such as hmcp1, hmcp6 and gcp7 of phenotypically distinct morphotypes of female H. contortus having knobbed and linguiform vulvar flaps were cloned and characterized. Complementary DNA (cDNA) was synthesized from total RNA of both the morphotypes. The hmcp1, hmcp6 and gcp7 genes were amplified from cDNA. The amplicons were cloned in pDRIVE T/A cloning vector and sequenced by Sanger's dideoxy method. The nucleotide and deduced amino acid sequences were compared with the USA/UK strain H. contortus cysteine proteinase sequences. The cysteine proteinase genes of Indian strain show considerable variations with USA/UK strains. Our results revealed that Indian strain of H. contortus expresses both UK strain (hmcp1 and 6) and USA strain (gcp7) cysteine proteinases.

Quantitative measurement of the nanoparticle size and number concentration from liquid suspensions by atomic force microscopy

Microscopy techniques are indispensable to the nanoanalytical toolbox and can provide accurate information on the number size distribution and number concentration of nanoparticles (NPs) at low concentrations (ca. ppt to ppb range) and small sizes (ca. <20 nm). However, the high capabilities of microscopy techniques are limited by the traditional sample preparation based on drying a small volume of suspension of NPs on a microscopy substrate. This method is limited by low recovery of NPs (ca. <10%), formation of aggregates during the drying process, and thus, the complete misrepresentation of the NP suspensions under consideration. This paper presents a validated quantitative sampling technique for atomic force microscopy (AFM) that overcomes the above-mentioned shortcomings and allows full recovery and representativeness of the NPs under consideration by forcing the NPs into the substrate via ultracentrifugation and strongly attaches the NPs to the substrate by surface functionalization of the substrate or by adding cations to the NP suspension. The high efficiency of the analysis is demonstrated by the uniformity of the NP distribution on the substrate (that is low variability between the number of NPs counted on different images on different areas of the substrate), the high recovery of the NPs up to 71%) and the good correlation (R > 0.95) between the mass and number concentrations. Therefore, for the first time, we developed a validated quantitative sampling technique that enables the use of the full capabilities of microscopy tools to quantitatively and accurately determine the number size distribution and number concentration of NPs at environmentally relevant low concentrations (i.e. 0.34-100 ppb). This approach is of high environmental relevance and can be applied widely in environmental nanoscience and nanotoxicology for (i) measuring the number concentration dose in nanotoxicological studies and (ii) accurately measuring the number size distribution of NPs; both are key requirements for the implementation of the European Commission recommendation for definition of nanomaterials.

Haemostatic effect of ecliptaalba on albino rabbits

Ecliptaalba (Bhringraj) is an important traditional Indian medicinal plant reported to have antipyretic, anti-inflammatory, antihistaminic, hepatoprotective and anthelmintic effect well documented in literature. In the present study ethanolic leaf extract of eclipta alba (EEEA) was evaluated for its haemostatic activity by their ability to affect the screening test or modify the experimentally induced prolongation of test time on the basis of its folklore claim in normal, aspirin and heparin treated rabbits. The parameters recorded were BT, CT, PT and APTT & platelet count in all the three groups. The study was carried out in 3 parts in different doses 200,400,600 & 800mg/kg. Part-A-study of the haemostatic effect of Ethanolic extract of E. alba (EEEA) in graded doses on normal rabbits. Part-B-study of EEEA in aspirin treated rabbits. Part-C-study of EEEA in heparin treated rabbits. Tranexamic acid was used as the standard drug. Statistical analysis was performed using one way ANOVA & student t test. In normal rabbits EEEA high doses 800mg/k & 600mg/kg exhibited significant reduction in BT & CT (p<0.01). The same doses were found to decrease the aspirin induced increase in BT & heparin induced increase in CT in a significant manner (p<0.01). As decrease in CT might be due to liberation of some active principles from leaves of Ecliptaalba which demonstrated to have anti-haemorrhagic activity against snake bite not affecting any coagulation factor. No significant effect on PT, APPT and platelet count was observed. EEEA exhibited definite haemostatic effect in the above 3 sets of study. Phytochemical analysis and isolation of active principle is essential to carry on beneficial effects from laboratory bench to bedside of patients.

Perception of medical students about pharmacology and scope of improvement

Pharmacology is a subject taught in the medical curriculum in India over a period of one and half years along with pathology, microbiology and forensic medicine. The present study was planned to know the opinion of medical students regarding pharmacology and to assess the proposed teaching schedule and methods of teaching pharmacology. The study was conducted in a private medical college in eastern India among the medical undergraduate students in 5th semester. Total 74 students participated in the study. A pre-designed, pre-tested, semi-structured questionnaire was given to the students and data was collected after one hour. Collected data was compiled, tabulated and analyzed in SPSS (version 16.0). The subject was perceived as interesting and useful by majority of students and most of them were in opinion to integrate pharmacology with the clinical subjects. Lecture in whole class was the most preferred teaching method according to the students and teaching with chalk and board they preferred most. Rational use of medicine, clinical trial, pediatric and geriatric pharmacology are the important topics the students felt to be included in the curriculum. Regular assessment of teaching methods by the students and taking suggestions from the students about improving the teaching method and redesigning the curriculum can help a lot in improving the learning capacity of the medical students and that will give benefit for the society as a whole.

Laparoscopic and thoracoscopic gastric pull-up for pure esophageal atresia in early infancy

In the developing countries, the babies with pure esophageal atresia undergo an esophagostomy and feeding gastrostomy at birth. It assists in early discharge from hospital. Esophageal substitution in these babies around six months is recommended. We report the first laparoscopic and thoracoscopic gastric pull up in early infancy from India.

Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis

Tako-Tsubo cardiomyopathy (TTC) is a reversible cardiomyopathy with a clinical presentation indistinguishable from myocardial infarction. TTC is estimated to represent 1%-2% of patients presenting with acute myocardial infarction. It most commonly occurs in postmenopausal women and is frequently precipitated by a stressful event. Chest pain and dyspnea are the typical presenting symptoms. Transient ST-segment elevation on ECG and a small rise in cardiac biomarkers are common. Characteristic wall motion abnormalities extend beyond the territory of a single epicardial coronary artery in the absence of obstructive coronary lesions. Supportive treatment leads to spontaneous rapid recovery in nearly all patients. The prognosis is excellent, and recurrence occurs in < 10% of patients. In this article, we review the clinical features of TTC that form the basis of the Mayo Clinic diagnostic criteria, as well as the long-term prognosis for this type of cardiomyopathy.

Distinguishing dynamics using recurrence-time statistics

The probability densities of the mean recurrence time, which is the average time needed for a system to recur to a previously visited neighborhood, are investigated in various dynamical regimes and are found to be in agreement with those of the finite-time Lyapunov exponents. The important advantages of the former ones are that they are easy to estimate and that comparable short time series are sufficient. Asymmetric distributions with exponential tails are observed for intermittency and crisis-induced intermittency, while for typical chaos, the distribution has a Gaussian shape. Further, the shape of the distribution distinguishes intermittent strange nonchaotic attractors from those appearing through fractalization and tori collision mechanisms. Furthermore, statistics performed on the peaks in the frequency distribution of recurrence times unveil scaling behavior in agreement with that obtained from the spectral distribution function defined as the number of peaks in the Fourier spectrum greater than a predefined value. The results of the present recurrence statistics are of relevance in classifying different dynamics and providing important insights into the dynamics of a system when only one realization of this system is available. The practical use of this approach for experimental data is shown on experimental electrochemical time series.