Removal of americium from aqueous nitrate solutions by sorption onto PC88A-impregnated macroporous polymeric beads

The removal of Am (III) ions from aqueous solutions was studied by solid-liquid extraction using indigenously synthesized Extractant Impregnated Macroporous Polymeric Beads (EIMPBs). These beads were prepared by an in situ phase inversion method using polyethersulfone (PES) as base polymer and 2-ethylhexyl phosphonic acid mono-2-ethylhexyl ester (PC88A) as an extractant. The synthesized EIMPBs were characterized by FTIR, TGA and SEM techniques. The batch equilibration study using these beads for the uptake of Am (III) was carried out as a function of parameters, like pH, equilibration time, Am (III) concentration, etc. The blank polymeric beads, without PC88A, have shown negligible sorption of Am (III) under the experimental conditions. The experimental data on the sorption behavior of Am (III) on the polymeric beads fitted well in the pseudo-second-order kinetics model. The synthesized polymeric beads exhibited very good sorption capacity for Am (III) at pH 3. The reusability of the beads was also ascertained by repetitive sorption/desorption of Am (III) up to 10 cycles of operation, without any significant change in their sorption characteristics.

Intracellular mannose binding lectin mediates subcellular trafficking of HIV-1 gp120 in neurons

Human immunodeficiency virus-1 (HIV-1) enters the brain early during infection and leads to severe neuronal damage and central nervous system impairment. HIV-1 envelope glycoprotein 120 (gp120), a neurotoxin, undergoes intracellular trafficking and transport across neurons; however mechanisms of gp120 trafficking in neurons are unclear. Our results show that mannose binding lectin (MBL) that binds to the N-linked mannose residues on gp120, participates in intravesicular packaging of gp120 in neuronal subcellular organelles and also in subcellular trafficking of these vesicles in neuronal cells. Perinuclear MBL:gp120 vesicular complexes were observed and MBL facilitated the subcellular trafficking of gp120 via the endoplasmic reticulum (ER) and Golgi vesicles. The functional carbohydrate recognition domain of MBL was required for perinuclear organization, distribution and subcellular trafficking of MBL:gp120 vesicular complexes. Nocodazole, an agent that depolymerizes the microtubule network, abolished the trafficking of MBL:gp120 vesicles, suggesting that these vesicular complexes were transported along the microtubule network. Live cell imaging confirmed the association of the MBL:gp120 complexes with dynamic subcellular vesicles that underwent trafficking in neuronal soma and along the neurites. Thus, our findings suggest that intracellular MBL mediates subcellular trafficking and transport of viral glycoproteins in a microtubule-dependent mechanism in the neurons.

Low dose methylprednisolone induced bradycardia

Methylprednisolone induced arrhythmias, especially bradycardia, are well known. Most of the available reports suggest the occurrence of these arrhythmias with high dose intravenous therapy. We, hereby report a case of low dose methylprednisolone induced bradycardia.

Quality evaluation of millet-soy blended extrudates formulated through linear programming

Whole pearl millet, finger millet and decorticated soy bean blended (millet soy) extrudates formulations were designed using a linear programming (LP) model to minimize the total cost of the finished product. LP formulated composite flour was extruded through twin screw food extruder at different feed rate (6.5-13.5 kg/h), screw speed (200-350 rpm, constant feed moisture (14% wb), barrel temperature (120 °C) and cutter speed (15 rpm). The physical, functional, textural and pasting characteristics of extrudates were examined and their responses were studied. Expansion index (2.31) and sectional expansion index (5.39) was found to be was found maximum for feed rate and screw speed combination 9.5 kg/h and 250 rpm. However, density (0.25 × 10(-3) g/mm(3)) was maximum for 9.5 kg/h and 300 rpm combination. Maximum color change (10.32) was found for 9.5 kg/h feed rate and 200 rpm screw speed. The lower hardness was obtained for the samples extruded at lowest feed rate (6.5 kg/h) for all screw speed and feed rate at 9.5 kg/h for 300-350 rpm screw speed. Peak viscosity decreases with all screw speed of 9.5 kg/h feed rate.

Open transinguinal preperitoneal mesh repair of inguinal hernia: a targeted systematic review and meta-analysis of published randomized controlled trials

OBJECTIVE

The objective of this article is to systematically analyse the randomized, controlled trials comparing transinguinal preperitoneal (TIPP) and Lichtenstein repair (LR) for inguinal hernia.

METHODS

Randomized, controlled trials comparing TIPP vs LR were analysed systematically using RevMan® and combined outcomes were expressed as risk ratio (RR) and standardized mean difference.

RESULTS

Twelve randomized trials evaluating 1437 patients were retrieved from the electronic databases. There were 714 patients in the TIPP repair group and 723 patients in the LR group. There was significant heterogeneity among trials (P < 0.0001). Therefore, in the random effects model, TIPP repair was associated with a reduced risk of developing chronic groin pain (RR, 0.48; 95% CI, 0.26, 0.89; z = 2.33; P < 0.02) without influencing the incidence of inguinal hernia recurrence (RR, 0.18; 95% CI, 0.36, 1.83; z = 0.51; P = 0.61). Risk of developing postoperative complications and moderate-to-severe postoperative pain was similar following TIPP repair and LR. In addition, duration of operation was statistically similar in both groups.

CONCLUSION

TIPP repair for inguinal hernia is associated with lower risk of developing chronic groin pain. It is comparable with LR in terms of risk of hernia recurrence, postoperative complications, duration of operation and intensity of postoperative pain.

An emerging role for Wnt and GSK3 signaling pathways in schizophrenia

Schizophrenia is a disabling illness with limited treatment options. The underlying pathophysiology remains unknown, partially due to its heterogeneous nature, and a lack of understanding of the biological functions of genetic risk factors. Several signaling pathways have been implicated, however, with the varying degrees of support. In this article, I will focus on the converging evidence supporting a prominent role for Wnt and glycogen synthase kinase 3 (GSK3) signaling in the biological bases of schizophrenia. This includes current pharmacological therapies that target GSK3, animal model and cell-based studies, and recent human genetic findings that implicate Wnt and GSK3 signaling.

Use of antibacterial sutures for skin closure in controlling surgical site infections: a systematic review of published randomized, controlled trials

Objective: The objective of this article is to systematically analyse the randomized, controlled trials that compare the use of antibacterial sutures (ABS) for skin closure in controlling surgical site infections.

Methods: Randomized, controlled trials on surgical patients comparing the use of ABS for skin closure in controlling the surgical site infections were analysed systematically using RevMan® and combined outcomes were expressed as odds ratios (OR) and standardized mean differences (SMD).

Results: Seven randomized, controlled trials evaluating 1631 patients were retrieved from electronic databases. There were 760 patients in the ABS group and 871 patients in the simple suture group. There was moderate heterogeneity among trials (Tau² = 0.12; chi² = 8.40, df = 6 [P < 0.01]; I² = 29%). Therefore in the random-effects model, the use of ABS for skin closure in surgical patients was associated with a reduced risk of developing surgical site infections (OR, 0.16; 95% CI, 0.37, 0.99; z = 2.02; P < 0.04) and postoperative complications (OR, 0.56; 95% CI, 0.32, 0.98 z = 2.04; P = 0.04). The durations of operation and lengths of hospital stay were similar following the use of ABS and SS for skin closure in patients undergoing various surgical procedures.

Conclusion: Use of ABS for skin closure in surgical patients is effective in reducing the risk of surgical site infection and postoperative complications. ABS is comparable with SS in terms of length of hospital stay and duration of operation.

Cryogenics and its application with reference to spice grinding: a review

Cryogenics is the study of very low temperature and its application on different materials including biological products. Cryogenics has numerous applications in space science, electronics, automobiles, the manufacturing industry, sports and musical instruments, biological science and agriculture, etc. Cryogenic freezing finds pivotal application in food, that is, spices and condiments. Although there is a wide range of cryogens to produce the desired low temperature, generally liquid nitrogen (LN₂) is used in food grinding. The application of low temperature shows a promising pathway to produce higher quality end product with higher flavor and volatile oil retention. Cryogenic grinders generally consist of precoolers and grinder with the cryogen distribution system. In such grinding systems, cryogens subject the raw material up to or lower than glass transition temperature before it is ground, thus eliminating much of the material and quality hassles of traditional grinding. At present, the capital investment including cryogen and handling costs escalate the final cost of the product. Thus, for large-scale production, a proper design to optimize and make it feasible is the need of the hour and understanding the behavior of different food materials at these low temperature conditions. This article reviews the scenario and application of cryogenics in different sectors, especially to spice grinding.

Routine on-table cholangiography during cholecystectomy: a systematic review

INTRODUCTION

The aim of this review was to systemically analyse trials evaluating the efficacy of routine on-table cholangiography (R-OTC) versus no on-table cholangiography (N-OTC) in patients undergoing cholecystectomy.

METHODS

Randomised trials evaluating R-OTC versus N-OTC in patients undergoing cholecystectomy were selected and analysed.

RESULTS

Four trials (1 randomised controlled trial on open cholecystectomy and 3 on laparoscopic cholecystectomy) encompassing 860 patients undergoing cholecystectomy with and without R-OTC were retrieved. There were 427 patients in the R-OTC group and 433 patients in the N-OTC group. There was no significant heterogeneity among trials. Therefore, in the fixed effects model, N-OTC did not increase the risk (p=0.53) of common bile duct (CBD) injury, and it was associated with shorter operative time (p<0.00001) and fewer peri-operative complications (p<0.04). R-OTC was superior in terms of peri-operative CBD stone detection (p<0.006) and it reduced readmission (p<0.03) for retained CBD stones.

CONCLUSIONS

N-OTC is associated with shorter operative time and fewer peri-operative complications, and it is comparable to R-OTC in terms of CBD injury risk during cholecystectomy. R-OTC is helpful for peri-operative CBD stone detection and there is therefore reduced readmission for retained CBD stones. The N-OTC approach may be adopted routinely for patients undergoing laparoscopic cholecystectomy providing there are no clinical, biochemical or radiological features suggestive of CBD stones. However, a major multicentre randomised controlled trial is required to validate this conclusion.

Adverse drug reaction reporting in a pharmacovigilance centre of Nepal

BACKGROUND

Pharmacovigilance is the "science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems". Nepal joined the international pharmacovigilance programme as a full member in 2007. KIST Medical College, Lalitpur, Nepal joined the national programme as a regional centre from mid-July 2008. Currently, the pattern and scope of adverse drug reactions (ADRs) in Nepal remains unexplored.

AIMS

To observe and analyse the pattern of ADRs at KIST Medical College, Lalitpur, Nepal.

METHOD

A retrospective analysis of all ADRs reported to the centre from mid July 2008 to July 2011 was performed. Data was analysed for ADR severity, causality, and preventability.

RESULTS

A total of 113 ADR reports were obtained from various clinical departments. The maximum number of reactions was due to antimicrobials, followed by anti-hypertensives and NSAIDs.

CONCLUSION

Antimicrobials were the commonest group of drugs causing ADRs and the most commonly seen ADR was maculopapular rash followed by diarrhea and vomiting.

Adverse drug reaction reporting in a pharmacovigilance centre of Nepal

BACKGROUND

Pharmacovigilance is the "science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems". Nepal joined the international pharmacovigilance programme as a full member in 2007. KIST Medical College, Lalitpur, Nepal joined the national programme as a regional centre from mid-July 2008. Currently, the pattern and scope of adverse drug reactions (ADRs) in Nepal remains unexplored.

AIMS

To observe and analyse the pattern of ADRs at KIST Medical College, Lalitpur, Nepal.

METHOD

A retrospective analysis of all ADRs reported to the centre from mid July 2008 to July 2011 was performed. Data was analysed for ADR severity, causality, and preventability.

RESULTS

A total of 113 ADR reports were obtained from various clinical departments. The maximum number of reactions was due to antimicrobials, followed by anti-hypertensives and NSAIDs.

CONCLUSION

Antimicrobials were the commonest group of drugs causing ADRs and the most commonly seen ADR was maculopapular rash followed by diarrhea and vomiting.

Comparative therapeutic evaluation of different topicals and narrow band ultraviolet B therapy combined with systemic methotrexate in the treatment of palmoplantar psoriasis

Background:

The incidence of uncomplicated psoriasis is 1–3% in the general population. The involvement of palm and sole is seen in 7–14.5% of cases. There are different topicals and systemic therapies available for treating the case of psoriasis but none is satisfactory for longer duration.

Aim:

The study involved the comparative therapeutic evaluation of the different topical regimens and narrow band ultraviolet B (NB-UVB) therapy in combination with systemic methotrexate.

Materials and Methods:

The study was held in out-patient department of Skin, VD and Leprosy of B.R.D. Medical College, Gorakhpur, from July 2007 to December 2008. The group included 98 new cases of palmoplantar psoriasis. These cases were divided into eight groups according to the eight regimens involved in the study. The severity of psoriasis was assessed by the ESIF (erythema, scaling, induration and fissuring) score.

Results:

The study showed that all the regimens had significant response rates. The combination of NB-UVB with systemic methotrexate had maximum response rate (64.85±4.52%) that was statistically significant (paired “t” at 16d.f. = 33.329, P<0.001) with minimum number of recurrences after stopping the treatment. The combination of halobetasol ointment with systemic methotrexate also had significant response rate (paired “t” at 19d.f. = 13.5183, P<0.001) but had maximum number of cases with recurrence (70%) after stopping the treatment.

Conclusion:

These results suggest that the combination of every regimen with systemic methotrexate resulted in an early and a good improvement in the quality of life of patients suffering from psoriasis. It also shows that NB-UVB in combination with systemic methotrexate is more efficacious and has minimum recurrence rate and side effects in the treatment of palmoplantar psoriasis.

Nevirapine nanosuspensions for HIV reservoir targeting

In this paper we discuss, production, characterization and in-vivo evaluation of nevirapine nanosuspensions. Laser diffraction showed that the average particles size was 457 nm. Following single-dose administration, the plasma gamma concentration profiles showed fast release. Macrophage uptake studies confirmed enhanced cellular uptake for nanonized nevirapine with no added cytotoxicity. Gamma scintigraphy showed that the nanosuspension prepared can be used to target spleen, thymus and lungs, which represent anatomical viral reservoirs. Thus nevirapine nanosuspensions with targeting potential have been prepared successfully.

Flaxseed: a potential source of food, feed and fiber

Flaxseed is one of the most important oilseed crops for industrial as well as food, feed, and fiber purposes. Almost every part of the flaxseed plant is utilized commercially, either directly or after processing. The stem yields good quality fiber having high strength and durability. The seed provides oil rich in omega-3, digestible proteins, and lignans. In addition to being one of the richest sources of α-linolenic acid oil and lignans, flaxseed is an essential source of high quality protein and soluble fiber and has considerable potential as a source of phenolic compounds. Flaxseed is emerging as an important functional food ingredient because of its rich contents of α-linolenic acid (ALA), lignans, and fiber. Lignans appear to be anti-carcinogenic compounds. The omega-3s and lignan phytoestrogens of flaxseed are in focus for their benefits for a wide range of health conditions and may possess chemo-protective properties in animals and humans. This paper presents a review of literature on the nutritional composition of flaxseed, its health benefits, and disease-prevention qualities, utilization of flaxseed for food, feed, and fiber, and processing of flaxseed.

Stavudine entrapped lipid nanoparticles for targeting lymphatic HIV reservoirs

The main objective of present research study was to evaluate the potential of lipid nanoparticles for active delivery of an antiretroviral drug to lymphatic tissues. Stavudine entrapped drug loaded solid lipid nanoparticles (SLNs) were prepared and characterized for a variety of physicochemical parameters such as appearance, particle size, polydispersity index and zeta potential. The targeting potential of the prepared nanoparticles was investigated by carrying out ex vivo cellular uptake studies in macrophages which depicted several times enhanced uptake as compared to pure drug solution. Further, the lymphatic drug levels and organ distribution studies demonstrated efficiency of the developed nanoparticles for prolonged residence in spleenic tissues. Thus it was concluded that stavudine entrapped lipid carriers can be exploited for effective and targeted delivery to cellular and anatomical HIV reservoirs and may ultimately increase the therapeutic safety and reduce side effects.

Study on disinfestation of pulses using microwave technique

Mortality of the pulse beetle (Callosobruchus chinensis L.) exposed, continuously, to microwave radiation (2450 MHz) was evaluated as a function of exposure time and percent power level, at adult stages. The microwave exposure time to attain 100% insect mortality at 100 %, 80%, 60%, 40%, and 20% power levels for Chickpea, Pigeon Pea and Green Gram was optimized. Effect of optimized microwave exposure time on viability, germination, cooking and milling characteristics of Chickpea, Pigeon Pea and Green Gram was also evaluated. Adult stage study was characterized by a distinct dose-exposure curve. The mortality curve was following third degree polynomial equation. The seed viability and germination of Chickpea, Pigeon Pea and Green Gram was affected by microwave exposure time and power level. It was observed that as the power level is decreasing the germination and viability of all the pulses are increasing. The effect on cooking and milling characteristics are not affected by microwave exposure time and power level. The insects in the mobile state were observed to move towards the surface from inside the nutrient medium during microwave exposure. They also curled up and in some cases aggregation was observed.

Effect of moisture content and residence time on dehulling of flaxseed

Effects of moisture content and residence time on various dehulling parameters of flaxseed including yield, hull, hullability, extraction rate and embryo (dehulled flaxseed) recovery were studied. A laboratory model rice polisher/ dehulling machine and a laboratory model aspirator were used for dehulling and aspiration (hull separation), respectively. The dehulling experiments were carried out for moisture contents ranging from 1.9 to 7.8% wb and residence times from 20 to 50 sec in dehulling machine at 2000 rpm of abrasive disc (rotor) of the polisher. Both moisture content and residence time played an important role in dehulling of flaxseed. The optimum moisture range and residence time for dehulling of flaxseed were 1.9 to 4.5% wb and 40 sec, respectively.

Rectal dosimetry in intracavitary brachytherapy by HDR at rural center of Maharashtra: Comparison of two methods

The purpose of this study was to calculate the radiation dose at the anterior rectal wall as per the International Commission on Radiation Units and Measurements (ICRU 38) recommendations and compare it with the dose calculated by the commonly used intrarectal catheter. Dose delivery by brachytherapy to the cervix is limited by the critical structure of the bladder and rectum. In this study the ICRU-38 rectal point was derived by using a radio-opaque gauze piece on the posterior vaginal wall, and the intrarectal point was derived by inserting a rubber catheter with a wire, inside the rectum. A total of 146 applications were performed in 81 patients. Rectal doses were compared for complementary rectal points R1 and R5, R2 and R6, R3 and R7, and R4 and R8, obtained by both methods. The rectal doses at each complementary pair were compared with each other. The average dose at R1 was 5% higher than at R5 (60.57% vs. 55.57%). The average dose at R2 was 1% higher than at R6 (58% vs. 57%). The average dose at R3 was 1.29% higher than at R7 (52.71% vs. 51.42%), and the average dose at R4 was 1.15% higher than at R8 (43% vs. 41.85%). There were many instances where the rectal dose exceeded by more than 15%, from the R1 to R4 points (43, 22, 21, and 11 times, respectively, for R1-R5, R2-R6, R3-R7, and R4-R8 pairs). The difference in dose between R1 and R5 was significant as seen on the statistical tests, i.e., Pair T test, Wilcoxan Signed Ranks test, and Sign test (p value 0.002). The rectal dose obtained by the intrarectal wire method underestimates the actual dose to the rectum when compared to the ICRU-38 method. Thus ICRU-38 recommendations should be strictly adhered to, to reduce late complications.

Prevalence of dural ectasia in 63 gene-mutation-positive patients with features of Marfan syndrome type 1 and Loeys-Dietz syndrome and report of 22 novel FBN1 mutations

Marfan syndrome is an autosomal dominant disorder involving different organ systems. Marfan syndrome type 1 (MFS1) is caused by mutations in the FBN1 gene. Heterozygosity for mutations in the TGFBR1 or TGFBR2 genes cause Loeys-Dietz syndrome (LDS) types 2A and 2B that overlap with MFS1 in their clinical features. The phenotype of MFS1 is defined by the Ghent nosology, which classifies the clinical manifestations in major and minor criteria. Dural ectasia is one of the major criteria for Marfan syndrome but it is rarely tested for. We here report 22 novel and 9 recurrent mutations in the FBN1 gene in 36 patients with clinical features of Marfan syndrome. Sixty patients with identified mutations in the FBN1 gene and three patients with mutations in the TGFBR1 or TGFBR2 genes were examined for dural ectasia. Forty-seven of the 60 patients (78%) with MFS1 showed the dural ectasia criterion and 13 (22%) did not. Thirty-three (55%) patients were suspected of having Marfan syndrome and 24 (73%) of them had dural ectasia. Two of the three patients with LDS had dural ectasia.

Chemical warfare agents

Chemical warfare agents (CWA's) are defined as any chemical substance whose toxic properties are utilised to kill, injure or incapacitate an enemy in warfare and associated military operations. Chemical agents have been used in war since times immemorial, but their use reached a peak during World War I. During World War II only the Germans used them in the infamous gas chambers. Since then these have been intermittently used both in war and acts of terrorisms. Many countries have stockpiles of these agents. There has been a legislative effort worldwide to ban the use of CWA's under the chemical weapons convention which came into force in 1997. However the manufacture of these agents cannot be completely prohibited as some of them have potential industrial uses. Moreover despite the remedial measures taken so far and worldwide condemnation, the ease of manufacturing these agents and effectiveness during combat or small scale terrorist operations still make them a powerful weapon to reckon with. These agents are classified according to mechanism of toxicity in humans into blister agents, nerve agents, asphyxiants, choking agents and incapacitating/behavior altering agents. Some of these agents can be as devastating as a nuclear bomb. In addition to immediate injuries caused by chemical agents, some of them are associated with long term morbidities and psychological problems. In this review we will discuss briefly about the historical background, properties, manufacture techniques and industrial uses, mechanism of toxicity, clinical features of exposure and pharmacological management of casualties caused by chemical agents.

Spermicidal agents

In recent years, there is a development of vaginal contraceptives incorporating potent spermicides. Many compounds with different pharmacological activity have been evaluated in vitro for their spermicidal activity. Drugs such as surfaceactive agents (synthetic and natural), ionophores, antiliquefying agents, antimicrobial agents and miscellaneous agents such as gossypol, Azadirachta indica, vanadocenes have all been demonstrated to possess good spermicidal activity. Nonoxynol is the only spermicidal agent currently marketed and widely used. But there is still a need to develop alternative compounds for future use as safe spermicide.

Removal of Cr(VI) from aqueous solutions using agricultural waste 'maize bran'

Novel biosorbent 'maize bran' has been successfully utilized for the removal of Cr(VI) from aqueous solution. The effect of different parameters such as contact time, sorbate concentration, pH of the medium and temperature were investigated and maximum uptake of Cr(VI) was 312.52 (mgg(-1)) at pH 2.0, initial Cr(VI) concentration of 200mgL(-1) and temperature of 40 degrees C. Effect of pH showed that maize bran was not only removing Cr(VI) from aqueous solution but also reducing toxic Cr(VI) into less toxic Cr(III). The sorption kinetics was tested with first order reversible, pseudo-first order and pseudo-second order reaction and it was found that Cr(VI) uptake process followed the pseudo-second order rate expression. Mass transfer of Cr(VI) from bulk to the solid phase (maize bran) was studied at different temperatures. Different thermodynamic parameters, viz., DeltaG degrees , DeltaH degrees and DeltaS degrees have also been evaluated and it has been found that the sorption was feasible, spontaneous and endothermic in nature. The Langmuir and Freundlich equations for describing sorption equilibrium were applied and it was found that the process was well described by Langmuir isotherm. Desorption studies was also carried out and found that complete desorption of Cr(VI) took place at pH of 9.5.

Ex-Servicemen Medical Aid Group (ESMAG) : The Hidden Force

Natural calamities such as cyclones, floods and earthquakes are common occurrences in the Indian sub continent which require super human effort to contain damage to men and material. Such events put the dedication, endurance capabilities and organizational skills available in the country to a litmus test. It is not surprising therefore, that the Armed Forces are often asked to spearhead the relief work in such disaster situations. So far, the potential for utilization of disciplined and trained ex-servicemen population for such situations has remained untapped due to the lack of an organizational framework. A concept of tapping this large pool of trained manpower is presented.

Laparoscopic gastrectomy for gastric cancer: early experience among the elderly

BACKGROUND

The data are scarce on the outcome for elderly patients presenting with resectable gastric cancer in the West who have been treated with minimally invasive surgery. This report presents the authors' early experience with totally laparoscopic gastric resections for cancer in elderly patients.

METHODS

A total of 20 patients underwent laparoscopic gastrectomy procedures: 14 distal, 5 subtotal, and 1 total gastrectomy. The male-to-female ratio was 15 to 5. The ages ranged from 75 to 88 years (mean, 80 years).

RESULTS

All cases were managed laparoscopically with R0 resection. Four patients needed high-dependency unit care postoperatively. There were no perioperative deaths. The median time required for the procedure was 212 min, and time to diet was 4 days. The hospital stay was 8 days. Four patients experienced significant complications, with two patients requiring reoperation. The pathology was adenocarcinoma for 17 patients and high-grade dysplasia for 3 patients.

CONCLUSION

Among elderly patients for whom conventional gastric surgery carries a high morbidity and mortality risk, minimal access surgery may offer equivalent oncologic integrity but with superior safety and economy. The primary aim is to remove the tumor with at least a D1 lymphadenectomy.

Curcuma longa as feed additive in broiler birds and its patho-physiological effects

Broiler birds (Vencob chicken of 3 days old) when given feed mixed with powdered rhizome of Curcuma longa (CL; @ 1 g/kg) for 42 days of age, showed significant decrease in serum uric acid and albumin as compared to control, whereas significant increase was recorded in the level of serum total protein and globulin. Level of serum glucose, alkaline phosphatase, aspartate amino transferase and calcium showed no significant variation between the two groups. Micronutrient assay revealed significantly higher level of manganese, zinc, iron and copper in treated group as compared to control group. HA/HI test revealed better humoral response against RD vaccine in CL administered birds. Haematological study showed significantly higher haemoglobin and absolute neutrophil count in treated group. Addition of CL as feed additive also resulted in better growth rate, feed consumption and F:C efficiency in the treated birds. Thus, it could be concluded that powdered CL might be a useful feed additive, since it enhanced the F:C efficiency and had nephroprotective properties.

Precipitation chemistry and occurrence of acid rain over Dhanbad, coal city of India

The present study investigated the chemical composition of wet atmospheric precipitation over Dhanbad, coal city of India. The precipitation samples were collected on event basis for three years (July 2003 to October 2005) at Central Mining Research Institute. The precipitation samples were analyzed for pH, conductivity, major anions (F, Cl, NO(3), SO(4)) and cations (Ca, Mg, Na, K, NH(4)). The pH value varied from 4.01 to 6.92 (avg. 5.37) indicating acidic to alkaline nature of rainwater. The pH of the rainwater was found well above the reference pH (5.6), showing alkalinity during the non-monsoon and early phase of monsoon, but during the late phase of monsoon, pH tendency was towards acidity (<5.6 pH) indicating the non-availability of proper neutralizer for acidic ions. The observed acidic events at this site were 91, (n = 162) accounting 56% for the entire monitoring months. The (NO(3) + Cl)/SO(4) ratio in majority of samples was found below 1.0, indicating that the acidity is greatly influenced by SO(4). The calculated ratio of (Ca + NH(4))/(NO(3) + SO(4)) ranges between 0.42-5.13 (average 1.14), however in most of the samples, the ratio is greater than unity (>1.0) indicating that Ca and NH(4) play an important role in neutralization of acidic ions in rainwater. Ca and SO(4) dominate the bulk ionic deposition and these two ions along with NH(4) accounts 63% of the annual ionic deposition.

Hepatotoxicity potential of saw palmetto (Serenoa repens) in rats

Saw palmetto (Serenoa repens L.) is an herbal drug used to treat symptoms of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). There has been a report that a preparation containing this herb has caused cholestatic hepatitis in one person and some indications exist that it may have the potential to produce liver toxicity. The purpose of this study was to evaluate the effect of saw palmetto on rat liver function by measuring its effects on several enzymes and formation of malondialdehyde (MDA), a byproduct of lipid peroxidation. A significant increase in these parameters is considered an indication of liver toxicity. Thirty-six rats were divided into 6 groups of 6 animals each. They were treated for 2 or 4 weeks with a placebo or saw palmetto at doses of 9.14 or 22.86 mg/kg/body wt./day; that is, 2 x and 5 x the maximum recommended daily human dosages. After 2 or 4 weeks, the animals were sacrificed and blood was collected to prepare serum for enzyme assays, which were performed using commercially available kits. A portion of the liver was removed, and a homogenate prepared for the lipid peroxidation assay. Results showed no significant difference in animal body weight, enzyme activity, or MDA formation at either time or dosage level, as compared to controls. The data indicate that at the doses and time periods tested, saw palmetto did not produce any significant effect on the normal biological markers of liver toxicity.

Multi-exon out of frame deletion of the FBN1 gene leading to a severe juvenile onset cardiovascular phenotype in Marfan syndrome

Marfan syndrome is caused by mutations in fibrillin-1, a large gene spanning approximately 200 kb of genomic DNA on chromosome 15q21. So far, more than 600 different mutations have been identified, accounting for 60-90% of all Marfan syndrome cases, the vast majority being single nucleotide exchanges as well as small deletions and insertions. Only four major rearrangements have been described in the literature so far. We have screened 11 individuals fulfilling the diagnostic criteria of Marfan syndrome but negative for point mutations in the fibrillin-1 gene by SSCP and/or direct sequencing, for large rearrangements. We report here the largest known de novo and out of frame deletion in the fibrillin-1 gene in a patient fulfilling the diagnostic criteria of Marfan syndrome. We identified the deletion breakpoints at the genomic and transcript levels and studied the expression of the mutated allele at the transcript and protein level. We conclude that large rearrangements may account for a non-negligible proportion of all Marfan cases.

Removal of lead from aqueous solutions by agricultural waste maize bran

Maize bran is a low cost biosorbent that has been used for the removal of lead(II) from an aqueous solution. The effects of various parameters such as contact time, adsorbate concentration, pH of the medium and temperature were examined. Optimum removal at 20 degrees C was found to be 98.4% at pH 6.5, with an initial Pb(II) concentration of 100 mg l(-1). Dynamics of the sorption process and mass transfer of Pb(II) to maize bran were investigated and the values of rate constant of adsorption, rate constant of intraparticle diffusion and the mass transfer coefficients were calculated. Different thermodynamic parameters viz., changes in standard free energy, enthalpy and entropy were evaluated and it was found that the reaction was spontaneous and exothermic in nature. The adsorption data fitted the Langmuir isotherm. A generalized empirical model was proposed for the kinetics at different initial concentrations. The data were subjected to multiple regression analysis and a model was developed to predict the removal of Pb(II) from an aqueous solution.

TGFBR1andTGFBR2mutations in patients with features of Marfan syndrome and Loeys-Dietz syndrome

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder characterized by manifestations in the cardiovascular, skeletal, ocular, and other organ systems. MFS type1 (MFS1) is caused by mutations in the gene encoding fibrillin (FBN1). Recently, the transforming growth factor-beta receptor-2 gene, TGFBR2, has been shown to be associated with a second type of this disorder with typically mild or absent ocular involvement (MFS type 2; MFS2). Several point mutations were found in the highly conserved serine/threonine kinase domain of TGFBR2. Mutations in both TGFBR1 and TGFBR2 are associated with Loeys-Dietz aortic aneurysm syndrome (LDS). We searched for TGFBR1 and TGFBR2 mutations in 41 unrelated patients fulfilling the diagnostic criteria of Ghent nosology or with the tentative diagnosis of Marfan syndrome, in whom mutations in the FBN1 coding region were not identified. In TGFBR1, two mutations and two polymorphisms were detected. In TGFBR2, five mutations and six polymorphisms were identified. Reexamination of patients with a TGFBR1 or TGFBR2 mutation revealed extensive clinical overlap between patients with MFS1, MFS2, and LDS.

Mirizzi syndrome: laparoscopic management by subtotal cholecystectomy

BACKGROUND

The authors present their experience with laparoscopic subtotal cholecystectomy for the management of Mirizzi's syndrome and their review of the literature.

METHODS

Over a period of 24 months, five cases of Mirizzi's syndrome were encountered, representing 1.5% of all the laparoscopic cholecystectomies performed in the authors' unit. The sex ratio was 4 females to 1 male, and the mean age of the patients was 66 years. All underwent a subtotal cholecystectomy.

RESULTS

All procedures were completed laparoscopically. Morbidities involved one case of biliary peritonitis and a one case of biliary leak requiring endoscopic stenting.

CONCLUSION

Mirizzi's syndrome cannot always be anticipated on the basis of preoperative staging, and often is encountered during the procedure. The "anatomic scenario" of this condition should be suspected for patients presenting with conditions such as empyema or mucocoele when there is a likelihood of stone impaction in the infundibulum of the gallbladder. Subtotal cholecystectomy with secure intraperitoneal biliary drainage appears to be a safe option for these patients.

Low cost bio-sorbent 'wheat bran' for the removal of cadmium from wastewater: kinetic and equilibrium studies

Novel bio-sorbent wheat bran has been successfully utilized for the removal of cadmium(II) from wastewater. The maximum removal of cadmium(II) was found to be 87.15% at pH 8.6, initial Cd(II) concentration of 12.5 mg l-1 and temperature of 20 degrees C. The effect of different parameters such as contact time, adsorbate concentration, pH of the medium and temperature were investigated. Dynamics of the sorption process were studied and the values of rate constant of adsorption, rate constant of intraparticle diffusion and mass transfer coefficient were calculated. Different thermodynamic parameters viz., changes in standard free energy, enthalpy and entropy have also been evaluated and it has been found that the reaction was spontaneous and exothermic in nature. The applicability of Langmuir isotherm showed of monolayer coverage of the adsorbate on the surface of adsorbent. A generalized empirical model was proposed for the kinetics at different initial concentrations.

Sequence variations in the 5′ upstream regions of the FBN1 gene associated with Marfan syndrome

Marfan syndrome (MFS; OMIM#154700) is a connective tissue disorder characterized by manifestations in the ocular, skeletal and cardiovascular systems. MFS is caused by mutation in the fibrillin-1 gene (FBN1; OMIM#134797) and more than 550 mutations have been identified so far. FBN1 is approximately 230 kb in size and contains three evolutionarily conserved alternatively spliced exons B, A and C at the 5'end. In a first systematic attempt to associate sequence variations in the FBN1 5' alternatively spliced exons with MFS, we investigated 41 individuals fulfilling the diagnostic criteria of Ghent nosology or with features of MFS including at least one major criterion or involvement of two organ systems but not fulfilling a strict interpretation of the Ghent nosology, and known to be negative for mutations in the FBN1 exons 1-65 as well as the TGFBR2 and TGFBR1 coding regions. We identified five novel and one previously reported variants in the six unrelated probands and provide preliminary evidence for their role in pathogenesis.

Healthcare infrastructure, contraceptive use and infant mortality in Uttar Pradesh, India

This paper analyzes data on approximately 30,000 women from a survey in Uttar Pradesh in 1995 together with the data from surveys of public and private providers of healthcare and family planning services. A framework was developed for analyzing the effects of quality of services on utilization, and for understanding the gradual evolution of the healthcare infrastructure. The empirical results from logistic regressions for use of female sterilization and IUD showed significant effects of quality of services in government and private hospitals, and of socioeconomic variables such as education, caste, and an index of household possessions. Secondly, models for infant mortality of children born in the preceding 3-year period showed significant effects of socioeconomic variables, quality of healthcare services and birth spacing. Lastly, analysis of data at a more aggregated (Primary Sampling Unit) level indicated differential effects of economic development on the quality of services available in the public and private facilities.

Removal of Cr(VI) from wastewater using rice bran

The novel biosorbent rice bran has been successfully utilized for the removal of Cr(VI) from wastewater. The maximum removal of Cr(VI) was found to be 99.4% at pH 2.0, initial Cr(VI) concentration of 200 mg l(-1), and temperature 20 degrees C. The effect of different parameters such as contact time, adsorbate concentration, pH of the medium, and temperature was investigated. The adsorption kinetics was tested for first-order reversible, pseudo-first-order, and pseudo-second-order; reaction and the rate constants of kinetic models were calculated. Mass transfer of Cr(VI) from the bulk to the solid phase (rice bran) was studied at different temperatures. Different thermodynamic parameters, viz., changes in standard free energy, enthalpy, and entropy, have also been evaluated and it has been found that the reaction was spontaneous and endothermic in nature. The Langmuir and Freundlich equations for describing adsorption equilibrium were applied to data. The constants and correlation coefficients of these isotherm models were calculated and compared. Desorption studies was also carried out and found that complete desorption of Cr(VI) took place at pH of 9.5. The data were also subjected to multiple regression analysis and a model was developed to predict the removal of Cr(VI) from wastewater.

Removal of cadmium from wastewater using agricultural waste 'rice polish'

A novel biosorbent rice polish has been successfully utilized for the removal of cadmium(II) from wastewater. The maximum removal of cadmium(II) was found to be 9.72 mg g(-1) at pH 8.6, initial Cd(II) concentration of 125 mg l(-1) and temperature of 20 degrees C. The effect of different parameters such as contact time, adsorbate concentration, pH of the medium and temperature were investigated. Dynamics of the sorption process were studied and the values of rate constant of adsorption, rate constant of intraparticle diffusion and mass transfer coefficient were calculated. Different thermodynamic parameters, viz., changes in standard free energy, enthalpy and entropy have also been evaluated and it has been found that the reaction was spontaneous and exothermic in nature. The applicability of Langmuir isotherm showed monolayer coverage of the adsorbate on the surface of adsorbents. A generalised empirical model was proposed for the kinetics at different initial concentrations. The data were subjected to multiple regression analysis and a model was developed to predict the removal of Cd(II) from wastewater.