Ratio of lipid parameters to coenzyme Q10 could be used as biomarker of the development of early complications of obesity in children

BACKGROUND

Chronic obesity is associated with reduced levels of antioxidants, increased free oxygen radicals, and oxidative stress. Child obesity may lead to the development of complications, such as changes in metabolism, metabolic syndrome, neurological, cardiological, respiratory, renal, gastrointestinal, endocrinological, and musculoskeletal conditions. The aim of the present study is to establish whether there is a correlation between basal CoQ10 plasma concentration and the ratio of lipid parameters to CoQ10 in obese children.

METHODS

The study included 101 obese children and 20 non-obese children, aged 10-18 years. Antioxidants - CoQ10-OX, α-tocopherol, β-carotene - in plasma were measured by HPLC method with UV detector, and plasma malondialdehyde spectrophotometrically.

RESULTS

High correlation was found between plasma concentration of CoQ10 and the ratio of total Chol/CoQ10-OX as well as between CoQ10-OX and the ratio of HDL Chol/CoQ10 in plasma of obese children. The lowest correlation was between plasma concentration of CoQ10-OX and the ratio of LDL Chol/CoQ10 , as well as between CoQ10-OX and the ratio of TAG/CoQ10 in obese children.

CONCLUSION

An increase of the ratios of lipid parameters to CoQ10 is associated with child obesity and could be used as biomarkers of early complications in the development of obesity in children (Tab. 3, Fig. 5, Ref. 22).

Management of female uro-genital fistulas: Framing certain guidelines

BACKGROUND

The study was carried out to discuss the pathogenesis and management protocol of seven different varieties of female uro-genital fistulas (FUGFs).

PATIENTS AND METHODS

During 2000-2007, total of 15 FUGFs were operated, which belonged to seven different varieties requiring different routes and surgical procedures for their repair. Different fistulas with different pathophysiological factors required specific examinations and investigations preoperatively.

RESULTS

The results of the repaired FUGFs, following the general surgical principles, were acceptable with formation of only one residual fistula.

CONCLUSIONS

Successful correction of FUGFs is a surgical challenge. Detailed history, through examination and planning, atraumatic tissue handling, routine use of the interposition or onlay reinforcement flaps and vigilant postoperative care were found the key factors in successful outcome of the repaired fistulas.

Peri-vesical fat interposition flap reinforcement in high vesico-vaginal fistulas

Background and Aim:

The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginal fistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap.

Materials and Methods:

An interposition flap of peri-vesical fat was raised from the anterior, superior and posterior surfaces of the urinary bladder and was interposed between the right angle closed vaginal vault and the urinary bladder to strengthen the repair. This technique was used in two patients of VVFs.

Results:

Both the patients had successful outcome and were able to retain sufficient quantity of urine at 3 months follow-up.

Conclusions:

Peri-vesical fat flap proved an effective interposition flap in the repairs of VVFs in selected cases.

The tsim tsoum approaches for prevention of cardiovascular disease

The Tsim Tsoum Concept means that humans evolved on a diet in which nature recommends to ingest fatty acids in a balanced ratio (polyunsaturated(P) : saturated(S) =w-6 : w-3 = 1 : 1)as part of dietary lipid pattern where monounsaturated fatty acids(MUFA) is the major fatty acid(P : M : S = 1 : 6 : 1) in the background of other dietary factors; antioxidants, vitamins, minerals and fiber as well as physical activity and low mental stress. Several hundred years ago, our diet included natural foods; fruits, vegetables, green vegetables, seeds, eggs and honey. Fish, and wild meat were also available to pre-agricultural humans which shaped modern human genetic nutritional requirement. Cereal grains (refined), and vegetable oils that are rich in w-6 fatty acids are relatively recent addition to the human diet that represent dramatic departure from those foods to which we are adapted. Excess of linoleic acid, trans fatty acids (TFA), saturated and total fat as well as refined starches and sugar are proinflammatory. Low dietary MUFA and n-3 fatty acids and other long chain polyunsarurated fatty acids (LCPUFA) are important in the pathogenesis of metabolic syndrome. Increased sympathetic activity with greater secretion of neurotransmitters in conjunction of underlying long chain PUFA deficiency, and excess of proinflammatory nutrients, may damage the neurons via proinflammatory cytokines, in the ventromedial hypothalamus and insulin receptors in the brain.Since, 30–50% of the fatty acids in the brain are LCPUFA, especially omega-3 fatty acids, which are incorporated in the cell membrane phospholipids, it is possible that their supplementation may be protective.Blood lipid composition does reflect one's health status: (a) circulating serum lipoproteins and their ratio provide information on their atherogenicity to blood vessels and (b) circulating plasma fatty acids, such as w-6/w-3 fatty acid ratio, give indication on proinflammatory status of blood vessels, cardiomyocytes, liver cells and neurones; (a) and (b) are phenotype-related and depend on genetic, environmental and developmental factors. As such, they appear as universal markers for holistic health and these may be important in the pathogenesis of cardiovascular diseases and cancer, which is the main consideration of Tsim Tsoum concept.

Self-inflicted macro urethro-cutaneous fistula

An 18-year-old male having a 3 cm coronal macro urethro-cutaneous fistula, developing as a result of a strangulating rope tied at the coronal sulcus in an attempt to cause penile detumescence, is presented for its rare mode of self-inflicted penile trauma and unexpected postsurgical successful cosmetic and functional outcome.

Characterization of phenolic compounds in some Indian mango cultivars

Mangoes (Mangifera indica) are rich in phenolic acids as detected by high-performance liquid chromatography. The phenolics have prominent medicinal properties. Among six important commercial mango cultivars (Deshi, Langra, Chausa, Mallika, Dashahari and Amrapali) tannic acid was maximal in Mallika, while gallic acid was maximal in Chausa and all other varieties. Caffeic acid was maximal in Langra followed by Chausa and Amrapali. Many of the pharmacological properties attributed to mango might be due to the presence of phenolic acids in fairly significant amounts.

Extra-hepatic biliary-ductal necrosis following acute pancreatitis: 10 years of follow-up

This case report is 10 years follow-up of a child who presented with acute abdomen at the age of 8 years. Exploration revealed acute pancreatitis with the necrosis of common bile duct and almost whole of the common hepatic duct with bile leaking from the junctional stump of the right and left hepatic ducts. The patient was managed successfully by Roux-en-Y hepaticojejunostomy. After 10 years, the patient again presented with a recurrent discharging sinus from the anterior abdominal wall. On exploration, it was found to be a stitch granuloma near the site of hepaticojejunostomy. However, hepaticojejunostomy was found to function normally as seen on MRCP. This rare case highlights that extra-hepatic biliary-ductal necrosis is very unusual complication of acute pancreatitis; and it can be successfully managed by Roux-en-Y hepaticojejunostomy as evident from long-term follow-up.

Chronobiology and chronomics: detecting and applying the cycles of nature

We monitor our streets to prevent assault and rodents to develop drugs, but not those for whom the drugs are intended. It took over half a century to begin to monitor blood sugar values in patients with insulin-dependent diabetes. Monitoring blood pressure is equally timely and technically feasible for individual home- and website-based personalised care. It also serves basic science and someday perhaps the management of societal illnesses.

Forensic characterization of HDPE pipes by DSC

The melting behavior of 28 high density polyethylene (HDPE) pipe samples manufactured and supplied by 13 different manufacturers in India was examined by 'differential scanning calorimetry (DSC)' to find out if this parameter could be used in differentiating between these HDPE pipe samples which are chemically the same and being manufactured by different manufacturer. The results indicate that the melting temperature may serve as the useful criteria for differentiating HDPE (i) pipe samples from different sources and (ii) samples of different diameter from the same source.

Soft tissue reinforcement interposition flaps in hypospadias repair

Purpose: To discuss the role and mechanism of action of soft tissue reinforcement interposition flaps (strifs) in hypospadias repairs (reinforced hypospadiac urethroplasties). Materials and methods: between 2000-2005, 120 consecutive hypospadiacs (distal 85, mid 20, proximal 15), who underwent primary reinforced urethroplasties employing different types of strifs, were retrospectively analyzed. the strifs were highly vascular soft tissue pedicled flaps (devoid of epithelium) interposed between neo-urethras and the covering skin to reinforce the neo-urethras against fistula formation. the strifs were harvested, without much donor site deformity, from: preputial skin, penile skin and scrotal skin by de-epithelialization. those from buck′s fascia, corpus spongiosum and tunica vaginalis are strifs without epithelium anyway, therefore do not need de-epithelialization. redo urethroplasties and micropenises were not included. seven patients were excluded because they had incomplete follow-up. the remaining 113 (distal 84, mid 17, proximal 12) were followed up for nine to 40 months for number, size, location, spontaneous closure and persistence of urethro-cutaneous fistula (ucf), and other complications with regard to the severity of hypospadias, method of neourethral re-construction, types of strifs employed and skin cover used. a total of 158 strifs and 124 skin covers were used in 113 hypospadiac urethroplasties. Results: the first surgery was curative in 74 (65%) of 113 patients. in the remaining 39 (35%), various complications included 12 urethro-cutaneous fistulas (ucfs), 10 urethral strictures, six cases each of penile torsion and meatal stenosis and five cases each of superficial necrosis and poor cosmesis. of these 39 patients, 25 (64%) recovered with conservative treatment and 14 (36%) required re-operation, i.e. ucfs and strictures in four cases each and penile torsion, meatal stenosis and dog-ears in two cases each. all the 12 ucfs were single, pinpointed and were located at the corona in five and at the shaft in seven. eight (67%) of the 12 ucfs healed spontaneously during the follow-up period of 12 weeks.Conclusions: harvesting strifs is technically easy, however, great care is required in their handling, accurate placement and suturing over and around the re-constructed neo-urethras for their secured reinforcement against fistula formation. use of strifs in hypospadias repairs decreases fistula-associated morbidity but does not absolutely prevent fistula formation. the strifs reduce the size and prevent multiplicity of ucfs and locate the ucfs eccentrically well away from the neo-urethra to facilitate their spontaneous (conservative) as well as subsequent (surgical) closure. the mechanism of action of strifs is multi-factorial, like acting as a mechanical barrier; preventing suture line superimposition; inducing neo-angio-genesis; working as biological drain; providing mechanical support; and, filling the dead spaces.

Polysaccharide structure of degraded glucomannan from Abrus precatorius Linn. seeds

Degraded glucomannan was isolated from Abrus precatorius Linn. seed polysaccharide (Papilionaceae). Acid hydrolysis and methylation studies produced certain degraded methyl sugars as, 2, 3, 6-tri-O-methyl-D-glucose and 2, 3, 6-tri-O-methyl-D-mannose in 1:4 molar ratio. On the basis of hydrolysis and methylation experiments, a polysaccharide structure has been assigned to the degraded glucomannan and to the parent glucomannan of Abrus precatorius Linn. seed.