Follow-up (99m)Tc EC renal dynamic scintigraphy and DMSA-III SPECT/CT in unmasking a masqueraded case of Horseshoe kidney

Hydronephrosis is a common finding in urinary tract outflow obstruction. Chronically obstructed hydronephrotic system may be associated with parenchymal changes. Ultrasound, intravenous urography, micturating cysto-urethrogram and scintigraphy are commonly performed to evaluate the cause of obstruction. In childhood, pelviureteric junction obstruction is a common cause of the hydronephrosis. Hydronephrosis can also be present in horseshoe kidneys due to poor drainage. However, a large sized hydronephrotic cavity may obscure the finding of horseshoe kidney. A case was reported, and it was diagnosed as horseshoe kidney on follow-up renal dynamic scan and confirmed with the help of dimercaptosuccinic acid SPECT/CT.

Alteration of the serum biomarker profiles of visceral leishmaniasis during treatment

Until recently, chemotherapy for visceral leishmaniasis (VL; also known as kala-azar) was severely limited by factors such as high cost, route of administration, generation of side effects and potential for resistance. Although largely effective, chemotherapies have become available with the introduction of new drugs and multi-drug regimens for VL. These could be further improved by the identification of biomarkers that are altered during effective treatment. The identification of such biomarkers in the circulation would also simplify efficacy trials. In this study, we determined immunological signatures within the serum of ethnically and geographically distinct VL patients (from Bangladesh and Brazil). Our results indicate that inflammatory and regulatory cytokines (IFNγ, TNFα, IL-10, IL-17), as well as levels of growth factors (FGF, VEGF), are elevated within the serum of VL patients from these sites. The examination of samples from Brazilian VL patients during and beyond standard treatment with meglumine antimoniate identified multiple parameters that revert to levels comparable to those of healthy endemic control individuals. The consolidation of these results provides a 'response to treatment' signature that could be used within efficacy trials to rapidly and simply determine successful interruption of VL.

Effect of Clay on Thermal, Mechanical and Gas Barrier Properties of Biodegradable Poly(lactic acid)/Poly(butylene succinate) (PLA/PBS) Nanocomposites

A series of poly(lactic acid) (PLA)/poly(butylene succinate) (PBS)/layered silicate nancomposites were prepared by simple melt extrusion of PLA/PBS/Cloisite 30BX (organically modified MMT) clay. Extruded and compression moulded samples containing 1, 3, 5, 7 and 10 wt.% of clay having 80 and 20 wt.% of PLA and PBS respectively, were prepared to investigate morphological, thermal, mechanical and gas barrier properties of these biodegradable nanocomposites. Wide angle X-ray diffraction (WAXD) was used to assess the periodic distance of the clay layers. WAXD indicated an exfoliated structure for nanocomposites containing 1 and 3 wt.% of C30BX, while, dominantly intercalated structures were noticed for nanocomposites having 5, 7 and 10 wt.% of C30BX. Transmission Electron Microscopy (TEM) images confirmed mixed morphology of intercalated and exfoliated structure even for nanocomposites having 1 and 3 wt.% of C30BX, while some clusters or agglomerated tactoids were detected for higher clay containing (>3 wt.%) nanocomposites. Thermo gravimetric analysis (TGA) revealed the thermal stabilities of polymer blend and their nancomposites. Nanocomposite with 3 wt.% C30BX clay showed enhanced thermal stability compared to other nanocomposites. The effect on the crystallinity, investigated by Modulated Differential Scanning Calorimetry (MDSC) showed slight improvement for nanocomposites having 1, 3, 7 and 10 wt.% of C30BX studied. However, nanocomposites having 5 wt.% of clay content showed higher crystallinity compared to the rest of the nanocomposites. Mechanical properties (tensile strength, % elongation at break and Young's modulus) were measured by Instron Universal Testing Machine. Tensile strength and Young's modulus initially increased for nanocomposites of up to 3 wt.% of clay but then decreased with the introduction of more clay. Oxygen permeabilities of the nanocomposites were also measured. Barrier properties were improved by approximately 26% with the increase of clay content in these nanocomposites.

Dexmedetomidine for monitored anesthesia care in patients undergoing liberation procedure for multiple sclerosis: An observational study

Background:

It has been postulated that Multiple sclerosis (MS) stems from a narrowing in the veins that drain blood from the brain, known medically as chronic cerebrospinal venous insufficiency, or CCSVI. It has been proposed that balloon angioplasty should alleviate the symptoms of MS. This procedure is also known as The “Liberation Procedure”. Accordingly, a clinical study was undertaken to determine the effects of dexmedetomidine in patients undergoing the liberation procedure.

Aims:

To assess the effectiveness of dexmedetomidine in providing adequate sedation and pain relief for patients undergoing the liberation procedure.

Settings and design:

A prospective, nonrandomized observational study of 60 consecutive adult patients undergoing the liberation procedure under monitored anesthesia care (MAC) who will receive dexmedetomidine as an anesthetic agent.

Methods:

A total of 60 adult patients were enrolled in the study. Dexmedetomidine was administered to all patients in a loading dose of 1 mcg/kg, which was followed by a maintenance dose of 0.2–0.5 mcg/kg/h. The evaluation of quality of sedation was based on Ramsay Sedation and the quality of analgesia was assessed using the visual analog scale. The following parameters were measured continuously: heart rate, mean arterial pressure and hemoglobin oxygen saturation. Patients were asked to answer the question, “How would you rate your experience with the sedation you have received during surgery?” using a seven-point Likert-like verbal rating scale.

Statistical analysis:

Repeated measurements were analyzed by repeated measures ANOVA for HR and BP.

Results:

Most of our patients were satisfied with their sedation. In most of the patients, MAP and HR dropped after the bolus dose of dexmedetomidine, and the drop was statistically significant.

Conclusions:

Dexmedetomidine can be used as a sole sedative agent in patients undergoing the liberation procedure.

The effect of glycosaminoglycans and hydration on the viscoelastic properties of aortic valve cusps

This paper reviews the rationale for developing a tissue-engineered aortic valve by building up the complex microstructure from its basic components, and presents recent progress towards that goal. Over the past 4 years, we have been working on engineering the functional components of the composite valve the collagen fiber bundles, the elastin sheets, and the hyaluronan matrix that keeps the tissue hydrated. Most recently, we have been working on optimizing the geometry and material properties of the collagen constructs, by varying their size and aspect ratio, and the types of loading protocols the constructs experience during the culture process.

High rate composting of herbal pharmaceutical industry solid waste

High rate composting studies of hard to degrade herbal wastes were conducted in a 3.5 m(3) capacity rotary drum composter. Studies were spread out in four trials: In trial 1 and 2, one and two turns per day rotation was observed, respectively, by mixing of herbal industry waste with cattle (buffalo) manure at a ratio of 3:1 on wet weight basis. In trial 3 inocula was added in raw waste to enhance the degradation and in trial 4 composting of a mixture of vegetable market waste and herbal waste was conducted at one turn per day. Results demonstrated that the operation of the rotary drum at one turn a day (trial 1) could provide the most conducive composting conditions and co-composting (trial 4) gave better quality compost in terms of temperature, moisture, nitrogen, and Solvita maturity index. In addition a FT-IR study also revealed that trial 1 and trial 4 gave quality compost in terms of stability and maturity due to the presence of more intense peaks in the aromatic region and less intense peaks were found in the aliphatic region compared with trial 2 and trial 3.

Evaluation of rK28 antigen for serodiagnosis of visceral Leishmaniasis in India

Antibody detection is a safely applied method at the wide scale in diagnosis of visceral Leishmaniasis (VL). In order to further advance serodiagnosis, the rK28 antigen has been recently introduced as a candidate for diagnosis of VL. We evaluated the sensitivity and specificity of the rK28 antigen in a micro-ELISA format in comparison to the rk39 antigen. The test was conducted on 252 parasitologically confirmed VL cases, 103 endemic healthy controls, 95 non-endemic healthy controls, 88 other infectious disease and 53 follow-up cases. Of 252 parasitologically confirmed VL cases, 251 cases were reported positive by rK28 antigen, yielding 99.6% sensitivity (95% CI, 0.97-0.99), which was similar to the sensitivity of rK39 ELISA (99.6%) (95% CI, 0.97-0.99). Specificity of the rK28 antigen in non-endemic and endemic healthy controls was 100% (95% CI 0.96-1) and 94.17% (95% CI, 0.88-0.97), respectively. In 88 different diseases, specificity was 95.45% (95% CI, 0.84-0.96). With the rK39 antigen, specificity of non-endemic and endemic controls and different diseases was 100% (95% CI 0.96-1), 92.23% (95% CI 0.85-0.96) and 96.59% (95% CI 0.90-0.98), respectively. Our results show that rK39 and rK28 antigens have similar sensitivity and specificity and rK28 can also be used as a serodiagnostic tool in the endemic population of Bihar.

The efficacy of anal fistula plug in fistula-in-ano: a systematic review

AIMS

To assess the efficacy of anal fistula plug (AFP) procedure for the treatment of fistula-in-ano especially the complex fistulas.

METHOD

The database of PUBMED, MEDLINE, SCOPUS, EMBASE and COCHRANE LIBRARY for the period 1995-2009 was searched. A systematic analysis was carried to evaluate the success rate of AFP procedure in fistula-in-ano.

RESULTS

A total of 25 studies were extracted and 12 (n = 317) were finally included in the systematic review. The follow-up period ranged from 3.5 to 12 months. The AFP procedure had a success rate (patient cure rate) ranging from 24% to 92%. In complex fistula-in-ano in prospective studies (8/12 studies), the success rate was 35-87%. The success rate in patients with Crohn's disease was 29-86%. The success rate in the patients with single tracts was 44-93% and in patients with multiple tracts, success ranged from 20% to 71%. The abscess formation/sepsis rate was 4-29% (11/108) and the plug extrusion rate was 4-41% (42/232-19%).

CONCLUSION

Anal fistula plug procedure has a success rate ranging from 24% to 92% in different studies. In prospective studies of complex fistula-in-ano, there was a moderate success rate of 35-87%. As AFP is associated with low morbidity and sepsis, it appears to be a safe procedure. Further randomized controlled trials studying objective parameters of fistula healing are needed to substantiate these findings.

Tamoxifen-loaded liposomal topical formulation arrests hair growth in mice

BACKGROUND

For several decades, androgens have dominated endocrine research in the domain of hair growth control. However, it has long been known that oestrogens also tend to alter hair follicle (HF) growth and cycling significantly by binding to locally expressed high-affinity oestrogen receptors (ORs). Tamoxifen (TAM) is a selective OR modulator.

OBJECTIVES

The current work aims to investigate the effect of topically applied TAM on the hair growth of mice.

METHODS

Test formulations were applied once daily on the shaved back area of the mice for a period of 5 weeks. The effect of these formulations was studied by visual and histological examinations.

RESULTS

Animals treated with saline and placebo gel formulation showed significant hair growth on the 20th day. The number and length of follicles were also found to be normal. In contrast, no hair growth was observed in the animals treated with TAM gel, even after the termination of treatment. The HFs were found to be arrested in telogen phase with clear signs of follicle dystrophy.

CONCLUSIONS

The hair growth-retarding effect of TAM observed in the current study clearly demonstrates its OR agonistic effect on hair growth. This work also provides a distinct lead towards the possible potential of TAM liposomal gel in the treatment of hirsutism.

Evaluation of evidenced-based radioprotective efficacy of Gymnema sylvestre leaves in mice brain

A Gymnema sylvestre leaves extract (GSE) rich in gymnemic acids was examined for its antioxidant activities through various in vitro assays, along with its radioprotective efficacy in mice brain. The IC(50) values of GSE for 2,2-diphenyl-1-picryl-hydrazyl scavenging assays, superoxide radical scavenging assays, inhibition of in vitro lipid peroxidation assays, and protein carbonyl formation assay were 238, 140, 99.46, and 28.03 microg/mL, respectively. Furthermore, the total phenolic content in GSE was equivalent to 18.06 microg/mL of Gallic acid. The rate of *OH radical scavenging activity of GSE is 0.46 times slower than SCN- derived from nanosecond pulse radiolysis studies. Results of in vivo studies showed that radiation (8 Gy)-induced augmentation in the levels of lipid peroxidation and depletion in glutathione and protein levels in mice brain were significantly ameliorated by GSE pretreatment. Results suggest that the radioprotective efficacy of GSE may be due to its antioxidant properties.

Global warming mitigation potential of biogas plants in India

Biogas technology, besides supplying energy and manure, provides an excellent opportunity for mitigation of greenhouse gas (GHG) emission and reducing global warming through substituting firewood for cooking, kerosene for lighting and cooking and chemical fertilizers. A study was undertaken to calculate (1) global warming mitigation potential (GMP) and thereby earning carbon credit of a family size biogas plant in India, (2) GMP of the existing and target biogas plants in the country and (3) atmospheric pollution reduction by a family size biogas plant. The GMP of a family size biogas plant was 9.7 t CO(2) equiv. year( - 1) and with the current price of US $10 t( - 1) CO(2) equiv., carbon credit of US $97 year( - 1) could be earned from such reduction in greenhouse gas emission under the clean development mechanism (CDM). A family size biogas plant substitutes 316 L of kerosene, 5,535 kg firewood and 4,400 kg cattle dung cake as fuels which will reduce emissions of NOx, SO(2), CO and volatile organic compounds to the atmosphere by 16.4, 11.3, 987.0 and 69.7 kg year( - 1), respectively. Presently 3.83 million biogas plants are operating in the country, which can mitigate global warming by 37 Mt CO(2) equiv. year( - 1). Government of India has a target of installing 12.34 million biogas plants by 2010. This target has a GMP of 120 Mt CO(2) equiv. year( - 1) and US $1,197 million as carbon credit under the CDM. However, if all the collectible cattle dung (225 Mt) produced in the country is used, 51.2 million family size biogas plants can be supported which will have a GMP of 496 Mt of CO(2) equiv. year( - 1) and can earn US $4,968 million as carbon credit. The reduction in global warming should encourage policy makers to promote biogas technology to combat climate change and integration of carbon revenues will help the farmers to develop biogas as a profitable activity.