Role of Lactobacillus acidophilus loaded floating beads in chronic fatigue syndrome: behavioral and biochemical evidences

BACKGROUND

  In recent years the interface between neuropsychiatry and gastroenterology has converged in to a new discipline referred to as enteric neuroscience. Implications of brain-gut communication in the pathogenesis of psychiatric disorders indicate a possible role of suitably packaged/delivered probiotics as newer therapeutic options. In the present study probable role of per-oral administration of free Lactobacillus acidophilus (LAB) and LAB loaded alginate beads in attenuation of the symptoms associated with chronic fatigue syndrome (CFS) were evaluated.

METHODS

  Chronic fatigue syndrome following physical fatigue was induced in rats by forcing them to swim (forced swim test; FST) in water till exhaustion, after weighing them down with 10% their body weight, daily for 28 days. Immobility (I) and postswim fatigue time (PSF) were taken as suitable markers. Free LAB and LAB loaded floating beads (FBs) were administered, from 21 to 28 days.

KEY RESULTS

  Immobility and PSF were found to increase considerably in FST rats (665 ± 22 s and 196 ± 6 s) as compared with the naïve (32 ± 7 s and 22 ± 2 s) at 20 days, establishing severe fatigue like behavior. FST control group exhibited significant (P < 0.05) hypertrophy of spleen, hypotrophy of thymus, and increased oxido-nitrosative stress in brain and tumor necrosis factor-α (TNF-α) levels in serum. Treatment with LAB and LAB FBs significantly decreased I and PSF and attenuated (P < 0.05) oxido-nitrosative stress and TNF-α levels. Spleen and thymus were also restored to their original size in this group.

CONCLUSIONS & INFERENCES

  The findings suggest a valuable therapeutic role of LAB especially when incorporated into alginate beads for the treatment of CFS.

Melatonin supplementation therapy as a potent alternative to ERT in ovariectomized rats

AIM

To evaluate the efficacy of melatonin supplementation therapy as an alternative to estrogen replacement therapy in an ovariectomized rat model and to assess diabetogenic metabolic dysregulation caused by estrogen deficiency in postmenopausal individuals.

METHODS

Ovariectomized adult Wistar rats were treated with either estrogen/progesterone, melatonin or a combination of estrogen and melatonin. Body weight gain, feed efficiency, serum glucose, insulin, glucose tolerance and insulin response, serum and tissue lipids, tissue glycogen contents and activities of glycogen phosphorylase and glucose-6-phosphatase were analyzed in all the experimental groups.

RESULTS

Ovariectomized animals showed increased body weight gain, feed efficiency, fasting insulin resistance, greater area under curve for the glucose tolerance test, higher serum and tissue lipids and reduced glycogen content and insulin sensitivity. A low dose of melatonin was more efficient than estrogen in reversing all the ovariectomy-induced changes. The combination of estrogen + melatonin was found to be best in correcting glycemic dysregulation while high doses of melatonin could effectively regulate dyslipidemia.

CONCLUSION

The present study provides strong evidence for melatonin supplementation therapy to be more potent and effective in comparison to estrogen replacement therapy due to its single-handed ability to revert all the ovariectomy-induced changes. No reported side-effect or long-term effect of melatonin, against the known effects of estrogen replacement therapy, make it more attractive as a candidate to treat postmenopausal symptoms.

Purification and characterization of a lectin with high hemagglutination property isolated from Allium altaicum

A lectin was purified from the leaves of Allium altaicum and corresponding gene was cloned. The lectin namely Allium altaicum agglutinin (AAA) was ~24 kDa homodimeric protein and similar to a typical garlic leaf lectin. It was synthesized as 177 amino acid residues pre-proprotein, which consisted of 28 and 43 amino acid long N and C-terminal signal peptides, respectively. The plant expressed this protein more in scapes and flowers in comparison to the bulbs and leaves. Hemagglutination activity (with rabbit erythrocytes) was 1,428 fold higher as compared to Allium sativum leaf agglutinin (ASAL) although, the insecticidal activity against cotton aphid (Aphis gossypii) was relatively low. Glycan array revealed that AAA had higher affinity towards GlcAb1-3Galb as compared to ASAL. Homology analysis showed 57-94% similarity with other Allium lectins. The mature protein was expressed in E. coli as a fusion with SUMO peptide in soluble and biologically active form. Recombinant protein retained high hemagglutination activity.

A very common case become rare: Anesthetic considerations of lepromatous leprosy

Leprosy or Hansen's disease is very uncommon in developed countries. More than 80% of the world's cases occurs and still reported from developing countries. But nowadays due to increase in international affairs, medical tourism, globalization and immigration, there is increasing possibility to find patients anywhere, which require anesthesia for surgical interventions. Leprosy is a chronic infectious disease caused by Mycobacterium leprae and involves mainly skin, peripheral nervous system, upper respiratory tract, eyes and testes. Anesthetic consideration is focused mainly on complications related to leprosy like cardiac or respiratory dysautonomia, autonomic dysfunctions and side effects which are related to drug therapy and are challenging. There can be drug-related hepatitis and renal insufficiency in these patients. We report the anesthetic management of a patient with lepromatous leprosy who had undergone laparoscopic radical nephrectomy for renal cell carcinoma under general anesthesia.

High prevalence of Mycobacterium avium subspecies paratuberculosis ('Indian bison type') in animal attendants suffering from gastrointestinal complaints who work with goat herds endemic for Johne's disease in India

OBJECTIVES

In this study we aimed to estimate the prevalence of Mycobacterium avium subspecies paratuberculosis (MAP) in animal attendants who were chronic colitis patients or who had inflammatory bowel disease and were suspected for Crohn's disease; these animal attendants worked with goat herds endemic for Johne's disease. Microscopic examination and culture tests were used. For comparison purposes a group of healthy human subjects (not suffering with colitis) was also screened.

METHODS

Stool samples obtained from 98 human subjects (58 animal attendants suspected for Crohn's disease and 40 healthy humans) were screened for the presence of MAP by microscopic examination and culture. Of the 58 animal attendants screened, 38 had abdominal pain, 29 had suffered episodes of diarrhea, 39 had experienced weight loss, 27 had fever, and 32 had a history of raw milk consumption. Animal attendants had had contact of variable duration with goat herds endemic for Johne's disease (1-5, 6-10, 11-15, and >15 years). Forty stool samples from healthy humans with no symptoms/history of contact with animals were also screened. IS900 PCR and IS1311 PCR restriction endonuclease analysis were used to characterize and genotype the MAP colonies.

RESULTS

MAP was recovered from 34 of the 98 human subject stool samples (34.7%). Of the 98 samples, 16.3% (n=16) were acid-fast. None of the 40 healthy human subjects were positive for MAP by microscopy, but five (12.5%) were positive for MAP by culture. Of the 58 animal attendants, 16 (27.6%) were positive by microscopy and 29 (50%) were positive by culture. MAP were recovered from 68.4% of animal attendants with abdominal pain, 72.4% of those with diarrhea, 71.8% of those with weight loss, 44.4% of those with fever, and 46.9% of those who had a history of raw milk consumption. Of the 29 culture-positive animal attendants, 48.3% had worked for >15 years, 27.6% for 11-15 years, 20.7% for 6-10 years, and 3.4% for 1-5 years with goat herds endemic for Johne's disease. Of the 34 culture isolates, 28 (82.4%) showed good quality DNA on agarose gel and were positive by IS900 PCR. Of the 28 IS900-positive DNA samples, 23 (82.1%) were genotyped as 'Indian bison type' and five (17.9%) as 'cattle type'.

CONCLUSIONS

The prevalence of MAP was higher in attendants suffering from gastrointestinal problems who worked with goat herds endemic for Johne's disease, than in humans with no history of contact with animals. The risk of developing gastrointestinal problems with clinical symptoms indistinguishable from inflammatory bowel disease was higher in humans who were in contact with goat herds endemic for Johne's disease as compared to healthy humans, and the risk was correlated with the duration of association with the endemic goat herds.

Identification of virulence factors and diagnostic markers using immunosecretome of Aspergillus fumigatus

Aspergillus fumigatus is a prime causative agent for various allergic and invasive aspergillosis. There has been a dramatic increase of such cases in last three decades yet the early diagnosis and virulence factor identification remains the challenge. In the present study secretome analysis of proteins isolated from the culture filtrate was done by 2D gel electrophoresis coupled with MS/MS and the immunosecretome analysis was carried out using immunoblotting of 2D transfer blots and probed with the sera of patients, immunized rabbit and mice. The identified proteins were analyzed further for homology with human proteins by BLAST search and for secretory signal by SignalP. A total of 65 protein spots from 2D gel resulted in identification of 24 different proteins along with their isoforms and out of which 15 proteins were identified as immunogenic in human. These findings may be helpful in the identification of virulence factors involved in aspergillosis and also useful as diagnostic markers.

In vitro degradation of fluoranthene by bacteria isolated from petroleum sludge

An investigation was carried out for in vitro degradation of fluoranthene by four bacterial strains (PSM6, PSM7, PSM10 and PSM11) isolated from the petroleum sludge. Although all the strains registered their growth in MSM with 100 ppm fluoranthene, PSM11 growth was better than other strains. Growth of bacterial strains invariably corresponded to their degradation potential of fluoranthene. After 168 h of incubation, 61% fluoranthene was degraded by PSM11, followed by PSM10 (48%) and PSM6 (42%) and the least was recorded in PSM7 (41%). Besides, 11% loss in fluoranthene was attributed to abiotic factors. Thirty-eight times more activity of catechol 2,3-dioxygenase than catechol 1,2-dioxygenase showed that it played a significant role in fluoranthene degradation. Molecular weight of catechol 2,3-dioxygenase isolated from PSM11 was determined as ∼ 136 kDa by size exclusion chromatography and 34 kDa on denaturing SDS-PAGE, indicating tetrameric nature of the enzyme.

Effect of sulphur and phosphorus on yield, quality and nutrient status of pigeonpea (Cajanus cajan)

A field experiment was conducted to study the impact of Sulphur(S) and Phosphorus (P) on yield, nutrient status of soil and their contents in pigeonpea (Cajanus cajan) during the year 2008-2009. Seven treatments were studied in Factorial Randomized Block Design with three replications. The treatment combinations were derived from three levels of sulphur (0, 20 and 40 kg S ha(-1)) and four levels of phosphorus (0, 25, 50 and 75 kg ha(-1)). The experimental soil was medium black, slightly calcareous, clay in texture and slightly alkaline in reaction. The results indicated a significant increase in grain yield (14.81 q ha(-1)) and straw yield (41.26 q ha(-1)) of pigeonpea after 20 kg S ha(-1) and 50 kg P2O5 ha(-1) treatment with common dose of nitrogen @ 30 kg ha(-1). The increase in grain and straw yield was 102.77 and 52.87% as compare to higher over control. Maximum number of pods plant(-1), maximum number of grains pod and test weight by this treatment was also observed as compared to control. Application of S and P improved soil fertility status and S alone did not influence P availability. Hence, in order to maintain the fertility status of the soil at high level, combine application of 20 kg S ha(-1) with 50 kg P2O5 ha(-1) is essential. The residual fertility status of soil is advocated for rainfed pigeonpea crop grown on vertisol in Vidarbha region.

Root canal complications: 'the hypochlorite accident'

Root canal treatment is performed routinely in dental practice, using sodium hypochlorite which serves as an effective irrigant. The literature reviewed shows that several complications following irrigation with sodium hypochlorite may occur, but few practitioners are aware of it and its management. Such complications include injury to skin, oral mucosa and eyes, damage to clothing, air emphysema, allergic reactions, and injection beyond the foramen. In this article, a case report of injection with sodium hypochlorite beyond the foramen is presented, together with a review of the recent literature regarding common manifestations and case histories. The literature shows no standard management of this condition, but symptomatic therapies are discussed. It is important to minimize the risk of sodium-hypochlorite-induced damage during root canal therapy by use of protective measures, appropriate instrumentation and techniques, and consider alternate irrigation solutions.

Melatonin protects against alterations in hippocampal cholinergic system, trace metals and oxidative stress induced by gestational and lactational exposure to cadmium

Dietary exposure to cadmium, even at lower doses, can lead to free radical induced neurotoxicity, neurobehavioral changes and alteration in neurotransmitters. Such changes are likely to be more pronounced in the developing brain due to incompleteness of blood brain barrier (BBB). Hippocampus being the seat of intelligence has a role in learning and cognitive behavior and any damage to hippocampus during developmental stage is likely to result in neurodegenerative changes in later life. To this end, fetal and neonatal exposure to cadmium was induced by exposing pregnant dams of Swiss albino strain throughout the period of gestation and following parturition up till 5^th day post partum (pp) through drinking water (3ppm/animal/day). The neonates were sacrificed on day 6 pp and indices of oxidative stress, levels of trace elements and changes in cholinergic system were evaluated in the hippocampus. Increased lipid peroxidation, surge in reactive oxygen species (ROS), depressed antioxidant defense, increased accumulation of cadmium, differential alterations in trace elements and decreased activity of AChE were the features of cadmium toxicity. Simultaneous administration of melatonin to cadmium challenged animals offset these detrimental changes. The results suggest that melatonin co-administration can effectively protect against the adverse effects of cadmium on endogenous antioxidant status, changes in trace metal concentrations and compromised hippocampal cholinergic system.

Impact of phosphorous on biochemical changes in Hordeum vulgare L. in mixed cropping with chickpea

Multiple cropping (i.e. intercropping or mixed cropping) plays an important role in agriculture because of the effective utilization of resources, significantly enhancing crop productivity compared with that of monocultured crops. The study was planed to assess the effect of various concentrations (00, 30, 60, 90 kg ha(-1)) of phosphorous on the biochemical composition of grains of Hordeum vulgare L. (NDB-1050) in mixed cropping system with Chickpea. Phosphorous is an essential ingredient for plants to convert atmospheric N (N2) into an ammonium (NH4) as a useable form. The available nitrogen content was found more in the year 2006 (131 kg ha(-1)) than year 2005 (105 kg ha(-1)). The results of available nitrogen content were showed that the mixed cropping system enhances N fixation process because phosphorous also influences nodule development through its basic functions in plants as an energy source. Reducing, non reducing and total sugar content of H. vulgare L. were influenced by changes in the phosphorous doses. Maximum protein (13.43%) was obtained at 60 kg P2O5 ha(-1) during the year 2006. Lysine, tryptophan and methionine content were found maximum in year 2006, respectively. Total mineral content of grains of plant (0.99 g 100g(-1)) was found maximum by the application of 60 kg P2O5 ha(-1). It is possible that there was an increase in the soil N made available by the leguminous chickpea species, and this could be another reason why there was an increase in Hordeum vulgare L. shoot mass per plant with intercropping with chickpea.

The reactive tumor microenvironment: MUC1 signaling directly reprograms transcription of CTGF

The MUC1 cytoplasmic tail (MUC1.CT) conducts signals from spatial and extracellular cues (growth factor and cytokine stimulation) to evoke a reprogramming of the cellular transcriptional profile. Specific phosphorylated forms of the MUC1.CT achieve this function by differentially associating with transcription factors and redirecting their transcriptional regulatory capabilities at specific gene regulatory elements. The specificity of interaction between MUC1.CT and several transcription factors is dictated by the phosphorylation pattern of the 18 potential phosphorylation motifs within the MUC1.CT. To better appreciate the scope of differential gene expression triggered by MUC1.CT activation, we performed microarray gene expression analysis and ChIP-chip promoter analysis and identified the genome-wide transcriptional targets of MUC1.CT signaling in pancreatic cancer. On a global scale, MUC1.CT preferentially targets genes relating to invasion, angiogenesis and metastasis, suggesting that MUC1.CT signaling contributes to establishing a reactive tumor microenvironment during tumor progression to metastatic disease. We examined in detail the molecular mechanisms of MUC1.CT signaling that induces expression of connective tissue growth factor (CTGF/CCN2), a potent mediator of ECM remodeling and angiogenesis. We demonstrate a robust induction of CTGF synthesis and secretion in response to serum factors that is enabled only when MUC1 is highly expressed. We demonstrate the requirement of phosphorylation at distinct tyrosine motifs within the MUC1.CT for MUC1-induced CTGF expression and demonstrate a phosphorylation-specific localization of MUC1.CT to the CTGF promoter. We found that MUC1 reorganizes transcription factor occupancy of genomic regions upstream of the CTGF gene, directing β-catenin and mutant p53 to CTGF gene regulatory elements to promote CTGF expression and destabilizing the interaction at these regions of the transcriptional repressor, c-Jun. With this example we illustrate the capacity of MUC1.CT to mediate transcription factor activity in a context-dependent manner to achieve widespread and robust changes in gene expression and facilitate creation of the reactive tumor microenvironment.

Electrophysiological characteristics of seizure clusters

The phenomenon of temporal clustering of seizures is well known, but its effect on seizure localization has not been rigorously analyzed. The aim of our study was to assess electrophysiological localization during Video EEG (VEEG) monitoring in patients with intractable epilepsy demonstrating a cluster of seizures. The study was conducted on 203 intractable epilepsy patients, aged 2 to 60 years (19.96 +/- 10.87). Patients with unilateral temporal lobe epilepsy having clusters were compared with patients not having clusters, and the effect of clustering on concordance was addressed. Fully consistent localization was observed in 116 patients, partially consistent localization in 18 patients, and inconsistent localization in 19 patients. ANOVA did not reveal any significant difference in these groups (p=0.65). A total of 770 seizures recorded from 149 patients was analyzed for clustering effect. Clustering was present in 603/770 seizures pairs (78.31%). In the cluster group, 483 (80.09%) seizure pairs were concordant for seizure onset, while 98 (16.25%) were discordant and 22 (3.65%) were indeterminate. In the noncluster group, 134 (80.24%) seizure pairs were concordant for seizure onset, while 23 (13.77%) were discordant and 10 (5.98%) were indeterminate. The study found that cluster seizures occurring within an interseizure interval (ISI) less than 8 hours are independent and have the same localizing value as those seizures with longer ISIs.

Esthesioneuroblastoma: a case report

Esthesioneuroblastoma (olfactory neuroblastoma) is an uncommon neuroectodermal tumor. Its biological activity ranges from indolent growth to local recurrence and rapid widespread metastasis. Treatment options consist of surgical resection followed by radiation therapy for primary lesions and the addition of chemotherapy for advanced, recurrent, or metastatic lesions. Patients often present with nasal obstruction, rhinorrhea, recurrent epistaxis, hyposmia, or anosmia. We report a case of esthesioneuroblastoma involving bilateral nasal cavity leading to bilateral nasal obstruction, epistaxis and proptosis of the right eye associated with decreased visual acquity on that eye and loss of smell. A diffuse nontender, 6x6 cms swelling with illdefined margins was seen over the nasal bridge, extending superiorly to glabella and laterally to right maxillary region. X-ray PNS showed soft tissue mass in the nasal cavity with destruction of nasal septum, intense periosteal reaction with destruction of right maxillary wall and extension to right orbit. CT scan of paranasal sinuses showed 8.5 x 4.9 x 7.8 cms irregularly marginated heterogeneous iso- to hyper dense soft tissue mass lesion with extensive adjacent bony destruction and spiculated periosteal reaction involving bilateral nasal cavity and anterior cranial fossa. Biopsy from right nasal mass showed neuroblastoma. The patient received radiotherapy and chemotherapy. The modified Kadish staging system, lymph node status, treatment modality, and age are useful predictors of survival in patients who present with esthesioneuroblastoma. Excellent outcomes for esthesioneuroblastoma are achievable. Long-term follow-up is necessary because of the extended interval for recurrent disease; unlike most sinonasal malignancies, surgical salvage is possible.

DNA content can improve the detection and prognosis of carcinoma of the cervix

In all malignant diseases, several clinical and histopathological tests are established as standard methods for diagnosis. Alternative diagnostic quantitative methods are still lacking or conflicting in cancer of the cervix. Although DNA analysis was one of the earliest applications in flow cytometry and the DNA content of fresh/frozen tissue have shown good prognostic results in many diseases including cervical cancer, prognostic ability cannot be easily clarified quantitatively by biochemical values. Thus, our objective was to determine whether the addition of a DNA content study using flow cytometry improves the detection of cervix cancer. The quantification of DNA content was done by high resolution DNA flow cytometry in fresh/frozen tissues of healthy cervix (control, n = 38) and from cancer of the cervix (n = 62). Results show that the mean fraction of Total S phase, Total Aneuploid and G2-M (Diploid) are significantly higher (p < 0.01); while G0-G1 (Diploid) and G0-G1 (Aneuploid) are significantly lower (p < 0.01) in cancer patients as compared to control. Among cell cycle parameters, G0-G1 (Diploid) shows a classifying ability of 97% and at a criterion/threshold value of ? 79.88, it discriminates cases with the highest sensitivity of 96.77 (88.8-99.5; 95% CI) and specificity 100.0 (90.7-100.0; 95% CI) and with Total S phase or Aneuploid, it discriminates cases with 100% sensitivity. G0-G1 (Diploid) also showed a direct and significant correlation (r = 0.66; p < 0.01) with patient survival indicating prognostic significance. Cell cycle parameters will be very helpful in false positive results or where the clinician is unable to diagnose the stage of cervix cancer clinically or histopathologically.

Zinc disc implantation model of urinary bladder calculi and humane endpoints

The zinc disc implantation-induced urinary bladder calculi model in the rat is commonly used for preclinical evaluation of the antiurolithiatic activity of test compounds. Certain published reports state that relatively long durations for which zinc discs must be implanted in the bladders of rats. Hence, there is a need to refine this model. These investigations aimed to determine whether long-term studies using the zinc disc implantation model provide any additional data that affect the final outcomes of the study. In this study, we evaluated the effects of a well-known antiurolithiatic polyherbal drug, Cystone, for different treatment durations of 10, 20 and 48 days postimplantation. Our results indicate that even the shortest duration of 10 days is sufficient to reveal antiurolithiatic effects of a test drug. Hence, in the zinc disc implantation-induced urinary bladder calculi model, the study duration is proposed to be minimized so as to reduce the distress caused to the rats due to long-term exposure to the implant. Further, it is suggested that the growth of the bladder calculi can be monitored by taking X-ray radiographs of the bladder deposits to decide the time to terminate the study. Use of preformed calcium oxalate crystal instead of zinc discs, as suggested in earlier reports by others, may also be considered to avoid the sacrifice of rats at the end of the study.

SUMO fusion facilitates expression and purification of garlic leaf lectin but modifies some of its properties

Over expression of lectin genes in E. coli often gives inclusion bodies that are solubilised to characterize lectins. We made N-terminal fusion of the Allium sativum leaf agglutinin (ASAL) with SUMO (small ubiquitin related modifier) peptide. The SUMO peptide allowed expression of the recombinant lectin in E. coli, predominantly in soluble form. The soluble fusion protein could be purified by immobilized metal affinity column (IMAC), followed by size exclusion chromatography. The SUMO protease failed to cleave the SUMO peptide from ASAL. This may be due to steric hindrance caused by the homodimer structure of the chimeric ASAL. Some properties like dimerization, haemagglutination and insecticidal properties of the recombinant SUMO-ASAL fusion protein were comparable to the plant derived native lectin. However, glycan array analysis revealed that the carbohydrate binding specificity of the recombinant SUMO-ASAL was altered. Further, the fusion protein was not toxic to E. coli (native ASAL exhibited toxicity). The recombinant lectin was more thermo-labile as compared to the native lectin. Three important findings of this study are: (1) sugar specificity of ASAL can be altered by amino-terminal fusion; (2) anti-E. coli activity of ASAL can be eliminated by N-terminal SUMO fusion and (3) SUMO-ASAL may be a preferred candidate insecticidal protein for the development of transgenic plants.

A huffing manoeuvre, immediately before induction of anaesthesia, prevents fentanyl-induced coughing: a prospective, randomized, and controlled study

BACKGROUND

Preinduction i.v. fentanyl bolus is associated with coughing in 28-65% of patients. Fentanyl-induced coughing (FIC) is not always benign and can be remarkably troublesome at the most critical moment of induction of anaesthesia when airway reflex is lost. We postulated that the huffing manoeuvre, a forced expiration against open glottis, just before i.v. fentanyl, may suppress this undesirable spasmodic cough.

METHODS

Three hundred patients of ASA I and II, aged 18-60 yr, undergoing elective surgical procedures were randomly allocated into two groups consisting of 150 patients. Both groups received i.v. fentanyl (2.5 microg kg(-1)). Group 1 patients breathed normally whereas Group 2 patients were asked to perform huffing manoeuvre just before the fentanyl injection. The incidence of cough was recorded for 1 min before the induction of anaesthesia, and graded as mild (1-2 cough), moderate (3-5 cough), and severe (>5 cough). The incidence of FIC was analysed with Fisher's exact test and severity was analysed with the Mann-Whitney U-test. A P-value of <0.05 was considered significant.

RESULTS

The incidence of cough was 32% in the control group and 4% in the huffing manoeuvre group (P<0.00). In the control group, 12% of FIC cases were moderate to severe in nature whereas no patient suffered severe coughing in the huffing manoeuvre group (P=0.049).

CONCLUSIONS

A huffing manoeuvre performed just before i.v. fentanyl (2.5 microg kg(-1)) significantly reduces the incidence and severity of FIC in the majority of the patients.

Strain diversity within Mycobacterium avium subspecies paratuberculosis--a review

Mycobacterium avium subspecies paratuberculosis (MAP), is the etiological agent of Johne's disease (or paratuberculosis) in animals and has also been linked with Crohn's disease of human beings. Extreme fastidious nature of the organism (MAP) has hampered studies on diversity within the organism. Studies based on phenotypic properties like growth rate, pigmentation, lipid profile etc., are unable to provide complete information on diversity of MAP organism in nature. However, with the advent of molecular assays (IS900 RFLP, PFGE, IS1311 PCR-REA, SSR typing, VNTR typing etc.) in last 2 decades, progress has been made to differentiate MAP strains. MAP isolates have been classified into various types and subtypes using these molecular tools. Optimization of these typing assays has led to generation of new information about MAP strains, subtypes, their comparative genomics, relative evolution, comparative virulence etc. Knowledge of strain diversity is important for better understanding of molecular and sero-epidemiology, infection and patho-biology, vaccine development and planning control strategies. The present review provides available information on MAP strains, ho st adaptations, their virulence,comparative genomics, relative genetic evolution and differentiation.

Variation of 18 STR loci in Shahabadi sheep of India

Shahabadi sheep represent an important but uninvestigated source of genetic diversity. Eighteen microsatellite markers were employed to analyze the genetic diversity of Shahabadi sheep population found in Bihar, India with fifty samples. Microsatellites were highly polymorphic with a mean allelic number 5.56 +/- 1.79. The observed heterozygosity, expected heterozygosity and observed and effective number of alleles were used to estimate the genetic variation of this breed. The observed heterozygosity in the population varied from 0.279-0.739 with the mean of 0.501 +/- 0.151, reflecting substantial genetic variation in this population. Population was observed to be heterozygote deficient (21.5%). The results of this study indicated that conservation of genetic variation in Shahabadi population should be considered by breeders, in the interest of long term future of the breed in its native tract.

High level expression of a functionally active cholera toxin B: rabies glycoprotein fusion protein in tobacco seeds

A synthetic DNA construct containing cholera toxin B subunit, genetically fused to the surface glycoprotein of rabies virus was expressed in tobacco plants from a seed specific (legumin) promoter. Seed specific expression was monitored by real-time PCR, GM1-ELISA and Western blot analyses. The fusion protein accumulated in tobacco seeds at up to 1.22% of the total seed protein. It was functionally active in binding to the GM1-ganglioside receptors, suggesting its assembly into pentamers in seeds of the transgenic plants. Immunoblot analysis confirmed that the approximately 80.6 kDa monomeric fusion polypeptide was expressed in tobacco seeds and accumulated as an approximately 403 kDa pentamer. Evaluation of its immunoprotective ability against rabies and cholera is to be examined.

Diagnostic Application of IS900 PCR Using Blood as a Source Sample for the Detection of Mycobacterium avium Subspecies Paratuberculosis in Early and Subclinical Cases of Caprine Paratuberculosis

Efficacy of IS900 blood PCR was evaluated for the presence of MAP infection. Serum, fecal, and blood samples of kids, young, and adult goats from farm and farmer's herds in Mathura district were also screened by ELISA, microscopy and culture. Of 111 goats (kids: 40, young: 14, adults: 57) screened, 77.5% were positive by blood PCR. Of 76 goats, 90.8% (kids: 87.5% and adults: 94.4%) were positive by PCR. From 21 kids and 14 young goats, 42.8 and 57.1% were positive. gDNA from goats was genotyped as MAP “Indian Bison type”. Of 21 fecal samples of kids examined by microscopy, 66.7% were positive. In ELISA, 9.5 and 57.1% kids were positives as “type I” and “type II” reactors, respectively. Screening 14 young goats by culture of blood clots, 28.6% were positive. Agreement was substantial between PCR and microscopy. It was fair and moderate when PCR and microscopy were compared with type I and type II reactors, respectively. Presence of MAP in non-clinical kids and young goats indicate early or subclinical infection. Blood PCR was rapid, sensitive, and specific assay for detection of MAP in any stage (early, subclinical, and clinical) and age (kids, young, and adult) of goats.

Patient controlled sedation during central neuraxial anesthesia

BACKGROUND

Patient controlled sedation (PCS) gives liberty to patients to choose the time of sedative administration to attain a desired level of comfort.

AIMS

The PCS use was evaluated in patients during surgery under central neuraxial blockade.

SETTINGS AND DESIGN

Prospective, cross-sectional, clinical study on consecutive patients in a tertiary care university hospital.

MATERIALS AND METHODS

PCS technique, using propofol (1%) 2 ml in 2 min was used in 160 adult patients undergoing urologic procedures under central neuraxial block. We observed the time to first PCS activation by patient, duration of surgery, propofol dose, sedation score, hemodynamic stability, patient's acceptability, and the factors correlating with the PCS use.

STATISTICAL ANALYSIS USED

Non-parametric two-tailed Pearson's test, univariate correlation analysis for the factors favoring PCS use followed by multivariate logistic regression analysis amongst correlating factors.

RESULTS

In our cohort, the majority (83%) of the patients activated PCS during surgery under central neuraxial blocks at median time of 30 min and (17%) did not activate PCS. Female patients activated sedation earlier (median 15 min) than male patients (median 30 min). All patients were hemodynamically stable and without significant side effects. Multivariate analysis showed that sedative use significantly ( P < 0.05) correlated with female gender (odds ratio-3.54 [IR-2.64 to 4.73]) and prolonged surgery (>90 min). Majority (91%) of patients rated PCS technique excellent to good.

CONCLUSIONS

PCS was very well accepted by patients during central neuraxial block. Propofol regimen (2 ml in 2 min) in PCS was safe, as it caused neither apnea nor significant hypotension.

The effect of prostanoid precursors and inhibitors on platelet angiotensin II binding

Pregnancy-induced hypertension is characterised by an imbalance of arachidonic acid metabolites: Prostacyclin (PGI2) is vasodilatory and a potent inhibitor of platelet reactivity. Thromboxane (TXA2) induces vasoconstriction and platelet aggregation. Previous intervention studies have been aimed at increasing vasodilatation and decreasing platelet aggregation using low dose aspirin or dietary manipulation of prostaglandins. The aim of this study was to investigate the value of combining low dose aspirin with dietary fatty acid supplementation and its effects on platelet angiotensin II binding in non-pregnant women. Sixty non-pregnant, healthy female volunteers were recruited and randomly allocated to one of six treatment regimens which included aspirin taken alone and in combination with fish oil or evening primrose oil. A control group took no treatment. Platelet AII binding was determined before and after treatment for 1 month. There was no change in platelet angiotensin II binding after 1 month in the control group or in those who received evening primrose oil or fish oil alone. A significant decrease in binding was found in those who took aspirin in combination with fish oil (P = 0.03). An increase in binding was seen in those who took aspirin only, although this was not statistically significant (P = 0.14). A decrease was found in those who took aspirin in combination with evening primrose oil but again this was not statistically significant (P = 0.07). This study found that the combined effect of low-dose aspirin and fish oil causes a significant decrease in platelet angiotensin II binding not caused by either compound taken alone. Given that angiotensin II exerts its effect in part by direct interaction with vascular AII receptors, (platelets being used as 'models' of vascular myocytes), and that pre-eclampsia is associated with major pathophysiological changes in prostanoid metabolism, these pilot data provide a basis for further investigation.

Exploring fish bioassay of textile dye wastewaters and their selected constituents in terms of mortality and erythrocyte disorders

Acute (4 day) and short-term (7 day) toxicity studies (at 1/5th and 1/10th of LC(50)) of textile dye wastewaters and their selected ingredients (azo dye methyl red and heavy metals Cd, Cu, Ni and Zn) were made on a freshwater fish Gambusia affinis under laboratory conditions. LC(50) value was found to be the lowest in four cases, and the EC(50) value for reduction in erythrocyte counts in the remaining four tests. Thus, the reduction in erythrocyte counts to the 50% level was similar in sensitivity to fish mortality. The short-term toxicity studies revealed significant disorders in erythrocyte morphology (poikilocytosis) and its counts to be the better indices for toxicity monitoring in the absence of fish mortality.

Effect of copper on growth, yield and concentration of Fe, Mn, Zn and Cu in wheat plants (Triticum aestivum L.)

A pot experiment was conducted at six graded levels of copper (Cu) viz., 0, 0.5, 1.0, 1.5, 2.0 and 2.5 mg kg(-1) to test the response of wheat plants grown in a copper-responsive alluvial soil (entisol) under glass house conditions. The growth attributes like plant height, fresh and dry matter yield, percent dry matter enhanced with increasing Cu levels and was maximum at 1.5 mg kg(-1) Cu while the number of tillers was minimum at this level. The grain yield at 1.5 mg kg(-1) Cu was enhanced by 62.9% from the control. The increase in weight of 1000 grains ranged from 33.93 to 41.35 g in comparison to control (32.58 g). Harvest index (%) also increased and ranged from 39.42 to 47.73 in different treatments in comparison to control (35.92). Both 1000 grain weight and harvest index were maximum in the plants at 1.5 mg kg(-1) copper. Cu concentrations in leaves, grain and straw enhanced with increasing levels of Cu application. The Fe concentration in leaves was significantly reduced by Cu application and the reduction was 10.3% at 2.5 mg kg(-1) Cu and was not influenced in by Cu application in grain and straw. The Mn concentration was not affected by Cu application in any of the plant part studied. However, Zn concentration decreased significantly at higher levels of Cu (2.0 and 2.5 mg kg(-1)) in leaves and remained unaffected in the grain and straw.

Open simultaneous double dislocation of the metacarpophalangeal and interphalangeal joints of the thumb with ulnar collateral ligament avulsion

Double dislocations of the thumb at the metacarpophalangeal joint (MCPJ) and interphalangeal joint (IPJ) occurring at the same time are seldom seen in medical practice. The sporadic occurrence of this interesting injury makes it difficult to formulate a clear management protocol. We report an unusual combination of injury involving the right thumb of a 60-year-old man, where the IPJ was dislocated dorsally with a volar dislocation of the MCPJ. It was an open injury with avulsion of the ulnar collateral ligament of the MCPJ. The dislocation was treated successfully by closed reduction in the casualty department, under a ring block. The ulnar collateral ligament was repaired later in the operating theatre. At six months' follow-up, the patient had a full painless range of movement in his thumb with no instability. To our knowledge, this is the first reported case of a thumb double dislocation where the injury was open at both joints. This is also the first case where a volar dislocation of the MCPJ was treated successfully by closed reduction, with an excellent functional outcome.

Bilateral coracoclavicular joints as a rare cause of bilateral thoracic outlet syndrome and shoulder pain treated successfully by conservative means

The coracoclavicular joint (CCJ) is a rare anomalous joint. Symptomatic CCJ, being an exceptional rarity, makes it difficult to formulate a standard set of practice or guidelines. We report a 50-year-old Indian man, a machine operator by profession, who experienced bilateral shoulder pain and arm paraesthesia for two years, and was diagnosed with bilateral CCJ. The symptoms gradually increased, affecting his daily activities. Dynamic magnetic resonance imaging revealed the compression of the brachial plexus in extreme shoulder abduction. After a thorough search of the literature, we retrieved four similar cases, all of them treated with individualised protocols. None of the cases was bilateral. The lack of clear evidence in any particular direction and the patient's medical condition prompted us to give a conservative trial, before embarking on more invasive methods. He showed rapid response to the conservative treatment with remission of all symptoms. To the best of our knowledge, this is the first reported case of bilateral symptomatic CCJ with bilateral thoracic outlet syndrome, that was managed conservatively.

Expression of the cry1EC gene in castor (Ricinus communis L.) confers field resistance to tobacco caterpillar (Spodoptera litura Fabr) and castor semilooper (Achoea janata L.)

Castor (cv. DCS-9) has been transformed through Agrobacterium-mediated and particle gun bombardment methods using appropriate vectors containing the Bt chimeric gene cry1EC driven by enhanced 35S promoter. About 81 and 12 putative transformants were regenerated following selection on hygromycin and kanamycin, respectively. Southern analysis of DNA extracted from T(0) plants confirmed integration of the introduced gene in castor genome. The integration and inheritance of the introduced genes was demonstrated up to T(4) generation by PCR and Southern analysis. Southern analysis of two events having single and two copies showed the same pattern of integration in the subsequent generations. Insect feeding experiments conducted in the laboratory by releasing neonate larvae of castor semilooper and S. litura on leaf tissues excised from transgenic and control plants showed varying degrees of larval mortality and slow growth in larvae fed on transgenic leaf tissue. Field bioassays against Spodoptera litura and castor semilooper conducted for eight events in T(1)-T(4) generations under net confinement were more informative and events conferring resistance to the two major defoliators were identified.

Comparative potential of modified indigenous, indigenous and commercial ELISA kits for diagnosis of Mycobacterium avium subspecies paratuberculosis in goat and sheep

In the present study, modified indigenous ELISA kit (kit 1) was compared with indigenous ELISA kit (kit 2) and commercial ELISA kit (kit 3) for its sensitivity and specificity with respect to faecal culture for diagnosis of Johne's disease in goats and sheep under natural conditions. Of the 64 positive animals, serum of 42.1, 48.4 and 18.7% animals yielded positive infection in kit 1, 2 and 3, respectively. Specificity of kit 1 (95.1%) was maximum followed by kit 3 (93.7%) and kit 2 (83.4%). Kit 1 showed superior diagnostic potential than the other two kits. Kit 1 may be used as single screening test regimen for diagnosis of MAP infection in the population of goats and sheep in India.

Extraskeletal ossifying chondroma in Hoffa's fat pad: an unusual cause of anterior knee pain

Hoffa's disease is an obscure cause of anterior knee pain. A misconception about its rarity is very common among clinicians, and hence it is often misdiagnosed and treated as meniscal pathology. Increased awareness is required to diagnose and treat the condition appropriately. These diagnostic uncertainties commonly result in increased patient morbidity and mismanagement. In spite of a widely-accepted common occurrence of Hoffa's disease, ossification of the Hoffa's fat pad is seldom reported. We report a giant extraskeletal ossifying chondroma in a 55-year-old man, presented as chronic knee pain and successfully treated by excision. The anatomy, pathology, histology, radiological features and management of the disease are described, to increase awareness in the orthopaedic community of this common, interesting but rarely discussed condition.

Unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third tibial fractures

PURPOSE

To assess the outcome of unreamed intramedullary nailing through the lateralised entry point using oblique proximal and biplanar distal interlocking screws.

METHODS

15 men and 3 women aged 25 to 58 (mean, 37) years underwent unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third metaphyseal tibial fractures. The entry point was kept proximal to the tibial tuberosity and slightly lateral to midline. Proximal locking was at 45 degrees to the coronal and sagittal planes. Biplanar distal locking was in the coronal and sagittal planes.

RESULTS

16 patients had bone union within 20 (mean, 17; range, 14-27) weeks; 2 underwent dynamisation for delayed union. Three patients had valgus angulation of less than 5 degrees; 2 had a loss of terminal knee flexion; 3 had a loss of ankle dorsiflexion; and 3 had shortening of more than 0.5 cm. Functional outcomes were excellent in 13, good in 4, and fair in one patient. No patient endured neurovascular injury, compartment syndrome or implant failure.

CONCLUSION

Unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third tibial fractures was effective in preventing malalignment.

Traumatic bilateral atlantoaxial rotatory subluxation mimicking as torticollis in an adult female

Rotatory subluxation of the atlantoaxial joint in adults is a rare, but potentially life-threatening injury. Delayed or missed diagnosis can lead to catastrophic consequences. Early recognition and prompt treatment is paramount to avoid long-term morbidity and disability. We report on an instance of bilateral atlantoaxial rotatory subluxation (AARS) in a 25-year-old female who presented to the Casualty Department with a painful neck, right-sided hemiparesis and torticollis after a road traffic collision. Reduction was achieved by controlled cervical traction followed by immobilization in a four-post Halo brace, with complete resolution of her symptoms. At the 12-month follow-up, she had normal neck movements with no signs of instability.

An ethnobotanical study of medicinal plants in Chandauli District of Uttar Pradesh, India

AIM OF THE STUDY

Chandauli district is one of the less studied regions of India for its ethnobotanical values. The present paper synthesizes the first report related to the documentation and conservation of ethnomedicinal plants of Chandauli district and their socio-economic relationship with the forests and its resources.

MATERIALS AND METHODS

Ethnobotanical data were collected using semi-structured interviews, field observations, preference and direct matrix ranking with traditional medicine practitioners.

RESULTS

The use of 40 medicinal plants belonging to 27 families was documented in the tribal communities of Chandauli district in India. These species were used in combination of some exotic species such as Foeniculum vulgare, Prosopis spicigera, Crataeva nurvala, Curcuma longa, Punica granatum, Aloe vera, Cocos nucifera, Ocimum sanctum and Allium cepa and some medicinal stones, minerals, salts, etc. Most of the plants (94.6%) were reportedly used to treat human diseases.

CONCLUSIONS

Documenting the eroding plants and associated indigenous knowledge can be used as a basis for developing management plans for conservation and sustainable use of medicinal plants in the area. The principal threatening factors reported were deforestation (90%), agricultural expansion (85%) and overgrazing (53%).

Mycobacterium avium subspecies paratuberculosis diagnosis and geno-typing: Genomic insights

Effective control of paratuberculosis and investigations of potential link to Crohn's disease have been hampered by the lack of effective assays for easy and accurate diagnosis of Mycobacterium avium subspecies paratuberculosis (Map). Map is extremely fastidious and depends on iron chelator (Mycobactin). Map strains from humans and sheep are very difficult to isolate and may require years to emerge. Therefore, small numbers of Map isolates have been maintained in available collections. This situation has limited the study of biodiversity of Map. Though, much is known about environmental and host factors that contribute to paratuberculosis disease, but little is known about bacterial genetic mechanism of infection. Diagnostic and strain typing markers still demand improvements. Complete genome sequence of Map K10 strain is available in public domain for comparative genomics with other mycobacteria and clinical isolates of Map. It is anticipated that the genome sequence will help in carrying molecular diagnosis and strain typing with respect to Map forward at rapid pace. This paper reviews the current diagnostic and strain typing markers, which may be useful in typing of clinical isolates in near future.

Estimation of genetic diversity in Siri cattle from India

Siri cattle, a dual purpose breed of India is currently showing declining population trend. Siri animals have been developing through natural selection and show high adaptation to wide range of hilly terrain (altitudes 150-2500 m). The present work evaluated the genetic diversity of 23 FAO recommended microsatellite loci in a sample of 50 animals. The allele and genotype frequencies, heterozygosities and gene diversity were estimated. A total of 141 alleles were detected by the 23 microsatellite markers investigated. Microsatellites were highly polymorphic with mean allelic number 6.13 +/- 1.63 (ranging from 3-10 per locus). The observed heterozygosity in the population varied from 0.26-0.80 with the mean of 0.53 +/- 0.16, indicating substantial genetic variation in this population. Heterozygote deficiency and mutation-drift equilibrium hypothesis were also examined. Population exhibited heterozygote deficit to the tune of 22.1%. Population was found to be in mutation-drift equilibrium. Substantial genetic variability verified in Siri cattle despite its reducing population size suggests that this breed has a rich reservoir of genetic diversity. This fact and its marked environmental adaptation reinforce the importance of its preservation as a pure breed, and/or its use in agricultural exploitation.

Sero-prevalence of Bovine Johne's disease in buffaloes and cattle population of North India using indigenous ELISA kit based on native Mycobacterium avium subspecies paratuberculosis ‘Bison type’ genotype of goat origin

Present pilot study is the first attempt in the country to estimate sero-prevalence of Bovine Johne's disease (BJD) by screening cattle and buffaloes representing large population belonging to farmer's and farm herds in the home tracts (Uttar Pradesh (UP) and Punjab) of Hariana cattle and Murrah buffaloes in North India. Indigenous and in-house plate ELISA kit (using protoplasmic antigen from native Mycobacterium avium subsp. paratuberculosis 'Bison type' strain of goat origin), originally developed for goats and sheep was standardized in bovines and used for screening. For this study, 33 villages of south and west UP were randomly selected and surveyed from 2001 to 2003. There were 7943 farmer's families having 38,251 livestock, including cattle, buffaloes, goats and sheep (per family 4.8% livestock). Numerically, buffaloes and cattle were 54.7% and 22.1%, respectively. Serum samples were collected from 726 animals (4.2% of 16, 981 livestock with 4375 farmer's families) located in 33 randomly surveyed villages. Serum samples (699), submitted to Epidemiology Department of Veterinary College (Punjab Agricultural University, Ludhiana), in the year 2004 by farmer's and organized farm herds (Buffaloes, 372, Cattle, 327), were screened by this ELISA kit. Soluble protoplasmic antigen was prepared from Map (S 5) 'Bison type' strain isolated from a terminally sick goat with Johne's disease. Of the total 1425 bovine (Buffaloes and cattle) serum samples screened using indigenous ELISA kit, sero-prevalence of Johne's disease was 29.0% (28.6% in buffalo and 29.8% in cattle) in Northern India. State-wise sero-prevalence was 31.9% and 23.3% in UP and Punjab, respectively. In UP, of the 601 randomly sampled buffaloes, sero-prevalence was 40.3% (16.6% in young and 40.9% adults) and 25.5% (10.5% in young and 26.3% adults) in south and west UP, respectively. Of the 125 cattle screened, sero-prevalence was 42.6% (nil in young and 44.4% adults) and 30.0% (nil in young and 30.6% adults) in south and west UP, respectively. Of the 699 serum samples screened from Ludhiana, Punjab, sero-prevalence of BJD was 23.0%. Sero-prevalence was 23.3% (12.1% in young and 24.4% in adults) and 26.9% (27.2% in young and 26.8% in adults) in buffaloes and cattle, respectively. High prevalence of BJD in buffaloes in native tract of Murrah breed, and Hariana breed of cattle correlated with poor per-animal productivity and BJD may be the major cause. Indigenous ELISA kit was rapid, economic and sensitive test for large-scale screening of buffaloes and cattle population against incurable BJD.

Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy

BACKGROUND

Postoperative pain is the dominating complaint and the primary reason for prolonged convalescence after laparoscopic cholecystectomy. We have evaluated the efficacy of a single preoperative dose of pregabalin for attenuating postoperative pain and fentanyl consumption after laparoscopic cholecystectomy.

METHODS

Sixty adults (16-60 yr), ASA physical status I and II, of either sex undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized placebo controlled, double-blind study. Subjects were divided into two groups of 30 each to receive either a matching placebo or pregabalin 150 mg, administered orally 1 h before surgery. Postoperative pain (static and dynamic) was assessed by a 100 mm visual analogue scale, where 0, no pain; 100, worst imaginable pain. Subjects received patient-controlled i.v. fentanyl analgesia during the postoperative period. Results were analysed by Student's t-test, chi(2) test, Mann-Whitney U-test, and Fisher's exact test.

RESULTS

Postoperative pain (static and dynamic) and postoperative patient-controlled fentanyl consumption were reduced in the pregabalin group compared with the placebo group (P<0.05). Side-effects were similar in both groups.

CONCLUSIONS

A single preoperative oral dose of pregabalin 150 mg is an effective method for reducing postoperative pain and fentanyl consumption in patients undergoing laparoscopic cholecystectomy.