Impact of killer immunoglobulin-like receptor-human leukocyte antigens ligand incompatibility among renal transplantation

Killer immunoglobulin-like receptor (KIR) gene shows a high degree of polymorphism. Natural killer cell receptor gets activated once they bind to self-human leukocyte antigens (HLAs) with specific ligand. KIR gene and HLA ligand incompatibility due to the presence/absence of KIR in the recipient and the corresponding HLA ligand in the allograft may impact graft survival in solid organ transplantation. This study evaluates the effect of matches between KIR genes and known HLA ligands. KIR genotypes were determined using sequence specific primer polymerase chain reaction. Presence of certain KIR in a recipient, where the donor lacked the corresponding HLA ligand was considered a mismatch. The allograft was considered matched when both KIR receptor and HLA alloantigen reveald compatibility among recipient and donor. The data revealed better survival among individuals with matched inhibitory KIR receptors and their corresponding HLA ligands (KIR2DL2/DL3-HLAC2, KIR3DL1-HLABw4). On the contrary, no adverse effect was seen for matched activating KIR receptors and their corresponding HLA ligands. One of the activating gene KIR2DS4 showed risk (P = 0.0413, odds ratio = 1.91, 95% confidence interval = 1.02-3.57) association with renal allograft rejection. We conclude that the presence of inhibitory KIR gene leads to better survival; whereas activating motifs show no significant role in renal allograft survival.

Maternal mortality in obstetrics and gynaecology in a tertiary care hospital

Maternal mortality is the leading causes of death and disability of reproductive age in the developing countries. Bangladesh is one of the developing countries where maternal mortality is very high. The purpose of the present study was to see the causes of maternal deaths at Obstetrics and Gynaecology ward. This retrospective study was carried out in the Department of Obstetrics and Gynaecology at Dhaka Medical College Hospital (DMCH). All maternal deaths were included in this study from July 2003 to June 2004 for a period of one year. The incidence of maternal death was 18.5/1000 live birth. Hypertensive disorder of pregnancy (41.84%) was the most common cause of maternal death followed by unsafe abortions (21.4%), PPH (10.2%), obstructed labour (8.2%). Among 98 patients 36(36.7%) cases are died due to eclampsia. Death due to pre-eclampsia (5.1%), unsafe Abortion (21.4%), Obstetric haemorrhage (18.4%) and obstructed labour (8.3%) were commonly found in this study. The study permits to conclude that Hypertensive disorder of pregnancy is the leading cause of pregnancy related deaths followed by unsafe abortions and obstetric haemorrhage. Other causes include obstructed labour, anaesthetic complications and others.

Improving the feeding value of straws with Pleurotus ostreatus

The high content of lignin in cell walls is the major limiting factor in the digestion and utilisation of cereal crop residues by ruminants. The aim of this study was to evaluate the effectiveness of the white rot fungus, Pleurotus ostreatus (P. ostreatus), to degrade lignin and to enhance the rumen degradability of maize stover, rice straw, wheat straw and their mixture in equal proportion on a dry-matter (DM) basis. Four samples of each substrate were incubated aerobically in triplicate with P. ostreatus for 0 (Control), 21, 28 and 35 days under solid-state conditions (temperature, 24°C; humidity, 70 ± 5%). The changes in chemical composition, DM and nutrient losses, and rumen fermentation characteristics using in vitro DM digestibility (DMD) and the in vitro gas-production (GP) technique were measured. The results showed that incubation with P. ostreatus decreased (P < 0.001) the contents of neutral detergent fibre and lignin with a concomitant increase (P < 0.001) in the contents of ash and crude protein. The losses of nutrients differed (P < 0.001) among the straw types, with rice straw and maize stover showing the largest (P < 0.05) lignin degradation compared to wheat and mixed straws. The DMD and 72-h cumulative GP increased (P < 0.001) consistently with increasing fungal incubation period and for all substrates the highest values of DMD and GP were measured after 35 days of incubation with P. ostreatus. The lignin degradation was strongly associated with hemicellulose degradation (r = 0.71) across the various straws. Results of the present study demonstrated that incubation of low-quality crop residues with P. ostreatus under solid-state conditions upgrades their feeding value by reducing the content of lignin and increasing the content of crude protein and ruminal degradation.

Processing of Polyetherimide/Cloisite 30B Nanocomposite by Vibration Casting Method

Vibration casting method was developed for making polyetherimide (PEI)/Cloisite 30B nanocomposite. Towards this, a vibration casting apparatus was designed and developed. Vibration casting apparatus provided vibrational energy and heat, simultaneously. The processing parameters were established for vibration casting in terms of frequency of vibration, temperature, time and viscosity of casting mixture. Casting mixture of PEI/Cloisite 30B/N,N-dimethyl acetamide (DMAc) was made by dissolving PEI in DMAc and then mixing Cloisite 30B in this solution. The viscosity of PEI/Cloisite 30B/DMAc mixture was optimized for casting by controlling the volume fraction of PEI in DMAc. Morphology of PEI/Cloisite 30B nanocomposite was examined by wide angle X-ray diffraction, transmission electron microscopy, scanning electron microscopy and contact angle measurement. Mechanical and thermal properties of PEI/Cloisite 30B nanocomposite were also compared with that of neat PEI to ascertain the efficacy of vibration casting method.

The Gonzalez hernia revisited: use of the ischiorectal fat pad to aid in the repair of rectovaginal and rectourethral fistulae

INTRODUCTION

During the development of the posterior sagittal approach to anorectal malformations a vital technical challenge was a precise midline dissection, which if off, allowed for the ischiorectal fat pad to bulge into the wound. This occurrence became affectionately known as a "Gonzalez hernia", after a trainee of Dr Pena's (and a co-author of this paper). We describe here an innovative use of the ischiorectal fat pad to aid in the repair of acquired rectovaginal and rectourethral fistulae.

METHODS

Patients with recurrent vaginal or urethral fistulae were selected for review. The ischiorectal fat pad was deliberately mobilized (via a posterior sagittal or transanal approach) and used to buttress the repair of the posterior vagina or urethra.

RESULTS

The ischiorectal fat pad technique was used in 9 patients. All had an acquired fistula (6 rectovaginal fistula, 3 rectourethral fistulas). We used the posterior sagittal approach in 7 and in 2 the transanal approach. Six patients had had at least two prior attempts at fistula repair. Six patients had a stoma, and 3 did not. There were no recurrences in greater than six month follow-up.

DISCUSSION

The ischiorectal fat pad is easily visualized and mobilized, either via a posterior sagittal or transanal approach, providing excellent coverage with native, well-vascularized tissue, in an area that is difficult to heal. It is an excellent option for recurrent rectovaginal and rectovaginal fistulae and may have other additional creative applications.

Infant robotic pyeloplasty: comparison with an open cohort

OBJECTIVE

To present our experience with infant pyeloplasty, comparing outcomes between robotic-assisted laparoscopic pyeloplasty (RALP) and open pyeloplasty (OP).

MATERIALS AND METHODS

A retrospective review was performed of all children <1 year of age who underwent unilateral dismembered pyeloplasty at a single pediatric institution since January 2007. Patients with standard laparoscopic pyeloplasty were excluded. Patient demographics, intraoperative details, narcotic usage, and complications were reviewed.

RESULTS

A total of 70 infants (51 boys and 19 girls) were identified, with nine RALP and 61 OP performed. Median age was 9.2 months (range, 3.7-11.9 months) for RALP and 4.1 months (range, 1.0-11.6 months) for OP (p = 0.005). Median weight was 8 kg (range, 5.8-10.9 kg) for RALP and 7 kg (range, 4-14 kg) for OP (p = 0.163). Median operative time was 115 min (range, 95-205 min) for RALP and 166 min (range, 79-300 min) for OP (p = 0.028). Median hospital stay was 1 day (range, 1-2 days) for RALP and 3 days (range, 1-7 days) for OP (p < 0.001). Median postoperative narcotic use of morphine equivalent was <0.01 mg/kg/day (range, 0-0.1 mg/kg/day) for RALP and 0.05 mg/kg/day (range, 0-2.2 mg/kg/day) for OP (p < 0.001). Median follow-up was 10 months (range, 7.2-17.8 months) for RALP and 43.6 months (3.4-73.8 months) for OP (p < 0.001). The success rate was 100% for RALP and 98% for OP.

CONCLUSIONS

Infant RALP was observed to be feasible and efficacious with shorter operative time, hospital stay, and narcotic utilization than OP.

The effect of an organophosphonite antioxidant on poly(ether ether ketone)/poly(ether imide) blend as studied by quasi-isothermal modulated differential scanning calorimetry and dynamic mechanical thermal analysis methods

In the present study, the effect of P-EPQ, an organophosphonite antioxidant, on the glass transition and the viscoelastic behavior of optimized poly(ether ether ketone) (PEEK)/poly(ether imide) (PEI; PEEK/PEI: 50/50) blend has been reported. For this, P-EPQ was added in various proportions to the PEEK/PEI blend and was studied by quasi-isothermal modulated differential scanning calorimetry (Qi-MDSC) and dynamic mechanical thermal analysis (DMTA) methods. The Qi-MDSC results clearly indicate a significant decrease in the glass transition temperature of the blend up to 1 wt% P-EPQ addition. The DMTA measurements revealed a decrease in tan δ peak temperature upon antioxidant addition in agreement with calorimetric results. The shift factors obtained using the time–temperature superposition of DMTA data exhibit Williams–Landel–Ferry behavior, and the fractional free volume of the blend increases with increase in antioxidant addition (up to 1 wt%). The “master curve” of storage modulus predicts high modulus for the blend with 1 wt% antioxidant, revealing its suitability for high-impact applications.

HIV nucleoside reverse transcriptase inhibitors efavirenz and tenofovir change the growth and differentiation of primary gingival epithelium

OBJECTIVES

An increasing number of HIV-infected patients are combating HIV infection through the use of antiretroviral drugs, including reverse transcriptase inhibitors. Oral complications associated with these drugs are becoming a mounting cause for concern. In our previous studies, both protease inhibitors and reverse transcriptase inhibitors have been shown to change the proliferation and differentiation state of oral tissues. This study examined the effect of a nonnucleoside and a nucleoside reverse transcriptase inhibitor on the growth and differentiation of gingival epithelium.

METHODS

Organotypic (raft) cultures of gingival keratinocytes were treated with a range of efavirenz and tenofovir concentrations. Raft cultures were immunohistochemically analysed to determine the effect of these drugs on the expression of key differentiation and proliferation markers, including cytokeratins and proliferating cell nuclear antigen (PCNA).

RESULTS

These drugs dramatically changed the proliferation and differentiation state of gingival tissues when they were present throughout the growth period of the raft tissue as well as when drugs were added to established tissue on day 8. Treatment with the drugs increased the expression of cytokeratin 10 and PCNA and, conversely, decreased expression of cytokeratin 5, involucrin and cytokeratin 6. Gingival tissue exhibited increased proliferation in the suprabasal layers, increased fragility, and an inability to heal itself.

CONCLUSIONS

Our results suggest that efavirenz and tenofovir treatments, even when applied in low concentrations for short periods of time, deregulated the cell cycle/proliferation and differentiation pathways, resulting in abnormal epithelial repair and proliferation. Our system could be developed as a potential model for studying the effects of HIV and highly active antiretroviral therapy (HAART) in vitro.

Microsurgical excision of olfactory groove meningioma's: a brief study of outcome of different surgical approaches

DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15810Bangladesh Med Res Counc Bull 2013; 39: 45-46

Congenital stenosis in the descending colon causing intestinal obstruction in a one and half years male child

A one and half years male child presented with constipation with severe colicky abdominal pain, bilious vomiting & abdominal distension. He had history of recurrent bouts of constipation followed by gastroenteritis since birth for which he had taken symptomatic treatment & sometimes remained symptom free but he had no other significant history or associated condition. In laboratory investigations, barium enema study of large gut result simulates to Hirschsprung's disease but suction rectal biopsy revealed normal rectal tissue texture. So, consideration of diagnostic tools along with patient's general condition decision was taken for diagnostic laparotomy & peroperatively the child was diagnosed as a case of intestinal obstruction due to congenital colonic stenosis in the descending colon. After resection of stenotic segment and end to end anastomosis, histopathologycal examination of resected stenosed colon was done & it was finally proved as congenital stenosis in the descending colon. The post operative period of the patient was uneventful and he was discharged on 7th postoperative day & followed up upto 6 months. He had been found alright without any complain. Here we tried to high light that the congenital colonic stenosis as a rare, but might be a possible cause of partial/complete intestinal obstruction from newborn to older children in any part of the colon & that should kept in mind for avoiding diagnostic dilemma & proper management of patient.

Investigating the Catalytic Activity of Monoclinic Zirconia; Oxidation of Benzyl Alcohol in Aqueous Medium at Mild Conditions

The oxidation/degradation of benzyl alcohol in artificially contaminated water under atmospheric pressure by molecular oxygen/air over ZrO2(m) catalyst was investigated. Monoclinic phase ZrO2 was synthesized and characterized by modern techniques. Oxidation of benzyl alcohol in aqueous medium was carried out in a typical three necked double walled batch reactor equipped with thermometer and condenser. The rate of oxidation was affected by different reaction parameters such as speed of agitation, catalyst loading, temperature, concentration of substrate solution (46.3 – 185 mmol/L) and partial pressure of oxygen. Major products were detected with GC and UV spectrophotometer. Optimal conditions were setup for better catalytic activity of ZrO2(m). To sum up, catalytic oxidation of benzyl alcohol in aqueous medium by ZrO2(m) is a useful and cheaper method for the conversion of benzyl alcohol to valuable products as well as for the removal of benzyl alcohol from industrial waste water.

Adsorption Studies of Basic Green 4 from Aqueous Solution on Ca2+ Exchanged Clay

The adsorption of basic green 4 from aqueous solution on calcium exchanged clay (Attock-Ca and Swat-Ca) was studied. Clays were first purified and activated with H2SO4 and then exchanged with Ca2+ ions. Clay was characterized by BET surface area, XRD and SEM/EDS. The adsorption kinetic at 298 K and 306 K showed that the first order models were applied to the data. The rate constant increased with the rise in temperature of adsorption/activation. Thermodynamic properties (ΔE≠, ΔH≠, ΔS≠ and ΔG≠) for the adsorption process were calculated. Positive values of ΔH≠ showed that the adsorption of basic green 4 is endothermic. Positive values of ΔS≠ reflected the increase in the disorder of the system at the solid-solution interface during adsorption. The Gibbs free energy, which is the driving force for adsorption is negative indicating spontaneous adsorption. Freundlich's and Langmuir's models described the equilibrium adsorption study and found to fit the experimental data.

Removal of Triphenylmethane Dye from Aqueous Solution by Carbonaceous Adsorbent

Removal of acid blue 1 from aqueous solution on activated carbon produced from Salvadora oleoides was investigated. The samples were characterized by BET surface area, BJH pore volume and pore diameter, XRD, SEM, EDS and FTIR analysis. The surfaces contain functional groups like ketones and hydroxyl which disappeared at high activation temperature; relatively high amount of carbon w.r.t. oxygen was found with the increase in activation temperature; the increase in surface area and development of porous structures showed a positive effect on the adsorption capacity. Adsorption of the dye on carbon at 10 and 45°C showed that the first order, Bangham and Elovich and parabolic diffusion equations apply to the kinetic data. The adsorption rate increased with the temperature and with thermal activation of the sample. Thermodynamic parameters like ΔE≠, ΔH≠, ΔS≠ and ΔG≠ were calculated from the kinetic data. The negative values of ΔS≠ reflect decrease in the disorder of the system at the solid-solution interface during adsorption. Gibbs free energy (ΔG≠), which represents the driving force for the affinity of dye for the carbon, increased with the increase in activation temperature.