Early arteriovenous fistula after radiofrequency ablation of long saphenous vein

A 75-year-old woman developed an arteriovenous fistula (AVF) between the common femoral artery and common femoral vein following radiofrequency ablation (RFA) of left long saphenous vein. Failed coil embolization of the AVF was followed by successful surgical ligation. Awareness of the aetiology of this uncommon complication of RFA and its treatment options is important with the increasing use of RFA for varicose vein treatment.

Screening of hospital patients for HIV: an experience in a tertiary care hospital of West Bengal

The clinical consequences of HIV infection encompass a wide spectrum. Early recognition of persons who have HIV will help in early interventions to halt or slow down the progress of HIV disease and to extend fruitful lives.This cross-sectional study was conducted among patients referred to the voluntary counselling and testing centre (VCTC) from various departments in North Bengal Medical College & Hospital, Darjeeling, West Bengal, to find out the pattern of disease/symptoms, high risk behaviour (HRB) for HIV, and HIV serostatus among the hospital patients. Following the guidelines prescribed by the National AIDS Control Organisation (NACO), anonymous data were collected through interview from 407 individuals. Where specific diagnosis of a disease was obtained, it was analysed as mutually exclusive disease; and where specific diagnosis was not obtained, mutually exclusive symptoms were considered for analysis.The major diseases/symptoms observed among those patients were tuberculosis in 32.19%, STD in 29.97%, prolonged unexplained fever in 19.41% of patients. The overall rate of HIV seroreactivity was 17.44%. The HIV serostatus by disease/symptoms showed that 32.91% of patients with prolonged unexplained fever were HIV seroreactive; the rate was 12.90% among patients with skin diseases, 12.29% in STD and 12.21% in tuberculosis patients. Overall, 270 patients (66.34%) had HRB for HIV/AIDS.The rate of HIV seroreactivity was more among patients who had HRB for HIV/ AIDS and who were referred from indoor departments (23.24%) compared to outdoor departments (13.65%).The patients suffering from prolonged unexplained fever need greater attention for HIV screening. Early detection of HIV positive patients makes Intervention possible at a very early stage and this can slow down/block the progress of HIV disease and, as a result, can extend fruitful life.

Multiple Parenchymal Neurocysticercosis: A Case Report

Cysticercosis is a parasitic infection with CNS involvement in 60-90% of infested patients. The larval form of pork intestinal tapeworm (Taenia solium) is responsible for cysticercosis. Humans are the definitive hosts and usually harbor the adult tapeworm in small intestine as an asymptomatic infestation. Neurocysticercosis most commonly affects the brain parenchyma. Solitary and multiple cysts in brain parencyma is common but we came across a 24 year old lady patient with huge number of cysts which is relatively rare. The aim of this article is to report the rare case. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6450 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 44-45

Genetic variation and population structure in Jamunapari goats using microsatellites, mitochondrial DNA, and milk protein genes

Jamunapari, a dairy goat breed of India, has been gradually declining in numbers in its home tract over the years. We have analysed genetic variation and population history in Jamunapari goats based on 17 microsatellite loci, 2 milk protein loci, mitochondrial hypervariable region I (HVRI) sequencing, and three Y-chromosomal gene sequencing. We used the mitochondrial DNA (mtDNA) mismatch distribution, microsatellite data, and bottleneck tests to infer the population history and demography. The mean number of alleles per locus was 9.0 indicating that the allelic variation was high in all the loci and the mean heterozygosity was 0.769 at nuclear loci. Although the population size is smaller than 8,000 individuals, the amount of variability both in terms of allelic richness and gene diversity was high in all the microsatellite loci except ILST 005. The gene diversity and effective number of alleles at milk protein loci were higher than the 10 other Indian goat breeds that they were compared to. Mismatch analysis was carried out and the analysis revealed that the population curve was unimodal indicating the expansion of population. The genetic diversity of Y-chromosome genes was low in the present study. The observed mean M ratio in the population was above the critical significance value (Mc) and close to one indicating that it has maintained a slowly changing population size. The mode-shift test did not detect any distortion of allele frequency and the heterozygosity excess method showed that there was no significant departure from mutation-drift equilibrium detected in the population. However, the effects of genetic bottlenecks were observed in some loci due to decreased heterozygosity and lower level of M ratio. There were two observed genetic subdivisions in the population supporting the observations of farmers in different areas. This base line information on genetic diversity, bottleneck analysis, and mismatch analysis was obtained to assist the conservation decision and management of the breed.

Hyposmotic stress causes ATP release and stimulates Na,K-ATPase activity in porcine lens

Purinergic receptors in lens epithelium suggest lens function can be altered by chemical signals from aqueous humor or the lens itself. Here we show release of ATP by intact porcine lenses exposed to hyposmotic solution (200 mOsm). 18α-glycyrrhetinic acid (AGA) added together with probenecid eliminated the ATP increase. N-ethylmaleimide (200 µM), an exocytotic inhibitor, had no significant effect on ATP increase. Lenses exposed to hyposmotic solution displayed a ~400% increase of propidium iodide (PI) entry into the epithelium. The increased ability of PI (MW 668) to enter the epithelium suggests possible opening of connexin and/or pannexin hemichannels. This is consistent with detection of connexin 43, connexin 50, and pannexin 1 in the epithelium and the ability of AGA + probenecid to prevent ATP release. Na,K-ATPase activity doubled in the epithelium of lenses exposed to hyposmotic solution. The increase of Na,K-ATPase activity did not occur when apyrase was used to prevent extracellular ATP accumulation or when AGA + probenecid prevented ATP release. The increase of Na,K-ATPase activity was inhibited by the purinergic P2 antagonist reactive blue-2 and pertussis toxin, a G-protein inhibitor, but not by the P2X antagonist PPADS. Hyposmotic solution activated Src family kinase (SFK) in the epithelium, judged by Western blot. The SFK inhibitor PP2 abolished both SFK activation and the Na,K-ATPase activity increase. In summary, hyposmotic shock-induced ATP release is sufficient to activate a purinergic receptor- and SFK-dependent mechanism that stimulates Na,K-ATPase activity. The responses might signify an autoregulatory loop initiated by mechanical stress or osmotic swelling.

Effect of source tuning parameters on the plasma potential of heavy ions in the 18 GHz high temperature superconducting electron cyclotron resonance ion source

Plasma potentials for various heavy ions have been measured using the retarding field technique in the 18 GHz high temperature superconducting ECR ion source, PKDELIS [C. Bieth, S. Kantas, P. Sortais, D. Kanjilal, G. Rodrigues, S. Milward, S. Harrison, and R. McMahon, Nucl. Instrum. Methods B 235, 498 (2005); D. Kanjilal, G. Rodrigues, P. Kumar, A. Mandal, A. Roy, C. Bieth, S. Kantas, and P. Sortais, Rev. Sci. Instrum. 77, 03A317 (2006)]. The ion beam extracted from the source is decelerated close to the location of a mesh which is polarized to the source potential and beams having different plasma potentials are measured on a Faraday cup located downstream of the mesh. The influence of various source parameters, viz., RF power, gas pressure, magnetic field, negative dc bias, and gas mixing on the plasma potential is studied. The study helped to find an upper limit of the energy spread of the heavy ions, which can influence the design of the longitudinal optics of the high current injector being developed at the Inter University Accelerator Centre. It is observed that the plasma potentials are decreasing for increasing charge states and a mass effect is clearly observed for the ions with similar operating gas pressures. In the case of gas mixing, it is observed that the plasma potential minimizes at an optimum value of the gas pressure of the mixing gas and the mean charge state maximizes at this value. Details of the measurements carried out as a function of various source parameters and its impact on the longitudinal optics are presented.

Triterpenoids from Schleichera oleosa of Darjeeling Foothills and Their Antimicrobial Activity

Two triterpenoids, taraxerone and tricadenic acid A were isolated from the methanol extract of the outer bark of Schleichera oleosa available in Darjeeling foothills. A preliminary study on their antimicrobial activities was also performed against some fungal and bacterial species. The structure of these compounds was determined by means of chemical characterisation and IR, NMR spectral data.

Genetic and environmental influences on faecal nematode egg counts of Jamunapari goats in India

The present study was carried out from 1999 to 2003 to determine the genetic and environmental influences of faecal egg count (FEC), an indicator of host resistance, in adult Jamunapari goats with naturally acquired gastrointestinal nematode parasite infections (predominantly Haemonchus contortus). FEC data on 670 records of Jamunapari goats descended from 54 bucks and 208 does were used in this study. Analyses were carried out by restricted maximum likelihood estimation, fitting an animal model. Four different animal models ignoring or including maternal genetic or permanent environmental effects were fitted. Different environmental effects, that is, sampling year, month and the sex of the animals, significantly (P<0.01) influenced FECs in the goats. Direct heritability estimates were inflated substantially for this trait when maternal effects were ignored. The direct heritability estimates for the trait ranged from 0.11 to 0.16 depending on the model used. Low estimates of maternal heritability (m(2)=0.06) and the fraction of variance due to maternal permanent environmental effects (c(2)=0.09) for FECs were observed in the present study. The results suggest that direct and permanent environmental maternal effects were important for this trait; however, maternal additive effects had less impact on this trait. These results also indicate that modest rates of genetic progress appear possible for FECs.

Cefditoren pivoxil associated rash and arthralgia in a child

Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as 'probable'. Analyzed by the Naranjo's ADR probability scale, the score was 7, which also makes it a 'probable' event.

The effect of endothelin-1 on Src-family tyrosine kinases and Na,K-ATPase activity in porcine lens epithelium

Previous studies show Src family kinase (SFK) activation is involved in a response that stimulates Na,K-ATPase. Here, we tested whether SFK activation is involved in the Na,K-ATPase response to endothelin-1 (ET-1). Intact porcine lenses were exposed to 100 nM ET-1 for 5-30 min. Then, the epithelium was removed and used for Na,K-ATPase activity measurement and Western blot analysis of SFK activation. Na,K-ATPase activity was reduced by ∼30% in lenses exposed to ET-1 for 15 min. The response was abolished by the SFK inhibitor PP2 or the ET receptor antagonist, PD145065. Activation of a ∼61 kDa SFK was evident from an increase in Y416 phosphorylation, which reached a maximum at 15 min ET-1 treatment, and a decrease in Y527 phosphorylation. PP2 prevented SFK activation. Since Fyn, Src, Hck, and Yes may contribute to the observed 61 kDa band, these SFKs were isolated by immunoprecipitation and analyzed. Based on Y416 phosphorylation, ET-1 appeared to activate Fyn, while Src and Hck were inhibited and Yes was unaltered. ET-1 requires SFK activation to cause Na,K-ATPase inhibition. ET-1 elicits a different pattern of SFK activation from that reported earlier for purinergic agonists that stimulate Na,K-ATPase activity and activate Src. In the ET-1 response Src is inhibited and Fyn is activated. The findings suggest SFK phosphorylation is involved in a regulatory mechanism for Na,K-ATPase. Knowing this may help us understand drug actions on Na,K-ATPase. Faulty regulation of Na,K-ATPase in the lens could contribute to cataract formation since an abnormal sodium content is associated with lens opacification.

Drug safety monitoring in patients of movement disorders of a tertiary care hospital

Background:

Movement disorders (MD) are neurological conditions that affect the speed, fluency, quality, and ease of movement and commonly include Parkinson’s disease, tremor and dystonias. Drugs are important causes of MD, and the incidence and prevalence of such disorders are possibly underappreciated because of the lack of recognition.

Objectives:

To assess the incidence of all adverse drug reactions (ADRs) and estimate the prevalence of drug-induced MD among patients attending the clinic.

Materials and Methods:

This prospective observational study was conducted at an outpatient referral MD clinic of a tertiary care hospital for 1 year. The demographic data, drug intake, diagnosis, and ADRs experienced by the subjects were recorded. Causality assessment was done by Naranjo’s scale.

Results:

Incidence of ADR among patients who attended this clinic was 19.7% (151 out of 768 patients experienced at least one ADR). A total of 299 ADRs were detected out of which 30.8% were gastrointestinal, 28.4% psychiatric, and 26% MD effects. The commonly implicated suspect drugs were levodopa (37.8%) and trihexyphenidyl (25.1%). The prevalence of drug-induced MD was 10.15% and drug-induced dyskinesias and dystonias were the most common.

Conclusion:

MDs are clinically important neurological disorders which are often caused by drugs and interestingly drugs used for its management are also associated with high incidence of ADRs. Hence these ADRs should be carefully monitored.

Triterpenoids from Psidium guajava with Biocidal Activity

In continuation of our studies on the phytochemical investigation of medicinal plants available in the foothills of Darjeeling and Teri, we report herein the isolation of two triterpenoids betulinic acid and lupeol from the leaf extract of Psidium guajava and their potential antimicrobial and phytotoxic activities. All the structures of the isolated compounds were confirmed by spectral (IR, NMR) analysis and by comparison with the literature reports.

Purification and characterization of an endoxylanase from the culture broth of Bacillus cereus BSA1

An extracellular xylanase from the fermented broth of Bacillus cereus BSA1 was purified and characterized. The enzyme was purified to 3.43 fold through ammonium sulphate precipitation, DEAE-cellulose chromatography and followed by gel filtration through Sephadex G-100 column. The molecular mass of the purified xylanse was about 33 kDa. The enzyme was an endoxylanase as it initially degraded xylan to xylooligomers. The purified enzyme showed optimum activity at 55 degrees C and at pH 7.0 and remained reasonably stable in a wide range ofpH (5.0-8.0) and temperature (40-65 degrees C). The Km and Vmax values were found to be 8.2 mg/ml and 181.8 micromol/(min mg), respectively. The enzyme had no apparent requirement ofcofactors, and its activity was strongly inhibited by Cu++, Hg++. It was also a salt tolerant enzyme and stable upto 2.5 M of NaCl and retained its 85% activity at 3.0 M. For stability and substrate binding, the enzyme needed hydrophobic interaction that revealed when most surfactants inhihited xylanase activity. Since the enzyme was active over wide range ofpH, temperature and remained active in higher salt concentration, it could find potential uses in biobleaching process in paper industries.

GSTT1 and GSTM1 gene deletions are not associated with hepatotoxicity caused by antitubercular drugs

BACKGROUND AND OBJECTIVE

Susceptibility to antitubercular drug (ATD)-induced hepatotoxicity may be genetically mediated, with variant alleles of genes such as N-acetyltransferase (NAT2) and CYP2E1 reported as risk factors. Two studies of Asian populations have reported that GSTM1*0 ⁄ *0 (null) genotype was a likely predictor of hepatotoxicity, whereas another of a Caucasian population implicated GSTT1*0 ⁄ *0. We undertook a prospective case-control study to investigate whether GSTM*0 ⁄ *0 and GSTT1*0 ⁄ *0 were risk factors for ATD-induced hepatotoxicity.

METHODS

Pulmonary tuberculosis patients on isoniazid, rifampicin and pyrazinamide who developed hepatotoxicity using defined criteria were prospectively identified. These cases were then matched with at least one control subject on the same drugs but without hepatotoxicity. Genotyping for GSTM1 and GSTT1 was performed by multiplex PCR on genomic DNA. The odds ratios for the frequency of specific GSTM1 and GSTT1 homozygotes in the case and control subjects were calculated to test for association between the genotypes and hepatotoxicity.

RESULTS AND DISCUSSION

Hundred and fifty-one subjects (51 cases, 100 controls) were enrolled. Odds ratio for GSTM1 null genotype was 1.00 (95% CI 0.51-1.97) and GSTT1 null was 2.02 (95% CI 0.39-10.39), respectively, showing that these genotypes are not associated with hepatotoxicity.

CONCLUSION

GSTM1 *0 ⁄ *0 or GSTT1 *0 ⁄ *0 or both null genotypes, do not appear to be associated with ATD-induced hepatotoxicity in our Indian population.

Characterization of casein gene complex and genetic diversity analysis in Indian goats

Milk protein polymorphism plays an important role in genetic diversity analysis, phylogenetic studies, establishing geographical diversity, conservation decision, and improving breeding goals. Milk protein polymorphism in Indian goat breeds has not been well studied; therefore, an investigation was carried out to analyze the genetic structure of the casein gene and milk protein diversity at six milk protein loci in nine Indian goat breeds/genetic groups from varied agro-climatic zones. Milk protein genotyping was carried out in 1098 individual milk samples by SDS-PAGE at alphaS1-CN (CSN1S1), beta-CN (CSN2), alphaS2-CN (CSN1S2), kappa-CN (CSN3), beta-LG, and alpha-LA loci. Indian goats exhibited alphaS1-casein A allele in higher frequency in the majority of breeds except Ganjam and local goats. The alphaS1-casein A allele frequencies varied from 0.45 to 0.77. A total of 16 casein haplotypes were observed in seven breeds and breed specific haplotypes were observed with respect to geographic region. The average number of alleles was lowest in Ganjam (1.66 +/- 0.81) and highest in Sirohi goats (2.50 +/- 1.05). Expected heterozygosity at six different loci demonstrated genetic diversity and breed fragmentation. Neighbor-Joining tree was built basing on Nei's distance. There was about 16.95% variability due to differences between breeds, indicating a strong subdivision. Principal component analysis was carried out to highlight the relationship among breeds. The variability among goat breeds was contributed by alphaS2-CN, beta-LG and alphaS1-CN. The Indian goats exhibited alphaS1-CN (CSN1S1) A allele in higher frequency in all the breeds indicating the higher casein yield in their milk.