Human umbilical cord Wharton's jelly stem cells and its conditioned medium support hematopoietic stem cell expansion ex vivo

Bone marrow mesenchymal stromal cells (BMMSCs) have been used as feeder support for the ex vivo expansion of hematopoietic stem cells (HSCs) but have the limitations of painful harvest, morbidity, and risk of infection to the patient. This prompted us to explore the use of human umbilical cord Wharton's jelly MSCs (hWJSCs) and its conditioned medium (hWJSC-CM) for ex vivo expansion of HSCs in allogeneic and autologous settings because hWJSCs can be harvested in abundance painlessly, are proliferative, hypoimmunogenic, and secrete a variety of unique proteins. In the presence of hWJSCs and hWJSC-CM, HSCs put out pseudopodia-like outgrowths and became highly motile. Time lapse imaging showed that the outgrowths helped them to migrate towards and attach to the upper surfaces of hWJSCs and undergo proliferation. After 9 days of culture in the presence of hWJSCs and hWJSC-CM, MTT, and Trypan blue assays showed significant increases in HSC numbers, and FACS analysis generated significantly greater numbers of CD34(+) cells compared to controls. hWJSC-CM produced the highest number of colonies (CFU assay) and all six classifications of colony morphology typical of hematopoiesis were observed. Proteomic analysis of hWJSC-CM showed significantly greater levels of interleukins (IL-1a, IL-6, IL-7, and IL-8), SCF, HGF, and ICAM-1 compared to controls suggesting that they may be involved in the HSC multiplication. We propose that cord blood banks freeze autologous hWJSCs and umbilical cord blood (UCB) from the same umbilical cord at the same time for the patient for future ex vivo HSC expansion and cell-based therapies.

Magnetic nonuniformity and thermal hysteresis of magnetism in a manganite thin film

We measured the chemical and magnetic depth profiles of a single crystalline (La(1-x)Pr(x))(1-y)Ca(y)MnO(3-δ) (x=0.52±0.05, y=0.23±0.04, δ=0.14±0.10) film grown on a NdGaO(3) substrate using x-ray reflectometry, electron microscopy, electron energy-loss spectroscopy, and polarized neutron reflectometry. Our data indicate that the film exhibits coexistence of different magnetic phases as a function of depth. The magnetic depth profile is correlated with a variation of chemical composition with depth. The thermal hysteresis of ferromagnetic order in the film suggests a first-order ferromagnetic transition at low temperatures.

Epidemiology of electrical injury: findings from a community based national survey in Bangladesh

OBJECTIVES

The objective of this study is to explore the magnitude and pattern of electrical injury in Bangladesh.

METHOD

A national survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171,366 rural and urban households comprising a 819,429 population. The survey was conducted at a household level with a structured questionnaire.

RESULTS

The incidence of fatal and non-fatal injury was found to be 1.6 and 73.7 per 100,000 population year respectively. Compared to females, males were found at a higher risk (RR 1.62; 95% CI 1.37-1.91) and rural people found more vulnerable compared to urban people (RR 5.97; 95% CI 4.71-7.57). The home was found as the most common place for electrical injury, with more than 50% of injury taking place at home. The household source of electricity was found as the most common source of electrical injury. Lightning was also found as major source for electrical injury which constituted more than 25% of the injuries cause by electrical current. More than 80% of electrical injuries occurred between 6a.m. and 6p.m.

CONCLUSION

Electrical injury is an emerging cause of mortality and morbidity in both urban and rural areas of Bangladesh. Males and rural people were the more vulnerable group for electrical injury compared to women and the urban population. The home is the most common place for injury occurrence.

Effectiveness of Tolperisone Hydrochloride with Aceclofenac as Combined Therapy in Acute Low Back Pain

Objective

An open label, non-randomised, prospective study was conducted to evaluate the effectiveness of tolperisone hydrochloride 150mg thrice daily with aceclofenac 100mg twice daily compared to aceclofenac 100mg twice daily alone for the treatment of acute low back pain (LBP) for 14 days. total (n=242) patients recruited for the study were divided into two treatment groups. One of the group (n=124) received oral tolperisone plus aceclofenac and the other (n=118) Aceclofenac alone. The pain intensity was assessed by visual analogue scale. Patients were informed to report any adverse effect encountered during the study period. The overall effect of the drug (global assessment of the study medication) on pain and adverse effects were assessed by the patients at the end of the trial on a categorical scale. There was significant reduction in pain score in the tolperisone group than aceclofenac group with insignificant adverse effects which didn't require discontinuation of the study. Tolperisone when added with aceclofenac can be more effective than aceclofenac alone for relief of acute LBP with minimum adverse effects.

Silver nanotoxicity using a light-emitting biosensor Pseudomonas putida isolated from a wastewater treatment plant

The effect of silver ions, nano- and micro-particles on a luminescent biosensor bacterium Pseudomonas putida originally isolated from activated sludge was assessed. The bacterium carrying a stable chromosomal copy of the lux operon (luxCDABE) was able to detect toxicity of ionic and particulate silver over short term incubations ranging from 30 to 240 min. The IC(50) values obtained at different time intervals showed that highest toxicity (lowest IC(50)) was obtained after 90 min incubation for all toxicants and this is considered the optimum incubation for testing. The data show that ionic silver is the most toxic followed by nanosilver particles with microsilver particles being least toxic. Release of nanomaterials is likely to have an effect on the activated sludge process as indicated by the study using a common sludge bacterium involved in biodegradation of organic wastes.

Burn injury in Bangladesh: electrical injury a major contributor

Electrical injury is a major cause of burn injury and significant cause of mortality, morbidity and disability. To explore the proportional incidence of thermal and electrical burn injuries in Bangladesh, a population-based cross sectional survey was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429.The study was designed to describe the proportional incidence of thermal, electrical and chemical cause of burn in Bangladesh. Electrical injury constituted about one third of the total burn injuries. Among the total 1,999 injuries about 31% were due to electrical injuries, about 26% were due to flame, about 25% were due to hot liquid, over 16% by hot object, about 2% by chemical and less than 1% were due to explosives. The incidence of death rate was 3.97 per 100,000 populations per year. Thermal burn was found as the major cause of death due to burn injures and constituted 58% of the total deaths due to burn. Electrical injuries caused 42% of the deaths. It was estimated that more than 5,600 people die due to burn and electrical injuries every year in Bangladesh considering the incidence rate of 3.97 per 100,000 populations per year in the 150 million population. Electrical injury including lightning constitute about one third of the burn related mortality, morbidity and disabilities. Rural people and children are the more vulnerable group. Electrical injury needs to be included as a special component in a burn prevention strategy, particularly in rural Bangladesh.

Disseminated cutaneous Mycobacterium chelonae infection in an immunocompetent host

Mycobacterium chelonae is a rare, rapidly growing, atypical acid-fast bacillus. Disseminated cutaneous infection has been reported in immunocompromised patients. We report an immunocompetent 86-year-old white woman, who presented with an 8-month history of extensive ulcerated abscess-like nodules. Mycobacterial culture confirmed M. chelonae infection and the patient was treated with a combination of clarithromycin and tobramycin. To our knowledge, this is the first reported case of spontaneous, disseminated cutaneous disease occurring in an immunocompetent patient.

Metabolic and body composition changes after six months of highly active antiretroviral therapy in northern Indian patients

This study was carried out to evaluate the metabolic and body composition changes among northern Indian patients receiving combination antiretroviral therapy (cART). We prospectively studied 68 adult patients at the All India Institute of Medical Sciences hospital, New Delhi. The CD4 count, blood pressure, anthropometry, metabolic and bioelectrical impedance data were collected prior to initiation of cART and six months later. The participants had a mean age of 35.9 years and 57 (84%) were male. Hypertension developed in 10.3%. The body mass index, waist circumference, total body fat and lean body mass increased significantly. The total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride and non-HDL-c increased significantly (P < 0.0001). Diabetes mellitus developed in 2.1%; metabolic syndrome in 19.1% (according to International Diabetes Federation criteria) and 25% (National Cholesterol Education Program--Adult Treatment Panel III criteria). Prolonged survival in the cART era may thus predispose these patients to adverse cardiovascular consequences. To the best of our knowledge, this is the first study of metabolic abnormalities in northern Indian HIV/AIDS patients receiving cART. Larger studies across India with long-term follow-up periods are required to confirm these preliminary findings. We also recommend that frequent biochemical monitoring should be performed in such patients.

Takotsubo cardiomyopathy: an uncommon cause of reversible heart failure

Takotsubo cardiomyopathy is increasingly being diagnosed as a cause of acute coronary syndrome in postmenopausal women. It may also present as reversible acute left heart failure with an excellent prognosis for recovery. Although rare, it may be an underdiagnosed condition in the medical intensive care units among patients admitted with non-cardiac acute conditions. Therefore, intensivists must be aware of the possibility of this condition; this can help to avoid unnecessary costly investigations and provide an early, definite prognosis.

A randomised controlled trial of low-dose misoprostol and dinoprostone vaginal pessaries for cervical priming

OBJECTIVE

We studied the efficacy of 25-microg misoprostol pessaries as either single or double dose compared with a 3-mg dinoprostone pessary for cervical priming.

DESIGN AND SETTING

A randomised controlled trial in Singapore.

POPULATION

One hundred and seventy-one women with term pregnancies and modified Bishop scores (mBS) < or =6 from 2003 to 2004.

METHOD

Patients were randomised to single misoprostol dose, double misoprostol dose or the current dinoprostone regimen.

MAIN OUTCOME MEASURES

Primary outcome was number of women who achieved favourable mBS >6 or active labour by day 2. Secondary outcomes were time interval from insertion to delivery, cardiotocographic abnormalities, delivery and neonatal outcome.

RESULTS

More women in the misoprostol double-dose group (96.6%) and dinoprostone group (93%) achieved the primary outcome compared with the single-dose group (77.8%) (P = 0.003 and P = 0.03, respectively). There was no difference in secondary outcomes. More multiparous women achieve primary outcome compared with nulliparous women (odds ratio 0.21, 95% confidence interval 0.06-0.77).

CONCLUSION

Double-dose misoprostol 25 microg is as effective as dinoprostone 3 mg inserts for cervical priming; both are more efficacious than a single-dose misoprostol pessary. Parity prognosticates the success of induction.

Effect of soybean meal substitution by different concentrations of sunflower meal on egg quality traits of white and coloured dwarf dam lines

1. The effect of soybean meal substitution by different concentrations of sunflower meal on egg quality traits of white and coloured dwarf dam lines was investigated. 2. A total of 144 dwarf hens (38 weeks of age) from the same hatch were randomly divided into 12 groups of 12 birds (4 dietary treatments x 3 replicates). 3. A 2 x 4 factorial design was used to study the effect of 2 lines (Factor A) and substitution of soybean meal (SBM) with 4 concentrations (0, 10, 15 and 20%) of sunflower meal (SFM) [Factor B] on egg quality traits of dwarf dam line hens. 4. All the diets were designed to be isocaloric (113 MJ ME/kg) and isonitrogenous (180 g/kg crude protein) The duration of the experiment was 12 weeks. 5. Analysis of variance indicated a highly significant line effect. There were non-significant effects of substitution of soybean meal with different concentrations of sunflower meal on egg quality traits except for Haugh unit. 6. White plumaged dwarf broiler breeder dam line produced significantly fewer, but larger, eggs than coloured dwarf dam line hens.

Development of quantitative-fluorescence polymerase chain reaction for the rapid prenatal diagnosis of common chromosomal aneuploidies in 1,000 samples in Singapore

INTRODUCTION

We aimed to develop a rapid quantitative-fluorescence polymerase chain reaction (QF-PCR) to detect common foetal aneuploidies in the Singapore population within 48 hours of sample collection in order to alleviate parental anxiety.

METHODS

DNA from 1,000 foetal samples (978 amniotic fluids, 14 chorion villi and eight foetal blood samples) was analysed using a QF-PCR of 19 microsatellite markers located on chromosomes 13, 18, 21, X and Y. A total of 523 samples were archived before the QF-PCR analysis (archived), while QF-PCR was performed and the results obtained within 48 hours of sample collection in the remaining 477 samples (live). The results were confirmed with their respective karyotypes.

RESULTS

In total, 47 autosomal trisomies (T) were found: 30 among the archived (three T13, 12 T18, 15 T21) and 17 among the live (four T18, 13 T21) samples. The QF-PCR results were verified with their respective karyotypes. We achieved 100 percent sensitivity (lower 95 percent confidence interval [CI], 92.8 percent) and specificity (lower 95 percent CI, 99.5 percent), and the time taken from sample collection to the obtaining of results for the 477 live samples was less than 48 hours.

CONCLUSION

Prenatal diagnostic results of common chromosomal abnormalities can be released within 48 hours of sample collection using QF-PCR. Parental anxiety is alleviated and clinical management is enhanced with this short waiting time.

Mutations affecting disulphide bonds contribute to a fairly common prevalence of F13B gene defects: results of a genetic study in 14 families with factor XIII B deficiency

Severe factor XIII (FXIII) deficiency is a rare autosomal recessive coagulation disorder affecting one in two million individuals. The aim of the present study was to screen for and analyse F13B gene defects in the German population. A total of 150 patients presenting with suspected FXIII deficiency and one patient with severe (homozygous) FXIII deficiency were screened for mutations in F13A and F13B genes. Twenty-five individuals presented with detectable heterozygous mutations, 12 of them in the F13A gene and 13 of them in the F13B gene. We report on the genotype-phenotype correlations of the individuals showing defects in the F13B gene. Direct sequencing revealed 12 unique mutations including seven missense mutations (Cys5Arg, Ile81Asn, Leu116Phe, Val217Ile, Cys316Phe, Val401Glu, Pro428Ser), two splice site mutations (IVS2-1G>C, IVS3-1G>C), two insertions (c.1155_1158dupACTT, c.1959insT) and one in-frame deletion (c.471-473delATT). Two of the missense mutations (Cys5Arg, Cys316Phe) eliminated disulphide bonds (Cys5-Cys56, Cys316-Cys358). Another three missense mutations, (Leu116Phe, Val401Glu, Pro428Ser) were located proximal to other cysteine disulphide bonds, therefore indicating that the region in and around these disulphide bonds is prone to functionally relevant mutations in the FXIII-B subunit. The present study reports on a fairly common prevalence of F13B gene defects in the German population. The regions in and around the cysteine disulphide bonds in the FXIII-B protein may be regions prone to frequent mutations.

Effect of higher dietary vitamin E concentrations on physical and biochemical characteristics of semen in Kadaknath cockerels

1. This experiment was to investigate the effects of increasing dietary vitamin E on physical and biochemical characteristics of semen in Indian reared Kadaknath (KN) cockerels. DL-alpha-Tocopherol acetate was used as the source of vitamin E. 2. A total of 135 one-day-old male KN chicks were randomly selected and divided into 9 groups with 15 chicks in each group (3 dietary treatments x 3 replicates). 3. The basal diet contained 15 IU (10 mg) vitamin E/kg and the two experimental diets were supplemented with 150 IU (100 mg) and 300 IU (200 mg) vitamin E/kg (diets T(2) and T(3), respectively). 4. Physical characteristics in terms of semen volume, sperm concentration, sperm motility and percentage live sperm did not differ significantly, whereas proportion of abnormal and dead spermatozoa were significantly lower and fertility higher in the T(2) group. 5. Biochemical characteristics in term of quantities of protein and nitric oxide (NO) did not differ significantly, whereas the quantity of glucose, acid phosphatase (ACP) and vitamin E were significantly higher in the T(2) group. 6. In contrast, the quantities of alkaline phosphatase (ALP), glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) were significantly lower in T(2) group and higher in the T(1) (control) group. 7. From this study it can be concluded that moderate supplementation of dietary vitamin E may be beneficial for physical and biochemical characteristics of semen in Indian reared KN cock.

Subgenotypes of hepatitis B virus genotype D (D1, D2, D3 and D5) in India: differential pattern of mutations, liver injury and occult HBV infection

Hepatitis B genotype D (HBV/D) is the most widespread genotype and exists as at least five subgenotypes (HBV/D1-D5). However, little is known about the association of virological characteristics with clinical differences among HBV/D subgenotypes. To investigate the virological characteristics of these subgenotypes and their clinical implications, we selected a cohort of 109 genotype D infected individuals from the state of West Bengal, India, including 68 HBsAg positive patients and 41 with occult HBV infection. Among the HBsAg positive subjects 28 had chronic hepatitis B virus infection, 40 were asymptomatic carriers based on clinical examination, liver function test and ultrasonograph results. Overall, HBV/D1 was found in 17%, HBV/D2 in 29%, HBV/D3 in 34% and HBV/D5 in 20% of the cases. HBV/D1 was significantly associated with chronic liver disease (P = 0.01), and in this subgenotype A1896 (PreC mutations) were most common. Although BCP mutations (A/C1753 and T1762/A1764) were found to be frequently associated with HBV/D2 (33% and 33%) and D5 (47% and 59%), no apparent clinical correlation was observed. On the other hand, occult HBV infection was significantly associated with HBV/D3 infection, along with low level of BCP and PreC mutations and several non-synonymous substitutions in the catalytic reverse transcriptase (RT) domain of polymerase gene. Similar nucleotide substitutions in the surface (S) gene region were observed from both northern and eastern Indian HBV/D3 isolates. In conclusion, HBV/D subgenotypes differ in their mutational patterns in the S, polymerase and the BCP/PreC regions that may influence their clinical outcomes.

Intrinsic tunneling in phase separated manganites

We present evidence of direct electron tunneling across intrinsic insulating regions in submicrometer wide bridges of the phase-separated ferromagnet (La,Pr,Ca)MnO3. Upon cooling below the Curie temperature, a predominantly ferromagnetic supercooled state persists where tunneling across the intrinsic tunnel barriers (ITBs) results in metastable, temperature-independent, high-resistance plateaus over a large range of temperatures. Upon application of a magnetic field, our data reveal that the ITBs are extinguished resulting in sharp, colossal, low-field resistance drops. Our results compare well to theoretical predictions of magnetic domain walls coinciding with the intrinsic insulating phase.

Quantitation of proteinuria in nephrotic syndrome by spot urine protein creatinine ratio estimation in children

In Nephrotic Syndrome the amount of protein excretion is a reflection of activity of disease. Quantitative measurement of proteinuria by a 24-hour urine collection has been the accepted method of evaluation. Recent studies have shown that calculation of protein/creatinine ratio in a spot urine sample correlates well with the 24-hour urine protein (24-HUP) excretion. A study was conducted to compare the accuracy of a spot urinary protein/creatinine ratio (P/C ratio) and urinary dipstick with the 24-hour urine protein. Fifty two samples from 26 patients of nephrotic syndrome were collected. This included a 24-hour urine sample followed by the next voided random spot sample. The protein/creatinine ratio was calculated and dipstick was performed on the spot sample. This was compared with the 24-hour urine protein excretion. The correlation between the three samples was statistically highly significant (p<0.001) for all levels of proteinuria. The normal value of protein/creatinine ratio in Indian children was also estimated on 50 normal children admitted in the ward without any renal diseases calculated to be 0.053 (SE of mean+/-0.003).

An investigation into a mass psychogenic illness at Burdwan, West Bengal

This investigation of the outbreak of mass psychogenic illness during July 2007 at three schools in Burdwan was done to observe the description of the epidemic, identify its characteristics and to study any particular factor associated with the spread of illness. Relevant data were obtained from medical and school records. All concurrent factors were considered. All the incidents happened prior to the examinations. There have been differences in presentations and final diagnosis among the schools. Intense media coverage influenced the manifestations. Poor school performance was associated with recurrence of symptoms. So understanding the academic anxiety is important to prevent such outbreaks.

Refining quantitative fluorescent polymerase chain reaction for prenatal detection of X chromosomal anomalies in the major Southeast Asian populations

INTRODUCTION

This study aimed to refine the current quantitative fluorescent polymerase chain reaction (QF-PCR) screen to detect X chromosome anomalies for prenatal diagnosis in the major Southeast-Asian populations.

METHODS

100 amniotic fluid samples from Chinese, Malay and Indian origins were subjected to QF-PCR using the X chromosome markers, HPRT, X22 and AMXY, along with the autosomal marker D21S1411.

RESULTS

Out of the 100 samples tested by markers X22 and HPRT, eight samples were homozygous for both markers, of which seven were resolved by comparison with the autosomal marker D21S1411.

CONCLUSION

99 percent of samples could be tested for X chromosome copy numbers, increasing the stringency for detection of X chromosome anomalies by QF-PCR. All results were confirmed by cytogenetics.