An evaluation of medication appropriateness in pregnant women with coexisting illness in a tertiary care hospital

Aim:

Prescribing drugs during pregnancy needs careful consideration of benefit to the mother and risk to the fetus. Therefore, this study was conducted to evaluate the appropriateness of medications among pregnant women with coexisting illness in a tertiary care hospital, Western India.

Materials and Methods:

It was a hospital-based cross-sectional study conducted in the obstetrics and gynecology department of a tertiary care hospital. The study was conducted over a period of 12 months wherein data from 800 pregnant women suffering from any co-existing illness and being prescribed any medication apart from routine supplementation were analyzed. The Medication Appropriateness Index (MAI) was used to assess the appropriateness of medications. Higher MAI scores indicate more inappropriate prescribing.

Results:

Drugs which were most inappropriately prescribed with the highest average MAI scores were albendazole, itraconazole, injection amikacin, oxcarbazepine, warfarin, domperidone, propylthiouracil, and combiflam (ibuprofen + paracetamol). Diseases with the highest average MAI scores were anemia, Grave's disease, umbilical hernia, urinary tract infection, urticaria, allergic rhinitis, and preeclampsia. The MAI criteria which had the highest percentage of inappropriately prescribed medications were “cost of drugs,” “duration of therapy,” and “indication.”

Conclusion:

Potentially inappropriate prescribing was seen in the study with some of the common coexisting illness being treated with drugs which fared poorly on the MAI. The study has also highlighted areas in drug prescribing where scope for improvement exists. Further, it can act as a benchmark for comparison of future studies to evaluate medication appropriateness in pregnant women.

Volatome finger printing of red wines made from grapes grown under tropical conditions of India using thermal-desorption gas chromatography-mass spectrometry (TD-GC/MS)

The current study evaluated the key characters of aroma composition in diversified red wines (Cinsaut, Grenache, Cabernet Franc, Petit Verdot, Cabernet Sauvignon, Nielluccio, Tempranillo, Syrah, Merlot and Caladoc). Out of hundreds of volatile compounds 64 compounds were considered for study. Different groups consisting of fatty acids, volatile alcohols, aldehydes, esters, volatile phenols and terpenes were analysed using gas chromatography mass spectrometry coupled with thermal desorption (TD-GC-MS). Among all these diversified classes, alcohols were found as the most dominant group followed by esters and acids whereas aldehydes, phenols and terpenes were found to be minor compounds. Among the varieties, Nielluccio wine recorded highest concentration of total volatile compounds (191.53 mg/L) while, it was least in Caladoc wines (15.45 mg/L). The principal component analysis clearly differentiated Grenache wines based on their relationships between scores and their aroma composition followed by Nielluccio and Cinsuat wines. Out of sixty four compounds, only six aromatic compounds viz. butanediol, isoamyl actate, γ-Terpene, butanol, acetic acid and furfural have satisfying aroma descriptors with floral and fruity nuances and contribute to differentiate the Grenache wines from other varieties which have similar scores in PC1 analysis. The cluster analysis also suggested that the wines in the same group (Cinsaut, Tempranillo and Syrah), (Cabernet Franc, Cabernet Sauvignon, Caladoc and Merlot) and (Nielluccio and Petit Verdot) had similar aroma characterization. Grenache wines were well differentiated from the sub group formed by other red varieties.

Biological approach in repair of partially inflamed dental pulp using second-generation platelet-rich fibrin and mineral trioxide aggregate as a pulp medicament in primary molars

AIM

The purpose of this study was to evaluate and compare clinically and radiographically PRF, MTA and Ca(OH)2 as a pulp dressing material in primary molars.

MATERIAL AND METHODS

The study was conducted on 30 children between 6-9 years of age. Pulpotomy was performed using MTA(Gp I), PRF + MTA(Gp II) and PRF +Ca(OH)₂(Group III). The teeth were evaluated clinically and radiographically after 1,3 and 6 months and were subjected to statistics analysis.

RESULTS

After 6 months follow-up the overall success rate was found to be highest in Gp I with success rate of 97% followed by Gp II 95% and Gp III 78.3%. The results were found to be statistically insignificant (P ≤ 0.05).

CONCLUSION

All materials used in the present study were equally effective as the success rates are statistically insignificant.

A cross-sectional study to assess the prevalence of early childhood caries and associated risk factors in preschool children in district Mandi, Himachal Pradesh

AIM

The aim of this cross-sectional study is to investigate the prevalence and related risk factors of early childhood caries (ECC) in preschool children of district Mandi, Himachal Pradesh, India.

MATERIALS AND METHODS

A total sample of 2859 children aged between 2 and 6 years were selected from various parts of district Mandi. The status of dental caries and decayed missing and filled teeth (DMFT) score was recorded.

RESULTS

ECC increased significantly with age. Boys had significantly higher caries prevalence and mean DMFT score as compared to girls. Children who belonged to low socioeconomic group showed higher caries prevalence and mean DMFT score. Children aged 3-6 years who brushed their teeth twice daily had the least prevalence of dental caries as well as DMFT score when compared to children with one time and no brushing.

CONCLUSION

The early identification of poor oral hygiene and improper feeding habits should be considered in preventive health promotion in low socioeconomic communities of district Mandi, Himachal Pradesh.

Molecular docking and dynamic approach to virtual screen inhibitors against Esbp of Candidatus Liberibacter asiaticus

Citrus greening (huanglongbing) is the most destructive disease of citrus worldwide caused by Candidatus Liberibacter asiaticus (CLA). Currently, no strategies have been developed to manage the Huanglongbing (HLB) disease and to stop the spreading of this disease to new citrus areas. Esbp is an extracellular solute-binding protein, involved in the uptake of iron in CLA. Thus, inhibiting this process may be a promising approach to design a drug against CLA. Thus, the present study focused on the identification of novel effective inhibitors which can inhibit the activity of CLas Esbp. A series of small molecules were screened against the CLas Esbp and the binding affinities were assessed using docking simulation studies. Top scored molecules were screened for different pharmacophore properties and Inhibitory Concentration 50 (IC50) values. Density functional theory was employed to check the chemical properties of the molecules. Further, Molecular Dynamics simulation analysis like RMSD, RMSF, Rg, SASA and MMPBSA results reveal that the identified molecules (ZINC03143779, ZINC05491830, ZINC19210425, ZINC08750867, and ZINC14671545) exhibit a good binding affinity for CLas Esbp and results in the formation of stable CLas Esbp-inhibitor(s) complex. The present study reported that these compounds appeared to be the suitable novel inhibitor of CLas Esbp and pave the way to further development of antimicrobial agents against CLA.

Trichoderma harzianum- and Methyl Jasmonate-Induced Resistance to Bipolaris sorokiniana Through Enhanced Phenylpropanoid Activities in Bread Wheat (Triticum aestivum L.)

The aim of the present study was to evaluate the impact of Trichoderma harzianum UBSTH-501- and methyl jasmonate-induced systemic resistance and their integration on the spot blotch pathogen, Bipolaris sorokiniana through enhanced phenylpropanoid activities in bread wheat (Triticum aestivum L.). It was found that the application of MeJA (>100 mg L^-1) inhibits the germination of B. sorokiniana spores under controlled laboratory conditions. To assess the effect of MeJA (150 mg L^-1) in combination with the biocontrol agent T. harzianum UBSTH-501 in vivo, a green house experiment was conducted. For this, biocontrol agent T. harzianum UBSTH-501 was applied as seed treatment, whereas MeJA (150 mg L^-1) was applied 5 days prior to pathogen inoculation. Results indicated that application of MeJA (150 mg L^-1) did not affect the root colonization of wheat by T. harzianum UBSTH-501 in the rhizosphere. The combined application of T. harzianum UBSTH-501 and MeJA also enhanced indole acetic acid production in the rhizosphere (4.92 μg g^-1 of soil) which in turn helps in plant growth and development. Further, the combined application found to enhance the activities of defense related enzymes viz. catalase (5.92 EU min^-1 g^-1 fresh wt.), ascorbate peroxidase [μmol ascorbate oxidized (mg prot)^-1 min^-1], phenylalanine ammonia lyase (102.25 μmol cinnamic acid h^-1 mg^-1 fresh wt.) and peroxidase (6.95 Unit mg^-1 min^-1 fresh wt.) significantly in the plants under treatment which was further confirmed by assessing the transcript level of PAL and peroxidase genes using semi-quantitative PCR approach. The results showed manifold increase in salicylic acid (SA) along with enhanced accumulation of total free phenolics, ferulic acid, caffeic acid, coumaric acid, and chlorogenic acid in the leaves of the plants treated with the biocontrol agent alone or in combination with MeJA. A significant decrease in the disease severity (17.46%) and area under disease progress curve (630.32) were also observed in the treatments with biocontrol agent and MeJA in combination as compared to B. sorokiniana alone treated plant (56.95% and 945.50, respectively). Up-regulation of phenylpropanoid cascades in response to exogenous application of MeJA and the biocontrol agent was observed. It was depicted from the results that PAL is the primary route for lignin production in wheat which reduces cell wall disruption and tissue disintegration and increases suberization and lignification of the plant cell as seen by Scanning Electron microphotographs. These results clearly indicated that exogenous application of MeJA with T. harzianum inducing JA- and/or SA-dependent defense signaling after pathogen challenge may increase the resistance to spot blotch by stimulating enzymatic activities and the accumulation of phenolic compounds in a cooperative manner. This study apparently provides the evidence of biochemical cross-talk and physiological responses in wheat following MeJA and biocontrol agent treatment during the bio-trophic infection.

Crystal structures of a putative periplasmic cystine-binding protein from Candidatus Liberibacter asiaticus: insights into an adapted mechanism of ligand binding

The amino acid-binding receptors, a component of ABC transporters, have evolved to cater to different specificities and functions. Of particular interest are cystine-binding receptors, which have shown broad specificity. In the present study, a putative periplasmic cystine-binding protein from Candidatus Liberibacter asiaticus (CLasTcyA) was characterized. Analysis of the CLasTcyA sequence and crystal structures in the ligand-bound state revealed novel features of CLasTcyA in comparison to related proteins. One of the unique features found in CLasTcyA structure was the positioning of the C-terminal extended loop of one chain very close to the substrate-binding site of the adjacent monomer in the asymmetric unit. The presence of a disulphide bond, unique to Candidatus Liberibacter family, holds the C-terminal extended loop in position. Analysis of the substrate-binding pocket of CLasTcyA suggested a broad specificity and a completely different orientation of the bound substrates in comparison to related protein structures. The open conformation for one of the two chains of the asymmetric unit in the Arg-bound structure revealed a limited open state (18.4°) for CLasTcyA as compared to open state of other related proteins (~ 60°). The strong interaction between Asp126 on helix-α5 of small domain and Arg82 (bigger domain) restricts the degree of opening in ligand-free open state. The dissociation constant of 1.26 μm by SPR and 3.7 μm by MST exhibited low affinity for the cystine. This is the first structural characterization of an l-cystine ABC transporter from plant pathogen and our results suggest that CLasTcyA may have evolved to cater to its specific needs for its survival in the host.

The unique composition of Indian gut microbiome, gene catalogue, and associated fecal metabolome deciphered using multi-omics approaches

BACKGROUND

Metagenomic studies carried out in the past decade have led to an enhanced understanding of the gut microbiome in human health; however, the Indian gut microbiome has not been well explored. We analyzed the gut microbiome of 110 healthy individuals from two distinct locations (North-Central and Southern) in India using multi-omics approaches, including 16S rRNA gene amplicon sequencing, whole-genome shotgun metagenomic sequencing, and metabolomic profiling of fecal and serum samples.

RESULTS

The gene catalogue established in this study emphasizes the uniqueness of the Indian gut microbiome in comparison to other populations. The gut microbiome of the cohort from North-Central India, which was primarily consuming a plant-based diet, was found to be associated with Prevotella and also showed an enrichment of branched chain amino acid (BCAA) and lipopolysaccharide biosynthesis pathways. In contrast, the gut microbiome of the cohort from Southern India, which was consuming an omnivorous diet, showed associations with Bacteroides, Ruminococcus, and Faecalibacterium and had an enrichment of short chain fatty acid biosynthesis pathway and BCAA transporters. This corroborated well with the metabolomics results, which showed higher concentration of BCAAs in the serum metabolome of the North-Central cohort and an association with Prevotella. In contrast, the concentration of BCAAs was found to be higher in the fecal metabolome of the Southern-India cohort and showed a positive correlation with the higher abundance of BCAA transporters.

CONCLUSIONS

The study reveals the unique composition of the Indian gut microbiome, establishes the Indian gut microbial gene catalogue, and compares it with the gut microbiome of other populations. The functional associations revealed using metagenomic and metabolomic approaches provide novel insights on the gut-microbe-metabolic axis, which will be useful for future epidemiological and translational researches.

Phylogenetic analysis of haemagglutinin gene deciphering a new genetically distinct lineage of canine distemper virus circulating among domestic dogs in India

Canine distemper (CD) is one of the highly contagious and invariably fatal viral diseases of dogs and other carnivores. Despite the widespread use of modified live vaccines to control CD, the prevalence of disease has increased at an alarming rate in recent years. Although a number of factors may be ascribed for vaccine failure, antigenic differences among the vaccine and wild-type strains have gained the interest of researchers. Considering the high genetic variability of haemagglutinin gene (H gene) and its role in eliciting the immune response to canine distemper virus (CDV), we have generated nine full-length CDV H gene sequences from infected dogs including three vaccinated cases. Bayesian analysis was performed using 102 full-length H gene nucleotide sequences over a time frame of 76 years (1940-2016) from 18 countries. The time to the most recent common ancestor (tMRCA) of CDV was estimated to be 1696 AD. Phylogenetic reconstruction clustered Indian wild-type viruses into a distinct monophyletic group clearly separated from the previously established CDV lineages. This signifies the presence of a novel genetic variant (proposed as "Lineage India-1/Asia-5") circulating among dog population in India. To investigate the importance of substitutions at amino acid residues 530 and 549 of CDV H protein in determining the host switches from canid to non-canid hosts, we analysed 125 H gene sequences including nine sequences generated in this study. Selection pressure analysis and analysis of amino acid sequences revealed a trend towards adaptation of 549H variants in non-canid hosts although no role of G/E530R/D/N substitution could be identified. This is the first comprehensive study about the nature and ecology of CDV circulating among dog population in India. Outbreaks in vaccinated animals as observed in this study have raised a concern towards the effectiveness of current vaccine strains warranting detailed investigation.

A process-based insight to the recent disappearance of streams in the central part of Tarai region, Uttarakhand, India

The integrated study of geomorphology and hydrogeology could be significant in predicting and assessing the groundwater environment of ecologically sensitive terrains such as the Tarai region in North India. In this article, we integrate topographic elevation, stream network, water level data, and input and output stresses acting on the aquifer to understand the hydrological processes and linkages between groundwater dynamics and geomorphic elements in Rudrapur sub-division of Udham Singh Nagar district, Uttarakhand in the central part of Tarai region. The study area was selected on account of the fact that the Rudrapur area of late has witnessed rapid agricultural growth, urbanization, and industrialization. It has been observed that primarily, water table elevations are controlled by the topography of the region. Further, the groundwater abstraction has increased with time; however, except in urbanized sectors, the water level does not show any significant decline. This has been attributed to increased recharge. Prima facie, it appears to be ecologically balanced. However, in a temporal framework, it was observed that over the years, a few streams have disappeared to compensate for enhanced groundwater abstraction. The article explains the underlying hydrological processes behind the disappearance of streams with help of schematic diagrams. It also put forward reasons for the persistence of shallow water level in parts of the study area. It suggests for preservation of the waterways of disappeared streams as possible sites for remedial measures like check dams etc. if required in future on account of over-exploitation of groundwater resources.

Development of a recombinase polymerase based isothermal amplification combined with lateral flow assay (HLB-RPA-LFA) for rapid detection of "Candidatus Liberibacter asiaticus"

Huanglongbing (HLB) or citrus greening is highly destructive disease that is affecting the citrus industry worldwide and it has killed millions of citrus plants globally. HLB is caused by the phloem limited, Gram negative, non-culturable, alpha-proteobacterium, 'Candidatus Liberibacter asiaticus'. Currently, polymerase chain reaction (PCR) and real time PCR have been the gold standard techniques used for detection of 'Ca. L. asiaticus'. These diagnostic methods are expensive, require well equipped laboratories, not user-friendly and not suitable for on-site detection of the pathogen. In this study, a sensitive, reliable, quick and low cost recombinase polymerase based isothermal amplification combined with lateral flow assay (HLB-RPA-LFA) technique has been developed as a diagnostic tool for detection of 'Ca. L. asiaticus'. The assay was standardized by designing the specific primer pair and probe based on the conserved 16S rRNA gene of 'Ca. L. asiaticus'. The assay was optimized for temperature and reaction time by using purified DNA and crude plant extracts and the best HLB-RPA-LFA was achieved at the isothermal temperature of 38°C for 20 to 30 min. The efficacy and sensitivity of the assay was carried out by using field grown, HLB-infected, HLB-doubtful and healthy citrus cultivars including mandarin, sweet orange cv. mosambi, and acid lime. The HLB-RPA-LFA did not show cross-reactivity with other citrus pathogens and is simple, cost-effective, rapid, user-friendly and sensitive. Thus, the HLB-RPA-LFA method has great potential to provide an improved diagnostic tool for detection of 'Ca. L. asiaticus' for the farmers, nurserymen, disease surveyors, mobile plant pathology laboratories, bud-wood certification and quarantine programs.

Anisamido-Polyethylenimines as Efficient Nonviral Vectors for the Transport of Plasmid DNA to Sigma Receptor-Bearing Cells In Vitro

Site-specific delivery of therapeutics promises better outcomes in the treatment of diseases. A small ligand, anisamide, has been shown to specifically bind sigma receptors highly overexpressed on prostate cancer cells, one of the leading cancers causing deaths worldwide. Here, anisamide-tethered polyethylenimine polymers (AP) have been synthesized and evaluated for their capability to transport nucleic acid across the cell membrane. A series of modified polymers (AP-1 to AP-4) was synthesized, physicochemically characterized, and evaluated for their transfection efficiency and cytotoxicity. Postconjugation, there was a marginal decrease in the buffering capacity; however, it did not diminish the ultimate objective of the study rather improved the transfection efficiency and decreased the cytotoxicity making these polymers as efficient and safe vectors for nucleic acid delivery. All the modified polymers displayed enhanced capability to deliver DNA inside the cells. Among the series, the modified polymer, AP-4 (10% attempted substitution), exhibited the highest transfection in HEK293 cells having abundant sigma receptors with minimal cytotoxicity. The projected polymer also showed complete protection of bound DNA against enzymatic degradation. Altogether, the results demonstrated targeting ability of the proposed polymers to deliver nucleic acid to sigma receptor-bearing cells in vitro.

Toxicity assessment of cypermethrin nanoparticles in Channa punctatus: Behavioural response, micronuclei induction and enzyme alteration

A comparative toxicity assessment was performed to evaluate the effect of cypermethrin nanoparticles (CypNPs) and cypermethrin (Cyp) on murrel, Channa punctatus. Size variation and shape morphology of nanoparticles were confirmed by scanning electron microscopy, UV-Vis absorption spectroscopy and transmission electron microscopy. CypNPs presented shoulder band at a wavelength of 277 nm and size range between 29.23 nm and 49.28 nm. The individuals of C. punctatus were exposed to two sublethal doses of LC₅₀ viz 1/20th (S₁) of LC₅₀ and 1/10th (S₂) of LC₅₀ of CypNPs (20.54 mg/L) and Cyp (4 μg/L) for 15 days. Micronucleus assay was used to assess the genotoxicity while enzyme activity was evaluated by using alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP). The percentage of micronuclei was increased significantly at different doses in Cyp compared to CypNPs. The AST value of Cyp was significantly different from CypNPs at both doses while ALP level at the S₂ dose (p < 0.05). Increased levels of ALT, AST, and ALP in blood serum caused tissue impairment cellular damage in liver in the fish exposed to Cyp compared to CypNPs which indicated that CypNPs is least toxic than the conventional form of Cyp. AST and ALT also acted as indicators of stress and altered physiological condition in C. punctatus.

Antimicrobial nano-zinc oxide-2S albumin protein formulation significantly inhibits growth of "Candidatus Liberibacter asiaticus" in planta

Huanglongbing (HLB, also known as citrus greening) is considered to be the most devastating disease that has significantly damaged the citrus industry globally. HLB is caused by the Candidatus Liberibacter asiaticus (CLas), the fastidious phloem-restricted gram-negative bacterium, vectored by the asian citrus psyllid. To date, there is no effective control available against CLas. To alleviate the effects of HLB on the industry and protect citrus farmers, there is an urgent need to identify or develop inhibitor molecules to suppress or eradicate CLas from infected citrus plant. In this paper, we demonstrate for the first time an in planta efficacy of two antimicrobial compounds against CLas viz. 2S albumin (a plant based protein; ~12.5 kDa), Nano-Zinc Oxide (Nano-ZnO; ~ 4.0 nm diameter) and their combinations. Aqueous formulations of these compounds were trunk-injected to HLB affected Mosambi plants (Citrus sinensis) grafted on 3-year old rough lemon (C. jambhiri) rootstock with known CLas titer maintained inside an insect-free screen house. The effective concentration of 2S albumin (330 ppm) coupled with the Nano-ZnO (330 ppm) at 1:1 ratio was used. The dynamics of CLas pathogen load of treated Mosambi plants was assessed using TaqMan-qPCR assay every 30 days after treatment (DAT) and monitored till 120 days. We observed that 2S albumin-Nano-ZnO formulation performed the best among all the treatments decreasing CLas population by 96.2%, 97.6%, 95.6%, and 97% of the initial bacterial load (per 12.5 ng of genomic DNA) at 30, 60, 90, and 120 DAT, respectively. Our studies demonstrated the potency of 2S albumin-Nano-ZnO formulation as an antimicrobial treatment for suppressing CLas in planta and could potentially be developed as a novel anti CLas therapeutics to mitigate the HLB severity affecting the citrus industry worldwide.

Estimation of polyphenols by using HPLC-DAD in red and white wine grape varieties grown under tropical conditions of India

Grapes are well known for their high content of phenolic compounds. Polyphenols are classified into flavonoids and non-flavonoids by their primary chemical structures of hydroxybenzene. Flavonoids mainly consist of anthocyanins, flavonoids, and flavonols whereas non-flavonoids include hydroxycinnamic and hydroxybenzoic acids. In the present study, sixteen phenolic compounds from ten red and nine white grape wine varieties were quantified using high-performance liquid chromatography. Gallic acid, Vanillic acid, Rutin hydrate, Ellagic acid, Chlorogenic acid, Sorbic acid, Catechin hydrate, Epicatechin, p-coumaric acid, Quercetin, Myricetin, Kaempferol, Piceatannol, and Resveratrol were major compounds found in red wine grapes. Among the varieties, Petit Verdot, Cabernet Franc showed maximum quantitative phenolics, whereas Cabernet Sauvignon, Niellucio, Cinsaut, and Syrah showed least quantitative phenolics in grape berries. Phenolic profile of white wine grapes showed lower concentration of phenolics than that of red wine grapes. The variety Gros Meseng showed maximum phenolics followed by Sauvignon, while the variety Colombard and Chenin Blanc showed least phenolics.

Transgene-free genome editing in marine algae by bacterial conjugation - comparison with biolistic CRISPR/Cas9 transformation

The CRISPR/Cas9 technology has opened the possibility for targeted genome editing in various organisms including diatom model organisms. One standard method for delivery of vectors to diatom cells is by biolistic particle bombardment. Recently delivery by conjugation was added to the tool-box. An important difference between these methods is that biolistic transformation results in transgene integration of vector DNA into the algae genome, whereas conjugative transformation allows the vector to be maintained as an episome in the recipient cells. In this study, we have used both transformation methods to deliver the CRISPR/Cas9 system to the marine diatom Phaeodactylum tricornutum aiming to induce mutations in a common target gene. This allowed us to compare the two CRISPR/Cas9 delivery systems with regard to mutation efficiency, and to assess potential problems connected to constitutive expression of Cas9. We found that the percentage of CRISPR-induced targeted biallelic mutations are similar for both methods, but an extended growth period might be needed to induce biallelic mutations when the CRISPR/Cas9 system is episomal. Independent of the CRISPR/Cas9 vector system, constitutive expression of Cas9 can cause re-editing of mutant lines with small indels. Complications associated with the biolistic transformation system like the permanent and random integration of foreign DNA into the host genome and unstable mutant lines caused by constitutive expression of Cas9 can be avoided using the episomal CRISPR/Cas9 system. The episomal vector can be eliminated from the diatom cells by removal of selection pressure, resulting in transient Cas9 expression and non-transgenic mutant lines. Depending on legislation, such lines might be considered as non-GMOs.

Type II aortopulmonary window with tetralogy of Fallot: successful repair

Aortopulmonary window associated with tetralogy of Fallot is a rare cardiac anomaly. An 8-month-old boy presented with failure to thrive and recurrent chest infections. Echocardiography and imaging studies revealed a type II aortopulmonary window with tetralogy of Fallot. Corrective surgery in the form of patch closure of the aortopulmonary window and intracardiac repair of tetralogy of Fallot was carried out successfully.

Quantitative distribution of Citrus yellow mosaic badnavirus in sweet orange (Citrus sinensis) and its implication in developing disease diagnostics

Citrus yellow mosaic badnavirus (CMBV) is the etiologic agent of citrus yellow mosaic disease, which has caused serious economic losses to Indian citrus industry. CMBV is a quarantined pathogen that is geographically restricted to India. To prevent unintentional movement of the virus to other major citrus-growing countries in fruits, root stocks or grafted citrus plants and facilitate trade, a sensitive, validated diagnostic tool is needed. In the present study, we developed a SYBR Green real-time PCR-based method to detect and quantify CMBV in different tissues of infected Mosambi sweet orange (Citrus sinensis) and compared its sensitivity to conventional PCR protocols. Primers were designed to recognize a portion of the CMBV capsid protein gene. Conventional and real-time PCR were performed on several different tissues: shoot tips, leaves displaying typical CMBV symptoms, asymptomatic leaves, senescent leaves, thorns, green stems and feeder roots. The detection limit of CMBV by conventional PCR was 2.5 × 10⁴ copies per 5 ng of total genomic DNA, while the detection limit of real-time PCR was found to be 4.6 × 10² virus copies per 5 ng of viral DNA. The viral load varied between different tissues. The highest concentration occurred in feeder roots (3.5 × 10⁸ copies per 5 ng of total genomic DNA) and the lowest in thorns (1 × 10⁶ copies per 5 ng of total genomic DNA). The variation in viral load within different tissues suggests movement of the virus within an infected plant that follows the path of photo-assimilates via the phloem. In symptomatic leaves, the CMBV concentration was highest in the lamella followed by midrib and petiole, suggesting that virus resides inside these sections of a leaf and side by side symptoms develop. On the other hand, in asymptomatic leaves, the petiole contained higher virus load than the lamella and midrib suggesting that the pathogen gets established from the stem through the phloem into petiole then infects the lamella and midrib. In addition to information on virus movement, the distribution of CMBV in different tissues helps with the selection of tissues with relatively higher viral load to sample for early and sensitive diagnosis of the disease, which will be useful for better management of the disease in endemic areas.

PI3K/Akt/mTOR Intracellular Pathway and Breast Cancer: Factors, Mechanism and Regulation

BACKGROUND

The most recurrent and considered second most frequent cause of cancer-related deaths worldwide in women is the breast cancer. The key to diagnosis is early prediction and a curable stage but still treatment remains a great clinical challenge. Origin of the Problem: A number of studies have been carried out for the treatment of breast cancer which includes the targeted therapies and increased survival rates in women. Essential PI3K/mTOR signaling pathway activation has been observed in most breast cancers. The cell growth and tumor development in such cases involve phosphoinositide 3 kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) complex intracellular pathway.

HYPOTHESIS

Through preclinical and clinical trials, it has been observed that there are a number of other inhibitors of PI3K/Akt/mTOR pathway, which either alone or in combination with cytotoxic agents can be used for endocrine therapies.

CONCLUSION

Structure and regulation/deregulation of mTOR provides a greater insight into the action mechanism. Also, through this review, one could easily scan first and second generation inhibitors for PI3K/Akt/mTOR pathway besides targeted therapies for breast cancer and the precise role of mTOR.

Preliminary clinical assessment and non- toxicity evaluation of an ayurvedic formulation BGR-34 in NIDDM

In view of the overall health impact of NIDDM, inventers understand the necessity of improving glycemic control in adults with type 2 diabetes. BGR-34 provides an effective treatment option for adults with type 2 diabetes who have been inadequately controlled on lifestyle with or without other oral hypoglycemic agents (OHGAs) such as metformin, sulfonylurea, or a glitazones. BGR-34 is an appropriate option to consider for addition to a managed care drug formulary. Treatment with BGR-34 produced clinically relevant and statistically significant reductions in all three key measures of glucose control studied -FPG, PPBG and HbA1c- when compared with placebo. BGR-34, showed the promising result with respect to glycemic parameters in NIDDM patient with a significant reduction in fasting blood sugar by 34.3%, postprandial blood sugar 35.5% & glycosylated haemoglobin by 20.31% as compared to placebo group showing a reduction by 13.2%, 10.9% & 10.87% respectively. The trial has also been registered to CTRI, India. This study has been registered in the clinical trial registry-India.