Modulation of radiation-induced biochemical alterations in mice by rosemary (Rosemarinus officinalis) extract

Radioprotective effect of leaves extract of Rosemarinus officinalis (ROE) has been studied against 6 Gy gamma-radiations in the liver of Swiss albino mice at various post-irradiation intervals between 12 h and 30 days. In control animals (without ROE treated irradiated), an elevation in glycogen, protein, acid and alkaline contents was found till day 5th, but thereafter decreased at successive intervals without returning to normal. Cholesterol level was found to be lower than normal till 10th day, then increased up to 20th day but later declined without restoring normal level. A similar trend of variation in these biochemical parameters was observed in experimental group (ROE pretreated irradiated) also but to a lower extent. ROE significantly delayed and inhibited the rise in these biochemical parameters. Almost normal values of such constituents were regained by day 30th in experimental animals; whereas in control animals, normal values were not ever attained. In control animals, there was an elevation in lipid peroxidation (LPx) and a decrease in glutathione (GSH) in blood and liver; whereas in experimental group, decline in LPx accompanied by an increase in GSH concentration was observed.

Influence of water soluble polymers on hydroxypropyl-beta-cyclodextrin complexation of rofecoxib

Rofecoxib (Rb) is a nonsteroidal anti-inflammatory drug (NSAID) with poor aqueous solubility. The present study was undertaken to investigate the influence of water-soluble polymers namely sodium carboxymethyl cellulose (Na CMC), polyvinylpyrrolidine (PVP) and polyethylene glycol (PEG-6000) on hydroxypropyl beta-cyclodextrin (HP beta-CD) complexation of Rb. The complexes were prepared by kneading, autoclaving and precipitation techniques in 1:1 and 1:2 molar ratios. The aqueous solubility enhancement of Rb by these polymers is found to be of the following order: Na CMC > PVP > PEG-6000. Complexes were characterized by Fourier transform infrared (FTIR) spectroscopy, Nuclear magnetic resonance (NMR) and X-ray diffractometry (XRD) techniques. In vitro dissolution studies were carried out on tablets formulated from molar ratios of the complexes prepared by different techniques.

Tuberculous retropharyngeal abscess in an HIV patient

With the emergence of the human immunodeficiency virus (HIV), the incidence of deep neck space infections and associated life-threatening complications has been on the rise. We describe a case of tubercular retropharyngeal abscess in an HIV-positive patient who developed bilateral parapharyngeal space abscesses and was treated by incision and drainage.

Waardenburg syndrome Type II

Two rare cases of Waardenburg type II are reported. First case had three main features of WS--profound SN hearing loss, hetrochromia iris and white forelock of hair. Second case had moderate SNHL and depigmentation of hair.

Prevalence of otitis media in school going children in Eastern Nepal

OBJECTIVES

To find out the prevalence of otitis media in school going children from lower socio-economic strata.

MATERIAL AND METHODS

This study was carried out in a government school, Shree Naragram Secondary School in Morang district, eastern Nepal, and included 1050 children aged between 5-15 years.

RESULTS

Of the 1050 school children, 346 children were found to have various ENT related problems. Hearing assessment revealed a conductive hearing loss on one or both sides in 114 cases (87%). Various middle ear pathologies were detected in these children, out of which chronic suppurative otitis media "Tubotympanic type" was the most common, followed by otitis media with effusion. The prevalence of otitis media in these children was found to be13.2% and those with hearing loss comprised 12.47%. Prevalence of otitis media is found to be much higher in school going children as compared to adults, and is even higher amongst children belonging to the lower socio-economic strata. Conditions complicating otitis media are more common and severe in children as compared to adults.

CONCLUSION

Primary ear care education to teachers, students and guardians can prevent these vulnerable children from developing hearing impairment. School based study could be one of the useful and cost-effective modality aimed at community oriented program.

Stress fracture of the distal tibia secondary to severe knee osteoarthritis: a case report

Stress fracture of the tibia secondary to sports-related activities is relatively common, but rarely occurs secondary to osteoarthritis of the knee. Such fractures usually involve the proximal tibia. We report a 61-year-old woman with osteoarthritis and severe varus deformity of the knee who had a stress fracture of the distal tibial shaft. The patient had declined total knee replacement for severe osteoarthritis. She developed a stress fracture that subsequently malunited. The patient presented late and the diagnosis was not made for several months. The pathomechanics, diagnosis, and management options for this patient are discussed.

Krabbe disease: psychosine-mediated activation of phospholipase A2 in oligodendrocyte cell death

Globoid cell leukodystrophy (Krabbe disease) is an inherited neurological disorder caused by the pathogenomic accumulation of psychosine (galactosylsphingosine), a substrate for the deficient enzyme galactocerebroside beta-galactosidase. This study underscores the mechanism of action of psychosine in the regulation of oligodendrocyte cell death via the generation of lysophosphatidylcholine (LPC) and arachidonic acid (AA) by the activation of secretory phospholipase A2 (sPLA2). There was a significant increase in the level of LPC, indicating a phospholipase A2 (PLA2)-dependent pathobiology, in the brains of Krabbe disease patients and those of twitcher mice, an animal model of Krabbe disease. In vitro studies of the treatment of primary oligodendrocytes and the oligodendrocyte MO3.13 cell line with psychosine also showed the generation of LPC and the release of AA in a dose- and time-dependent manner, indicating psychosine-induced activation of PLA2. Studies with various pharmacological inhibitors of cytosolic phospholipase A2 and sPLA2 and psychosine-mediated induction of sPLA2 enzymatic activity in media supernatant suggest that psychosine-induced release of AA and generation of LPC is mainly contributed by sPLA2. An inhibitor of sPLA2, 7,7-dimethyl eicosadienoic acid, completely attenuated the psychosine-mediated accumulation of LPC levels, release of AA, and generation of reactive oxygen species, and blocked oligodendroyte cell death, as evident from cell survival, DNA fragmentation, and caspase 3 activity assays. This study documents for the first time that psychosine-induced cell death is mediated via the sPLA2 signaling pathway and that inhibitors of sPLA2 may hold a therapeutic potential for protection against oligodendrocyte cell death and resulting demyelination in Krabbe disease.

Plasma pooling to expedite bioequivalence estimation of rifampicin in fixed dose combinations

Rifampicin has been found to be one of the most important antitubercular drugs; however, variable bioavailability of rifampicin in some fixed dose combinations (FDCs) as well as separate formulations has been reported in the literature. This resulted in proper evaluation of FDCs with standard protocol for bioequivalence trials. Earlier, plasma pooling as a rapid method for bioequivalence assessment of rifampicin in FDCs was proposed from our laboratory. Results obtained after pooled plasma sample analysis were compared with those from the individual plasma sample analysis. Case studies from our laboratories further validate and support the use of plasma pooling method as a faster and cost effective tool for bioequivalence assessment of rifampicin in FDCs, which will be useful in order to speed up the registration and approval of good quality FDCs.

Rho/ROCK pathway as a target of tumor therapy

This study emphasizes the importance of Rho/ROCK pathway in lovastatin-induced apoptosis as replenishment with exogenous isoprenoid, geranylgeranylpyrophosphate (GGPP), resulted in inhibition of apoptosis in cultured tumor cells. Treatment of C6 glioma cells with Toxin B and exoenzyme C3 resulted in cell death suggesting the role of geranylgeranylated protein(s) in the survival of glioma cells. Relative apoptotic death observed in cells transfected with dominant negative constructs of RhoA, Rac, and cdc42 imply Rho A as playing the major role in cell survival. Furthermore, the inhibition of Rho A kinase (ROCK), a direct downstream effector of Rho A, by Y-27632 or dominant negative of ROCK, induced apoptosis in glioma cells. These findings indicate that RhoA/ROCK pathway is involved negatively in the regulation of glioma cell death pathway. Moreover, in vivo studies of lovastatin treatment in animals implanted with C6 glioma cell tumors also resulted in smaller tumor size and induced apoptosis in the tumor tissue. The implantation of stably transfected C6 glioma cells with expression vector of C3 exoenzyme, dominant negative of RhoA and ROCK, resulted in significant smaller tumor mass, further establishing the importance of geranylgeranylated proteins, specifically RhoA and its downstream effecter ROCK, in cell survival and tumor genesis.

Epidemiologic classification of seizures associated with neurocysticercosis: observations from a sample of seizure disorders in neurologic care in India

AIMS

To determine the etiologic role of neurocysticercosis (NC) in a hospital-based sample of epilepsies divided according to International League Against Epilepsy (ILAE) epidemiological criteria and number of seizures prior to presentation.

METHODS

A sample comprising 1026 consecutive patients with either definite seizures or epilepsy attending a Neurology Outpatient Service was divided into four subgroups: single seizure (n = 314), incident epilepsy (n = 127), prevalent epilepsy (n = 398) and recurrent acute symptomatic seizures (RASS) (n = 175). The etiologic contribution of NC to each of the subgroups was examined with imaging studies.

RESULTS

Neurocysticercosis was diagnosed on imaging studies in 34.6% of patients with seizure disorder of any type, 59.2% of those with a single seizure, 23.7% of those with recurrent seizure disorder, 92.0% of those with RASS, none of cases of incident epilepsy and 2.0% with prevalent epilepsy. A diagnosis of NC was significantly associated with single seizures (P < 0.001).

CONCLUSIONS

Imaging abnormalities consistent with NC are frequently noted in persons presenting with a single seizure in neurologic care in NC-endemic countries like India. The probability of diagnosing NC diminishes with increasing numbers of seizures. Among samples of individuals with recurrent-unprovoked seizures, it is rare for imaging to demonstrate lesions of NC.

Emblica officinalis (Linn.) Fruit Extract Provides Protection against Radiation-Induced Hematological and Biochemical Alterations in Mice

Oral administration of Emblica officinalis (Linn.) before exposure to gamma radiation was found to be effective in protecting mice against the hematological and biochemical modulation in peripheral blood. A significant increase in the RBC, WBC, hemoglobin, and hematocrit values was observed in the animals pretreated with E. officinalis extract as compared to the hematological values observed in the irradiated group. Furthermore, radiation sickness was greatly inhibited in those mice that were irradiated with prior treatment of E. officinalis. A significant decrease in glutathione (GSH) content and increase in lipid peroxidation (LPx) level were also observed in irradiated animals; whereas E. officinalis pretreated irradiated animals exhibited a significant increase in GSH content and decrease in LPx level, but such remained below the normal. The results from the present study suggest that E. officinalis pretreatment provides protection against irradiation to Swiss albino mice.

Minimum sample size and sampling time requirements for assessment of rifampicin bioequivalence from FDC formulations

SETTING

The WHO- and IUATLD-recommended protocol for rifampicin (RMP) bioequivalence utilises 20-22 volunteers and 8 h, whereas the requirement of other regulatory authorities is 12 volunteers with a 24 h sampling schedule. Differing sampling size and time requirements may change the outcome of RMP bioequivalence.

OBJECTIVE

To determine the minimal sample size and time required to assess RMP bioequivalence from FDC formulations.

DESIGN

Bioequivalence studies were conducted that fulfilled the criteria of the WHO and Indian regulatory protocols. From earlier studies, retrospective pharmacokinetic evaluation, power of the test and bioequivalence limits were also calculated using 8-22 volunteers and sampling points of 8-24 h. Pharmacokinetic and statistical evaluations from three representative studies showing low, moderate and high intra-subject variability are given to determine minimum requirements for RMP bioequivalence.

RESULT

It was found that a sampling schedule up to 8 h was sufficient to compare the absorption process of RMP. There was no influence of reduced sample size on bioequivalence estimates of RMP that showed low or moderate variability. However, in a study showing higher variation, a sample size of 14-16 subjects was found to be optimal.

CONCLUSION

It is possible to reduce the sample size requirement for determination of RMP bioequivalence using the WHO protocol.

Pneumatization correlated to myringoplasty and tubal function

The prognostic significance of the size of mastoid air cell system in the results of myringoplasty has been a matter of debate. Fifty ears with dry central perforation following C.S.O.M. were investigated. The size of mastoid air cell system was determined with planimetry of the X-ray picture and eustachian tube function was assessed using flourescein dye and nasal endoscopy. Myringoplasty was performed in all the 50 ears and postoperative results in terms of graft take up and hearing gain were assessed. The correlation between the size of mastoid air cell system, results of myringoplasty and tubal function has been discussed. The results show no correlation between the size of mastoid air cell system, postoperative results of myringoplasty and eustachian tube function.

Emphysematous pyelonephritis: a consequence of adenocarcinoma of urinary bladder in a nondiabetic patient

Emphysematous pyelonephritis (EP) is a life threatening condition of acute necrotising renal parenchymal infection that encompasses a much wider spectrum of complicated urinary tract infections such as renal abscesses, emphysematous pyelitis, pyelonephritis, acute renal papillary necrosis, and sepsis. We report an unusual case of adenocarcinoma bladder in a middle aged nondiabetic patient, presenting with EP. Emphysematous pyelonephritis was the initial symptom in this case with an underlying carcinoma of the bladder. The role of imaging is prime in management of such cases, if an early diagnosis is to be made and a potentially devastating outcome is to be avoided. The literature regarding EP has been reviewed and discussed. The goals of managing EP should be (1) early institution of parenteral antibiotics and a (2) a staged nephrectomy (preceded by a temporary percutaneous drainage particularly with antibiotic resistant septicemia) so as to maximize survival rather than proceeding directly to emergency nephrectomy.

Effect of adenotonsillitis on peak exploratory flow rate in children

Peak Exploratory Flow Rate (PEFR) is a simple, economical, reproducible, non-invasive test, which can be quickly performed with ease. PEFR was assessed in 36 children with adenotonsillar enlargement with mean age 10.75 years and equal number of age and sex matched normal children who acted as controls. PEFR was found to be 250. 61 +/- 66.92 lt/min in controls and 216.85 +/- 59.76 lt/min in children with adenotonsillar enlargement signifying impairment of PEFR in children in the second group.

Compound composite odontome associated with an unerupted deciduous incisor--a rarity

Odontomes are considered to be hamartomatous malformation rather than true neoplasm and are generally asymptomatic. Here is a case presentation of compound composite odontome with impacted deciduous teeth in an 11-year-old girl. A calcified mass was revealed in the radiograph and the case was finally diagnosed to be compound composite odontome. The mass was surgically excised.

Establishment of a reference formulation for bioequivalence assessment of rifampicin-containing FDCs: an essential step towards improving tuberculosis treatment

SETTING

Selection of a reference product for bioequivalence studies of rifampicin (RMP) in prequalifying fixed-dose combinations (FDC) for worldwide distribution through the WHO is critical.

OBJECTIVE

To investigate the feasibility of establishing FDC formulations as reference products for bioequivalence studies of RMP in prequalification programmes.

DESIGN

A biostudy was conducted as an open, two-period randomised cross-over trial. Two three-drug FDCs containing RMP, isoniazid and ethambutol hydrochloride were administered to a group of 22 volunteers with a wash-out period of 1 week. Plasma samples were collected and analysed for the concentration of RMP and desacetyl-RMP, a major active metabolite of RMP, up to 24 h. Pharmacokinetic parameters of RMP were calculated: Cmax, AUC0-24, Tmax, kel and absorption efficiencies.

RESULTS

No significant difference was observed between the administered formulations with respect to the major pharmacokinetic parameters Cmax, Tmax and AUC0-24 when evaluated by parametric (two-way ANOVA) and non-parametric (Hauschke's analysis) statistical analysis. The concentration of RMP falls within the reported acceptable therapeutic range.

CONCLUSION

FDCs can be developed as a reference product for bioequivalence studies.

Plasma pooling: utility in expediting bioequivalence assessment of rifampicin-containing fixed-dose combinations

To improve the rapidity of the registration process of rifampicin (RMP) containing fixed-dose combination (FDC) formulations, a plasma pooling methodology was used to increase the throughput of bioanalysis of plasma samples from bioequivalence trials of FDCs. Plasma samples of a biostudy were analysed for RMP using traditional analysis methods as well as a plasma pooling method (volunteer and time pooling). Both methods produced similar results, with less than 15% variability in both volunteer and time pooling. The plasma pooling method for bioanalysis was validated. Further studies are required to identify and reduce the percentage variability.

Determination of rifampicin bioequivalence in a three-drug FDC by WHO and indian protocols: effect of sampling schedule and size

SETTING

To promote the quality assurance of fixed-dose combination (FDC) formulations, the World Health Organization (WHO) has prepared a convenient simplified protocol for the determination of rifampicin (RMP) bioequivalence. During the development of this protocol, it was proved that sampling time up to 8 h can determine the rate and extent of RMP absorption. However, this protocol utilises 20 volunteers in contrast to other local regulatory requirements of a minimum of 12 volunteers. The different sample sizes utilised in these protocols may affect the sensitivity of the bioequivalence outcome.

OBJECTIVE

To determine the effect of sampling size and schedule on RMP bioequivalence when two different protocols are used.

DESIGN

A bioequivalence trial was conducted with a study design of 20 volunteers and 24 h sampling time, which fulfils the requirements of both the WHO and Indian regulatory protocols. Pharmacokinetic and statistical analysis was done by stepwise reduction in sample size and schedule.

RESULT

Bioequivalence limits of RMP were unaffected by a reduced sample size of 12 volunteers and 8 h sampling time.

CONCLUSION

Minimising sample size after validation for borderline and poor quality FDC formulations can further reduce the cost of conducting bioequivalence trials.

Radioprotection of Swiss albino mice byEmblica officinalis

The fruit pulp of Emblica officinalis (EO) is an important drug used in Indian systems of medicine for several diseases and as a tonic. In view of its multifarious uses, the plant extract (aqueous) was tested for its radioprotective properties against sublethal gamma radiation (9 Gy) in Swiss albino mice. Animals were divided into two groups and irradiated with gamma radiation externally, with or without EO extract, which was given orally at different doses before irradiation. The dose of fruit pulp extract found to be most effective against radiation was 100 mg/kg b.wt. This dose increased the survival time and reduced the mortality rate of mice significantly. Furthermore, body weight loss in EO administered irradiated animals was significantly less in comparison with animals who were given radiation only.

Nasal dermoid with intracranial extension

Nasal dermoids are rare congenital anomalies, which usually present in early childhood as a midline nasal mass that requires surgical management. It is important to rule out any intracranial extension before subjecting the patient to surgery. We describe a case of nasal dermoid with intracranial extension. The embryology of the formation of the nasal dermoid, cyst and sinus, with the role of CT scan and MRI in diagnosing intracranial extension, and its management are discussed.

Nutritional support and stroke

Following stroke poor nutritional status is common, under recognized and associated with worse outcomes. This article explores existing assessment and management strategies aimed at recognizing and reducing the impact of malnutrition in stroke patients.

Quality control of anti-tuberculosis fixed-dose combination formulations in the global market: an in vitro study

OBJECTIVE

To determine the quality, and especially the dissolution properties of rifampicin, of fixed-dose combination (FDC) formulations of anti-tuberculosis agents manufactured by major market holders in the anti-tuberculosis sector and supplied for use in national tuberculosis control programmes.

METHODS

Dissolution studies were performed for four formulations supplied by four different manufacturers in four dissolution media (0.1N and 0.01N HCl, phosphate buffer [PB] and 20% vegetable oil in PB), at four different agitation rates using USP apparatus II. The formulations were subjected to 4-week accelerated stability studies (40 degrees C / 75% RH) and evaluated for physical, chemical and dissolution stability.

RESULTS

The formulations tested complied with pharmacopeial quality control (QC) tests. The extent of rifampicin release was independent of dissolution medium; however, a slight decrease in the dissolution rate was observed in two products. More than 75% of drug was released in 45 min at all agitation intensities except 30 rpm, and 20% oil in the medium reflected fed state. Formulations were stable in the packaging conditions recommended by the manufacturer for at least 4 weeks.

CONCLUSIONS

The formulations tested passed the QC tests and were found to be stable. A decrease in the rate, although not the extent, of dissolution necessitated multiple point dissolution in gastric and intestinal pH conditions to ensure consistency in in vivo bioavailability.

The use of clozapine in adults with intellectual disability

BACKGROUND

There are not many studies on the use of clozapine in patients with intellectual disability (ID). The authors describe a case series of patients treated with clozapine, drawn from a medium secure unit, a low secure assessment and treatment service and a community team in the London region.

METHOD

A retrospective file-review of patients treated in these three settings during the time period March-June 2002 was performed (n = 24). Information was collected using a semistructured proforma.

RESULTS

Of the 24 patients, 67% had schizophrenia, 17% had schizoaffective disorder and 8% had bipolar disorder. Patients had been unwell for a mean of 6 years and had been tried on a mean of four antipsychotics. The mean maximum dose of clozapine was 488 mg. The outcomes on the clinical global impression (CGI) scale showed 29% very much improved, 42% much improved, 21% minimally improved and 8% no change. 54% of the whole sample and 53% of those from the medium secure unit were discharged to homes in the community. The drug had to be stopped in four patients, of which three were because of neutropaenia.

CONCLUSION

Clozapine appears to be safe and efficacious in many people with ID. Careful monitoring of side-effects is needed during therapy.

Idiopathic cases of male infertility from a region in India show low incidence of Y-chromosome microdeletion

Chromosomal and Y-chromosomal microdeletion analysis has been done in cases of idiopathic infertility with the objective of evaluating the frequency of chromosomal and molecular anomaly as the causal factor of infertility. Barring a few cases of Klinefelter syndrome (XXY or XY/XXY mosaics), no chromosomal anomaly was encountered. Y-microdeletion was analysed by PCR-screening of STSs from different regions of the AZF (AZFa, AZFb, AZFc) on the long arm of the Y, as well as by using DNA probes of the genes RBM, DAZ (Yq), DAZLA (an autosomal homologue of DAZ) and SRY (Yp; sex determining gene). Out of 177 cases examined, 9 (azoospermia - 8 and oligoasthenospermia - 1) showed partial deletion of AZF. The size of deletion varied among patients but AZFc was either totally or partially removed in all of them. In contrast, no deletion was detected in AZFa. Testis biopsy done on a limited number of cases (50) showed diverse stages of spermatogenic arrest with no specific correlation with the genotype. The frequency of Y-chromosome microdeletion in our samples (approximately 5%) is much lower than the frequency (approximately 10%) reported globally and the two previous reports from India. We contend that the frequency may be affected by population structures in different geographical regions.

Intermediate care and diversity: principles and practice

The last few decades have seen a dramatic reduction in the number of hospital beds, despite the UK being an ageing society and the elderly being major users of hospital resources. The National Beds Inquiry (Department of Health, 2000a) and the British Geriatrics Society’s (2001) bed-blocking surveys confirmed the lack of sufficient community alternatives to hospital care, inappropriate use of hospital beds, and delays in hospital discharges as key factors for the high numbers of people who stay in an acute hospital longer than is desirable. At the same time the expectations of patients and their families have risen, and it is therefore easy to understand how many medical departments struggle to cope with large numbers of sick older people.

Effects of passive smoking on outcome in pregnancy

BACKGROUND

Adverse health effects of exposure to environmental tobacco smoke (ETS) among non-smokers have been studied occasionally in developing countries.

AIMS

To study the effects of exposure to ETS on outcome in pregnancy

SETTINGS AND DESIGN

A cross-sectional study at a secondary level teaching hospital Material and Methods: Consecutive 576 non-smoking women delivering a singleton live baby were studied. A pre-designed structured questionnaire was used to record the details of exposure to ETS at home. The maternal and foetal variables were compared among those who were exposed to ETS vis-à-vis not exposed. Unpaired Student t-test was used for the comparison of continuous variables and Fisher's Exact test was used for categorical variables. Multiple logistic regression analysis was performed after including all variables found to have significant differences on univariate analysis.

RESULTS

Of the 576 women studied 141 (24%) were exposed to ETS. In the mothers exposed to ETS, there was a significantly higher incidence of pre-term birth (24.1% vs. 16.1%; P = 0.027) and small-for-gestation babies (31.9% vs.17.2%; p<0.001) as compared to unexposed mothers. The mean birth weight of the babies born to the mothers exposed to ETS was 138 g less than that of babies in the unexposed group (2632 -/+577 g vs. 2770 -/+562 g respectively, p = 0.014). The multiple logistic regression analyses showed that ETS exposure during pregnancy was significantly associated with a higher risk of small-for-gestation babies (OR 2.10; 95% CI: 1.27-3.48).

CONCLUSION

Exposure to ETS during pregnancy is associated with higher risk of having a small-for-gestation baby.

Inhibition of factor VIII with a partially inhibitory human recombinant monoclonal antibody prevents thrombotic events in a transgenic model of type II HBS antithrombin deficiency in mice

Venous thromboembolic disease is a major cause of morbidity and mortality, necessitating antithrombotic therapy. A human monoclonal anti-factor (F)VIII antibody, LCL-mAb-LE2E9, produced by a lymphoblastoid cell line derived from a hemophilia A patient with inhibitor to wild-type but not mutant self FVIII, was previously reported to achieve efficient inhibition of thrombosis in an experimental vena cava thrombosis model in mice. Here, the antithrombotic efficacy of a recombinant DNA-derived version of this anti-FVIII antibody (rec-mAb-LE2E9) was tested in mice which carry a type II heparin binding site antithrombin deficiency mutation and display spontaneous chronic thrombosis in several sites including the penile vein of sexually active males. The recombinant anti-FVIII antibody (100 microg, repeated after 3 days) prevented thrombotic priapism in all treated males, whereas all control animals treated with saline (group of four animals) developed priapism within 6 days after mating (P < 0.05 for treated vs. saline). The rec-mAb-LE2E9 and the original LCL-mAb-LE2E9 were equally effective (five and seven males/group, respectively). These results confirm that FVIII inhibition represents a potent antithrombotic strategy, and show that both LCL-mAb-LE2E9 and rec-mAb-LE2E9 efficiently prevent thrombosis in a physiological model representative of thrombosis in patients with a severe prothrombotic risk.

Tuberculosis of zygoma

A case of tubercular osteomyelitis of zygoma is reported. It is difficult to diagnose because of its rarity unless a high index of suspicion is kept in mind more so in an endemic area.

A study on plasma selenium level among pregnant women at Rohtak, Haryana

Selenium is an important trace element for human health. Selenium levels in mothers may have significant effects on fetal and neonatal nutrition. In a cross-sectional study undertaken in Rohtak, Haryana, plasma selenium level in mothers was investigated at the time of delivery. The mean plasma selenium level in full term mothers (n=82) was 70.63 +/- 1.62 ppb and in preterm mothers (n = 58), it was 63.28 +/- 2.31 ppb. The difference was statistically significant (p < 0.05). These levels were, however, below the reported normal level of 75-120 ppb in adults. Rura/urban stay, parity, maternal age, socio-economic and literacy status etc. did not influence the selenium level of mothers in either of the groups.

Failure of thrombus to resolve in urokinase-type plasminogen activator gene-knockout mice: rescue by normal bone marrow-derived cells

BACKGROUND

Monocytes may have an important role in the resolution of venous thrombosis. Increased expression of tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) is associated with an ingress of monocytes into the thrombus. This study was designed to evaluate the importance of these activators in thrombus resolution.

METHODS AND RESULTS

Inferior caval vein thrombosis was induced in cohorts of adult wild-type, uPA gene-knockout (uPA-/-), and tPA gene-knockout (tPA-/-) mice in a flow model. Thrombi were harvested from wild-type and uPA-/- mice (n=60 per group) between 1 and 60 days. Thrombi were also obtained from groups of wild-type and tPA-/- mice (n=24 per group) between 1 and 28 days. Thrombus size and macrophage content were measured by computer-assisted image analysis. Thrombus resolution was significantly impaired in the uPA-/- mice compared with wild-type controls (P<0.0001) but was unaffected in tPA-/- mice. Monocyte content in wild-type mice was highest at 14 days after thrombus induction and was approximately 4 times greater than in uPA-/- mice (P=0.0043). Thrombus size in uPA-/- mice transplanted with wild-type marrow (0.29+/-0.06 mm2) was significantly smaller than in uPA-/- mice given uPA-/- bone marrow (3.9+/-1.1 mm2) (P=0.0022). Donor bone marrow-derived cells expressing LacZ were present in the thrombus after transplantation.

CONCLUSIONS

The resolution of experimental venous thrombus is dependent on uPA but is unaffected by the absence of tPA. Absence of uPA is also associated with delayed monocyte recruitment into the thrombus. Transplanting wild-type bone marrow restores thrombus resolution in uPA-/- animals, suggesting an important role for bone marrow-derived cells in this process.