Revisiting appendicular lump

INTRODUCTION

Appendicular lump is a well known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. As many controversies are arising regarding management of appendicular lump. The aim of this study was to find out the outcome and evaluate possible need of changing our management strategy of appendicular lump.

METHODS

A retrospective analysis of the patients managed with appendicular lump were done. All the patients admitted with diagnosis of appendicular lump and managed between, over two and half years, were included in the study. All age groups and both sex were included. Any patients whose diagnosis was changed after initial diagnosis of appendicular lump were excluded from the study.

RESULTS

Total 75 patients had appendicular lump suggesting 10% incidence. Age varied between 11-83 years with nearly equal incidence in both sexes. Majority had onset of symptoms between 2 to 14 days with an average of 4 days. Average stay was 3 to 4 days. During study period, 12 (16%) came with recurrence and 13 (17%) cases came for elective appendectomy.

CONCLUSIONS

Based on our finding, it is not sufficient to change our classical management strategy of appendicular lump and suggests a need for long term prospective study in this very common clinical condition.

Preparation, characterization, and in vitro release study of albendazole-encapsulated nanosize liposomes

The purpose of the present study was to formulate effective and controlled release albendazole liposomal formulations. Albendazole, a hydrophobic drug used for the treatment of hydatid cysts, was encapsulated in nanosize liposomes. Rapid evaporation method was used for the preparation of albendazole-encapsulated conventional and PEGylated liposomes consisting of egg phosphatidylcholine (PC) and cholesterol (CH) in the molar ratios of (6:4) and PC:CH: polyethylene glycol (PEG) (5:4:1), respectively. In this study, PEGylated and conventional liposomes containing albendazole were prepared and their characteristics, such as particle size, encapsulation efficiency, and in vitro drug release were investigated. The drug encapsulation efficiency of PEGylated and conventional liposomes was 81% and 72%, respectively. The biophysical characterization of both conventional and PEG-coated liposomes were done by transmission electron microscopy and UV-vis spectrophotometry. Efforts were made to study in vitro release of albendazole. The drug release rate showed decrease in albendazole release in descending order: free albendazole, albendazole-loaded conventional liposomes, and least with albendazole-loaded PEG-liposomes. Biologically relevant vesicles were prepared and in vitro release of liposome-entrapped albendazole was determined.

Mucinous cystic neoplasm masquerading a pseudo pancreatic cyst

Owing to recent improvements in pancreatic imaging, an increasing number of cystic lesions have been identified in asymptomatic as well as in patients presenting with jaundice, pancreatitis, or abdominal pain. In spite of many diagnostic modalities, pseudocysts of pancreas still create confusions with pancreatic cystic neoplasms. Here we report a 38 year old lady who presented with abdominal lump and jaundice following an episode of pain abdomen suggesting acute pancreatitis. She was fully investigated and managed for pseudocyst of pancreas. The diagnosis of mucinous cystic neoplasm was evident only after the biopsy from the wall of the cyst.

Control of electron localization in deuterium molecular ions using an attosecond pulse train and a many-cycle infrared pulse

We demonstrate an experimental control of electron localization in deuterium molecular ions created and dissociated by the combined action of an attosecond pulse train and a many-cycle infrared (IR) pulse. The attosecond pulse train is synthesized using both even and odd high order harmonics of the driving IR frequency so that it can strobe the IR field once per IR cycle. An asymmetric ejection of the deuterium ions oscillates with the full IR period when the APT-IR time-delay is scanned. The observed control is due to the creation of a coherent superposition of 1s sigma{g} and 2p sigma{u} states via interference between one-photon and two-photon dissociation channels.

Effect of yoga on pulmonary function tests of hypothyroid patients

Aim of this study was to see any effect on respiratory functions in hypothyroid patients after pranayama (yoga). The subjects for the study were 20 hypothyroid females, 39.70 +/- 8.27 years of mean age referred from medicine department of UCMS & G.T.B. Hospital. Spiro metric recordings were taken with hypair (version-1.28). Baseline (first) recordings were taken when patient came for the first time. Patients came to yoga lab in physiology department for 21 days continuously where they were trained by the yoga instructors and then told to do pranayama at home and called at regular intervals after 7 days to see the compliance. The breathing exercises were done for 45 minutes everyday. After 6 months of pranayama second recording was taken and compared with the baseline. There were significant improvement in forced expiratory volume in first second (FEV1), Maximum voluntary ventilation (MVV) and Inspiratory Capacity(IC). Thus Pranayama and meditation has beneficial effect on pulmonary functions of hypothyroid patients along with conventional treatment.

Ion-energy dependence of asymmetric dissociation of D2 by a two-color laser field

Two-color (800 and 400 nm) short (45 fs) linearly polarized pulses are used to ionize and dissociate D2 into a neutral deuterium atom and a deuteron. The yields and energies of the ions are measured left and right along the polarization vector. As the relative phase of the two colors is varied, strong yield asymmetries are found in the ion-energy regions traditionally identified as bond softening, above-threshold dissociation and rescattering. The asymmetries in these regions are quite different. A model based on the dynamic coupling by the laser field of the gerade and ungerade states in the molecular ion accounts for many of the observed features.

Abdominal lump: a diagnostic dilemma

Abdomen is a Pandora's Box. During our routine patient evaluation we come across different types of abdominal lumps out of which some are straight forward and diagnosed after routine clinical examinations and available investigations. At times these abdominal lumps present differently from their usual presentations and create confusions despite undergoing necessary investigations. The truth is explored only after opening the Pandora's Box. We present a case of 21 years old male who presented with history of gradually increasing right sided upper abdominal lump of three years duration. He was thoroughly investigated with USG and CT scan abdomen along with other supportive investigations and was diagnosed to have Hydatid cyst of liver. Accordingly patient was prepared for surgery and it was only at the time of laparotomy that he was found to have right sided giant hydronephrosis with a nonviable renal parenchymal tissue. He underwent right sided nephrectomy and had a good postoperative recovery. So at times the abdominal lumps keep on creating diagnostic dilemmas.

Abdominal Lump: A Diagnostic Dilemma

Abdomen is a Pandora's Box. During our routine patient evaluation we come across different types of abdominal lumps out of which some are straight forward and diagnosed after routine clinical examinations and available investigations. At times these abdominal lumps present differently from their usual presentations and create confusions despite undergoing necessary investigations. The truth is explored only after opening the Pandora's Box. We present a case of 21 years old male who presented with history of gradually increasing right sided upper abdominal lump of three years duration. He was thoroughly investigated with USG and CT scan abdomen along with other supportive investigations and was diagnosed to have Hydatid cyst of liver. Accordingly patient was prepared for surgery and it was only at the time of laparotomy that he was found to have right sided giant hydronephrosis with a nonviable renal parenchymal tissue. He underwent right sided nephrectomy and had a good postoperative recovery. So at times the abdominal lumps keep on creating diagnostic dilemmas.Key words: abdominal lump, giant hydronephrosis 

Influence of pranayamas and yoga-asanas on serum insulin, blood glucose and lipid profile in type 2 diabetes

A distinguishable feature of type 2 diabetes besides hyperglycemia and deranged lipid profile is an impaired insulin secretion, peripheral insulin resistance and obesity which has become a major health concern worldwide. India with an estimated 31million diabetics in 2000 and 79mllions by the yr 2030 has the highest number of type 2 diabetics in the world. In this study, we aimed to see if yoga-asanas and pranayamas have any influence in modifying certain biochemical parameters. Sixty patients of uncomplicated type 2 diabetes (age 35-60 yrs of 1-10 yrs duration) were divided into two groups: Group 1 (n=30): performed yoga along with the conventional hypoglycemic medicines and group 2 (n=30): patients who only received conventional medicines. Duration of the study was 45 days. Basal recordings of blood glucose (fasting and post-prandial), lipid profile and serum insulin were taken at the time of recruitment and the second reading after forty five days. Results showed a significant improvement in all the biochemical parameters in group 1 while group 2 showed significant improvement in only few parameters, thus suggesting a beneficial effect of yoga regimen on these parameters in diabetic patients.

Severe primary antiphospholipid syndrome

Antiphospholipid syndrome (APS) is characterised by recurrent venous or arterial thrombosis and/or fetal losses. In APS, the homeostatic regulation of blood coagulation is altered, however, the mechanism of thrombosis is not yet defined and it has varied manifestations. Deep vein thrombosis with or without pulmonary embolism is the most common manifestation followed by arterial occlusion of cerebral, coronary and other arteries including subclavian, retinal, renal and pedal arteries. We report a case of a 42 years old female, with severe primary APS, who presented with symmetrical peripheral gangrene, an uncommon presentation and was treated successfully.

Control of Erysiphe pisi Causing Powdery Mildew of Pea (Pisum sativum) by Cashewnut (Anacardium occidentale) Shell Extract

The effect of methanolic extract of cashewnut (Anacardium occidentale) shell extract was seen on conidial germination of Erysiphe pisi and powdery mildew development in pea (Pisum sativum). Maximum conidial germination inhibition of E. pisi on glass slides was observed at 300 ppm. Similar effect on floated pea leaves was observed after 48 h at the same concentration. Conidial germination on intact untreated pea leaves was also assessed on II and IV nodal leaves while IV and II nodal leaves were treated with the extract and vice versa. There was tremendous reduction in conidial germination on all the nodal leaves. The disease intensity of pea powdery mildew was significantly reduced by methanolic extract of cashewnut shells. Maximum reduction was observed with 200 ppm where 39% disease intensity was recorded in comparison to 96.53% in the control. The phenolic acid content of pea leaves following treatments with this extract varied and no definite pattern was observed. Out of several phenolic compounds, namely, gallic, ferulic, chlorogenic, and cinnamic acids, only gallic acid was found to be present consistently in all the treatments with varied amounts.

Abnormal anther development and high sporopollenin synthesis in benzotriazole treated male sterile Helianthus annuus L

Foliar application of 1.5% benzotriazole induced 100% pollen sterility in H. annuus. Pollen abortion in treated plants was mainly associated with abnormal behaviour of tapetum. A limited number of anther locule showed early degeneration of tapetum followed by disintegration of sporogenous tissues. On the other hand, some locules showed normal development of tapetum at initial stages. However, this tapetum exhibited degenerated and non-functional cell organelles. In both these situations tapetum failed to provide proper nourishment to developing microspores. The ultrastructure of both tapetum and microspores is different from that of control material with irregularities of exine deposition, endopolyploidy of tapetal nuclei and an alteration of organelle composition being correlated with sterility. Pollen grains thus developed were devoid of nucleus and cell organelles and were complete sterile.

Multivariate analysis of selected metals in agricultural soil receiving UASB treated tannery effluent at Jajmau, Kanpur (India)

Tannery effluent and soils samples were collected from 12 different sites of an agricultural area receiving treated tannery wastewater near Kanpur city (India). The samples were analyzed for heavy metals (Fe, Cr, Zn, Mn, Cu, Ni and Pb) content with a view to assess the impact of industrial wastewater on agricultural soils. The results revealed elevated levels of Fe and Cr in agricultural soils irrigated with treated tannery effluents. Cluster analysis of tannery effluent and soil datasets yielded two groups of the metals and demonstrated their relationship in each media. Principal component analysis performed on two datasets yielded two significant factors each for the effluents and soils, suggested tanneries as the probable sources of metals in the soils.

Foliar Application of Plant Growth-Promoting Rhizobacteria Increases Antifungal Compounds in Pea (Pisum sativum) Against Erysiphe pisi

Systemic effect of two plant growth-promoting rhizobacterial (PGPR) strains,viz., Pseudomonas fluorescens (Pf4) and P. aeruginosa (Pag), was evaluated on pea (Pisum sativum) against the powdery mildew pathogen Erysiphe pisi. Foliar spray of the two PGPR strains was done on specific nodal leaves of pea and conidial germination of E. pisi was observed on other nodal leaves,distal to the treated ones. Conidial germination was reduced on distant leaves and at the same time,specific as well as total phenolic compounds increased in the leaves distal to those applied with PGPR strains,thereby indicating a positive correlation. The strains induced accumulation of phenolic compounds in pea leaves and the amount increased when such leaves were get inoculated with E. pisi conidia. Between the two strains, Pag was found to be more effective than Pf4 as its effect was more persistent in pea leaves. Foliar application of PGPR strains for the control of powdery mildew of pea is demonstrated in vitro while correlating it with the increased accumulation of plant phenolics.

Human cytomegalovirus (CMV)-specific CD8+ T cell responses are reduced in HIV-infected individuals with a history of CMV disease despite CD4+ T cell recovery

Cytomegalovirus (CMV)-specific immunity was investigated in human immunodeficiency virus (HIV)-infected individuals. A case-control (1:2) study was performed with cases defined as having a history of CMV end-organ disease (n=15) and controls (n=30) matched by current CD4(+) T cell count. CMV-specific CD8(+) T cells responses were quantified using the high throughput Quantiferon-CMV test (Cellestis, Melbourne, Australia). 40/44 (91%) had a positive Quantiferon-CMV test and the magnitude of response to CMV peptides correlated significantly with response to mitogen (p<0.0001) but not with CD4(+) T cell count at the time of testing, CD4(+) T cell nadir or HIV viral load. Cases had a significantly lower Quantiferon-CMV test than controls but there was no significant difference in response to mitogen or other antigens. In individuals with a history of CMV disease, CMV-specific CD8(+) T cell responses are reduced even in the setting of CD4(+) T cell reconstitution.

Evaluation of the efficacy, safety and tolerability of miglitol in adult Indian patients with uncomplicated type 2 diabetes mellitus

Postprandial hyperglycaemia and spikes have deleterious effects on Insulin secretion and sensitivity. The present study was undertaken to evaluate the efficacy, safety and tolerability of miglitol 50 mg three times daily for 12 weeks in 129 patients with type 2 diabetes mellitus, inadequately managed with diet and exercise therapy alone for 3 months after obtaining their written informed consent. The primary efficacy variables were per cent change from baseline at week 12 in fasting and postprandial plasma glucose concentrations and glycosylated haemoglobin (HbA(1C)) levels. After treatment at the end of 12 weeks mean reduction in fasting plasma glucose levels was 35.7% and 44.33% in postprandial plasma glucose levels while the mean HbA(1C) was significantly reduced by 0.88% (p<0.05). Total cholesterol, HDL, LDL and TC/HDL ratio did not showed any significant change but a non-significant reduction in triglyceride levels was observed in some patients. The mean body mass index was reduced non-significantly by 8% from baseline values. A total 19.5% patients treated with miglitol reported adverse events like flatulence, abdominal pain, nausea/vomiting, diarrhoea and dyspepsia. Only one patient reported hypoglycaemia. The results of the present study indicate that miglitol reduces fasting and postprandial plasma glucose levels, Improving glycaemic control, which is reflected in a reduced HbA(1C) level in patients with type 2 diabetes mellitus. It could be a useful first-line therapy in patients with type 2 diabetes mellitus inadequately controlled by diet alone and as adjuvant therapy in patients who are inadequately controlled with diet and sulfonylureas.

Differential expression of collagen, MMP, TIMP and fibrogenic-cytokine genes in the granulomatous colon of Schistosoma mansoni-infected mice

Schistosomiasis mansoni is a major helminthic disease of the tropics characterised by chronic hepatic and intestinal granulomatous inflammation and fibrosis. The fibrotic response is regulated by the amount of collagen deposited in the tissues and the degradation of that collagen by matrix metalloproteinases (MMP). In the murine model of the disease, although hepatic granuloma formation and the ensuing fibrosis have been thoroughly examined, there is a dearth of information on the intestinal fibrotic process. The expression of fibrosis-related genes in the colons of chronically infected mice has therefore been investigated. Compared with that seen in uninfected mice, the expression of the genes coding for collagen of types I, III and IV was upregulated. Similarly, the messages for MMP-2, MMP-3 and MMP-8 were elevated, indicating the potential for collagen degradation. The genes for two tissue inhibitors of metalloproteinases (TIMP), TIMP-1 and TIMP-4, were, however, expressed at higher levels than those coding for the MMP. As a corollary, expression of the genes coding for three fibrogenic cytokines, transforming growth factor-beta, tumour necrosis factor and interleukin-4, was elevated. These data indicate that an imbalance in MMP:TIMP expression and enhanced levels of the messages for fibrogenic cytokines underlie the mechanism(s) of the colonic fibrosis seen in mice chronically infected with Schistosoma mansoni.

Variation in Biochemical Composition among Indian Isolates of Sclerotinia sclerotiorum

Biochemical variability among 20 Indian isolates of Sclerotinia sclerotiorum collected from different hosts/soil samples from different localities in India is reported. High Performance Liquid Chromatographic (HPLC) analysis of ethyl acetate fraction of culture filtrate, mycelia, sclerotia and sclerotial exudate showed 15~23 peaks but only 11 could be identified. They were tannic, gallic, oxalic, caffeic, vanillic, ferulic, O-coumeric, chlorogenic, cinnamic, salicylic and gentisic acids. The amount of phenolic compounds varied among the culture filtrates, mycelia, sclerotia and sclerotial exudates of S. sclerotiorum.

SKCG-1: a new candidate growth regulatory gene at chromosome 11q23.2 in human sporadic Wilms tumours

Using arbitrary primed-PCR (AP-PCR), we have identified a novel genetic alteration located at chromosome 11q23.2 and this genetic alteration was common in 38% of the human Wilms tumour samples analysed. Further characterisation by cloning and sequencing of this genomic region revealed that it represents a part of an uncharacterised gene. We have named this gene as Sporadic Kidney Cancer Gene-1 (SKCG-1). Using fluorescence in situ hybridisation (FISH) approach, we established its localisation on the chromosome 11q23.2. Northern analysis revealed the transcript size of SKCG-1 of 2.09 kb and this was further confirmed by full-length cDNA sequence. Sequence analysis revealed an active translation start site (ATG sequence), a polyadenylation signal sequence (AATAAA), and an open reading frame (ORF) encoding a peptide of 124 amino acids in the cDNA sequence of SKCG-1. Analysis of genomic sequence of SKCG-1 revealed a promoter region containing TATA box located at −13 bp upstream of transcription start site. The AP-PCR, SCAR, and Southern blot analyses indicated genomic loss of SKCG-1 in Wilms tumours. The transcript of SKCG-1 was abundantly present in brain, kidney, liver, testis, salivary gland, foetal brain, foetal liver, whereas relatively lower expression in heart, stomach, prostate and no expression in spleen, colon, lung, small intestine, muscle, adrenal gland, uterus, skin, PBL, and bone marrow was detected. The expression of this gene transcript was either very less or undetectable in Wilms and breast tumours compared to their matched uninvolved tissues. Inhibition of SKCG-1 by siRNA resulted in increased cell proliferation of kidney epithelial cells. Based on the presence of two transmembrane regions in its peptide, SKCG-1 has been predicted as a transmembrane protein. Thus, the findings of this study revealed (i) SKCG-1, a new gene located at 11q23.2 and harbouring genetic alteration in Wilms tumours, (ii) the presence of SKCG-1 gene transcripts in various human normal tissues and its lower expression or absence in Wilms and breast tumours indicate that it may be associated with tumour growth suppressor activity, (iii) the presence of an open reading frame in the cDNA sequence of SKCG-1 indicates that it has potential to encode a protein, (iv) increased cell growth by silencing this gene in HEK293 cells further supports a potential role of this gene in growth of kidney epithelial cells. Our findings suggest that SKCG-1 may have a tumour suppressor role, and implicate genetic alteration in this gene as a potential oncogenic pathway and therapeutic target in kidney and breast cancer.

Distribution of metals in the edible plants grown at Jajmau, Kanpur (India) receiving treated tannery wastewater: relation with physico-chemical properties of the soil

The implications of metal contamination of agricultural soils due to long term irrigation with treated industrial wastewater and their subsequent accumulation in the vegetables/crops growing on such soils has been assessed in an area of industrial complex, Jajmau, Kanpur (India). Physico-chemical properties of the soil were also studied. The soil and vegetables/crops were sampled from an area of 2100 acre agricultural land and analyzed for physico-chemical properties and metal accumulation in different parts of the plants. The comparison of the data of physico-chemical properties of control and contaminated soil showed that salinity, electrical conductivity, available phosphorous, sodium and potassium content (both water soluble and exchangeable) were found high in contaminated soil. The analysis of plant available metal content in the soil showed the highest level of Fe, which ranged from 529.02 to 2615 microg g(-1) dw and lowest level of Ni (3.12 to 10.51 microg g(-1) dw). The analysis of the results revealed that accumulation of toxic metal Cr in leafy vegetables was found more than fruit bearing vegetables/crops. Thus, it is recommended that the leafy vegetables are unsuitable to grow in such contaminated sites. It is important to note that toxic metal, Ni was not detected in all the plants. The edible part of the vegetables (under ground) such as, garlic (19.27 microg g(-1) dw), potato (11.81 microg g(-1) dw) and turmeric (20.86 microg g(-1) dw) has accumulated lowest level of toxic metal, Cr than leafy and fruit bearing vegetables. In some fruit part of vegetables such as, bitter gourd, egg plant, jack tree, maize and okra, the accumulation of Cr was not detected and may be grown in this area.

Variability in Indian isolates of Arthrobotrys dactyloides Drechsler: a nematode-trapping fungus

Five isolates of Arthrobotrys dactyloides (A, B, C, D, and E) were isolated from different locations of India. Their variability in relation to morphology, radial growth, and nematode capturing or trap-forming ability was observed. All of the five isolates produced two-celled slender conidia, whereas wider two- and three-celled conidia were produced by isolates A, C, D, and E only. The wider two- and three-celled conidia were not observed in cultures of isolate B. The isolate B produced macroconidia as well as microconidia. The microconidia were produced on separate conidiophores of smaller size. Macroconidia and microconidia were never produced on the same conidiophore, but the two types of conidiophores were produced on same or different hyphae. Similar to macroconidia, the microconidia also produced constricting rings of smaller size in presence of Meloidogyne graminicola. The constricting rings formed on microconidia did not capture second-stage juveniles of M. graminicola because of their smaller size. Among all the isolates, isolate B showed slow growth and higher nematode-capturing ability or trap-forming ability.

Diversity of flowering and fruiting phenology of trees in a tropical deciduous forest in India

BACKGROUND AND AIMS

In the dry tropics, vegetative phenology varies widely with tree characteristics and soil conditions. The present work aims to document the phenological diversity of flowering and fruiting with reference to leafing events in Indian dry-tropical tree species.

METHODS

Nine tree species, including one leaf-exchanging and eight deciduous showing varying leafless periods, were studied. Monthly counts of leaves, flowers and fruits were made on 160 tagged twigs on ten individuals of each species for initiation, completion and duration of different phenological events through two annual cycles.

KEY RESULTS

Variation in flowering relative to leaf flushing (which occurred just prior to or during a hot, dry summer) revealed five flowering types: summer flowering (on foliated shoots), rainy-season flowering (on foliated shoots following significant rains), autumn flowering (on shoots with mature leaves), winter flowering (on shoots undergoing leaf fall) and dry-season flowering (on leafless shoots). Duration of the fruiting phenophase was shortest (3-4 months) in dry-season and winter-flowering species, 6-9 months in rainy-and autumn-flowering species, and maximum (11 months) in summer-flowering species. A wide range of time lag (<1 to >8 months) between the start of vegetative (first-leaf flush) and reproductive (first-visible flower) phases was recorded in deciduous species; this time lag was correlated with the extent of the leafless period. A synthesis of available phenological information on 119 Indian tropical trees showed that summer-flowering species were most abundant (56 % of total species) amongst the five types recognized.

CONCLUSIONS

The wide diversity of seasonal flowering and fruiting with linkages to leaf flush time and leafless period reflect the fact that variable reproductive and survival strategies evolved in tree species under a monsoonic bioclimate. Flowering periodicity has evolved as an adaptation to an annual leafless period and the time required for the fruit to develop. The direct relationship between leafless period (inverse of growing period) and time lag between onset of vegetative and reproductive phases reflects the partitioning of resource use for supporting these phases. Predominance of summer flowering coupled with summer leaf flushing seems to be a unique adaptation in trees to survive under a strongly seasonal tropical climate.