Mediastinal mass diagnosed as a benign schwannoma

Neurogenic tumours of the mediastinum are most commonly present in the posterior mediastinal compartment. Schwannomas, being the most frequently encountered type, can be either benign or malignant, although the former is more common. They typically appear as an asymptomatic mass on radiographic imaging. These tumours with spindle-shaped cells are often asymptomatic, and are routinely detected on standard pulmonary radiography. However, computed tomography and magnetic resonance imaging, especially for posterior mediastinal tumours, provide additional information and help to determine its possible extension to adjacent structures. Therefore, radiographic and histopathological examinations are vital diagnostic tools in the detection of these silent tumours. Complete surgical resection using video-assisted thoracic surgical technique is the mainstay of treatment, and offers an excellent prognosis.

Glycosylation of purified buffalo heart galectin-1 plays crucial role in maintaining its structural and functional integrity

A buffalo heart galectin-1 purified by gel filtration chromatography revealed the presence of 3.55% carbohydrate content, thus it is the first mammalian heart galectin found to be glycosylated in nature and emphasizes the need to perform deglycosylation studies. Physicochemical comparative analysis between the properties of the native and deglycosylated proteins was carried out to understand the significance of glycosylation. The deglycosylated protein exhibited lesser thermal and pH stability compared to the native galectin. When exposed to thiol blocking reagents, denaturants, and detergents, remarkable differences were observed in the properties of the native and deglycosylated protein. Compared to the native glycosylated protein, the deglycosylated galectin showed enhanced fluorescence quenching when exposed to various agents. CD and FTIR analysis showed that deglycosylation of the purified galectin and its exposure to different chemicals resulted in significant deviations from regular secondary structure of the protein, thus emphasizing the significance of glycosylation for maintaining the active conformation of the protein. The remarkable differences observed in the properties of the native and deglycosylated galectin add an important dimension to the significance of protein glycosylation and its associated biological and clinical relevance.

Inhibition of quorum sensing regulated bacterial functions by plant essential oils with special reference to clove oil

AIMS

To evaluate quorum sensing (QS) inhibitory activity of plant essential oils using strains of Chromobacterium violaceum (CV12472 and CVO26) and Pseudomonas aeruginosa (PAO1).

METHODS AND RESULTS

Inhibition of QS-controlled violacein production in C. violaceum was assayed using disc diffusion and agar well diffusion method. Of the 21 essential oils, four oils showed varying levels of anti-QS activity. Syzygium aromaticum (Clove) oil showed promising anti-QS activity on both wild and mutant strains with zones of pigment inhibition 19 and 17 mm, respectively, followed by activity in cinnamon, lavender and peppermint oils. The effect of clove oil on the extent of violacein production was estimated photometrically and found to be concentration dependent. At sub-MICs of clove oil, 78.4% reduction in violacein production over control and up to 78% reduction in swarming motility in PAO1 over control were recorded. Gas chromatography-mass spectrometry analysis of clove oil indicated presence of many phytocompounds. Eugenol, the major constituent of clove oil could not exhibit anti-QS activity.

CONCLUSIONS

Presence of anti-QS activity in clove oil and other essential oils has indicated new anti-infective activity. The identification of anti-QS phytoconstituents is needed to assess the mechanism of action against both C. violaceum and Ps. aeruginosa.

SIGNIFICANCE AND IMPACT OF THE STUDY

Essential oils having new antipathogenic drugs principle because of its anti-QS activity might be important in reducing virulence and pathogenicity of drug-resistant bacteria in vivo.

Prevalence of HIV, HCV and sexually transmitted infections among injecting drug users in Rawalpindi and Abbottabad, Pakistan: evidence for an emerging injection-related HIV epidemic

OBJECTIVES

To measure the prevalence of hepatitis C virus (HCV), HIV and sexually transmitted infections (STI) among injecting drug users (IDUs) in Rawalpindi and Abbottabad and to examine risk factors associated with HIV and HCV.

METHODS

Two cross-sectional surveys were performed of community-recruited IDUs with collection of clinical specimens for testing of HCV, HIV and other STIs. Behavioural data were collected through interviewer-administered questionnaires. Characteristics and risk behaviours were compared across cities. Univariate and multivariate analyses explored risk factors associated with HIV and HCV.

RESULTS

The prevalence of HIV was 2.6% (95% CI 0.83% to 4.5%) in Rawalpindi (n = 302) and zero in Abbottabad (n = 102). The prevalence of HCV was significantly higher in Rawalpindi at 17.3% (95% CI 13.0% to 21.6%) than in Abbottabad at 8% (95% CI 2.6% to 13.4%). The prevalence of other STIs was low in both cities, with <2% of participants having current gonorrhoea or Chlamydia and <3% with active syphilis. Injecting risk behaviours were greater in Rawalpindi. An increased risk of HCV was associated with using informal sources as a main source of new needles/syringes (OR 2.8, 95% CI 1.3 to 6.0) compared with pharmacies and a history of drug treatment (OR 3.7, 95% CI 0.9 to 11.6). Reporting symptoms of an STI was associated with decreased odds of HIV in Rawalpindi (OR 0.02, 95% CI 0.03 to 0.9).

CONCLUSIONS

The findings suggest recent transmission of HIV and HCV and point to the urgent need for the provision of clean needles/syringes to IDUs and a review of how needles/syringes are currently provided via healthcare establishments.

HIV and other sexually transmitted infections among men, transgenders and women selling sex in two cities in Pakistan: a cross-sectional prevalence survey

OBJECTIVES

The extent and possibilities of spread of the HIV epidemic are not fully understood in Pakistan. A survey was conducted among men, women and transgender populations selling sex in Rawalpindi (Punjab) and Abbottabad (North West Frontier Province) in order to inform evidence-based programme planning.

METHODS

A cross-sectional survey was performed with participants recruited through respondent-driven sampling. Male and transgender sex workers were analysed in three gender groups; women were analysed as one group. Behavioural surveys were conducted and clinical specimens collected. Laboratory tests looked for evidence of acute infection (gonorrhoea, Chlamydia, syphilis, Trichomonas) and infection over the lifetime (HIV, herpes simplex virus-2, syphilis). Predictors of infection were explored using univariable and multivariable logistic regression.

RESULTS

The prevalence of HIV was low in 917 male and transgender sex workers and absent in 533 female sex workers in the study. High levels of current sexually transmitted infections were found, predominantly among transgender sex workers. Risk behaviours were common and knowledge of HIV was extremely low. Multivariable analysis found a large number of factors associated with higher levels of infection, including experience of forced first sex. Protection against risk was low, but those sex workers who reported using condoms at last sex had lower rates of infection.

CONCLUSIONS

The HIV epidemic is currently in its early stages among people who sell sex, but there may be potential for a much greater spread given the levels of other sexually transmitted infections found and the concomitant low levels of both protective knowledge and risk-reducing behaviours. Action is needed now to avert an epidemic. Framing interventions by upholding the recognition and protection of human rights is vital.

Observation of multiple volume reflection of ultrarelativistic protons by a sequence of several bent silicon crystals

The interactions of 400 GeV protons with different sequences of bent silicon crystals have been investigated at the H8 beam line of the CERN Super Proton Synchrotron. The multiple volume reflection of the proton beam has been studied in detail on a five-crystal reflector measuring an angular beam deflection theta = 52.96 +/- 0.14 microrad. The efficiency was found larger than 80% for an angular acceptance at the reflector entrance of 70 microrad, with a maximal efficiency value of epsilon = 0.90 +/- 0.01 +/- 0.03.

Volume reflection dependence of 400 GeV/c protons on the bent crystal curvature

The trend of volume reflection parameters (deflection angle and efficiency) in a bent (110) silicon crystal has been investigated as a function of the crystal curvature with 400 GeV/c protons on the H8 beam line at the CERN Super Proton Synchrotron. This Letter describes the analysis performed at six different curvatures showing that the optimal radius for volume reflection is approximately 10 times greater than the critical radius for channeling. A strong scattering of the beam by the planar potential is also observed for a bend radius close to the critical one.

Risk to household contacts of tuberculous patients based on Mantoux test and antibody titre

BACKGROUND

Tuberculosis, being an infectious disease, carries a risk of infection to contacts attending tuberculous patients. This study was conducted to evaluate the risk for household contacts of tuberculous patients as compared to non-contacts. The study was conducted at PGMI, Gulab Devi Hospital and Defence Housing Authority Lahore. The study included 120 household contacts and 80 non-contacts.

METHODS

A Cross sectional study for evaluation of antituberculous antibodies levels by ELISA method in two groups; Mantoux positive household contacts 49, Mantoux negative household contacts 71 and normal healthy persons 'non contacts' 80. Routine Haematological investigations like HB, TLC and ESR were done by conventional methods and all the sera of 200 subjects included in the study were tested for IgM, IgG and IgA anti tuberculous antibodies by enzyme linked immunosorbant assay (ELISA). Purified protein derivative 0.1 ml containing 5 TU was injected intradermally. The test was read after 72 hours by measuring the induration around injection site of forearm.

RESULTS

There was no difference in the average age of the household contacts and non-contacts. The complaints of pyrexia, night sweats and weight loss were more in house hold contacts as compared to non-contacts. The awareness about BCG vaccination was equal in both. There were 49 contacts with positive Mantoux test while negative Mantoux test was found in 71 contacts. There were only three Mantoux positive among eighty non-contacts. There was no significant difference in the presence of IgM among household contacts as compared to non-contacts. However both IgG and IgA were present in significantly higher number of household contacts compared to non-contacts.

CONCLUSION

Household contacts of patients suffering from active pulmonary tuberculosis have more chances of being infected with Mycobacterium tuberculosis as compared to the healthy non-contact, as shown by the higher levels of antituberculous antibodies & positivity of Mantoux test.

Gut ischaemia following cardiac surgery

Gut ischaemia following cardiac surgery carries a high mortality and is usually due to non-occlusive mesenteric ischaemia. We reviewed 4464 patients undergoing cardiac surgery over a 5-year period. Sixteen of them developed gut ischaemia post-operatively, 13 of whom were discovered at laparotomies while the remaining 3 were post-mortem diagnoses. Eleven patients were found to have extensive ischaemia and all 11 died irrespective of the treatment and the delay in diagnosis. In five patients ischaemia was localized, involving the caecum in three and terminal ileum in two. They all underwent local resections and survived. The differences in the groups were analysed and the average time between onset of symptoms and laparotomies was longer in the localized ischaemia group compared to the extensive ischaemia group. Our experience illustrates the continuing difficulty in diagnosis of mesenteric ischaemia before gut infarction has occurred. We conclude that different pathologies might be involved in post-cardiac surgery gut ischaemia and although early diagnosis and treatment is considered to be crucial, early laparotomies do not necessarily equate to survival in cases of extensive ischaemia. There is a need to evaluate aggressive strategies for early diagnosis if prognosis is to be improved in these cases.

Carcinoma-rectum in an 11 years old boy

Carcinoma rectum is a very uncommon malignancy in childhood. The incidence of colon cancer is found to be 1.3 cases per million children. An eleven years old boy with carcinoma rectum was admitted in the Department of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU). The boy presented with irregular fever, altered bowel habit, poor appetite, gradual weight loss and abdominal pain. His abdomen was tender with no organomegaly. The rectal wall was tender and hard mass could be felt in the surrounding area on direct rectal examination. Diagnosis was confirmed by biopsy of the tissue from the growth. Surgical resection and anastomosis was done. After one month of surgery chemotherapy was started. Since carcinoma rectum in children has not been reported in Bangladesh we share the information with professionals.