Occurrence of yellow mosaic geminiviral disease on bitter gourd (Momordica charantia) and its impact on phytochemical contents

Natural occurrence of yellow mosaic disease was observed on bitter gourd (Momordica charantia). Association of geminivirus with the disease was investigated through polymerase chain reaction using geminivirus-specific primers and Southern hybridization with a probe prepared from the cloned DNA of a known geminivirus. The fruits, leaves and stem of infected and healthy plants were studied for phytochemical composition. The amounts of protein were 49%, 50% and 66% higher, total carotenoids were 36%, 33% and 40% lower, vitamin C were 23%, 48% and 50% lower, total phenols were 28%, 31% and 43% lower, and antioxidant activity were 36%, 48% and 43% lower in the severely virus infected fruits, leaves and stem, respectively, as compared with healthy plants. The loss in the quantity of these phytochemicals was also observed even in mild infected plants, which further increased with the severity of the symptoms. Similarly, ethanol and 50% ethanol soluble extractive were also 25-43% lower in the fruits, leaves and stem of infected plants as compared with the healthy plants. A 45% and 54% lower caffeic acid, and 78% and 59% lower amounts of ferulic acid in the fruits and stem, respectively, and a 25% loss of gallic acid were noticed in the leaves of the severely infected plants.

Laparoscopic Management of Cryptorchidism in Adults

OBJECTIVES

Little is reported on the management of impalpable testis in adults. We present the impact of laparoscopy in this patient group.

PATIENTS AND METHODS

Twelve adult patients have been referred to our centre over the last year, with impalpable testis. Pre-operative assessment was by either ultrasound or magnetic resonance imaging (MRI) or both. Quality of life and patient satisfaction were assessed by validated SF8 and client satisfaction (CSQ-8) questionnaires. Patients were also administered a self constructed questionnaire specifically looking at the impact of a laparoscopic service on their condition.

RESULTS

The mean age was 29 yrs (range: 19-36). Two patients declined treatment. Of ten patients undergoing transperitoneal laparoscopy, five had intra-abdominal testes treated by laparoscopic orchidectomy (none malignant), two had the vas going into the deep ring and needed inguinal orchidectomy for an impalpable nubbin while in three cases there were blind ending vessels and vas. SF8 scores for physical HRQoL were unchanged but mental scores were significantly improved (p < 0.03). All patients were completely satisfied with a mean CSQ-8 score of 30.6 out of a possible 32. The majority of patients indicated that the availability of a laparoscopic service had prompted them to seek medical advice.

CONCLUSIONS

Laparoscopic examination and orchidectomy is a safe and reliable procedure. Excellent patient satisfaction and quality of life are achievable. In particular mental health scores improve as previous uncertainty is removed. The advent of laparoscopy has encouraged adult patients to seek advice regarding a condition that has been present since childhood. We advocate the use of laparoscopy in evaluating and treating adult patients with maldescended testes.

Follow-up of polytetrafluoroethylene arteriovenous fistulae for haemodialysis

The polytetrafluoroethylene (PTFE) arteriovenous fistula allows vascular access for haemodialysis where a primary fistula or brachio-basilic vein transposition is not possible. We report patency rates and complications associated with these prosthetic grafts. Fifty-nine upper limb PTFE grafts in 48 patients were evaluated with a mean follow-up of 19 months (range 2-54 months). Three grafts (5%) were never used. The primary patency rate at 6 weeks was 90%. Cumulative secondary patency rates were 66% at 6 months, 36% at 12 months, 17% at 18 months, 3% at 24 months and 2% at 30 months. None of the grafts had remained patent at 3 years. Forty-six percent of the grafts studied thrombosed at least once and 32% became infected. Although the initial primary patency rate achieved compares favourably with that reported for brachio-basilic transposition fistulae, this study confirms that the use of prosthetic material is associated with a poor overall patency rate and high risk of complications. All options using autologous vein should be exhausted before considering prosthetic material.

Volvulus--a rare complication of ileal conduit

Conduit volvulus is a very rare complication of ileal conduit. To date, only seven surgically confirmed cases have been reported. Conduit volvulus is a potentially reversible cause of renal impairment in patients with urinary diversion. The diagnosis depends on accurate radiological evaluation. The length of the bowel to construct the ileal conduit, closure of defects around the conduit and its mesentery and retroperitonealization of ureteroileal anastomosis are the determining factors for such a complication.

Urinary tract infections: new insights into a common problem

This review discusses recent advances in the understanding of how the common pathogen, uropathogenic Escherichia coli, interacts with the host to lead to infection.

Eczema herpeticum: a case report

Primary herpetic gingivostomatitis is a relatively common and well-recognized condition that the dental practitioner may encounter in clinical practice. A primary herpetic infection in a child with atopic dermatitis such as eczema, however, predisposes them to eczema herpeticum. This can be a severe and potentially life-threatening condition. This paper describes one such case, discusses the aetiology, presentation and management of this condition, and highlights the importance of early recognition by the clinician.

Eosinophilic cystitis and its management

Eosinophilic cystitis (EC) is a rare clinicopathological condition characterized by transmural inflammation of the bladder predominantly with eosinophils, associated with fibrosis with or without muscle necrosis. The cause of EC remains unclear, although it has been associated with various aetiological factors, such as allergy, bladder tumour, bladder trauma, parasitic infections and chemotherapeutic agents. EC is, probably, caused by the antigen-antibody reaction. This leads to the production of various immunoglobulins, which, in turn, cause the activation of eosinophils and initiates the inflammatory process. The most common symptom complex consists of frequency, haematuria, dysuria and suprapubic pain. Cystoscopy and biopsy are the gold standard for diagnosis. Additional laboratory evidence supporting the diagnosis includes proteinuria, microscopic haematuria and peripheral eosinophilia, the last one occurring in few patients. There is no curative treatment for this condition. Current treatment modalities include transurethral resection of the bladder lesion along with non-specific medical therapy, such as non-steroidal anti-inflammatory agents or steroids. Because the lesion tends to recur in spite of the above therapy, long-term follow-up is mandatory.

Attitudes towards skills examinations for basic surgical trainees

Objective measures of surgical skill and cognition are becoming available. A questionnaire study examining surgeons' beliefs towards a skills-based examination, current standards and possible benefits was devised. Three hundred pairs of standardised anonymous questionnaires were sent to consultants and their basic surgical trainees (BSTs) irrespective of surgical specialty. Responses were requested using a Likert scale (1-5, 3=neutral response). Two-hundred and two replies were received (including 54 pairs). BST experience ranged from 6 to 60 months (mean 24 months). When questioned regarding current training in basic surgical skills, only 34% believed that they were given adequate training at present. Sixty-four per cent of respondents believed the introduction of a skills examination would raise standards and 66% believed it necessary. Eighty-three per cent of respondents believed that they or their BST would practice these skills, if an examination were introduced and 85% wanted or would provide dedicated teaching time for this. However, 68% had no access to a dedicated skills facility, and uptake of these, where available, was variable. When questioned about their ability to perform the six appropriate tasks, there was a poor correlation of scoring between the groups. Consultants and their BSTs do not believe that they are given adequate training in basic skills. The introduction of an examination would lead to practice of these skills and is seen as a positive move.

The Increasing Significance of How to Learn Motor Skills

The training of surgeons has traditionally been an apprenticeship. In recent times it has become increasingly difficult for trainees to acquire operative skills. The acquisition and refinement of these technical skills by the surgical trainee are central to surgical teaching. Much work has been done looking into the theories of motor skill learning, working on the assumptions that if they are understood then tests may be developed to be used as skill predictors. Two schools of thought exist as to the use of neuropsychological factors in learning fine motor skills but all agree that practice and instructional feedback are essential for the correct acquisition of these essential surgical skills. With the current climate of shortened training and new guidelines its even more important to understand skill acquisition and assist in the learning of new surgical skills.

Long-term Outcomes of Brachiobasilic Transposition Fistula for Haemodialysis

OBJECTIVES

The transposed basilic vein to brachial artery arteriovenous fistula provides secondary vascular access for haemodialysis. The long-term results of such fistula are assessed in this retrospective series.

MATERIAL AND METHODS

Over a 5-year period 75 brachiobasilic transposition fistulae were performed in 74 patients. There was a median follow up of 14 months.

RESULTS

Primary patency was achieved in 69 (92%) of the fistulae, and secondary patency in 74 (99%) of the fistulae. Successful interventions included angioplasties in four, and saphenous vein interposition in one, whilst three patients had failed thrombectomies. Dialysis was performed using 69 (92%) of the fistulae while 6 (8%) were never used. Of the 75 fistulae 47 (63%) were patent at follow up. Cumulative secondary patency was 66% at 1 year, 52% at 2 years, and 43% at 3 years. Complications developed in 41 (55%), and included thrombosis, infection, stenosis, arm oedema, bleeding, steal syndrome and microaneurysm formation.

CONCLUSIONS

Brachiobasilic transposition fistulae have good long-term patency rates. The complication rate, although high, is lower than that reported for PTFE grafts. Brachiobasilic fistulae should be used in preference to PTFE grafts for secondary access.

Circadian variation--increased morning incidence of acute myocardial infarction in patients with coronary artery disease

OBJECTIVE

To examine whether a circadian variation exists in the onset of symptoms of Acute Myocardial Infarction (AMI) in patients with Coronary Artery Disease (CAD) and to review the characteristics of such variation.

SETTING

Patients with AMI admitted to the coronary care units of two teaching hospitals in the city of Karachi, Dr. Ziauddin Medical University Hospital and National Institute of Cardiovascular Disease.

METHOD

The study population included patients admitted to the coronary care unit. The diagnosis was based on the onset of AMI signs and symptoms and ECG changes. The inclusion criterion was an age less than 76 years.

RESULTS

The incidence of Myocardial infarction assessed by the onset of clinical symptoms exhibited a marked circadian variation. Myocardial infarction occurred 2.8 times more frequently during morning hours (period of maximum incidence) as compared to evening (period of minimum incidence).

CONCLUSION

This result extends previous observation of the circadian variation in the incidence of AMI onset. This study also helps in searching the potential triggers to physiological changes that may occur during morning hours. Design and timing of cardioprotective medication may play a crucial role in improving circadian variation and prevention of AMI.

Spin-dependent exciton formation in pi-conjugated compounds

The efficiency of light-emitting diodes (LEDs) made from organic semiconductors is determined by the fraction of injected electrons and holes that recombine to form emissive spin-singlet states rather than non-emissive spin-triplet states. If the process by which these states form is spin-independent, the maximum efficiency of organic LEDs will be limited to 25 per cent. But recent reports have indicated fractions of emissive singlet states ranging from 22 to 63 per cent, and the reason for this variation remains unclear. Here we determine the absolute fraction of singlet states generated in a platinum-containing conjugated polymer and its corresponding monomer. The spin-orbit coupling introduced by the platinum atom allows triplet-state emission, so optically and electrically generated luminescence from both singlet and triplet states can be compared directly. We find an average singlet generation fraction of 22 +/- 1 per cent for the monomer, but 57 +/- 4 per cent for the polymer. This suggests that recombination is spin-independent for the monomer, but that a spin-dependent process, favouring singlet formation, is effective in the polymer. We suggest that this process is a consequence of the exchange interaction, which will operate on overlapping electron and hole wavefunctions on the same polymer chain at their capture radius.

The energy gap law for triplet states in Pt-containing conjugated polymers and monomers

The energy gap law established for aromatic hydrocarbons and rare earth ions relates the nonradiative decay rate to the energy gap of a transition through a multiphonon emission process. We show that this energy gap law can be applied to the phosphoresce of a series of conjugated polymers and monomers for which the radiative decay rate has been enhanced through incorporation of a heavy metal. We find that the nonradiative decay rate from the triplet state T(1) increases exponentially with decreasing T(1)-S(0) gap for the polymers and monomers at 300 and 20 K. Comparison of the nonradiative decay of polymers with that of their corresponding monomers highlights the role of electron-lattice coupling.

Synthesis of novel tetrahydroimidazole derivatives and studies for their biological properties

Ethylenediamine was reacted with suitable aromatic aldehydes in order to prepare their respective diSchiff bases. These compounds were then reduced to give the corresponding tetrahydrodiSchiff bases, which were low melting in nature. Finally, these derivatives were condensed with different aromatic aldehydes to give the desired tetrahydroimidazoles. The structures of all these compounds were established on the basis of spectral data. These novel tetrahydroimidazoles showed promising anti-inflammatory and analgesic activity. The compounds were also screened for their anti-bacterial property against Staphylococcus aureus and Escherichia coli.

Rupture of the male membranous urethra

BACKGROUND

Management of traumatic rupture of the male membranous urethra remains controversial. Long-term morbidity can include urinary incontinence, urethral stricture and erectile dysfunction.

AIMS

To review management and outcome of urethral rupture to improve treatment protocols.

METHODS

A retrospective study of 47 patients presenting with traumatic urethral rupture over 25 years was performed.

RESULTS

All patients underwent emergency suprapubic catheterisation, 32 patients had open surgical realignment at 1-2 weeks; 78% of whom developed strictures. Ten patients unsuitable for early repair underwent delayed transabdominal transpubic urethroplasty at three months: 40% of whom developed strictures. Five patients with partial rupture were managed by cystoscopy and urethral catheter. Erectile dysfunction correlated to initial injury rather than treatment.

CONCLUSIONS

If the patient is stable and requires emergency laparotomy for other abdominal injuries, he should have immediate realignment of the urethra. Early realignment of the urethra at laparotomy at 1-2 weeks can be combined with orthopaedic fixation of pelvic fractures. Patients who remain unstable due to associated injuries should have delayed urethroplasty at three months.

Electronic spectra of 1-methyl and 2-methyl phenanthrenes and their radical cations

Electronic spectra of phenanthrene (P), 1-methyl phenanthrene (1-MeP), 2-methyl phenanthrene (2-MeP) and their monopositive ions are investigated experimentally as well as theoretically. The ions were produced by photo-oxidation of the hydrocarbons in boric acid matrix. The electronic absorption spectrum of 2-methyl phenanthrene cation (2-MeP+) is entirely new. For the interpretation of the electronic spectra of neutral and ionized MePs, semi-empirical AM1 (Austin Model 1) calculations are carried out for the first time. The bathochromic shifts in the spectral bands of the neutral and ionized MePs are attributed to 'conjugative' effect. The present experiments reveal that the 448 nm band of 1-methyl phenanthrene cation (1-MeP+) and the 486 nm band of 2-MeP+ show close matching with the respective 450 nm and 488 nm 'diffuse interstellar bands'. This suggests the possibility of the existence of such ionic species in the interstellar matter.

Fine-needle aspiration diagnosis of Kaposi's sarcoma in a developing country

Fine-needle aspiration (FNA) cytology was performed on 15 patients with peripheral lymphadenopathy and/or skin lesions referred to the Department of Pathology of the Hospital Central of Maputo, Maputo, Mozambique. Epitrochlear lymph nodes were the most frequently aspirated site. All aspirates allowed diagnoses of Kaposi's sarcoma (KS). Smears contained loosely cohesive clusters of bland spindle cells, with a radial arrangement and nuclear crush artifacts. These diagnostic clues have not been described in other spindle-cell intranodal lesions that should be considered in differential diagnoses. Taking into consideration the high prevalence of AIDS and limited resources for diagnosis in Africa, FNA cytology appears to be a useful method for the diagnosis of KS in developing countries, reducing the necessity for surgical lymph node excision.

An evaluation of pharmacokinetics and pharmacodynamics of leuprorelin acetate 3M-depot in patients with advanced and metastatic carcinoma of the prostate

OBJECTIVES

The investigational objectives of this open, noncomparative phase I study were to determine the pharmacokinetic profile of a single dose of 11.25 mg leuprorelin acetate, the effective duration of the chemical castration (serum testosterone < or = 1.73 nmol/l) and safety in patients with locally advanced and/or metastatic carcinoma of the prostate foreseen for chemical castration, in the hope that such a dose of leuprorelin acetate may be suitable as a depot formulation to be administered 3-monthly to these patients.

METHODS

A total of 24 males up to 85 years old with histologically proven advanced carcinoma of the prostate were enrolled in the study to obtain 18 eligible patients. Each patient was given 11.25 mg of leuprorelin acetate in a depot formulation subcutaneously after reconstitution in 2 ml of a special suspension vehicle. The study period lasted 24 weeks. Patients whose serum testosterone levels reincreased prior to the end of the observation period of 24 weeks were withdrawn from the study and received the monthly depot formulation of 3.75 mg of leuprorelin acetate.

RESULTS

The 3M-depot formulation of leuprorelin acetate ensured continuous and constant drug release and effective suppression of testosterone serum levels to castration range for at least 13 weeks. After an initial rise, 5 alpha-dihydrotestosterone as well as the gonadotropin serum levels of luteinizing hormone and follicular stimulating hormone reflected the testosterone serum pattern.

CONCLUSION

The results of this study show that the 3M-depot preparation of leuprorelin acetate is effective in suppressing the serum testosterone levels to the castration range for a targeted period of at least 13 weeks.

Development of a blocking enzyme-linked immunosorbent assay for the detection of avian polyomavirus-specific antibodies

Avian polyomavirus, described originally as budgerigar fledgling disease virus, has been associated with devastating contagious disease outbreaks in budgerigar aviaries. At present, this virus affects a wide range of psittacine and non-psittacine birds worldwide, and the serum neutralisation test is used for the serodiagnosis of avian polyomavirus infections. A blocking enzyme-linked immunosorbent assay was developed for the screening of large numbers of sera collected from various avian species. The assay employs a monoclonal antibody directed against the major structural protein VP1 as a blocking antibody in a sandwich blocking procedure. Either purified avian polyomavirus particles or avian polyomavirus VP1 expressed in recombinant baculovirus-infected Sf9 cells were used as antigen. The specificity of the blocking enzyme-linked immunosorbent assay was evaluated by testing sera directed against mammalian polyomaviruses. Using sera obtained from chicken infected experimentally with avian polyomavirus and a collection of psittacine field-origin sera, a good correlation was observed between the results of the blocking enzyme-linked immunosorbent assay and the serum neutralisation test. However, the blocking enzyme-linked immunosorbent assay is more rapid and more economic. Both, avian polyomavirus particles and VP1 produced by recombinant DNA technology proved to be suitable antigens.