Study of histopathological changes in atrophic rhinitis

A punch biopsy from the inferior turbinate was taken in 71 consecutive cases of atrophic rhinitis and studied for histopahtological changes. Squamous metaplasia was seen in 85 percent of cases. Tunica propria showed granulation tissue (41 percent) and chronic inflammatory cellular infiltrate (32 percent). Mucosal glands were decreased in 42 percent of cases and absent in 28 percent. Areas of dilated vessels were observed in 35 percent and decreased vascularity in 59 percent of cases. These observations are similar to those reported by others. Total squamous metaplasia with keratinisation and hypertrophy was seen by us in one case. This has not been reported earlier.

A comparison of three methods of recovery of goat oocytes for in vitro maturation and feritilization

Experiments were conducted to determine an efficient method for recovering a large number of usable oocytes and its effect on subsequent in vitro maturation, fertilization and development. Follicular oocytes were recovered from goat ovaries using 3 different methods: aspiration, puncturing and slicing. The average total number of oocytes recovered per ovary was significantly higher by the aspiration method (2.7+/-0.15) than by puncturing (2.2+/-0.13) or by slicing (2.4+/-0.12). However, significantly more good-quality usable oocytes enclosed with compact cumulus cells were obtained by slicing (0.9+/-0.06) than by aspiration (0.5+/-0.07) or by puncturing (0.5+0.06). Time required for processing each ovary by the slicing method was comparatively less (0.90 min) than that required for puncturing (1.83 min) or for aspiration (1.78 min). Usable oocytes recovered by all three methods were matured, fertilized and developed to the blastocyst stage in vitro. There were no significant differences in the subsequent percentages of oocytes maturing, being fertilized and developing in vitro among the 3 methods of recovering oocytes. In conclusion, the recovery of goat oocytes by the slicing method is simple and efficient compared with the aspiration and puncturing methods.

Mortality in Ghana: Evidence from the cape coast project data

Abstract This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974-7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85-6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.

Safety and efficacy of oral ivabradine as a heart rate-reducing agent in patients undergoing CT coronary angiography

OBJECTIVE

To investigate the role of oral ivabradine as a heart rate reducing agent in patients undergoing CT coronary angiography (CTCA). Despite the routine use of β-blockers prior to CTCA studies, it is not uncommon to have patients with heart rates persistently above the target range of 65 bpm. Ivabradine is a selective inhibitor of the I(f) current, which primarily contributes to sinus node pacemaker activity, and has no significant direct cardiovascular effects such as reduction of blood pressure, cardiac contractility or impairment of cardiac conduction.

METHODS

We investigated 100 consecutive patients who had been referred for CTCA for the evaluation of suspected coronary artery disease (CAD). Patients were randomised to receive either of the following two pre-medication protocols: oral metorprolol or oral ivabradine.

RESULTS

Ivabradine was significantly more effective than metorprolol in lowering the heart rate; the mean percentage reduction in heart rate with ivabradine vs metorpolol was 23.89+6.95% vs 15.20+4.50%, respectively (p=0.0001). Metoprolol significantly lowered both systolic and diastolic blood pressure while ivabradine did not. The requirement of additional doses to achieve a target heart rate of <65 beats per min was also significantly more frequent with metoprolol.

CONCLUSION

Ivabradine is a potentially attractive alternative to currently used drugs for reduction of heart rate in patients undergoing CTCA.

Public health response to the first case of Japanese encephalitis in Delhi, 2011

Japanese Encephalitis (JE) is an acute viral zoonotic infection of the central nervous system. A confirmed case of JE was reported in the MVH, Pooth Khurd, following which the epidemiological investigation was carried out in the study area. Clinical/Syndromic surveillance started in the hospital. The local practitioners and anganwadi workers were contacted and requested to report similar cases in their areas. Serosurveillance to delineate high risk population, animal and vector survey done by taking transect walks through the colony to look for presence of amplifying hosts like pigs, ducks etc. Out of 2328 persons surveyed, 404 persons were found to have/had fever in the preceding one month. Current fever cases were 166, out of which 9 fitted into the criteria of AES. Large water body with vegetations was present within the colony. Piggeries and ducks were found in the colony. In the hospital 9 AES cases were screened. In total only 18 (9 from field, 9 from hospital) cases subjected to testing and found to be negative for IgM specific for JE. In total only 18 (9 from field, 9 from hospital) cases subjected to testing and found to be negative for IgM specific for JE. Most probably the above case of nine year child is the first case of JE indigenous to Delhi. The environmental conditions were conducive for the transmission of the viral agent. Further research is hence recommended to find the missing links and to prevent outbreaks in Delhi.

Primary mesenteric liposarcoma: An unusual presentation of a rare condition

Primary mesenteric liposarcoma is a rare neoplasm. Here, we report the case of a 50 year old Indian man with a pleomorphic liposarcoma of the mesentery. The clinical findings pointed towards a retroperitoneal growth but imaging resolved the issue. A laparotomy was performed and a 20 cm × 20 cm multilobulated tumour arising from the mesentery and weighing 1.8 kilograms was excised with a segment of jejunum. The cut surface had a variegated appearance with regions of necrosis. The histological features were suggestive of pleomorphic liposarcoma. Tumour cells were positive for S-100 and negative for SMA/Desmin. Complete resection is curative although the role of chemotherapy remains to be established.

Storage behavior of mango as affected by post harvest application of plant extracts and storage conditions

The use of plant extracts could be a useful alternative to synthetic fungicides in the post harvest handling of fruits and vegetables. The aim of this study was to access the efficacy of extracts obtained from four plants (neem, Pongamia, custard apple leaf and marigold flowers) on the extension of shelf life of mango fruits cv. Dashehri under two storage conditions (Cool store and ambient condition). The fruits were treated with 2 concentrations of each plant extracts (10 % and 20 %) were placed in perforated linear low density poly ethylene bags and stored in storage conditions viz., cool storage and ambient condition, respectively. The treatment of neem leaf extract in combination with cool storage gave encouraging results. Up to the end of the storage study the treatment combination of 20 % neem leaf extract and cool store completely inhibited the pathogens, and no spoilage was observed. There was minimum physiological loss in weight (6.24 %), minimum girth reduction (0.62 %), maximum ascorbic acid content (29.96 mg/ 100 g of pulp), maximum acidity (0.19 %), minimum pH (5.28), maximum total soluble solids (20.96 %), maximum total sugars (12.50 %), reducing sugars (4.12 %) and non- reducing sugars (7.96 %) and best organoleptic score (7.93/10) in this interaction. The inhibitory effect of neem leaf extract was ascribed to the presence of active principle azadirachtin.

Lumbosacral arachnoid cyst with tethered cord: A rare case report

Arachnoid cysts are cerebrospinal fluid collections in the spine that can present with neurological symptoms or be discovered accidentally. Intradural location of such cysts especially in the lumbosacral region is relatively rare. The association of such cysts with other congenital anomalies such as tethered cord lends evidence to the developmental origin of arachnoid cysts. We report a case of lumbosacral arachnoid cyst with tethered cord in a 6-year-old male child and discuss the etiopathogenesis and management options.

SREBP-2 1784 G/C genotype is associated with non-alcoholic fatty liver disease in north Indians

BACKGROUND

Genetics of non-alcoholic fatty liver (NAFLD) in Asian Indians has been inadequately investigated. This study aims to determine the association of the 1784G>C polymorphism in the SREBP-2 gene with NAFLD in Asian Indians in north India.

METHODS

In this study, (n=335); 162 obese with NAFLD, 91 obese without NAFLD and 82 non-obese without NAFLD subjects were recruited. Abdominal ultrasound, clinical profile, anthropometry, metabolic profile, serum levels of alanine aminotransferase, aspartate aminotransferase, fasting insulin and high sensitivity C-reactive protein (hs-CRP) were analysed. Polymerase chain reaction and restriction fragment length polymorphism were used to identify individual genotypes, and the association of this polymorphism with clinical and biochemical parameters was assessed.

RESULTS

The observed frequency of G allele was 0.73 and C allele was 0.27. Frequency of C/C genotype was higher in NAFLD as compared to obese and non-obese subjects (p=0.003). In NAFLD subjects 57.4% were G/G homozygous, 31.5% G/C heterozygous and 11.1% were C/C homozygous. The SREBP-2 genotype frequencies deviated from the Hardy Weinberg Equilibrium (X² = 6.39, p = 0.0114). Mean values of TG (p = 0.002), TC (p =0.002), ALT (p =0.04) and AST (p =0.03) levels were significantly higher in NAFLD subjects with G/C genotype as compared to G/G genotypes in obese and non-obese groups. Fasting insulin (p =0.03), HOMA (p =0.009) and hs-CRP levels were significantly higher in NAFLD subjects with G/C genotype as compared to obese and non obese subjects with G/G genotypes.

CONCLUSION

In this study, conducted for the first time in Asian Indians, SREBP-2 1784 G>C genotype was associated with NAFLD.

Covered skin transcutaneous bilirubin estimation is comparable with serum bilirubin during and after phototherapy

OBJECTIVE

To determine whether transcutaneous bilirubin (TcB) from covered skin (TcB-C) during and after discontinuing phototherapy (PHT) is reliable in treating neonatal jaundice.

STUDY DESIGN

In this prospective observational study, before starting PHT, part of the forehead was covered. TcB-C and TcB from exposed skin (TcB-E) to PHT were measured before starting PHT, on a 12-hourly basis while receiving PHT and 6 h after stopping PHT. We used ANOVA (analysis of variance) and Bonferroni's t-tests.

RESULT

A total of 39 infants were enrolled (mean gestation 39 weeks, 51% males and 80% Hispanic). The mean TSB over all time periods was 10.9±2.4, TcB-C 10.9±2.4 and TcB-E 7.2±3.4. Before PHT, there were no significant differences in bilirubin by all three techniques. TcB-C was not significantly different from TSB at any time point. However, TcB-E was significantly lower during PHT and after stopping PHT.

CONCLUSION

TcB-C is a reliable method in the management of neonatal jaundice.

2,3-Diaryl-2H-1-benzopyran derivatives interfere with classical and non-classical estrogen receptor signaling pathways, inhibit Akt activation and induce apoptosis in human endometrial cancer cells

OBJECTIVES

The present study was undertaken to explore the mechanism of anti-proliferative action of benzopyran compound D1 (2-[piperidinoethoxyphenyl]-3-phenyl-2H-benzopyran) and its hydroxy-(D2) and methoxy-(D3) derivatives in Ishikawa and human primary endometrial adenocarcinoma cells.

METHODS

Transcriptional activation assays were performed using luciferase reporter system and cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). The stage of cell cycle was determined by flow-cytometry and real time analysis of cyclinE1 and cdc2 genes. The apoptotic effects were measured by AnnexinV/PI staining and TUNEL. The expression of PCNA, cyclinD1, pAkt, XIAP, cleaved caspase-9, -3, PARP, Bax and Bcl2 were determined by immunoblotting. The caspase-3 activity and mitochondrial membrane potential were measured by colorimetric assay.

RESULTS

All three compounds inhibited E(2)-induced ERE- and AP-1-mediated transactivation and proliferation in endometrial adenocarcinoma cells dose-dependently. Compound D1 caused the arrest of cells in the G(2) phase while D2 and D3 caused arrest in G(1) phase of the cell cycle. All compounds interfered with Akt activation, decreased XIAP expression leading to an increased cleavage of caspase-9, -3, PARP, increased Bax/Bcl2 ratio and caspase-3 activity.

CONCLUSION

Findings suggest that benzopyran derivatives inhibit cellular proliferation via modulating ER-dependent classical and non-classical signaling mechanisms, interfere with Akt activation and induce apoptosis via intrinsic pathway in endometrial adenocarcinoma cells.

Influence of CYP2C9, GSTM1, GSTT1 and NAT2 genetic polymorphisms on DNA damage in workers occupationally exposed to organophosphate pesticides

Previous studies have revealed that organophosphate pesticides (OPs) are primarily metabolized by xenobiotic metabolizing enzymes (XMEs). Very few studies have explored genetic polymorphisms of XMEs and their association with DNA damage in pesticides-exposed workers. Present study was designed to determine the influence of CYP2C9, GSTM1, GSTT1 and NAT2 genetic polymorphisms on DNA damage in workers occupationally exposed to OPs. We examined 268 subjects including 134 workers occupationally exposed to OPs and an equal number of normal healthy controls. The DNA damage was evaluated using alkaline comet assay and genotyping was done using individual polymerase chain reaction (PCR) or polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Acetylcholinesterase and paraoxonase activity were found to be significantly lowered in workers as compared to control subjects which were analyzed as biomarkers of toxicity due to OPs exposure (p<0.001). Workers showed significantly higher DNA tail moment (TM) compared to control subjects (14.32±2.17 vs. 6.24±1.37 tail % DNA, p<0.001). GSTM1 null genotype was found to influence DNA TM in workers (p<0.05). DNA TM was also found to be increased with concomitant presence of NAT2 slow acetylation and CYP2C9*3/*3 or GSTM1 null genotypes (p<0.05). DNA TM was found increased in NAT2 slow acetylators with mild and heavy smoking habits in control subjects and workers, respectively (p<0.05). The results of this study suggest that GSTM1 null genotypes, and an association of NAT2 slow acetylation genotypes with CYP2C9*3/*3 or GSTM1 null genotypes may modulate DNA damage in workers occupationally exposed to OPs.

The epistasis between vascular homeostasis genes is apparent in essential hypertension

OBJECTIVE

The epistasis influence of vascular homeostasis genes is vital to multigenetic diseases. This study was designed to perceive the possible role of epistasis in the etiology of essential hypertension.

METHODS

We investigated seven polymorphisms of ACE, CYP11B2 and NOS3 epistatically, and SBP, DBP, MAP, ACE activity, plasma aldosterone concentration (PAC) and NOx level in 860 age- and ethnicity-matched unrelated north-Indian subjects.

RESULTS

The hypertension risk in individuals with interacted-genotypes (IwIw+IwIc)+(4aa), (IcIc)+(4bb+4ba) and IcIc+4aa of the CYP11B2 and NOS3 was significantly higher with odds ratio 5.5 (95% CI=2.9-10.6, P<0.0001), 2.4 (95% CI=1.4-4.1, P<0.0008) and 7.5 (95% CI=1.6-34.8, P=0.010), respectively. The odds ratio for hypertension with interacted-haplotypes (-344T/Ic)+(-922A/-786T/4a/894G) and (-344T/Ic)+(-922G/-786C/4a/894G) of CYP11B2 and NOS3 was 5.3 (95% CI=2.0-14.2, P=0.005) and 3.9 (95% CI=1.4-10.4, P=0.04), respectively; whereas for the protective interacted-haplotypes (-344T/Iw)+(-922A/-786T/4b/894G), the odds ratio was 0.7 (95% CI=0.5-0.9, P=0.03). While the interacted-genotypes, IcIc+4aa correlated with higher SBP and MAP (P=0.006; P=0.04), the interacted-haplotypes, (-344T/Ic)+(-922A/-786T/4a/894G) and (-344T/Ic)+(-922G/-786C/4a/894G) correlated with higher MAP and lower NOx level (P=0.02 and P=0.03, respectively), and the protective interacted-haplotypes (-344T/Iw)+(-922A/-786T/4b/894G) correlated with lower PAC and MAP (P=0.024 and P=0.018, respectively).

CONCLUSIONS

The epistasis between CYP11B2 and NOS3 and its correlation with varied clinical and biochemical parameters signify its possible contribution in the complex etiology of hypertension.

Role of genetic polymorphisms of CYP1A1, CYP3A5, CYP2C9, CYP2D6, and PON1 in the modulation of DNA damage in workers occupationally exposed to organophosphate pesticides

Organophosphate pesticides (OPs) are primarily metabolized by several xenobiotic metabolizing enzymes (XMEs). Very few studies have explored genetic polymorphisms of XMEs and their association with DNA damage in pesticide-exposed workers. The present study was designed to determine the role of genetic polymorphisms of CYP1A1, CYP3A5, CYP2C9, CYP2D6, and PON1 in the modulation of DNA damage in workers occupationally exposed to OPs. We examined 284 subjects including 150 workers occupationally exposed to OPs and 134 normal healthy controls. The DNA damage was evaluated using the alkaline comet assay and genotyping was done using PCR-RFLP. The results revealed that the PONase activity toward paraoxonase and AChE activity was found significantly lowered in workers as compared to control subjects (p<0.001). Workers showed significantly higher DNA damage compared to control subjects (14.37±2.15 vs. 6.24±1.37 tail% DNA, p<0.001). Further, the workers with CYP2D6*3PM and PON1 (QQ and MM) genotypes were found to have significantly higher DNA damage when compared to other genotypes (p<0.05). In addition, significant increase in DNA damage was also observed in workers with concomitant presence of certain CYP2D6 and PON1 (Q192R and L55M) genotypes which need further extensive studies. In conclusion, the results indicate that the PON1 and CYP2D6 genotypes can modulate DNA damage elicited by some OPs possibly through gene-environment interactions.

Evaluation of Antiseizure Activity of Essential Oil from Roots of Angelica archangelica Linn. in Mice

In the present study, the effect of essential oil of the root of Angelica archangelica Linn. was evaluated against electrically and chemically induced seizures. The seizures were induced in mice by maximal electroshock and pentylenetetrazol. The effect of essential oil of the root of Angelica archangelica on seizures was compared with standard anticonvulsant agents, phenytoin and diazepam. The essential oil of the root of Angelica archangelica suppressed duration of tonic convulsions and showed recovery in maximal electroshock induced seizures while it delayed time of onset of clonic convulsions and showed mortality protection in pentylenetetrazol induced seizures. The essential oil of the root of Angelica archangelica also produced motor impairment at the antiseizure doses. The study indicated that the essential oil exhibited antiseizure effect. The antiseizure effect may be attributed to the presence of terpenes in the essential oil.

A novel cyano derivative of 11-keto-β-boswellic acid causes apoptotic death by disrupting PI3K/AKT/Hsp-90 cascade, mitochondrial integrity, and other cell survival signaling events in HL-60 cells

Intervention of apoptosis is a promising strategy for discovery of novel anti-cancer therapeutics. In this study, we examined the ability of a novel cyano derivative of 11-keto-β-boswellic acid, that is, butyl 2-cyano-3,11-dioxours-1,12-dien-24-oate (BCDD) to induce apoptosis in cancer cells. BCDD inhibited cell proliferation with 48 h IC(50) of 0.67 µM in HL-60, 1 µM in Molt4, and 1.5 µM in THP1 cells. The mechanism of cell death was investigated in HL-60 cells where it caused apoptosis by acting against several potential apoptosis suppressive targets. It inhibited phosphatidylinositol-3-kinase (PI3K)/AKT activity, NF-κB, Hsp-90, and survivin which may enhance the sensitivity of cells to apoptosis. Also, BCDD decreased the activity of Bid and Bax in cytosol, caused ΔΨ(mt) loss, releasing pro-apoptotic cytochrome c, SMAC/DIABLO leading to caspase-9-mediated down stream activation of caspase-3, ICAD, and PARP1 cleavage. Translocation of apoptotis-inducing factor (AIF) from mitochondria to the nucleus indicated some caspases-independent apoptosis. Though it upregulated DR-5 and caspase-8, the caspase inhibitor yet had no effect on apoptosis as against 75% inhibition by caspase-9 inhibitor. Attempts were made to examine any acclaimed role of AIF in the activation of caspase-8 using siRNA where it had no effect on caspase-8 activity while the Bax-siRNA inhibited caspase-3 activation suggesting predominance of intrinsic signaling. Our studies thus demonstrated that BCDD exerts multi-focal action in cancer cells while it required 10-fold higher the concentration to produce cytotoxicity in normal human PBMC and gingival cell line, and therefore, may find usefulness in the management of human leukemia.

Alendronate induced femur fracture complicated with secondary hyperparathyroidism

Alendronate is considered to be the gold standard drug for the treatment of postmenopausal osteoporosis. A 75 years old female presented with diaphyseal fracture following trivial fall. Though this fracture pattern was reported in the western world its presence among the population of this subcontinent is very rare. Radiographs showed a transverse fracture in diaphyseal area with lateral cortical thickening and medial spiking. History confirmed that patient was on long term bisphosphonate therapy. Opposite femur also showed lateral cortical thickening at the same level as was seen on fractured side. Biochemical picture was complicated with secondary (Vitamin-D deficiency) hyperparathyroidism. Fracture was fixed with Locking Compression plate and allogenic bone grafting was done. Prophylactic nailing was done on the contralateral side. Vitamin-D and calcium deficiency was corrected and subcutaneous Teriparatide was started. Radiographic evidence of callus formation is present but confirmation of union is uncertain.

Mucormycosis of the anterior chest wall presenting as a soft tissue tumour

Mucormycosis is a fungal infection caused by order Mucorales in humans. It commonly affects immunocompromised individuals, usually following trauma, and is associated with high rates of mortality despite the use of modern antifungal therapy and debridement. This report describes a case of the mucormycosis that presented as a non-healing ulcer over the chest wall (an extremely rare site for this lesion) which appeared to be a soft tissue tumour. The patient was immunocompetent and had no history of trauma. Repeated biopsies suggested there were only inflammatory changes but a fungal culture confirmed Rhizopus microsporus. The ulcer was managed successfully with high doses of intravenous Amphotericin B and aggressive surgical debridement.

Genetic polymorphisms of GSTM1, GSTT1 and GSTP1 and susceptibility to DNA damage in workers occupationally exposed to organophosphate pesticides

GSTM1, T1 and P1 are important enzymes of glutathione S-transferases (GSTs), involved in the metabolism of many endogenous and exogenous compounds. Individual genetic variation in these metabolizing enzymes may influence the metabolism of their substrates. The present study was designed to determine the genotoxic effects using DNA damage and its association with GSTM1, GSTT1, and GSTP1 (Ile105Val) genetic polymorphisms in workers occupationally exposed to organophosphate pesticides (OPs). We examined 230 subjects including 115 workers occupationally exposed to OPs and an equal number of normal healthy controls. The DNA damage was evaluated using the alkaline comet assay and genotyping was done using individual PCR or PCR-RFLP. Significantly higher DNA tail moment (TM) was observed in workers as compared to control subjects (14.41 ± 2.25 vs. 6.36 ± 1.41 tail % DNA, p<0.001). The results revealed significantly higher DNA TM in workers with GSTM1 null genotype than those with GSTM1 positive (15.18 vs. 14.15 tail % DNA, p=0.03). A significantly higher DNA TM was also observed in workers with homozygous Ile-Ile GSTP1 genotype than heterozygous (Ile-Val) and mutant (Val-Val) GSTP1 genotype (p=0.02). In conclusion, the results show that null deletion of GSTM1 and homozygote wild GSTP1 genotype could be related to inter-individual differences in DNA damage arises from the gene-environment interactions in workers occupationally exposed to OPs.

Incidental congenital transmesenteric hernia in an adult

Transmesenteric hernia is a rare type of internal hernia. We report a case of a 45 year old lady who was found to have an incidental congenital transmesenteric hernia of ileum caused by a congenital mesenteric defect during radical cystectomy done for muscle invasive transitional cell carcinoma of urinary bladder.

A prospective, randomized study of comparison of clipless cholecystectomy with conventional laparoscopic cholecystectomy

INTRODUCTION

Laparoscopic cholecystectomy has become a gold standard in the treatment of symptomatic gallstone disease. Amalgamation with upcoming technology makes the present-day procedure faster and safer. Ultrasonic shears, which perform dissection and ligation by cavitation and coaptation of vessels, are the latest addition to the armamentarium of laparoscopic surgeons. Acceptance of its safety and efficacy awaits its use as the sole instrument in the widely accepted procedure.

METHODS

A prospective, randomized control trial was conducted in 200 patients with symptomatic gallstone disease, who were randomly divided into two comparable groups, one undergoing cholecystectomy using ultrasonically activated shears and the other using conventional clip and electrocautery. Various parameters such as duration of surgery, removal of gallbladder, blood loss, postoperative pain scores, analgesic requirement, duration of stay, and complications were compared between the two groups.

RESULTS

Patients who underwent laparoscopic cholecystectomy using ultrasonic shears had a faster surgery (64.7 versus 50 minutes; P < .002) and removal of gallbladder from gallbladder bed (3.94 versus 7.46 minutes; P < .001) with less blood loss and pain scores (1.86 versus 3.01; P < .002). They had a shorter duration of hospital stay (1.89 versus 2.52 days; P < .001) and decreased risk of gallbladder perforation (9 versus 18; P < .005). The analgesic requirement was also less on the first postoperative day. There was no incidence of any major complication or bile leak during a 6-month follow-up period in either of the groups.

CONCLUSION

Ultrasonically activated scalpel can be used safely in laparoscopic cholecystectomy without risk of major injuries or leaks. It fairs better than electrocautery in terms of faster and safer surgery with decreased associated morbidity, less pain, and early return back home.

DNA damage and cholinesterase activity in occupational workers exposed to pesticides

The present study was designed to evaluate genotoxicity, acetyl cholinesterase (AChE) activity, hepatic and renal toxicity in occupational workers exposed to mixture of pesticides (n=70) with same number of healthy subjects as controls. The mean comet tail DNA % (TD %) and tail moment (TM) were used to measure DNA damage, while AChE activity and other biochemical parameters such as markers of nephrotoxicity (urea and creatinine) and hepatotoxicity (AST, ALT and ALP) were measured as biomarkers for toxicity due to exposure of pesticides. The occupational workers were continuously exposed to mixture of pirimiphos methyl, chlorpyrifos, temephos and malathion on a regular interval as per usage and activity. The comet assay using lymphocytes of exposed workers showed significantly higher TD percentage value (60.43% vs. 31.86%, p<0.001) and TM value (14.48 μm vs. 6.42 μm, p<0.001) in occupational workers as compared to controls. AChE activity in erythrocytes was found to be decreased (3.45 KAU/L vs. 9.55 KAU/L in controls, p<0.001) and associated with the duration of exposure to pesticides used by the workers. Enzyme levels for hepatic and renal functions were also found significantly different in occupational workers than healthy controls (p<0.001). These results suggest that the exposure to mixture of pirimiphos methyl, chlorpyrifos, temephos and malathion may induce DNA damage, decrease in AChE activity, hepatotoxicity as well as nephrotoxicity. Periodic biomonitoring of these biomarkers along with imparting education and training to occupational workers for safe application of pesticides is recommended for its potential hazards.

Correlation of adiponectin and leptin with insulin resistance: a pilot study in healthy north Indian population

The increasing incidence of obesity, leading to metabolic complications is now recognized as a major public-health problem. Insulin resistance is a central abnormality of the metabolic syndrome, or syndrome X, originally hypothesized by Reaven Insulin resistance is more strongly linked to intra abdominal fat than to fat in other depots. Adipose tissue secretes numerous factors (adipokines) known to markedly influence lipid and glucose/insulin metabolism, oxidative stress, and cardiovascular integrity. Some of these adipokines have been shown to directly or indirectly affect insulin sensitivity through modulation of insulin signaling and the molecules involved in glucose and lipid metabolism. A pilot study was conducted with 80 healthy subjects who were non diabetic, non hypertensive and having no family history of hypertension, the aim was to evaluate the correlation of adiponectin and leptin levels with obesity and insulin resistance markers in healthy north Indian adult population. Serum leptin, adiponectin and insulin was estimated by sandwich ELISA method. In our study, Leptin correlated significantly with BMI (P value of 0.0000), WC (P value = 0.007), and HC (P value = 0.000). leptin showed significant positive correlation with fasting insulin (P value 0.002), post prandial insulin (P value = 0.000) and HOMA-IR (P value = 0.002). Adiponectin showed significant positive correlation with triglycerides (P value = 0.038), strong negative correlation with HDL-cholesterol (P value = 0.017). Serum concentrations of leptin are associated with central body fat distribution. Insulin resistance and adiponectin is associated with dyslipidemia and these all disorders may ultimately lead to metabolic syndrome.