A detailed multi-omics analysis of GNB2 gene in human cancers

Abstract The Guanine-nucleotide binding protein 2 (GNB2) encodes for β2 subunit (Gβ2) of the G-protein complex. Keeping in view the increased demand of reliable biomarkers in cancer, the current study was planned to extensively explored GNB2 expression variation and its roles in different cancers using online available databases and diverse methodology. In view of our results, the GNB2 was notably up-regulated relative to corresponding controls in twenty three cancer types. As well, the elevated expression of GNB2 was found to be associated with the reduced overall survival (OS) of the Liver Hepatocellular Carcinoma (LIHC) and Rectum Adenocarcinoma (READ) only out of all analyzed cancer types. This implies GNB2 plays vital role in the tumorigenesis of LIHC and READ. Several additional analysis also explored six critical pathways and few important correlations related to GNB2 expression and different other parameters such as promoter methylation, tumor purity, CD8+ T immune cells infiltration, and genetic alteration, and chemotherapeutic drugs. In conclusion, GNB2 gene has been identified in this study as a shared potential biomarker (diagnostic and prognostic) of LIHC and READ.

The elevation of a unique population of Corynosoma strumosum (Acanthocephala: Polymorphidae) from the Caspian seal, Pusa caspica, in the Caspian Sea to Corynosoma neostrumosum n. sp

An isolated population of 700 specimens initially described as Corynosoma strumosum (Rudolphi, 1802) Lühe, 1904 and currently reassigned to Corynosoma neostrumosum n. sp. was collected from one young male Caspian seal, Pusa caspica (Gmelin) in the southern land-locked Caspian Sea in April 2009. Collected worms were morphologically unique compared with those reported by other observers in open waters, especially in shape and distribution of proboscis hooks and trunk spines, dorso-ventral differences in proboscis hooks and their organization, the baldness of anterior proboscis, consistently smaller size of trunk and testes, larger eggs, the rough egg topography, epidermal micropores, and variations in the female gonopore. Molecular data from the internal transcribed spacer region of rDNA and the mitochondrial cox1 gene was also provided to supplement the morphological study of the new species.

Revision of Corynosoma australe Johnston, 1937 (Acanthocephala: Polymorphidae) from a North American population using novel SEM images, Energy Dispersive X-ray Analysis, and molecular analysis

We describe a population of the acanthocephalan Corynosoma australe Johnston, 1937 (Polymorphidae) from a California sea lion Zalophus californianus (Lesson, 1828) in California using novel scanning electron microscopy (SEM) images, Energy Dispersive x-ray analysis (EDXA), and molecular analysis for the first time. The taxonomic history of C. australe is replete with accounts using only line drawings some of which proved erroneous. The distribution of ventral spines on the female trunk has been the primary distinction between C. australe and Corynosoma obtuscens Lincicome, 1943, its junior synonym; being continuous in the latter but discontinuous posteriorly in the former species. The distribution of ventral spines is invariably discontinuous in males. Our redescription and SEM images help to resolve this issue further validating the synonymy. Morphological variability has been documented between our California population and others from various host species in California, South Australia, South Shetlands, and the Argentinian coast. Our SEM images document features not previously detectable in line drawings, erroneously reported or missed in previous accounts. The EDXA spectra show high levels of calcium and phosphorous and low levels of sulfur characteristic of C. australe. EDXA for other species of Corynosoma Lühe, 1904 provide support for the diagnostic distinction of C. australe. EDXA spectra were shown to be species specific and have diagnostic value in the taxonomy of the Acanthocephala. Our molecular analysis used amplification of 18S of ribosomal DNA and cytochrome c oxidase 1 (Cox1) gene. Phylogenetic analyses for Cox1 gene revealed a close relationship between Corynosoma hannae Zdzitowiecki, 1984 and C. australe. The phylogenetic trees confirmed that the isolates belonged to C. australe. The haplotype network inferred by Cox1 with C. australe sequences revealed that haplotypes clearly separated from each other and formed clusters related to samples from the Northern Hemisphere (the USA and Mexico), and the second from the Southern Hemisphere (Argentina, Brazil and Peru).

Computational Characterization of Xyloketal B with Human C-Reactive Protein For Management of Kawasaki Disease (KD)

The most common underlying cause of acquired cardiovascular disease in developed countries is Kawasaki disease (KD), a systemic vasculitis. The most serious and common consequence of KD is the growth of coronary artery involvement, however therapy with intravenous gammaglobulin can minimized this issue. There are various limitations of using intravenous gammaglobulin which further make researchers to look for alternative medicine. It has been found that marine natural products and compounds from natural sources are having cardioprotective nature. The present research aims at filling the gap with computational analysis to explore the target ability y of Xyloketal B on human C-Reactive Protein having vital role in Kawasaki disease. It has been found that the marine compound has the ability to inhibit CRP with considerable negative biding energy of-8.47Kcal/mol. The present stdy may aid researchers to explore new invention having the potential for enzymatic and chemical modification of the molecule for the management of KD. Patients having a history of coronary artery disease, involvement are encouraged to have long-term follow-up.

Arthroscopic Debridement for Mucoid Degeneration of Anterior Cruciate Ligament - A Single Institution Experience from Nepal

Background Mucoid degeneration of anterior cruciate ligament is characterized by infiltration of mucoid-like material scattered throughout the anterior cruciate ligament substance. It is an uncommon condition, but previously, underdiagnosed or often misdiagnosed as an anterior cruciate ligament tear. Objective To present our early experiences with mucoid degeneration of anterior cruciate ligament in last five years in terms of clinical presentation and the outcomes of arthroscopic management. Method This was a retrospective descriptive cross-sectional study on patient who received arthroscopic debridement for mucoid degeneration of anterior cruciate ligament in Dhulikhel Hospital over five years period (2017 May to 2022 April). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale that has been translated and validated to be used in local (Nepali) language and context was used for evaluation of outcome evaluation. Result Twenty-one patients of mean age 44.21 years, predominantly females (18), were managed in five years period. The mean Western Ontario and McMaster Universities Osteoarthritis Index score was 16.33±10.47 with a range of 0 to 36 (11.57 to 21.09 at 95% confidence interval). The mean Western Ontario and McMaster Universities Osteoarthritis Index score converted on a scale of 0 to 100 was 17. Thirteen patients had isolated Mucoid degeneration of anterior cruciate ligament whereas nine others had associated either meniscal tear or chondral lesions. Conclusion Mucoid degeneration of anterior cruciate ligament could be a cause of knee pain in middle-aged patients and arthroscopic debridement can improve the patient's symptoms and provide a good functional outcome.

Biofilm assemblage and activity on plastic in urban streams at a continental scale: Site characteristics are more important than substrate type

The fate of plastics in rivers is a key component of the global plastic cycle. Plastics entering freshwater ecosystems are colonized by microbial biofilms, and microbe-plastic interactions can influence ecosystem processes and plastic fate. While literature examining the role of geographic region on plastic biofilms is quickly expanding, research which covers large (i.e., continental) spatial scales and includes freshwater ecosystems is warranted. In addition, most research focuses on bacterial communities, while biofilm eukaryotes are less commonly studied. We assessed biofilm metabolism and community structure on plastic (foamed polystyrene and polyvinyl chloride; PVC) and natural substrates (unglazed ceramic tile) in urban streams spanning a nested geographic gradient in the continental United States. We measured biofilm biomass, community respiration, and chlorophyll a, in addition to assessing marker gene-based community diversity of bacterial, fungal, and algal assemblages. Results demonstrated some substrate-specific trends in biofilm characteristics, including higher biofilm biomass on polystyrene across sites, and lower diversity of bacterial assemblages on both types of plastic litter versus tile. However, there were no differences among substrates for chlorophyll, respiration, and the abundance and diversity of algal and fungal assemblages. Thus, we concluded that the primary driver of biofilm metabolism and community composition were site characteristics, rather than substrate type. Additional studies are needed to quantify which site-specific characteristics drive biofilm dynamics on plastic litter in streams (e.g., water chemistry, light, seasonality, hydrology). These results add to the growing literature on the biofilm 'plastisphere' in aquatic ecosystems, demonstrating that the factors which control the assembly and activity of biofilm communities on plastic substrates (including bacteria, algal, and fungal assemblages together) in urban streams are similar to those driving biofilm dynamics on natural substrates.

Anti-bacterial activity of essential oils against multidrug-resistant foodborne pathogens isolated from raw milk

The presence of pathogenic bacteria in food is considered as a primary cause of food-borne illness and food quality deterioration worldwide. The present study aimed to determine the effectiveness of five essential oils (EOs) against multidrug-resistant foodborne pathogens. In the current study Gram-negative bacteria (Escherichia, Enterobacter, Citrobacter, Proteus, Pseudomonas, and Klebsiella) and the Gram-positive bacteria Staphylococcus were isolated from raw milk and biochemically characterized. The anti-bacterial effect of different antibiotics and EOs (thyme, oregano, lemongrass, mint, and rosemary) was determined using the standard disc diffusion method. The antibiogram study revealed that Gram-negative bacteria were highly resistant to penicillin while Staphylococcus was resistant to streptomycin, amoxicillin, and lincomycin. Moderate resistance was observed to doxycycline, amikacin, enrofloxacin, kanamycin and cefixime. Isolates were found less resistant to gentamycin, chloramphenicol, and ciprofloxacin. EOs showed a broad range of antimicrobial activity against all bacteria except P. aeruginosa. Of these, thyme was more effective against most of the multi-drug resistant bacterial strains and formed the largest zone of inhibition (26 mm) against Escherichia followed by oregano oil (18 mm) against Staphylococcus (p<0.05). Klebsiella spp and Citrobacter spp showed resistance to mint and lemongrass oil respectively. The EOs such as lemongrass, mint and rosemary were less active against all the bacteria. The findings of the recent study suggest the use of EOs as natural antibacterial agents for food preservation.

Optimized biotransformation of acid-treated water melon peel hydrolyzate into ethanol

Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.

Pattern of third molar impactions in north-eastern peninsular Malaysia: A 10-year retrospective study

Background

Third molar impaction, if left untreated, has the potential to cause several complications. The evaluation of surgical difficulty of impacted third molar extraction aids in better formulation of treatment plan by minimizing surgical complications.

Objective

This study aimed to determine the prevalence of third molar impaction and related pathologic conditions in a cohort of patients living in North-eastern Peninsular Malaysia.

Methods

In this retrospective study, 490 orthopantomograms (OPGs) of patients who were referred to the Oral and Maxillofacial Surgery department between January 2010 and December 2019 were assessed. Data including age, gender, ethnicity, frequency of third molar impactions, their angulations and levels of eruption, retromolar space, and associated pathologic conditions were collected. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 24.0. The significance level was set to P < 0.05.

Results

A total of 490 patients with a mean age of 28.87 years (range: 20-64) demonstrated 1957 impacted third molars (1022 mandibular + 935 maxillary). Impacted third molars were more likely present in females than males (1:2.20) (p < 0.05); and in Malay-ethnic (44.49%) patients followed by Chinese (34.45%) and Indians (21.02%). Mesioangular was the most common angulation of impaction both in the maxilla (24.68%) and mandible (18.34%). The most common pattern of third molar impaction was IIA (61.67%), and the retromolar space was significantly larger in males (13.6 mm; P < 0.05) than females (11.6 mm). The most frequently occurring pathological condition associated with third molars impaction is dental caries in the second or third molar (15.38%).

Conclusions

This study highlights mesioangular impaction with their occlusal plane at the same level as the occlusal plane of the adjacent tooth being the most prevalent pattern of third molar impaction in North-eastern Peninsular Malaysia.

Initiating resuscitation before umbilical cord clamping in infants with congenital diaphragmatic hernia: a pilot feasibility trial

BACKGROUND

Infants with congenital diaphragmatic hernia (CDH) often experience hypoxaemia with acidosis immediately after birth. The traditional approach in the delivery room is immediate cord clamping followed by intubation. Initiating resuscitation prior to umbilical cord clamping (UCC) may support this transition.

OBJECTIVES

To establish the safety and feasibility of intubation and ventilation prior to UCC for infants with CDH. To compare short-term outcomes between trial participants and matched controls treated with immediate cord clamping before intubation and ventilation.

DESIGN

Single-arm, single-site trial of infants with CDH and gestational age ≥36 weeks. Infants were placed on a trolley immediately after birth and underwent intubation and ventilation, with UCC performed after qualitative CO₂ detection. The primary feasibility endpoint was successful intubation prior to UCC. Prespecified safety and physiological outcomes were compared with historical controls matched for prognostic variables using standard bivariate tests.

RESULTS

Of 20 enrolled infants, all were placed on the trolley, and 17 (85%) infants were intubated before UCC. The first haemoglobin and mean blood pressure at 1 hour of life were significantly higher in trial participants than controls. There were no significant differences between groups for subsequent blood pressure values, vasoactive medications, inhaled nitric oxide or extracorporeal membrane oxygenation. Blood gas and oxygenation index values did not differ between groups at any point.

CONCLUSIONS

Intubation and ventilation prior to UCC is safe and feasible among infants with CDH. The impact of this approach on clinically relevant outcomes deserves investigation in a randomised trial.

Effect of Sustained Inflations vs Intermittent Positive Pressure Ventilation on Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants: The SAIL Randomized Clinical Trial

IMPORTANCE

Preterm infants must establish regular respirations at delivery. Sustained inflations may establish lung volume faster than short inflations.

OBJECTIVE

To determine whether a ventilation strategy including sustained inflations, compared with standard intermittent positive pressure ventilation, reduces bronchopulmonary dysplasia (BPD) or death at 36 weeks' postmenstrual age without harm in extremely preterm infants.

DESIGN, SETTING, AND PARTICIPANTS

Unmasked, randomized clinical trial (August 2014 to September 2017, with follow-up to February 15, 2018) conducted in 18 neonatal intensive care units in 9 countries. Preterm infants 23 to 26 weeks' gestational age requiring resuscitation with inadequate respiratory effort or bradycardia were enrolled. Planned enrollment was 600 infants. The trial was stopped after enrolling 426 infants, following a prespecified review of adverse outcomes.

INTERVENTIONS

The experimental intervention was up to 2 sustained inflations at maximal peak pressure of 25 cm H2O for 15 seconds using a T-piece and mask (n = 215); standard resuscitation was intermittent positive pressure ventilation (n = 211).

MAIN OUTCOME AND MEASURES

The primary outcome was the rate of BPD or death at 36 weeks' postmenstrual age. There were 27 prespecified secondary efficacy outcomes and 7 safety outcomes, including death at less than 48 hours.

RESULTS

Among 460 infants randomized (mean [SD] gestational age, 25.30 [0.97] weeks; 50.2% female), 426 infants (92.6%) completed the trial. In the sustained inflation group, 137 infants (63.7%) died or survived with BPD vs 125 infants (59.2%) in the standard resuscitation group (adjusted risk difference [aRD], 4.7% [95% CI, -3.8% to 13.1%]; P = .29). Death at less than 48 hours of age occurred in 16 infants (7.4%) in the sustained inflation group vs 3 infants (1.4%) in the standard resuscitation group (aRD, 5.6% [95% CI, 2.1% to 9.1%]; P = .002). Blinded adjudication detected an imbalance of rates of early death possibly attributable to resuscitation (sustained inflation: 11/16; standard resuscitation: 1/3). Of 27 secondary efficacy outcomes assessed by 36 weeks' postmenstrual age, 26 showed no significant difference between groups.

CONCLUSIONS AND RELEVANCE

Among extremely preterm infants requiring resuscitation at birth, a ventilation strategy involving 2 sustained inflations, compared with standard intermittent positive pressure ventilation, did not reduce the risk of BPD or death at 36 weeks' postmenstrual age. These findings do not support the use of ventilation with sustained inflations among extremely preterm infants, although early termination of the trial limits definitive conclusions.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT02139800.

Association of Socio-Demographic Profile with Prevalence of Multi Drug Resistant Tuberculosis among Retreated Pulmonary Tuberculosis Patients in North India

Methods: An observational cross sectional study, which includes 116 patients of sputum smear positive pulmonary TB of age 18 or above. Further, detailed history taking regarding different demographic profile was done. Also, they were subjected to CB-NAAT and rifampicin resistant cases were considered as MDR-TB. Results: Proportion of MDR-TB was 31.89% among retreatment TB cases. 56.75 % (n=21) of MDR-TB cases were between the age group of 21-40 years. Proportion of MDR-TB was higher among males (75.67%), married (59.45%) and rural dwellers 59.45%. Proportion was 61.76% among patients with BMI <16; 31.57% with BMI 16-16.99, 28.57% with BMI 17-18.49 and 5.7% with BMI 18.50-24.99. MDRTB proportion was less 29.72% (n=11) in patients with history of TB contact in family. Pulmonary TB including MDR-TB was more common among illiterates (37.83% among MDR). Conclusion: Proportion of MDR-TB was high among retreatment cases in north India. Among them low BMI and education status are modifiable factor and this study signifies that MDR-TB burden can be reduced by improving health and education status of patient.

Magnetite and Green Rust: Synthesis, Properties, and Environmental Applications of Mixed-Valent Iron Minerals

Mixed-valent iron [Fe(II)-Fe(III)] minerals such as magnetite and green rust have received a significant amount of attention over recent decades, especially in the environmental sciences. These mineral phases are intrinsic and essential parts of biogeochemical cycling of metals and organic carbon and play an important role regarding the mobility, toxicity, and redox transformation of organic and inorganic pollutants. The formation pathways, mineral properties, and applications of magnetite and green rust are currently active areas of research in geochemistry, environmental mineralogy, geomicrobiology, material sciences, environmental engineering, and environmental remediation. These aspects ultimately dictate the reactivity of magnetite and green rust in the environment, which has important consequences for the application of these mineral phases, for example in remediation strategies. In this review we discuss the properties, occurrence, formation by biotic as well as abiotic pathways, characterization techniques, and environmental applications of magnetite and green rust in the environment. The aim is to present a detailed overview of the key aspects related to these mineral phases which can be used as an important resource for researchers working in a diverse range of fields dealing with mixed-valent iron minerals.

Milrinone in congenital diaphragmatic hernia - a randomized pilot trial: study protocol, review of literature and survey of current practices

Background

Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH.

Methods/design

Data on pulmonary vasodilator management and outcome of CDH patients was collected from 18 university NICUs affiliated with the Neonatal Research Network (NRN) from 2011 to 2012. The proposed pilot will be a masked, placebo–controlled, multicenter, randomized trial of 66 infants with CDH with an oxygenation index (OI) ≥10 or oxygen saturation index (OSI) ≥5. The primary outcome is the oxygenation response, as determined by change in OI at 24 h after initiation of study drug. As secondary outcomes, we will determine oxygenation at 48 h and 72 h post-infusion, right ventricular pressures on echocardiogram and the incidence of systemic hypotension, arrhythmias, intracranial hemorrhage, survival without extracorporeal membrane oxygenation, and chronic lung disease (oxygen need at 28 days postnatal age). Finally, we will evaluate the pulmonary and nutritional status at 4, 8 and 12 months of age using a phone questionnaire.

Results

Three hundred thirty-seven infants with CDH were admitted to NRN NICUs in 2011 and 2012 of which 275 were ≥36 weeks PMA and were exposed to the following pulmonary vasodilators: iNO (39%), sildenafil (17%), milrinone (17%), inhaled epoprostenol (6%), intravenous epoprostenol (3%), and intravenous PGE1 (1%). ECMO was required in 36% of patients. Survival to discharge was 71%.

Discussion

CDH is an orphan disease with high mortality with few randomized trials evaluating postnatal management. Intravenous milrinone is a commonly used medication in neonatal/pediatric intensive care units and is currently used in 17% of patients with CDH within the NRN. This pilot study will provide data and enable further studies evaluating pulmonary vasodilator therapy in CDH.

Trial registration

ClinicalTrials.gov; NCT02951130; registered 14 October 2016.

The Effect of Skin Pigmentation on the Accuracy of Pulse Oximetry in Infants with Hypoxemia

To compare pulse oximetry measurement bias between infants with hypoxemia with either dark skin or light skin with Masimo Radical 7 and Nellcor Oximax. There was no significant difference in systematic bias based on skin pigment for either oximeter.

Procamallanus spiculogubernaculus Agarwal, 1958 (Nematoda: Camallanidae) from Stinging catfish, Heteropneustes fossilis in India: morphological characterization and molecular data

The nematode, Procamallanus spiculogubernaculus Agarwal, 1958 was found from the Stinging catfish, Heteropneustes fossilis (Bloch, 1794) from Ghazipur, Delhi, India. Morphological characterization, including scanning electron microscope observation supplemented with DNA sequences is provided. Specimens recently found are characterized by the presence of an unlined buccal capsule having a small basal ring, esophagus muscular and glandular, vulva position is slightly post-equatorial, tail conical, long, and ending in three digit-like processes, phasmids present at about mid-length and cloaca located at the posterior end. In this study the species P. spiculogubernaculus is validated on the basis of molecular data after 47 years from its original description. In the scanning electron microscope examination, the topology of mouth and sensory pits in anterior portion, while the phasmids and digit like processes in posterior portion is clearly observed. Molecular data of the 18S ribosomal RNA and mitochondrial cytochrome c oxidase subunit 1 (cox1) gene were analyzed. Molecular phylogenetic analyses supported the validity of Procamallanus spiculogubernaculus and confirmed the paraphyletic status of the members of Procamallanus, Spirocamallanus, Camallanus and Paracamallanus. Taxonomic status of members of the family Camallanidae are briefly discussed along with the results of the systematic evaluation of P. spiculogubernaculus based on molecular data.

Redescription and phylogenetic analyses of Thaparocleidus gomtius and T. sudhakari (Monogenea: Dactylogyridae) from Wallago attu (Siluriformes: Siluridae) in India

Two species of Thaparocleidus Jain (1952a) were found harboring W. attu from the Ganga River at two localities, Meerut and Farrukhabad, Uttar Pradesh, India, during the period of 2013-2015. Morphology and morphometric study of specimens identified as Thaparocleidus gomtius (Jain, 1952a) Lim, 1996 and T. sudhakari (Gusev, 1976) Lim, 1996. Molecular analyses using the 18S rRNA gene confirmed the validity of T. gomtius and T. sudhakari and demonstrated that both the species clustered with other Thaparocleidus species from different geographical regions. We aim at reassessing the taxonomy and establishing the phylogenetic relationships among these two redescribed species with other representatives of the genus Thaparocleidus.

Role of MMP-7 in the pathogenesis of systemic lupus erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a clinically heterogeneous chronic, inflammatory autoimmune disorder. The association of MMP-7 and disease severity is still unclear. A total of 150 SLE patients and matched healthy controls were recruited for this study. Disease activity was scored according to SLEDAI (98 active and 52 inactive disease). Mean serum MMP-7 levels were significantly higher in SLE patients than controls ( p < 0.001). Patients with active disease showed higher levels (16.24 ± 6.2 ng/ml) as against inactive disease (10.50 ± 3.97 ng/ml) ( p ≤ 0.0001). Mean MMP-7 mRNA expression was significantly higher in patients (RQ = 3.16 ± 0.93) as compared to controls (RQ = 2.21 ± 0.89, p = 0.006). A positive correlation between MMP-7 levels, mRNA expression and SLEDAI score was observed ( r = 0.563, r = 0.427). The MMP-7 -181 G allele was found to be significantly higher among SLE patients ( p < 0.0001). A significant association was noted between MMP-7 -181 A/G +G/G genotypes with renal ( p = 0.0027) and CNS ( p = 0.0031) manifestations and anti-dsDNA autoantibodies ( p = 0.0312). Serum MMP-7 levels and mRNA expression were elevated in advanced stages of SLE, indicating that MMP-7 is associated with disease activity in SLE.

Molecular characterization of three species belongs to the Allocreadioidea, Hemiuroidea and Plagiorchioidea (Platyhelminthes: Trematoda) infecting freshwater fishes in India

Three species of digenetic trematodes are redescribed based on specimens collected from the intestine of freshwater fishes of Hastinapur and Meerut (U.P.), India: Allocreadium handiai (Pande, 1937) Madhavi, 1980 (Allocreadioidea: Allocreadiidae) from Mystus tengara (Hamilton, 1822) (Siluri-formes: Bagridae), Genarchopsis goppoOzaki, 1925 (Hemiuroidea: Derogenidae) and Phyllodistomum chauhaniMotwani & Srivastava, 1961 (Plagiorchioidea: Gorgoderidae) from Channa punctata (Bloch, 1793) (Perciformes: Channidae). The three species were subjected to morphological, morphometric and molecular analyses. The morphological study revealed that A. handiai, G. goppo and P. chauhani can be distinguished by their congeners on the basis of their morphology. Partial nucleotide sequences of the 28S ribosomal RNA gene were obtained from the three trematode species and deposited in the GenBank. A phylogenetic reconstruction based on the 28S rRNA gene placed the three studied species within their respective families and their validity is discussed. For the first time molecular data of newly collected material of these species from India were used for confirmation of their validity and to assess their phylogenetic relationships.

Genome wide array-CGH and qPCR analysis for the identification of genome defects in Williams' syndrome patients in Saudi Arabia

Background

Williams-Beuren Syndrome (WBS) is a rare neurodevelopmental disorder characterized by dysmorphic features, cardiovascular defects, cognitive deficits and developmental delay. WBS is caused by a segmental aneuploidy of chromosome 7 due to heterozygous deletion of contiguous genes at the long arm of chromosome 7q11.23. We aimed to apply array-CGH technique for the detection of copy number variants in suspected WBS patients and to determine the size of the deleted segment at chromosome 7q11.23 in correlation with the phenotype. The study included 24 patients referred to the CEGMR with the provisional diagnosis of WBS and 8 parents. The patients were subjected to conventional Cytogenetic (G-banding) analysis, Molecular Cytogenetic (Fluorescent In-Situ Hybridization), array-based Comparative Genomic Hybridization (array-CGH) and quantitative Real time PCR (qPCR) Techniques.

Results

No deletions were detected by Karyotyping, however, one patient showed unbalanced translocation between chromosome 18 and 19, the karyotype was 45,XX, der(19) t(18;19)(q11.1;p13.3)-18. FISH technique could detect microdeletion in chromosome 7q11.23 in 10/24 patients. Array-CGH and qPCR confirmed the deletion in all samples, and could detect duplication of 7q11.23 in three patients and two parents. Furthermore, the size of the deletion could be detected accurately by both array-CGH and qPCR techniques. Three patients not showing the 7q11.23 deletion were diagnosed by array-CGH to have deletion in chr9p13.1-p11.2, chr18p11.32-p11.21 and chr1p36.13.

Conclusion

Both FISH and array-CGH are reliable methods for the diagnosis of WBS; however, array-CGH has the advantage of detection of genome deletions/ duplications that cannot otherwise be detected by conventional cytogenetic techniques. Array-CGH and qPCR are useful for detection of deletion sizes and prediction of the interrupted genes and their impact on the disease phenotype. Further investigations are needed for studying the impact of deletion sizes and function of the deleted genes on chromosome 7q11.23.

Trial registration

ISRCTN ISRCTN73824458. MOCY-D-16-00041R1. Registered 28 September 2014. Retrospectively registered.

Non-invasive respiratory support for infants in low- and middle-income countries

The overwhelming majority of neonatal deaths worldwide occur in low- and middle-income countries. Most of these deaths are attributable to respiratory illnesses and complications of preterm birth. The available data suggest that non-invasive continuous positive airway pressure (CPAP) is a safe and cost-effective therapy to reduce neonatal morbidity and mortality in these settings. Bubble CPAP compared to mechanical ventilator-generated CPAP reduces the need for subsequent invasive ventilation in newborn infants. There are limited data on the safety and efficacy of high-flow nasal cannulae in low- and middle-income countries, requiring further study prior to widespread implementation.

Molecular and ultrastructure characterization of two nematodes (Thelandros scleratus and Physalopteroides dactyluris) based on ribosomal and mitochondrial DNA sequences

The phylogenetic relationships of the nematode species Thelandros scleratus (Oxyurida: Pharyn-godonidae) and Physalopteroides dactyluris (Spirurida: Physalopteridae) were analyzed using the ribosomal 18S rRNAand the mitochondrial cytochrome C oxidase subunit genes. The nematodes were recovered from Brook's house gecko, Hemidactylus brooki (Reptilia: Gekkonidae) from Hast-inapur, Meerut (U.P.), India. The results demonstrated that T. scleratus shows 100% similarity with another sequence available from the same species and a close relationship (98-99%) with species of Parapharyngodon in both 18S rRNAand cox 1 regions. Regarding the nematode Physalopteroides. analysis showed a close phylogenetic relationship between P. dactyluris and several species of Phy-saloptera. This is the first sequence of 18S available for any species of the genus Physalopteroides

ID: 64: REVERSIBLE BLINDNESS ASSOCIATED WITH DIABETIC KETOACIDOSIS: A RARE COMBINATION

Introduction

A wide spectrum of ocular diseases is associated with diabetes mellitus (DM) and most of them lead to gradual loss of vision that is almost always irreversible. Sudden vision loss in severe diabetic ketoacidosis (DKA) that is reversible with treatment of the metabolic abnormality is a very rare complication that has been reported three times previously.

Case Presentation

A 59 year-old male with Type 1 DM presented with altered consciousness, epigastric pain, hypothermia and sudden complete bilateral vision loss for three days. He was not complaint with insulin. There was no history or laboratory evidence of ethanol, methanol, ethylene glycol ingestion, head trauma, baseline vision problem, cold or intense bright light exposure.

Physical examination revealed rapid shallow breathing at 55/min, blood pressure 90/60 mm Hg, heart rate 102/min and temperature 90.2F. He was oriented only to place,pupils were dilated and non-reactive to light. No light perception in both eyes. Fundoscopy was normal without any evidence of retinal pallor, retinal detachment, retinal hemorrhages, papilledema or cataract.

Labs revealed blood glucose 1100 mg/dl, pH 6.95,positive serum and urine ketones, pCO2 11 mm Hg and anion gap 36. He received aggressive warm fluid resuscitation, electrolyte replacements and intravenous insulin infusion with close monitoring. 18 hrs later his blood glucose, pH,anion gap and body temperature normalized and vision spontaneously returned to normal. A repeat fundoscopy exam by ophthalmologist and magnetic resonance image (MRI) brain was completely normal; ruling out posterior ischemic optic neuropathy and occipital stroke. He recovered very well, resumed diet, was ambulatory and had an uneventful rest of hospital course.

Discussion

Sudden painless vision loss has a wide differential diagnosis and it is usually caused by ischemia at retinal, ocular or cortical level. No history of methanol ingestion or trauma, normal fundoscopy, normal MRI and rapid return of vision after correction of diabetic ketoacidosis strongly suggests that blindness was related to acidosis.

Alcoholic ketoacidosis has been reported to cause transient reversible blindness in other case reports and correction of acidosis lead to reversal of blindness. Other rare causes of reversible blindness include posterior reversible encephalopathy syndrome, brain tumors, anterior ischemic optic neuropathy and valsalva retinopathy.

The mechanism of acidosis causing blindness is believed to be uncoupling of horizontal cells at pH <7.0 inhibiting photoreceptor transmission as suggested by studies on fish and salamander. Other possible mechanisms include hyperosmolarity causing ischemia or transient lens opacification but in none of the reported cases this was proven. Also lens opacification would have been seen at fundoscopy. Posterior ischemic optic neuropathy is another possibility but it is irreversible. The exact mechanism of blindness remains poorly understood. However irrespective of mechanism of acidosis, its rapid correction to pH >7.0 leads to rapid recovery suggesting a common pathogenesis.

ID: 55: FIBRILLARY GLOMERULONEPHRITIS:LOOKS LIKE AMYLOID BUT ITS NOT!

Introduction

Fibrillary glomerulonephritis is a rare disorder with a prevalence of 1% in renal biopsies.The mean age of presentation is 50 years, proteinurea in 100%, nephrotic syndrome in 70–75%, renal insufficiency (Cr≥1.5) in 50–55%, hypertension 70% and hematuria in 70% cases.Etiology is unknown and diagnosis is established by pathognomonic electron microscopy findings. This case illustrates the presentation, workup and diagnosis of fibrillary glomerulonephritis (FGN).

Case Description

A 49 year-old-female with history of hypertension, obstructive sleep apnea,non-steroidal anti inflammatory drug use for chronic back pain presented with shortness of breath on exertion and bilateral lower extremity swelling.

Vital signs showed temperature 35.6 C, heart rate 75/min, respiratory rate 21/min and blood pressure 112/68 mm Hg.She had mild respiratory distress, bilateral crackles at lung bases and bilateral +2 pedal edema on physical examination.

Complete blood count showed hemoglobin 10.7 g/dl and normal white cell count. Complete metabolic panel showed creatinine 1.1 mg/dl, blood urea nitrogen 21 mg/dl, albumin 2.6 g/dl and normal electrolytes. Urinalysis showed pH 6.0,specific gravity 1.028,+4 proteinuria,+2 hematuria and no casts. 24hour urine collection showed 4.3 g/day nephrotic proteinuria. Lipid profile showed cholesterol 308 mg/dl and non-HDL cholesterol 246 mg/dl.

Hepatitis C, HIV, Goodpasture Disease, Cryoglobulinemia, Systemic Lupus Erythematosus and other autoimmune diseases were ruled out by appropriate tests. Serum and urine protein electrophoresis were without M-spike but with high free Lambda (29.7 mg/dl) and Kappa chains (23.6 mg/dl). A diagnosis of nephrotic syndrome was made due to the presence of edema, proteinuria, hypoalbuminemia and hyperlipidemia.

A renal biopsy was done to evaluate the etiology of nephrotic syndrome. Biopsy showed focal segmental and global glomerulosclerosis with mild to moderate interstitial fibrosis and tubular atrophy. Immunofluorescence showed staining of glomerular capillary walls and mesangium for IgG, kappa and lambda. Electron microscopy showed linear, non-branching fibrils in the mesangium that averaged 20 nm in width (11.7–28.6 nm).Congo red staining was negative.

Discussion

A study of 66 cases identified most common histologic patterns as mesangial, membranoproliferative, endocapillary proliferative, crescentic and necrotizing, membranous and diffuse sclerosing in order of likelihood.This case had focal segmental and global glomerulosclerosis that is a rare finding.

In the same study immunofluorescence staining was positive for IgG in 100%, C3 in 92% and both kappa and lambda in 84% cases. This case also demonstrated positive staining for IgG, kappa and lambda.

The pathognomonic finding is presence of fibrillary deposits in the mesangium and glomerular capillary walls distinct from amyloidosis.The size of fibrils ranges from 8–15 nm in Amyloid and 12–24 nm in FGN. IgG is usually monoclonal in AL Amyloid as compared to polyclonal in FGN. The characteristic difference from amyloid is absence of reaction to histochemical dyes like Congo Red and Thioflavin T in FGN.

One third of FGN cases are associated with malignancy, monoclonal gammopathy and autoimmune disorders. In our case an extensive workup was negative for all these conditions.

Angiotensin inhibitors (ACEI) are used if the glomerular filtration rate is normal and proteinuria is present,to control blood pressure and reduce disease progression. Evidence for use of steroids and immunosuppressants is based on uncontrolled studies with variable success.In our patient a limited trial of corticosteroids with mycophenolate resulted in some improvement in proteinuria alongwith ACEI.

Clinical Spectrum of Chikungunya in Bikaner (North Western India) in 2006 and Follow up of Patients for Five Years

OBJECTIVE

To find out clinical and laboratory profile of patients of chikungunya outbreak in 2006 in Bikaner (North-West Rajasthan) and follow up of chikungunya patients for 5 years.

METHODS

Study was conducted among 50 chikungunya patients. For this study the inclusion criteria was clinical presentation consistent with chikungunya virus infection (e.g. abrupt onset of fever and/or polyarthralgia) and laboratory confirmation of chikungunya virus infection by IgM-capture ELISA. All patients were subjected for thorough clinical and general physical examination, investigations like CBC, ESR, CRP, rheumatoid factor, ECG, LFT, RFT, anti-CCP antibody were done in all patients and their follow up was done for 5 years.

RESULTS

Among the 50 patients of chikungunya arthritis 34 (68%) patients developed persistent arthritis. Among the patients with persistent arthritis 70.58% were shown positive for anti-ccp antibody. CRP (95.24%) and ESR level were raised (68%) in patient with persistent arthralgia. Level of CRP and ESR was proportionally related to number of partially recovered joints, higher the CRP positivity and raised ESR levels severe were the persistent arthralgias.

CONCLUSIONS

Our study shows that chikungunya patients who had persistent arthralgia on 5 year follow up mimicked rheumatological disorder like rheumatoid arthritis in 70.58%. Therefore DMARD can be effective.

Bursectomy for gastric cancer: What does the evidence indicate?

Radical resection of the bursa omentalis (radical bursectomy) as part of a curative resection for gastric cancer has been advised for close to a century. However, the postulated associated morbidity and lack of a clear benefit in terms of survival preclude its routine use. To objectively review the available evidence on the role of bursectomy as part of a curative resection for gastric cancer. A systematic search of the scientific literature was carried out using Embase, PubMed, MedLine and the Cochrane central register of controlled trials for the years 1965-2013 to obtain access to all publications, especially randomized controlled trials (RCTs), systematic reviews and meta-analyses involving bursectomy in gastric cancer with the appropriate specific search terms, namely, "bursectomy," "stomach cancer," "gastric cancer," "survival," "morbidity," "outcomes" and "RCTs". Using the above search strategy, a total of 29 publications was retrieved of which five publications were identified describing bursectomy and its outcomes in gastric cancer. These included three retrospective cohort studies and two publications from a single RCT. Bursectomy do not appear to add the morbidity or mortality of the overall surgery. However, it did not appear to significantly improve overall survival neither in the retrospective cohort studies nor in the only RCT. The evidence to date is insufficient to suggest any additional benefit of routine bursectomy to a radical gastrectomy with D2 lymphadenectomy for gastric cancer. Results of an on-going RCT are awaited to determine if bursectomy may further improve overall survival in patients with advanced T-stage of disease.

Effect of thermal pre-treatment on the availability of PAHs for successive chemical oxidation in contaminated soils

This is the premier study designed to evaluate the impact of thermal pre-treatment on the availability of polycyclic aromatic hydrocarbons (PAHs) for successive removal by chemical oxidation. Experiments were conducted in two soils having different PAH distribution originating from former coking plant sites (Homécourt, H, and Neuves Maisons, NM) located in northeast of France. Soil samples were pre-heated at 60, 100, and 150 °C for 1 week under inert atmosphere (N2). Pre-heating resulted in slight removal of PAHs (<10%) and loss of extractable organic matter (EOM). Then, these pre-heated soil samples were subjected to Fenton-like oxidation (H2O2 and magnetite) at room temperature. Chemical oxidation in soil without any pre-treatment showed almost no PAH degradation underscoring the unavailability of PAHs. However, chemical oxidation in pre-heated soils showed significant PAH degradation (19, 29, and 43% in NM soil and 31, 36, and 47% in H soil pre-treated at 60, 100, and 150 °C, respectively). No preferential removal of PAHs was observed after chemical oxidation in both soils. These results indicated the significant impact of pre-heating temperature on the availability of PAHs in contaminated soils and therefore may have strong implications in the remediation of contaminated soils especially where pollutant availability is a limiting factor.

Excellent mechanical properties of carbon fiber semi-aligned electrospun carbon nanofiber hybrid polymer composites

The excellent mechanical properties of carbon fiber fabric hybrid polymer composites is achieved by integrating continuous semi-aligned carbon nanofiber layers in the interlaminar region between carbon fiber fabric plies.

Plant Pathogenic Microbial Communication Affected by Elevated Temperature in Pectobacterium carotovorum subsp. carotovorum

Gram-negative plant pathogenic bacteria regulate specific gene expression in a population density-dependent manner by sensing level of Acyl-Homoserine Lactone (HSL) molecules which they produce and liberate to the environment, called Quorum Sensing (QS). The production of virulence factors (extracellular enzyme viz. cellulase, pectinase, etc.) in Pectobacterium carotovorum subsp. carotovorum (Pcc) is under strong regulation of QS. The QS signal molecule, N-(3-oxohexanoyl)-L-Homoserine Lactone (OHHL) was found as the central regulatory system for the virulence factor production in Pcc and is also under strict regulation of external environmental temperature. Under seven different incubation temperatures (24, 26, 28, 30, 33, 35, and 37 °C) in laboratory condition, highest amount of OHHL (804 violacein unit) and highest (79 %) Disease Severity Index (DSI) were measured at 33 °C. The OHHL production kinetics showed accumulation of highest concentration of OHHL at late log phase of the growth but diminution in the concentration occurred during stationary phase onwards to death phase. At higher temperature (35 and 37 °C) exposure, OHHL was not at detectable range. The effect of temperature on virulence factor production is the concomitant effect of HSL production and degradation which justifies less disease severity index in cross-inoculated tomato fruits incubated at 35 and 37 °C. The nondetection of the OHHL in the elevated temperature may because of degradation as these signal molecules are quite sensitive and prone to get degraded under different physical factors. This result provides the rationale behind the highest disease severity up to certain elevated temperature and leaves opportunities for investigation on mutation, co-evolution of superior plant pathogen with more stable HSL signals-mediated pathogenesis under global warming context.

A multicenter prospective hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children less than five years of age in India

BACKGROUND

Rotavirus is the leading cause of severe, dehydrating diarrhea in children aged <5 years globally, with an estimated 25 million outpatient visits and 2 million hospitalizations attributable to rotavirus infections each year. The aim of this hospital-based surveillance was to summarize the local epidemiological and virological features of rotavirus and to estimate the disease burden in the population under surveillance in India.

METHODS

During the 16 months surveillance period from April 2011 through July 2012, a total of 4711 children under the age of 5 years were admitted with acute diarrhea at 12 medical centers attached to medical schools throughout India. Stool samples were randomly collected from 2051 (43.5%) subjects and were analyzed for rotavirus positivity using commercial enzyme immunoassay kit (Premier Rotaclone Qualitative Elisa) at the respective study centers. Rotavirus positive samples were genotyped for VP7 and VP4 by reverse-transcription polymerase chain reaction (RT-PCR) at a central laboratory.

RESULTS

During the study period, maximum number of rotavirus related hospitalizations were reported from December 2011 through February 2012. Out of the 2051 stool samples tested for rotavirus, overall 541 (26.4%) samples were positive for rotavirus VP6 antigen in stool. The highest positivity was observed in the month of December, 2011 (52.5%) and lowest in the month of May, 2011 (10.3%). We found that majority of the rotavirus positive cases (69.7%) were in children <24 months of age. The most common genotypes reported were G1 (38%), G2 (18%), G9 (18%), G12 (9%) and mixed strains (17%).

CONCLUSIONS

The results of this study confirm the significant burden of acute rotavirus gastroenteritis as a cause of hospitalizations in under five children in India.

1,2,4-triazine analogs as novel class of therapeutic agents

1,2,4-Triazine nucleus is a prominent structural core system present in numerous pharmacologically active compounds. Till date, various 1,2,4-triazine analogs, possesing a wide range of potent pharmacological activities, have been reported. This review is an attempt to compile the medicinal chemistry aspects of various synthesized 1,2,4-triazine analogs reported so far.

A novel planar ion funnel design for miniature ion optics

The novel planar ion funnel (PIF) design presented in this article emphasizes simple fabrication, assembly, and operation, making it amenable to extreme miniaturization. Simulations performed in SIMION 8.0 indicate that ion focusing can be achieved by using a gradient of electrostatic potentials on concentric metal rings in a plane. A prototype was fabricated on a 35 × 35 mm custom-designed printed circuit board (PCB) with a center hole for ions to pass through and a series of concentric circular metal rings of increasing diameter on the front side of the PCB. Metal vias on the PCB electrically connected each metal ring to a resistive potential divider that was soldered on the back of the PCB. The PIF was tested at 5.5 × 10(-6) Torr in a vacuum test setup that was equipped with a broad-beam ion source on the front and a micro channel plate (MCP) ion detector on the back of the PIF. The ion current recorded on the MCP anode during testing indicated a 23× increase in the ion transmission through the PIF when electric potentials were applied to the rings. These preliminary results demonstrate the functionality of a 2D ion funnel design with a much smaller footprint and simpler driving electronics than conventional 3D ion funnels. Future directions to improve the design and a possible micromachining approach to fabrication are discussed in the conclusions.

A genetic model for gallbladder carcinogenesis and its dissemination

Gallbladder cancer, although regarded as the most common malignancy of the biliary tract, continues to be associated with a dismal overall survival even in the present day. While complete surgical removal of the tumour offers a good chance of cure, only a fraction of the patients are amenable to curative surgery owing to their delayed presentation. Moreover, the current contribution of adjuvant therapies towards prolonging survival is marginal, at best. Thus, understanding the biology of the disease will not only enable a better appreciation of the pathways of progression but also facilitate the development of an accurate genetic model for gallbladder carcinogenesis and dissemination. This review provides an updated, evidence-based model of the pathways of carcinogenesis in gallbladder cancer and its dissemination. The model proposed could serve as the scaffolding for elucidation of the molecular mechanisms involved in gallbladder carcinogenesis. A better understanding of the pathways involved in gallbladder tumorigenesis will serve to identify patients at risk for the cancer (and who thus could be offered prophylactic cholecystectomy) as well as aid oncologists in planning the most suitable treatment for a particular patient, thereby setting us on the vanguard of transforming the current treatment paradigm for gallbladder cancer.