A Computational Study of Tissue Plasminogen Activator (Tpa) and Vanillylamine for Treatment of Heart Stroke

When blood cannot flow to the brain, a stroke occurs. A blockage or burst blood vessel inside the brain is a common culprit for this disturbance in blood flow because they both limit oxygen to the brain tissue. If this happens, the brain's oxygen-starved cells begin to die quickly, so it's important to get medical attention at once for the patient's chances of recovery. The major objective of this study is to investigate potent thrombolytics from natural sources that are used to treat stroke. Natural sources have been found to exhibit thrombolytic action, with active molecules also extracted and described. The ligand strength was confirmed in the present work using the binding energy, which is based on computer-aided molecular modeling. Vanillylamine exhibited a stronger docking score and had greater thrombolytic potency than other drugs. The main objective of this study is to find an effective treatment for heart attacks. The protein and ligand combination had an affinity of -5.40 kcal/mol, which further suggests that it may be employed in future studies to create a potential inhibitor against stroke.

Magnetocardiography as a noninvasive diagnostic strategy for suspected coronary microvascular dysfunction

Background

Coronary microvascular dysfunction (CMD) is increasingly recognized as an independent predictor of mortality with a 4-fold higher risk. However current diagnostic modalities are limited by the need for an invasive procedure, access, cost, and exposure of ionizing radiation.

Purpose

To investigate the ability of magnetocardiography (MCG) to identify CMD in patients with suspected ischemia and no obstructive coronary artery disease (INOCA).

Methods

This is an observational, prospective pilot study of patients scheduled for coronary functional angiography (CFA), gold standard for evaluation for CMD (defined as coronary flow reserve (CFR) ≤2). 13 patients underwent both CFA and a noninvasive 36-channel MCG scan. A machine learning model was developed to characterize the presence of CMD in these patients against age matched controls (AMCs). The model consists of a logistic regression classifier which takes features representing the relative strengths of the “characteristic dipoles” of the MCG scan as input. The characteristic dipoles are parameterizations of the three strongest magnetic field map components resulting from a singular value decomposition of the MCG signal. A total of 37 patients were included in this analysis including 13 patients who completed CFA (7 had CMD and 6 had CFR >2 and included in the AMCs group). An additional 24 asymptomatic, healthy patients that did not undergo CFR were also included in the AMC group.

Results

The mean age for AMCs was 57 years (70% women) and mean age for CMD patients was 54 years (100% women). The performance of the model was evaluated using repeated stratified cross-validation with 5 folds and 3 repeats, resulting in 15 different 80%/20% train/test splits. Figure 1 shows the distribution of samples belonging to the CMD and AMC groups in a 2-dimensional representation of the feature space. The clear separation of the two groups and the clustering of the AMCs demonstrates the ability of the model to identify patients with CMD. We found that MCG had a mean accuracy of 94.8% (±6.4%), sensitivity of 100% (±0.0%) and specificity of 93.3% (±8.2%) for the detection of CMD using gold standard CFR ≤2 as reference.

Conclusion(s)

First study to show that MCG can be used with 94.8% accuracy to identify CMD among patients suspicious for INOCA with no exposure to ionization, 90 seconds of scan time and minimal cost. The use of this noninvasive modality to identify CMD warrants further investigation.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Genetesis

A unique approach to screen for blood donors lacking high-prevalence antigen Inb of the Indian blood group system

The In^b antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-In^b in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for In^b and to include individuals found to be In(b-) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for In^b because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for In^a, and samples typed as In(a+) were then tested both serologically and molecularly for In^a and In^b to find homozygous IN*01/01 [i.e., the predicted In(b-) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b-), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b-) phenotype.

The In^b antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-In^b in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for In^b and to include individuals found to be In(b–) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for In^b because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for In^a, and samples typed as In(a+) were then tested both serologically and molecularly for In^a and In^b to find homozygous IN*01/01 [i.e., the predicted In(b–) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b–), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b–) phenotype.

Developmental delay among children under two years of age in slums of Burdwan Municipality: A cross-sectional study

Context:

Development is an ongoing process through which an individual acquires competence to function adequately. Developmental delay is said to occur when a child fails to reach the age-appropriate anticipated milestones. This imparts long-term direct as well as indirect effects on the health of a community obviating routine measurement of its prevalence especially in high-risk populations.

Aim:

To find out the prevalence and correlates of developmental delay among children under two years of age in slums of Burdwan Municipality, West Bengal.

Settings and Design:

A community-based descriptive cross-sectional study.

Methods and Materials:

This study was conducted between September-November 2019 among 240 study subjects selected by multistage simple random sampling. Data were collected by interviewing the respondents using a predesigned, pretested schedule. Developmental status was assessed by applying Trivandrum Developmental Screening Chart (TDSC). Chi-square test and logistic regression was done to find associations.

Results:

Prevalence of developmental delay was 6.6%(95%CI 3.6-9.8) and proportion was more among male infants. Chi square test revealed gender (p = 0.03), mothers' education (p = 0.00), socio-economic status (p = 0.00), parity (p = 0.02), birth spacing (p = 0.01) birth weight (p = 0.00) to be significantly associated with developmental delay and multivariable analysis showed all the factors to be significant predictors except gender, parity and birth spacing. Gestational duration, maternal age at delivery, mode of delivery was not found to be significantly associated with developmental delay.

Conclusion:

Developmental delay is considerably high in the study area. A larger study using appropriate tool and follow-up may elicit the burden and associated determinants.

Prevalence of Intestinal Parasitosis among Under-Five Children in a Rural Community of Purba Bardhaman District, West Bengal

Context:

Intestinal parasitosis (IP), a group of diseases caused by one or more species of protozoa and helminths, is still considered a neglected tropical disease and a public health concern in India. Poor sanitation and unhygienic conditions largely contribute to sustained transmission, primarily among children, adversely affecting health and development. The problem needs area-specific assessment and interventions.

Aims:

The present study aimed at determining the prevalence of IP and its correlates among under-five children in a rural community of Purba Bardhaman district, West Bengal, India.

Settings and Design:

A descriptive cross-sectional study was conducted in Bhatar Block of Purba Bardhaman district.

Subjects and Methods:

Mothers/caregivers of 294 under-five children (selected through multistage sampling) were interviewed for background characteristics at the household level, and stool samples from each child were collected, transported, and examined for ova/parasite/cysts following standard guidelines.

Statistical Analysis Used:

Statistical analysis of the data obtained was done using SPSS (V20).

Results:

The overall prevalence of IP was 17.0%. Majority of the intestinal parasites were protozoa (42, 84%), of which the most common was Giardia lamblia (24, 48.0%). Age of the child and practice of defecation showed a significant association with IP on logistic regression.

Conclusions:

Protozoa, mainly G. lamblia, contributes for majority of intestinal parasitic infections among the study population, and children belonging to the age group of 25–60 completed months and with open-field defecation practice have higher risk of acquiring them.

Nutritional status of adult Tuberculosis patients in Burdwan municipality area of West Bengal

Background: Nutritional status of a Tuberculosis (TB) patient plays a role in disease manifestation.  Aims & Objective: To assess the nutritional status of adult tuberculosis patients under intensive phase of treatment. Settings and Design: A descriptive study with cross-sectional design was conducted at Burdwan Municipality of West Bengal. Methods and Material: In this study, TB patients aged 18 years and above receiving intensive phase of treatment, registered in the Tuberculosis units in the months of October-December, 2018 and residing in the municipality were approached. Nutritional status was evaluated through two approaches - dietary intake by twenty-four hours recall method and anthropometric status by measuring weight, height, BMI and MUAC. Data were analysed using SPSS v20. Results: Out of 113 study subjects, under-nutrition was present in 61.9% and inappropriate MUAC was observed in 68.1%. Interestingly, intake of Cereals and Millets among food groups was found to be deficient. The adjusted odds ratio for having under-nutrition among new cases compared to previously treated was 0.16 (0.33-0.82). Conclusions: For combating protein energy malnutrition in TB patients, emphasis should be given on balanced diet intake.

In vitro biocontrol activity of halotolerant Streptomyces aureofaciens K20: A potent antagonist against Macrophomina phaseolina (Tassi) Goid

A halotolerant actinobacterial strain isolated from salinity affected soil of Eastern Indo-Gangetic plains (IGP), Uttar Pradesh, India, was characterised for its antagonistic potential against Macrophomina phaseolina by dual-culture assay. It was shown to effectively inhibit the growth of M. phaseolina with an inhibition zone of 27 ± 1.33 mm. Further the actinobacterial strain was evaluated for its plant growth promoting (PGP) properties and its ability to produce biocontrol related extracellular enzymes viz. amylase, protease, cellulase, chitinase, gelatinase and urease. The results revealed that the actinobacterial strain had PGP potential along with positive assay for amylase, chitinase and urease. The interaction study between antagonist strain and fungal pathogen, performed by scanning electron microscopy technique revealed that the actinobacterium was able to damage fungal mycelia may be due to chitinase, establishing its role as a potential antagonist against M. phaseolina. The actinobacterial isolate was characterised by 16S rDNA gene sequencing, and was identified as Streptomyces genera. The identified gene sequence was deposited to NCBI GenBank with an accession number KP331758.

Seroprevalence of transfusion transmissible infections among blood donors at the blood bank of a Medical College of Kolkata

Seroprevalence of transfusion transmissible infections (TTIs) among blood donors can be used to monitor the prevalence among apparently healthy adult population. The present study was conducted to determine the profile of blood donors and seroprevalence of TTI among them. Retrospective analysis of the donors of a blood bank attached with a tertiary care hospital of Kolkata in 2011 was carried out. Data were analyzed with SPSS version 17. Majority (85%) of the donors were male, two-third in the age group of 21-40 years. Among the donors 2.79% were positive for any of the screened TTIs. Seroprevalence was highest for hepatitis B (1.41%) followed by human immunodeficiency virus (0.60%) and hepatitis C (0.59%) and least for syphilis (0.23%). Seropositivity increased with age up to 50 years. There was no significant difference in seropositivity between male and female. Highly sensitive donor screening and public awareness program can make transfusion of blood products safe.

Burden of hospitalized pediatric morbidity and utilization of beds in a tertiary care hospital of kolkata, India

BACKGROUND

Childhood morbidity consumes a substantial portion of health care resources in terms of hospital bed utilization, and overload in hospital ward remains a major concern in many countries, including India. A possible way to minimize the problem of scarcities of bed is to analyze the pattern of bed utilization by causes and plan services accordingly.

OBJECTIVES

To determine the burden of pediatric morbidity and utilization pattern of pediatric beds in a tertiary care hospital.

MATERIALS AND METHODS

A retrospective analysis of pediatric inpatient's records was conducted over a period of 1 year from 1 January 2007 to 31 December 2007.

RESULTS

Of 3983 total admitted cases, about one-third were infants, of which neonatal and post-neonatal age group constituted 45% and 55% of the cases, respectively. In terms of bed-day utilization, infants, 1-4 years and 5-11 years age group accounted for 35.10%, 32.58% and 32.32% of total days of admission, respectively. Utilization of pediatric beds by major causes of morbidity was respiratory tract infection (22.23%), convulsive disorder (12.68%), accident and poisoning (6.07%), diarrheal disease (4.97%) and chronic hemolytic anemia (4.42%).

CONCLUSION

A minor change in admission policy through provision of day care unit for management of certain cases would allow efficient use of hospital beds.

An epidemiological investigation of mumps outbreak in a slum of Kolkata

An unexpected clustering of mumps cases were reported in a slum of Kolkata during early part of 2009. An epidemiological investigation was initiated with a view to assess the characteristics and determinants of the disease, and implications of such clustering of cases in a slum of Kolkata. Data were collected through house to house visit using predesigned schedule and epidemiological case sheet. The propagated outbreak existed for fifteen weeks yielding 104 clinical cases. On the whole, attack rate was 4.7%, the highest and lowest being in 6-10 years (11.68%) and above 15 years (0.94%), respectively. The parotid swelling was bilateral in 92.3% of cases; fever was the most common general symptom, reportedly present in 92.3% of study subjects. The overall mean duration of parotid swelling was 6.85 +/- 1.89 days. Morbidity from mumps far exceeds the mortality rate. Improved ventilation of living rooms, personal & oral hygiene; isolation of cases, upgradation of routine immunization, better nutrition etc. were recommended at family & community level and introduction of MMR vaccine in National Immunization Schedule was suggested.

Awareness and perception of mothers about functioning and different services of ICDS in two districts of West Bengal

Integrated Child Development Services, a national programme of the Government of India has health, nutrition, and pre-school education components of services. To ascertain awareness, perception of mothers about functioning and different services of ICDS a cross-sectional community based study was conducted between June to September 2007 in Howrah and Purulia districts of West Bengal. A total of 1235 mothers were included as study subjects. As per opinion of the mothers 73% AWCs opened regularly, behaviour of the AWWs was friendly (71.6%) and 63% mothers opined that ICDS is beneficial to their children. 84.2% mothers were aware of any ICDS services. Quantity and quality of supplementary food was acceptable to 88% and 72.7% mothers respectively. 79.2% and 87.5% mothers did not receive any advice on child feeding and growth chart. Making beneficiaries aware about services by targeted interventions will ensure better utilization of ICDS.

Profile of postmortem cases conducted at a morgue of a tertiary care hospital in Kolkata

A record based cross-sectional study of postmortems performed at the mortuary attached to the forensic medicine and toxicology department of RG Kar Medical College and Hospital from March 2008 to February 2009 comprising 1900 cases was conducted to determine the sociodemographic profile and to assess the nature and cause of such deaths. Bodies of 5 foetuses were decomposed which were excluded from the study. Out of a total of 1895 postmortems analysed, 23 autopsies were performed of limbs where the subjects were alive. Out of 1872 cases in 325 (17.4%) the manner of death was natural, whereas in 1547 cases (82.6%) it was unnatural. Accidents, suicides, homicides and undetermined deaths were 63.1%, 29.8%, 2.8% and 4.3% respectively. Among the natural deaths, evidence of pulmonary tuberculosis and coronary heart disease was found in 141 (43.4%) and 124 (38.2%) cases respectively. Burn injuries (22.6%) were the most common cause of unnatural deaths and occurred in 77.4% females. Rail track injuries and road traffic injuries were responsible for 21.9% and 14% of unnatural deaths. Hanging, poisoning and self-immolation were responsible for 48.4%, 28.9% and 19.7% of suicidal deaths respectively.

Validity of mid arm circumference to detect protein energy malnutrition among 8-11 months old infants in a rural medical college of West Bengal

This institution-based cross-sectional observational validation study was conducted in the immunisation clinic of North Bengal Medical College and Hospital, Sushrutanagar. The objective was to identify the validity characteristics of mid arm circumference to detect protein energy malnutrition among 8-11 months infants and to find out a suitable cut-off value if any. Study variables were age, sex, body weight and mid arm circumference. Mid arm circumference was validated against weight for age criteria (gold standard) of malnutrition. The mean mid arm circumference of the infants was found to be almost constant with only about 2.22% change over 4 months, signifying that single cut-off point can be used to detect protein energy malnutrition. Mid arm circumference values from 13.0 to 12.5 cm were found to have the highest accuracy to detect protein energy malnutrition (about 86%). The cut-off values of 12.5 and 12.6 cm were noted to have a sensitivity and specificity of about 52% and 96% respectively, a false negativity of 48% but a false positivity of only 4%. Receiver operating characteristics curve detected 12.5(12.6) cm as the best diagnostic cut-off point which can detect more than 50% of the malnourished babies with very little false positivity/misdiagnosis (only 4%). A simple measuring tape with some reorientation of the health workers can detect the beginning of childhood malnutrition.

A follow up study on revised national tuberculosis control programme (rntcp): results from a single centre study

OBJECTIVE

To know the follow up status of tuberculosis patients after 1 year of completion of treatment in RNTCP. MATERIALS #ENTITYSTARTX00026;

METHODS

Those patients of tuberculosis, who were registered from June 2003 to June 2004 at DOTS centre of our institution, were followed up at their homes after one year of completion of treatment between August 2005 and August 2006, with the help of health visitor. Patients were followed up clinically and symptomatic patients were also followed radiologically as well as bacteriologicalty. Results of the study were recorded in terms of number of patients remained asymptomatic, number of patients relapsed and number of patients died.

RESULTS

Out of 237 patients registered, 8 patients died during treatment period, 12 patients defaulted the treatment, the number of failures was 5 and 212 patients were declared cured/treatment completed. Out of these 212 patients 60 were unavailable for interview due to various reasons. The study observed that out of a total of 152 patients interviewed, 137 patients (90.1%) of remained asymptomatic, 11 patients (7.2%) had relapsed and 4 patients (2.6%) died during follow up.

CONCLUSION

The study observed that majority of patients (90.1%) re-mained asymptomatic after the completion of one year of treatment under DOTS.

Assessment of changes in gait parameters and vertical ground reaction forces after total hip arthroplasty

The principal objectives of arthroplasty are relief of pain and enhancement of range of motion. Currently, postoperative pain and functional capacity are assessed largely on the basis of subjective evaluation scores. Because of the lack of control inherent in this method it is often difficult to interpret data presented by different observers in the critical evaluation of surgical method, new components and modes of rehabilitation. Gait analysis is a rapid, simple and reliable method to assess functional outcome. This study was undertaken in an effort to evaluate the gait characteristics of patients who underwent arthroplasty, using an Ultraflex gait analyzer.

MATERIALS AND METHODS

The study was based on the assessment of gait and weight-bearing pattern of both hips in patients who underwent total hip replacement and its comparison with an age and sex-matched control group. Twenty subjects of total arthroplasty group having unilateral involvement, operated by posterior approach at our institution with a minimum six-month postoperative period were selected. Control group was age and sex-matched, randomly selected from the general population. Gait analysis was done using Ultraflex gait analyzer. Gait parameters and vertical ground reaction forces assessment was done by measuring the gait cycle properties, step time parameters and VGRF variables. Data of affected limb was compared with unaffected limb as well as control group to assess the weight-bearing pattern. Statistical analysis was done by't' test.

RESULTS

Frequency is reduced and gait cycle duration increased in total arthroplasty group as compared with control. Step time parameters including Step time, Stance time and Single support time are significantly reduced (P value <.05) while Double support time and Single swing time are significantly increased (P value <.05) in the THR group. Forces over each sensor are increased more on the unaffected limb of the THR group as compared to the control group. Vertical ground reaction force variables are also altered.

CONCLUSION

Significant changes (P value <.05) in gait parameters and vertical ground reaction forces show that gait pattern is not normalized after THR and weight-bearing is not equally shared by both hips. Patient walks with residual antalgic gait even after surgery, which results in abnormal loading around hip joints and the integrity of the prosthesis fixation could be compromised.

Oxetane Locked Thymidine in the Dickerson-Drew Dodecamer Causes Local Base Pairing Distortions—An NMR Structure and Hydration Study

The introduction of a North-type sugar conformation constrained oxetane T block, 1-(1',3'-O-anhydro-beta-D-psicofuranosyl) thymine, at the T(7) position of the self-complementary Dickerson-Drew dodecamer, d[(5'-C(1)G(2)C(3)G(4)A(5)A(6)T(7)T(8)C(9)G(10)C(11)G(12)-3')](2), considerably perturbs the conformation of the four central base pairs, reducing the stability of the structure. UV spectroscopy and 1D NMR display a drop in melting temperature of approximately 10 degrees C per modification for the T(7) oxetane modified duplex, where the T(7) block has been introduced in both strands, compared to the native Dickerson-Drew dodecamer. The three dimensional structure has been determined by NMR spectroscopy and has subsequently been compared with the results of 2.4 ns MD simulations of the native and the T(7) oxetane modified duplexes. The modified T(7) residue is found to maintain its constrained sugar- and the related glycosyl torsion conformations in the duplex, resulting in staggered and stretched T(7).A(6) and A(6).T(7) non-linear base pairs. The stacking is less perturbed, but there is an increased roll between the two central residues compared to the native counterpart, which is compensated by tilts of the neighboring base steps. The one dimensional melting profile of base protons of the T(7) and T(8) residues reveals that the introduction of the North-type sugar constrained thymine destabilizes the core of the modified duplex, promoting melting to start simultaneously from the center as well as from the ends. Temperature dependent hydration studies by NMR demonstrate that the central T(7).A(6)/A(6).T(7) base pairs of the T(7) oxetane modified Dickerson-Drew dodecamer have at least one order of magnitude higher water exchange rates (correlated to the opening rate of the base pair) than the corresponding base pairs in the native duplex.

Iodine deficiency disorders among school children of Dakshin Dinajpur District, West Bengal

Iodine deficiency disorders (IDD) are major public health problems in India, including West Bengal. Existing programme to control IDD needs to be continuously monitored through recommended methods and indicators. Thus we undertook the study to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Dakshin Dinajpur district, West Bengal. We conducted a community-based, cross-sectional study in 2004; among 2250 school children, aged 8-10 years. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were used for the study. Goitre was assessed by standard palpation technique, UIE was analyzed by wet digestion method and salt samples were tested by spot iodine testing kit. Of the 2250 children, 419 (18.6%) had goitre (95% CI = 17.0 - 20.2%). Total goitre rate (TGR) was not significantly different in respect of gender, age and religion. Visible goitre rate was 2.5%. Median urinary iodine excretion level was 16 mcg/dL (normal: > or = 10 mcg/dl.) and 16.5% children had value less than 5 mcg/dL. Only 67.4% of the salt samples tested had adequate iodine content of > or = 15 ppm, with significant difference between Hindus and Muslims (chi2 = 12.68, d.f. = 1, p < 0.01). TGR of 18.6% indicate the district is still endemic for IDD, but median urinary iodine within normal range reflects no current iodine deficiency. The district is in the transition phase from iodine-deficient to iodine-sufficient. Measures are to be sustained for successful transition towards elimination.

Leigh's syndrome

A 15-month-old female child presented with sudden onset cough and hyperventilation along with evidence of metabolic acidosis. She had past history of recurrent vomiting, episodes of abnormal posturing, difficulty in deglutition and regression of milestones since 12 months of age. CT scan of the brain revealed hypodense lesions in bilateral basal ganglia and on MRI there were T2 hyperintensities in bilateral lentiform nuclei, caudate nuclei, thalamus, red nuclei and dentate nuclei. Biochemical examination revealed persistently elevated serum lactate levels with high lactate/pyruvate ratio. Resuscitative measures were of no avail and the child succumbed to the illness on the second day of admission. Neuropathological examination at autopsy demonstrated marked spongiosis, focal necrosis, endothelial proliferation, reactive astrogliosis and extensive demyelination involving bilateral basal ganglia, midbrain and spinal cord which were typical of Leigh's sub acute necrotizing encephalomyelopathy.

Activation of tumor-associated macrophages by thymosin alpha 1

It was shown earlier that the progressive growth of a transplantable T-cell lymphoma of spontaneous origin, designated as Dalton's lymphoma (DL), in a murine host is associated with an inhibition of macrophages (TAM) along with an involution of thymus. However, it remained unclear if a decline in the level of thymic peptides in DL-bearing host, due to thymic regression, has any implications in the inhibited responses of TAM. Therefore, the present investigation was under taken to study whether the TAM of DL-bearing host can be activated to tumoricidal state by peptides of thymic origin. It was observed that intraperitoneal administration of thymosin alpha 1 to DL-bearing mice resulted in activation of TAM. Such TAM were found to produce enhanced amount of interleukin-1 (IL-1), tumor necrosis factor (TNF), reactive oxygen intermediates (ROI), nitric oxide (NO) and showed an increased abilities of pinocytosis, phagocytosis, antigen presentation and tumor cytotoxicity. The TAM were found to be directly responsive to thymosin alpha1 as in vitro treatment with thymosin alpha 1 could activate TAM to tumoricidal state. Treatment of TAM with thymosin alpha 1 also enhanced their LPS responsiveness for an augmented state of activation. The findings of this study demonstrate for the first time that the TAM of a T cell lymphoma can be activated to tumoricidal state by thymosin alpha 1.

P.C. Sen Memorial best paper award on rural health practice: A study on visual acuity and vitamin A deficiency among primary school students in Naxalbari Village, Darjeeling district of West Bengal

331 primary school students studying from Nursery classes to Class IV in 2 randomly selected schools in Naxalbari Village in Darjeeling district of West Bengal were tested for visual acuity (VA), Vitamin A deficiency (VAD) and Bitot's spot. 329 students could be tested for visual acuity whereas all 331 students were tested for VAD and Bitot's spot. The prevalence of abnormal Visual Acuity (VA) (VA < 6/9 in any eye) in this study group was 3.65% and it was highest in 7-8 years age group in both the sexes contributing to 75% of the total students having abnormal VA. All these children fell within 50th percentile of weight and height for their respective age and sex. Hindu & ST children accounted for 91.67% & 50% abnormal VA respectively; however, when presence of abnormal VA was compared with its absence between 2 sexes, Hindu and Muslim students and in different castes, no statistically significant differences were found (p > .05). Students of Class-I and Class-II contributed 25% and 50% respectively and together accounted for 75% of abnormal VA. Prevalence of VAD was 8.16%. Among sufferers of VAD Hindus (81.48%) and ST (51.85%) were the main contributors; the differences between presence and absence of VAD in 2 sexes, among 3 religious groups were not statistically significant (p > .05); however, differences among ST and NonSCST groups, and again SC, ST and Non-SCST groups were statistically significant (p < .05). Prevalence of Bitot's spot was 3.63%. Among the students having Bitot's spot, females (58.33%) outnumber the males (41.67%); but the difference between presence and absence of Bitot's spot in 2 sexes was not statistically significant (p > .05). 83.33% each of Hindus and STs had Bitot's spot. No SC and no Muslim student had this spot; the differences between presence and absence of Bitot's spot between Hindu and Christian students were statistically significant (p < .01); similarly when the findings were considered between ST and NonSCST students the difference was found to be statistically highly significant (p < .001).

Effect of H1 Antagonists on the Progressive Growth of T Cell Lymphoma

The present investigation was undertaken to study the effect of H1 antihistaminic drugs: Chloropheniramine maleate (CPM) and Fexofenadine hydrochloride (Fx) on the progressive growth of a murine transplantable T cell lymphoma of spontaneous origin, designated as Dalton's Lymphoma (DL), and on the immune responses of the DL-bearing host. Administration of CPM and Fx to DL-bearing mice resulted in an augmentation of DL growth with an increase in the tumor cell count in Dl-bearing mice. Further, it was observed that there was a direct influence of the two drugs on DL cell proliferation. CPM and Fx augmented DL cell proliferation 1.4 and 1.5 folds, respectively. In vitro administration of CPM and Fx resulted in an increase in the count of splenocytes whereas that of thymocytes and bone marrow cells remained unchanged. However, splenocytes and thymocytes obtained from CPM and Fx administered mice showed an enhanced in vivo proliferation. CPM and Fx were found to enhance production of IL-1 by macrophages in the presence of LPS, which could be an additional indirect mode of the action of CPM and Fx on DL cell growth. These results may have clinical significance for patients-bearing lymphoma if undergoing treatment with CPM and Fx.

Effect of thymosin-alpha1 on the production of nitric oxide by tumor-associated macrophages

The present investigation was conducted to study the effect of thymic peptide: thymosinalpha1 (thyalpha1) on the activation of tumor associated mphi (TAM) obtained from mice bearing a transplantable T cell lymphoma of spontaneous origin designated as Dalton's lymphoma, to produce nitric oxide (NO). It was found that in vivo administration of aqueous thymic extract obtained from thymus of normal mice or thyalpha1 could activate the TAM to produce enhanced amount of NO which was further augmented on in vivo treatment of these TAM by LPS. These observations suggest that thyalpha1 could prime TAM for activation by second signal of LPS. The study also presents evidence that tumor cell elaborate factors that enhance the effect of thyalpha1 on TAM for production of NO. This is the first study to show that thyalpha1 can activate TAM directly even in the absence of LPS, and may, therefore, have clinical significance.

Management of colonic perforation during percutaneous nephrolithotomy in horseshoe kidney

Few cases of colonic injury during percutaneous nephrolithotomy (PCNL) have been reported in orthotopic kidneys and none in horseshoe kidney, and the management protocol has not been standardized. A plain film on postoperative day 1 following PCNL showed contrast medium in the descending colon, leading to the diagnosis of colonic injury in a 53-year-old male patient with horseshoe kidney and multiple bilateral stones. He was asymptomatic and was treated successfully by minimally invasive techniques. An asymptomatic patient with a colonic injury following PCNL can be treated by minimal manipulations. Computed tomography imaging is necessary prior to percutaneous surgery on a horseshoe kidney.

Anticancer drug-induced apoptosis in human monocytic leukemic cell line U937 requires activation of endonuclease(s)

Anticancer agents effect tumor cell killing both in vivo and in vitro through the induction of apoptosis. Endonuclease-mediated internucleosomal DNA fragmentation, the most widely used biochemical marker of apoptosis, has been shown to play a central role in apoptosis in many experimental systems. In the present investigation, we report that activation of endonuclease(s) leading to oligonucleosomal DNA fragmentation is common and an essential event in apoptosis, induced by different anticancer drugs, adriamycin, etoposide and cisplatin. The endonuclease inhibitors aurintricarboxylic acid and zinc ion prevented apoptotic cell death in human monocytic leukemic cell line U937, as documented by DNA fragmentation, morphological and nuclear alterations, and cell viability assay. Additional studies suggest endonuclease(s)-mediated DNA fragmentation may not play a central role in apoptosis in the same cell line in response to other inducers such as heat shock and cells may undergo cell death showing all morphological features of apoptosis even in the absence of DNA fragmentation.

Circumvention of multidrug resistance by a quinoline derivative, MS-209, in multidrug-resistant human small-cell lung cancer cells and its synergistic interaction with cyclosporin A or verapamil

PURPOSE AND METHODS

To develop a clinically useful approach to circumvent P-glycoprotein (P-gp)-mediated multidrug resistance (MDR) in MDR human small-cell lung cancer (SCLC), we examined the ability of a novel quinoline compound, MS-209, to reverse MDR by inhibition of P-gp function in combination with other MDR-reversing drugs using a cytotoxicity assay.

RESULTS

We established MDR human SCLC cells by culture in medium with gradually increasing concentrations of adriamycin (ADM). Compared with the parental human SCLC cells, SBC-3, the MDR variant SBC-3 cells obtained (SBC-3/ADM) were highly resistant to various chemotherapeutic agents due to P-gp expression. MS-209 reversed the resistance to ADM and vincristine (VCR) of SBC-3/ADM and H69/VP cells in a dose-dependent manner. Moreover, MS-209 in combination with cyclosporin A (CsA) or verapamil (VER) synergistically enhanced the antitumor effects of ADM and VCR on SBC-3/ADM cells. MS-209 restored ADM incorporation and this effect was enhanced by CsA and VER, suggesting that these synergistic effects were due to competitive inhibition of P-gp function.

CONCLUSION

MS-209 in combination with CsA or VER might increase the efficacy of these chemotherapeutic agents against MDR human SCLC cells.

Hyperthermia quality assurance guidelines

These Hyperthermia Quality Assurance guidelines are a result of a joint workshop of the Hyperthermia Committee of the American College of Radiology and the Hyperthermia Physics Center, which is the national quality assurance program under Contract No. N01-CM-37512 with the National Cancer Institute. Hyperthermia technology presently lacks the kind of standardization in equipment, treatment procedures, patient monitoring, and treatment documentation available in radiotherapy. Therefore, preventing unacceptable variability in treatment data demands a strong commitment to in-house quality control procedures and to centralized quality assurance reviews in cooperative multi-institutional trials. This paper presents a set of test procedures necessary to ensure proper operation of equipment, suggests a frequency for such tests, and also includes guidelines on quality control procedures to be used during treatment to improve the safety, effectiveness, and reproducibility of hyperthermia treatments. A set of forms are presented to indicate the minimum data, albeit incomplete, that must be collected for acceptable documentation of treatment. These guidelines should be valuable not only to the new entrants in the field but also to those participating in multi-institutional cooperative hyperthermia trials. They have been approved by the Hyperthermia Committees of American College of Radiology, American Society for Therapeutic Radiology and Oncology, Radiation Therapy Oncology Group and the American Association of Physicists in Medicine.

Integrating strategy formulation with organizational culture

Managers, consultants, and management researchers are increasingly realizing the important role of organizational culture in determining the decision‐making patterns and the long‐term success of organizations. A unique characteristic of most continuously successful organizations, according to Peters and Waterman, is that they possess consciously developed recognizable cultures that support innovation and strategic actions.