A Report of a Symptomatic Progressive Myeloma during Pregnancy and Postpartum Period from Asymptomatic State

Multiple myeloma is a plasma cell malignancy that is most commonly observed in males in the sixth and seventh decade of life. The clinical scenario of multiple myeloma with concurrent pregnancy is considered to be very rare. We detail here the case of a young female with known IgG kappa multiple myeloma who was found to have a steady elevation of her IgG kappa paraprotein during pregnancy and symptomatic progression in the postpartum period. She delivered a healthy baby at 40 weeks gestation. We present a review of all reported cases of known multiple myeloma progressing during pregnancy and in the postpartum period, the treatments given, and their outcomes. The report also provides suggestions for diagnosis and management of myeloma during pregnancy in order to have an outcome of successful uncomplicated pregnancy with healthy offspring.

Parents and healthcare professionals' attitudes to Kangaroo Care for preterm infants in the UK

AIM

To explore the attitudes of parents and healthcare professionals (HCPs), and facilitators and barrier to implementation of Kangaroo Care (KC) in the UK.

METHODS

Online cross-sectional survey; distributed via the British Association of Perinatal Medicine, Bliss (UK-based charity), social media.

RESULTS

Sixty HCPs responded. 37 (62%) were nurses/nurse practitioners. 57 (95%) regularly implement KC. The most important factor that supported KC implementation was the team's belief in benefits of KC. Increased workload, staff shortage, and fear about safely of KC in unwell infants were recognised as the challenges preventing implementation. 518 parents responded. 421 (81%) had a preterm baby within three years. 338 (80%) were familiar with KC. The main facilitator was the belief that their baby enjoyed it. Excess noise and crowding on the unit were the most frequently reported barriers. Lack of opportunity and limited staff support were the main reasons why they had been unable to practice KC.

CONCLUSION

We found that most HCPs and parents believe that KC is beneficial and would like to practice it. Lack of resources to enable effective implementation is the main barrier. Service development and implementation research is required to ensure that KC is delivered in all UK neonatal units.

Accidental lipid overdose in a preterm infant: A case report

BACKGROUND

Intravenous lipid emulsions (ILEs) provide essential fatty acids during parenteral nutrition (PN). Serious adverse events including death can occur from overdose. We report an accidental overdose in a preterm infant.

METHOD

On Day 2 of life, a 29-week gestational age (GA) twin was accidentally given 47.5 mL of Intralipid20% (≈3x daily amount) in 50-minutes.

RESULTS

No apparent clinical deterioration occurred, although blood samples were lipaemic. Outcomes at 2 years corrected GA were similar to that of his twin. Service changes were made to infusion packaging and administration to avoid similar errors.

CONCLUSIONS

Medication errors in neonates are unfortunately common. Published articles usually focus on poor outcomes, which can increase the distress for parents of children where errors have occurred. Publishing the full spectrum of outcomes instead allows parents and professionals to be aware of all possibilities and lessons learnt, even if serious harm was avoided.

Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptomatology in the aftermath of trauma: a cross-sectional study from Nepal

Introduction

Resilience is a multidimensional construct. Despite being quoted as protective against mental disorders, it remains largely unexplored in our context.

Objectives

We attempted to explore the role of resilience in the development of various psychiatric symptoms as depression, anxiety and post-traumatic stress disorder following trauma in clinical population in a psychiatry outpatient of a university hospital.

Methods

We interviewed one hundred patients who sought treatment in psychiatry outpatient in a university hospital in Kathmandu, Nepal. We collected sociodemographic and trauma related information using semi-structured interview format. Other instruments used were the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of depression and anxiety symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We explored the associations between resilience scores and the scores on depression, anxiety and posttraumatic stress disorder using bivariate and multivariate analysis.

Results

Resilience had negative correlations with depression, anxiety, and post-traumatic stress disorder symptoms after adjusting for other variables such as gender, marital status, employment status, socioeconomic status and trauma types which were observed to have significant association in the bivariate analysis.

Conclusions

There was inverse correlation between resilience scores and depression, anxiety, and post-traumatic stress symptoms. Resilience should be considered in studies involving trauma population.

Disclosure

No significant relationships.

Fluorescence-based characterisation of selected edible insect species: Excitation emission matrix (EEM) and parallel factor (PARAFAC) analysis

Fluorescence spectroscopy coupled with chemometric tools is a powerful analytical method, largely used for rapid food quality and safety evaluations. However, its potential has not yet been explored in the novel food sector. In the present study, excitation emission matrices (EEMs) of 15 insect powders produced by milling insects belonging to 5 Orthoptera species (Acheta domesticus, Gryllus assimilis, Gryllus bimaculatus, Locusta migratoria, Schistocerca gregaria) from 3 different origins were investigated. Parallel factor (PARAFAC) analysis performed on the overall averaged dataset was validated for five components, highlighting the presence of five different fluorescence peaks. The presence of these peaks was confirmed on each species, suggesting that fluorescence compounds of edible insects are the same in several species. PARAFAC analysis performed on the overall averaged dataset after alternatively adding the EEM recorded from one standard compound allowed to speculate that edible insects fluorescence raises from mixtures of: tryptophan + tyrosine (PARAFAC component-1), tryptophan + tyrosine + tocopherol (PARAFAC component-2), collagen + pyridoxine + pterins (PARAFAC component-3). This study suggests that fluorescence spectroscopy may represent a powerful method for investigating composition and quality of insect-based foods.

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Fluorescence landscape of edible insects comprises of 5 different peaks.

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Similar fluorescence compounds are present among several Orthoptera species.

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Fluorescence peaks of edible insects result from several chemical molecules.

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Fluorescence intensity of edible insects depends on their species and origin.

Immunotherapy for Alzheimer's Disease: Current Scenario and Future Perspectives

Alzheimer's disease (AD) is a global health concern owing to its complexity, which often poses a great challenge to the development of therapeutic approaches. No single theory has yet accounted for the various risk factors leading to the pathological and clinical manifestations of dementia-type AD. Therefore, treatment options targeting various molecules involved in the pathogenesis of the disease have been unsuccessful. However, the exploration of various immunotherapeutic avenues revitalizes hope after decades of disappointment. The hallmark of a good immunotherapeutic candidate is not only to remove amyloid plaques but also to slow cognitive decline. In line with this, both active and passive immunotherapy have shown success and limitations. Recent approval of aducanumab for the treatment of AD demonstrates how close passive immunotherapy is to being successful. However, several major bottlenecks still need to be resolved. This review outlines recent successes and challenges in the pursuit of an AD vaccine.

Plateletpheresis donation through donor awareness, motivation, and recruitment drives: A unique concept and experience from a tertiary care oncology centre in India

OBJECTIVES

The majority of blood donor motivational and awareness activities are directed toward whole blood donation and not much emphasis is given to the plateletpheresis. The study was designed to analyze the effectiveness of the unique concept of platelet drives (PD) to increase voluntary plateletpheresis donations.

MATERIALS AND METHODS

The study was a retrospective study conducted at a tertiary care oncology hospital-based blood transfusion services (BTS).

RESULTS

A total of 13 PDs were conducted from January 2016 to December 2020. A total of 559 potential donors came for the donor registration and 125 donors got deferred on medical history. A total of 434 donors gave their samples for the testing of plateletpheresis. The median age of potential male and female donors was 32 and 30 years respectively. A total of 58 males and two females have donated single donor platelets (14.3% vs. 7.4%, P=0.319). The median age of male and female donors was 36 and 42 years, respectively. In male donors, 48 had donated once, seven donated twice, two donated thrice and one donor donated four times. Out of two female donors, one donor donated twice and the other donor donated four times. The female donors were more committed to repeat donations (P=0.004). Since the start of PDs, the number of voluntary donations has increased considerably over the years.

CONCLUSION

PDs have helped in increasing the number of voluntary plateletpheresis donors. All the BTS must have the standard operating procedures in place for these kinds of awareness and motivational drives.

Signature of strong localization and crossover conduction processes in doped ZnO thin films: synergetic effect of doping fraction and dense electronic excitations

Ga_xZn_1-xO thin films with varying Ga fraction within the solubility limit were irradiated with high-energy heavy ions to induce electronic excitations. The films show good transmittance in the visible region and a reduction of about 20% in transmittance was observed for irradiated films at higher ion fluences. The Urbach energy was estimated and showed an augmenting response upon increase in doping fraction and ion irradiation, this divulges an enhancement of localized states in the bandgap or disorder in the films. The evolution of such localized states plays a vital role in charge transport and thus the temperature dependent electrical conductivity of irradiated thin films was studied to elucidate the dominant conduction mechanisms. The detailed analysis unfolds that in the high-temperature regime (180 K <T< 300 K), the charge conduction was dominated by thermally activated band conduction followed by the nearest neighbor hopping (NNH) mechanism. Whereas in the lower temperature regime (25 K <T< 170 K), the conduction mechanism was governed by Mott-VRH (variable range hopping) followed by Efros-Shklovskii (ES)-VRH. A sudden and steep rise in resistivity below 30 K was observed for GZO films with higher doping fraction at higher ion fluence and proclaims the presence of strong localization of carriers.

A study on chemical exfoliation and structural and optical properties of two-dimensional layered titanium diselenide

Titanium diselenide (TiSe₂) is the least studied member of the transition metal dichalcogenide family due to a lack of available synthesis methodology, controlled bandgap engineering, and rapid characterization of layers. In this paper, we report the chemical exfoliation of TiSe₂ platelets synthesized by the chemical vapor transport route in ortho-dichlorobenzene (o-DCB) functionalized with oleylamine (OLA), for the first time to the best of our knowledge. It is found that the addition of OLA supports the formation of a stable dispersion of a large area of the TiSe₂ sheets due to surface capping with the OLA molecules indicating the importance of the ligand in dispersion behavior. The X-ray diffraction pattern confirms the hexagonal structure of the TiSe₂ platelets with the space group P3[combining macron]m1 while Raman spectroscopy reveals that two modes of vibration i.e. A_1g and E_2g exist with layered structures having dimensions in micrometers as confirmed by scanning electron microscopy. Fourier transform infrared spectroscopy confirms the successful functionalization of chemically exfoliated TiSe₂ nanosheets. Field-emission scanning electron microscopy reveals that exfoliated TiSe₂ has a thickness of 15-55 nm whereas high-resolution transmission electron microscopy indicates thicker sheets for ligand-free exfoliated TiSe₂ which are crystalline. Atomic force microscopy confirms the formation of nanosheets. UV-Visible, photoluminescence, and time-resolved PL spectroscopy showed an enhanced effect and better average lifetime of excitation for the exfoliated sheets with OLA than those without OLA. The C-V studies reveal that with increasing scan rate, the corresponding current also increases. The present study offers the possibility of their utilization in optoelectronics, advanced low-power electronics, voltage-controlled oscillators, ultra-fast electronics, and electrochemical devices.

Inactivation efficacy and mechanisms of plasma activated water on bacteria in planktonic state

AIMS

The study aimed to investigate the inactivation efficacy and mechanisms of plasma activated water (PAW) on selected bacteria in planktonic state.

METHODS AND RESULTS

Plasma activated water was generated using an atmospheric cold plasma jet at 15, 22 and 30 kV for 5 min. Escherichia coli, Listeria innocua, Staphylococcus aureus, Aeromonas hydrophila, Pseudomonas fluorescens and Shewanella putrefaciens were selected as the representative bacterial species. Each bacterial suspension was inoculated into PAW immediately after generation, and the viable counts at different exposure times of 0·5, 1, 3, 5 and 24 h during 4°C storage were measured to determine the inactivation efficacy. Scanning electron microscopy images of the bacteria were conducted to examine the structural changes. Physicochemical properties of PAW, including pH, conductivity, oxidation reduction potential (ORP), and reactive species of H₂ O₂ , NO₂ ^- and NO₃ ^- were measured. The results demonstrated that inactivation efficacy was in positive correlation with voltage and exposure time. Gram-negative bacteria were more susceptible to PAW than Gram-positive bacteria. Morphology damage was observed for all the bacterial species. PAW was significantly acidified, conductivity and ORP were significantly increased, and reactive species were detectable after 48 h.

CONCLUSIONS

This study offered a better understanding of the inactivation mechanisms of PAW, and the inactivation efficacy can be affected by voltage, exposure time and bacterial species.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrated the potential usage of PAW as an alternative disinfectant.

Localized Surface Plasmon Resonance Studies on Pd/C Nano-Composite System: Effect of Metal Concentration and Annealing Temperature

The effects of metal concentration and annealing temperature on the localized surface plasmon resonance (LSPR) properties of the Pd nanoparticles (NP) dispersed in carbon were investigated. The Pd/C nano-composite thin films with 7 to 39 atomic % concentration of metal content were deposited using the atom beam co-sputtering techniques and subjected to annealing at temperature varying from 300 °C to 600 °C. The UV-vis spectroscopy studies on as-prepared films displayed a Mie scattering profile, but not well-defined LSPR bands were observed for all the values of Pd concentration. This is attributed to the smaller size (3-4 nm) of Pd NPs and rough Pd/C interface, as confirmed from TEM studies. When samples were annealed at a temperature of 300 °C, three broad LSPR absorption bands in the visible region, along with a sharp peak at 210 nm, were observed and the effect of Pd concentration variation was insignificant on their position. The multiple LSPR bands were observed due to agglomeration NPs, which is consistent with earlier reports and is also observed in the TEM images. When annealing temperature was subsequently increased to 500 °C, a blue shift in the LSPR peak position with an increase in the Pd concentration was observed, which phenomena is attributed to the formation of bigger NPs with the formation of sharp NPs-interface at high temperature upon annealing. A monotonic increase in the magnitude and decrease in the FWHM with an increase in concentration suggested change in the dielectric function of sample due to the growth of NPs. This is further confirmed from XRD studies, where strain relaxation and grain growth were observed. The intensity of the SPR peak decreased with an increase in the annealing temperature. The LSPR peak disappeared on annealing at a temperature of 600 °C, suggesting the formation of continuous polycrystalline thin films of Pd. In summary, NPs size, metalmatrix interface, and concentration of metal play key roles in the tailoring the LSPR properties of the Pd.

Role of Ni substitution on structural, magnetic and electronic properties of epitaxial CoCr2O4 spinel thin films

Cubic spinel CoCr2O4 has recently attained attention due to its multiferroic properties. However, the Co site substitution effect on the structural and magnetic properties has rarely been studied in thin film form. In this work, the structural and magnetic properties of Co1-x Ni x Cr2O4 (x= 0, 0.5) epitaxial thin films deposited on MgAl2O4 (100) and MgO (100) substrates to manipulate the nature of strain in the films using pulsed laser deposition (PLD) technique are presented. The epitaxial nature of the films was manifested through x-ray diffraction (XRD), reciprocal space mapping (RSM) and Rutherford backscattering spectrometry (RBS) measurements. Raman measurements revealed a disappearance of characteristic A 1 g and F 2 g modes of the CoCr2O4 with increase in the Ni content. Atomic force microscopy (AFM) and field emission scanning electron microscopy (FE-SEM) studies show a modification of the surface morphology upon Ni substitution. Magnetic measurements disclose that the ferrimagnetic Curie temperature (T C) of the CoCr2O4 in thin film grown on MgAl2O4 (100) and MgO (100) substrates were found to be 100.6 ± 0.5 K and 93.8 ± 0.2 K, respectively. With Ni substitution the T C values were found to be enhanced to 104.5 ± 0.4 K for MgAl2O4 (100) and 108.5 ± 0.6 K for MgO (100) substrates. X-ray photoelectron spectroscopy (XPS) suggests Cr3+ oxidation states in the films, while Co ions are present in a mixed Co2+/Co3+ oxidation state. The substitution of Ni at Co site significantly modifies the line shape of the core level as well as the valence band. Ni ions are also found to be in a mixed 2+/3+ oxidation state. O 1s core level display asymmetry related to possible defects like oxygen vacancies in the films.

An assessment on crystallization phenomena of Si in Al/a-Si thin films via thermal annealing and ion irradiation

In the present study, crystallization of amorphous-Si (a-Si) in Al/a-Si bilayer thin films under thermal annealing and ion irradiation has been investigated for future solar energy materials applications. In particular, the effect of thickness ratio (e.g. in Al : a-Si, the ratio of the Al and a-Si layer thickness) and temperature during irradiation on crystallization of the Si films has been explored for the first time. Two sets of samples with thickness ratio 1 : 1 (set-A: 50 nm Al/50 nm a-Si) and thickness ratio 1 : 3 (set-B: 50 nm Al/150 nm a-Si) have been prepared on thermally oxidized Si-substrates. In one experiment, thermal annealing of the as-prepared sample (of both the sets) has been done at different temperatures of 100 °C, 200 °C, 300 °C, 400 °C, and 500 °C. Significant crystallization was found to initiate at 200 °C with the help of thermal annealing, which increased further by increasing the temperature. In another experiment, ion irradiation on both sets of samples has been carried out at 100 °C and 200 °C using 100 MeV Ni7+ ions with fluences of 1 × 1012 ions per cm2, 5 × 1012 ions per cm2, 1 × 1013 ions per cm2, and 5 × 1013 ions per cm2. Significant crystallization of Si was observed at a remarkably low temperature of 100 °C under ion irradiation. The samples irradiated at 100 °C show better crystallization than the samples irradiated at 200 °C. The maximum crystallization of a-Si has been observed at a fluence of 1 × 1012 ions per cm2, which was found to decrease with increasing ion fluence at both temperatures (i.e. 100 °C & 200 °C). The crystallization of a-Si is found to be better for set-B samples as compared to set-A samples at all the fluences and irradiation temperatures. The present work is aimed at developing the understanding of the crystallization process, which may have significant advantages for designing crystalline layers at lower temperature using appropriate masks for irradiation at the desired location. The detailed mechanisms behind all the above observations are discussed in this paper.

Crystallization of Ge in ion-irradiated amorphous-Ge/Au thin films

Herein, the structural, optical, and electrical properties of Au-induced crystallization in amorphous germanium (a-Ge) thin films are presented for future solar energy material applications.

Therapeutic potential of benfotiamine and its molecular targets

OBJECTIVE

The water-soluble vitamin, thiamine forms an important part of the diet because of its role in the energy metabolism. The protective effects of thiamine against diabetic vascular complications have been well documented. However, slower absorption and reduced bioavailability is a major limiting factor for its clinical use. To overcome this issue, lipid-soluble derivatives of thiamine (allithiamines) was developed. Among the many synthetic lipophilic derivatives of thiamine, benfotiamine (BFT) is regarded as the first choice based on its safety and clinical efficacy data. BFT facilitates the action of thiamine diphosphate, a cofactor for the enzyme transketolase. The activation of transketolase enzyme accelerates the precursors of advanced glycation end products (AGEs) towards the pentose phosphate pathway thereby reducing the production of AGEs. The reduction in AGEs subsequently decreases metabolic stress which benefits vascular complications seen in diabetes. The effects of BFT on the AGE-dependent pathway is well established. However, several studies have shown that BFT also modulates pathways other than AGE such as arachidonic acid (AA), nuclear transcription Factor κB (NF-κβ), protein kinase B, mitogen-activated protein kinases (MAPK) and vascular endothelial growth factor receptor 2 (VEGFR2) signaling pathways. In the present review, we have comprehensively reviewed all the molecular targets modulated by BFT to provide mechanistic perspective to highlight its pleiotropic effects.

Conversion of clinically isolated syndrome to multiple sclerosis: a prospective multi-center study in Eastern India

Background

In White populations more than 60% of clinically isolated syndrome (CIS) convert to multiple sclerosis (MS) on a long-term follow-up; several predictors for conversion have been identified.

Objective

This study aimed to determine the conversion rate and the predictors of conversion from CIS to MS (McDonald 2010) among Indians. The other objective was to evaluate the diagnostic accuracy of the new McDonald 2017 criteria in prediction of a second clinical attack.

Methods

Clinical and demographic data of CIS cohorts were collected. Baseline investigations included cerebrospinal magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid (CSF) testing for oligoclonal band (OCB). Follow-up clinical and MRI examinations were performed annually for at least 24 months.

Results

Of the 82 subjects (age range 15-58 years), 36 (43.9%) converted to MS; 31/82 (37.8%) converted in 24 months. The predictors for conversion were earlier age of onset, CSF-OCB, cerebral MRI T2 lesion count, and periventricular and juxtacortical location of lesions. Twenty-two (26.83%) CIS fulfilled the McDonald MS 2017 criteria at baseline.

Conclusion

In this first prospective study of CIS in India, the risk factors for conversion are similar but the conversion rate to MS is lower than that in the western nations.

Immunization with subunits of a novel pilus produced by virulent Clostridium perfringens strains confers partial protection against necrotic enteritis in chickens

Necrotic enteritis (NE) is an economically important disease of broiler chickens that is caused primarily by Clostridium perfringens strains that produce the NetB toxin. It is controlled in North America principally through the application of in-feed antimicrobials, but alternative control methods, such as vaccination, are urgently needed. We previously identified a cluster of C. perfringens genes prevalent in disease-causing strains, denominated VR-10B, that is predicted to encode a pilus. The current study evaluated the ability of three predicted pilin structural subunits (CnaA, FimA, FimB) to protect against NE in two immunization studies. In the first study, young broiler chickens were immunized twice intramuscularly (i.m.) with CnaA or FimA, which resulted in only a weak serum antibody response, and no reduction in the severity of intestinal lesions following experimental challenge with C. perfringens strain CP1. In the second study, chickens were injected subcutaneously (s.c.) with CnaA, FimB, or a combination of all three proteins, on days 7, 14 and 19, which resulted in a marked antibody response specific to each antigen. Chickens immunized with either CnaA or FimB had significantly reduced NE lesion severity, whereas immunization with all three proteins in combination did not provide protection. Western blot experiments using serum from immunized birds were also performed, providing the first experimental evidence to suggest that this locus may in fact encode a functional pilus structure.

Plant derived antimicrobial peptide Ib-AMP1 as a potential alternative drug candidate for Staphylococcus aureus toxins

Due to an increase in the occurrence of multi drug resistant microorganisms a need for the development of alternative drugs comes in light. This alternative drug should be such that the microorganisms should not be able to develop resistance against them easily. Antimicrobial peptides are the most potential candidates to be developed as alternative drug. In the present study the three toxins ETA, ETB and PVL of Staphylococcus aureus were docked with four antimicrobial peptides, Ib-AMP1, JCPep7, Snakin2, Sesquin, derived from plants. The docking studies predict that Ib-AMP1 shows significant interactions with all these three toxins. Hence, further studies can be carried out for developing Ib-AMP1 as an alternative drug against the toxins of Staphylococcus aureus.

Efficacy and Stability studies of microbial folate fortified fruit juices prepared using probiotic microorganism

Folate, natural form of water soluble vitamin folic acid, is significant for humans as involved in most important metabolic reactions i.e. nucleotide synthesis and amino acid inter conversions. Thus its deficiency causes neural tube defects in newborns and cardiovascular diseases, and cancers. Humans cannot synthesize folate de novo so consumption through diet is essential. Natural food sources, supplements and fortified food products are the choices available to complete the Daily recommended intake. However microbial fortification using probiotics recently gained wide attention due to dual advantage of natural food matrix with enhanced folate content along with the probiotics benefits. Current study was focused on the microbial fortification of fruit juices and their efficacy and stability studies. Freshly filtered orange and tomato juice was prepared and inoculated with Streptococcus thermophilus NCIM 2904. Incubation was done at 40°C and samples were collected at different time interval. Folate extraction was done using human plasma and content was measured by microbiological assay using Lactobacillus casei NCIM No. 2364. Efficacy and stability studies were carried out to ensure the quality of juices to be consumed in terms of folate content, viable cell count and pH after 4 weeks of storage at low temperature. Positive results were observed as folate content was quite stable whereas viable cell count was also found to be significant till some time without adding any preservatives. The results indicated that fortified fruit juices could be used as probiotic beverages with enhanced folate content.

Beneficial effects of phytochemicals in diabetic retinopathy: experimental and clinical evidence

Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus and a major preventable cause of blindness. Strict control of blood glucose, blood pressure, and lipid profiles are the pivotal criteria to reduce the risk of developing DR. Although timely intervention with laser photocoagulation therapy could mitigate the progression of DR, it may not significantly improve visual acuity. Therefore, invasive surgical interventions such as vitrectomy are sometimes the only option to treat or manage advanced stages of DR. However, the risk of intra-ocular infections outweighs the benefits of the surgery. Newer therapies such as intraocular injection of anti-vascular endothelial growth factor (VEGF) antibody and steroids serve as a viable option for the treatment of DR. However, several clinical studies that assessed the long-term efficacy and safety of this therapy have yielded inconclusive results. Therefore, there is an urgent need to develop potent and safe drugs for the effective management of DR. In this review, we discuss various plant-derived small molecules (phytochemicals) that have been investigated for retinal cytoprotective effects in pre-clinical and clinical studies. Furthermore, we highlight the caveats on using phytochemicals for the management of DR.

Phytocannabinoids for Cancer Therapeutics: Recent Updates and Future Prospects

Phytocannabinoids (pCBs) are lipid-soluble phytochemicals present in the plant, Cannabis sativa L. and non-cannabis plants which have a long history in recreation and traditional medicine. The plant and the constituents isolated were central in the discovery of the endocannabinoid system (ECS), the most new target for drug discovery. The ECS includes two G-protein-coupled receptors; the cannabinoid receptors-1 and -2 (CB1 and CB2) for marijuana's psychoactive principle Δ(9)-tetrahydrocannabinol (Δ(9)-THC), their endogenous small lipid ligands; namely anandamide (AEA) and 2-arachidonoylglycerol (2-AG), also known as endocannabinoids and the enzymes for endocannabinoid biosynthesis and degradation such as fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL). The ECS has been suggested as a pro-homeostatic and pleiotropic signaling system activated in a time- and tissue-specific way during pathological conditions including cancer. Targeting the CB1 receptors becomes a concern because of adverse psychotropic reactions. Hence, targeting the CB2 receptors or the endocannabinoid metabolizing enzymes by pCBs obtained from plants lacking psychotropic adverse reactions has garnered interest in drug discovery. These pCBs derived from plants appear safe and effective with a wider access and availability. In the recent years, several pCBs derived other than non-cannabinoid plants have been reported to bind to and functionally interact with cannabinoid receptors and appear promising candidate for drug development including cancer therapeutics. Several of them also targets the endocannabinoid metabolizing enzymes that control endocannabinoid levels. In this article, we summarize and critically discuss the updates and future prospects of the pCBs as novel and promising candidates for cancer therapeutics.

Electronic structure modification and Fermi level shifting in niobium-doped anatase titanium dioxide thin films: a comparative study of NEXAFS, work function and stiffening of phonons

The electronic structure and tuning of work function (WF) by electronic excitations (EEs) induced by swift heavy ions (SHIs) in anatase niobium-doped titanium dioxide (NTO) thin films is reported.

Enhanced surface and interface diffusion in Ni–Bi bilayers by swift heavy ion irradiation

Enhanced surface and interface diffusion in Ni–Bi bilayers has been observed using 100 MeV Au ion irradiation. The experimental observations were demonstrated using thermal spike model calculations.

Geomorphic and geologic controls of geohazards induced by Nepal's 2015 Gorkha earthquake

The Gorkha earthquake (magnitude 7.8) on 25 April 2015 and later aftershocks struck South Asia, killing ~9000 people and damaging a large region. Supported by a large campaign of responsive satellite data acquisitions over the earthquake disaster zone, our team undertook a satellite image survey of the earthquakes' induced geohazards in Nepal and China and an assessment of the geomorphic, tectonic, and lithologic controls on quake-induced landslides. Timely analysis and communication aided response and recovery and informed decision-makers. We mapped 4312 coseismic and postseismic landslides. We also surveyed 491 glacier lakes for earthquake damage but found only nine landslide-impacted lakes and no visible satellite evidence of outbursts. Landslide densities correlate with slope, peak ground acceleration, surface downdrop, and specific metamorphic lithologies and large plutonic intrusions.

A case of gossypiboma mimicking intrahepatic cholangiocarcinoma

INTRODUCTION

A gossypiboma refers to a cotton-based foreign body left inadvertently in the human body following a surgical procedure. Although a rare event, they tend to be found in the abdomen but few are known to be intrahepatic.

CASE HISTORY

We report the case of a 44 year-old man who presented with recurrent episodes of jaundice and cholangitis, on a background of a right hepatectomy for hydatid cyst excision 20 years previously. This case was discussed at our hepatobiliary multidisciplinary team meetings on several occasions and a presumed diagnosis of intrahepatic cholangiocarcinoma was made. Biopsies of the mass had purely shown inflammation and remained inconclusive. It was decided that the patient should undergo a complete extended right hepatectomy with resection and reconstruction of the left branch of the portal vein. On attempting to obtain intraoperative frozen section specimens prior to resection, open excision revealed two large swabs encased in a calcified cavity. Removal of the swabs resulted in resolution of the mass and obstructive symptoms.

CONCLUSIONS

Gossypiboma should be a rare differential diagnosis in all patients following a laparotomy presenting with obstructive symptoms, particularly in countries where strict surgical protocols may not be in place. This case also highlights the need to perform an intraoperative biopsy in any uncertain case of a liver lesion as we have shown that an extensive operation with its increased morbidity can occasionally be avoided.

Cardioprotective effect of lycopene against isoproterenol-induced myocardial infarction in rats

The present study was designed to evaluate the cardioprotective potential of lycopene (LCP) against isoproterenol (ISP)-induced myocardial infarction (MI), by assessing hemodynamic, biochemical and histopathological parameters. Wistar male albino rats were orally administered with LCP (0.5, 1.0 and 1.5 mg/kg) or with vehicle for 30 days, with concurrent subcutaneous injections of ISP (85 mg/kg) on days 28 and 29. ISP significantly (p < 0.05) decreased systolic, diastolic and mean arterial blood pressure (SAP, DAP and MAP, respectively) and heart rate (HR). ISP also decreased contractility (+LVdP/dt), relaxation (-LVdP/dt) and increased left ventricular end-diastolic pressure (LVEDP). In addition to functional impairment, ISP also caused a significant (p < 0.05) decrease in antioxidants, namely, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHPx), glutathione (GSH), cardiac injury marker enzymes, creatine phosphokinase-MB (CK-MB) and lactate dehydrogenase (LDH), as well as induced lipid peroxidation, malonaldialdehyde (MDA) and histopathological alterations in heart. However, pretreatment with LCP significantly (p < 0.05) attenuated ISP-induced cardiac dysfunction as evidenced by improved SAP, DAP, MAP, HR, (±)LVdP/dt and reduced LVEDP. Pretreatment with LCP also significantly (p < 0.05) prevented the depletion of antioxidants (SOD, CAT, GSHPx and GSH), myocyte injury marker enzymes (CK-MB and LDH) and inhibited lipid peroxidation and MDA formation in the heart. Furthermore, reduced necrosis, edema and infiltration of inflammatory cells on histopathological examination also depicted the protective effect of LCP against the deleterious effect of ISP. Based on the results, it is suggested that LCP possesses significant cardioprotective potential and may serve as an adjunct in treatment and prophylaxis of MI.

Effect of varying glucose concentrations during in vitro maturation and embryo culture on efficiency of in vitro embryo production in buffalo

This study was aimed to optimize glucose level at different stages of buffalo in vitro embryo production procedure. Three glucose levels (1.5, 5.6 and 10 mm) along with a control (0 mm) were used at three phases of in vitro fertilisation (IVF) procedure viz. in vitro maturation (IVM), in vitro culture (IVC-I) (12-72 hpi) and IVC-II (72 hpi to 7 dpi). Maturation rate of oocytes was found different under different glucose concentrations, and significantly more number of oocytes reached to MII under 5.6 mm glucose. The glucose levels at each phase (IVM, IVC-I and IVC-II) individually had significant effect on blastocyst rate, and the level used at one phase had significant effect on the outcome of next phase. Complete withdrawal of glucose from any of these stages irrespective of concentrations used at subsequent stage/s resulted in significantly lower number of blastocysts. However, the changing levels of glucose had differential effects during different phases of IVF steps. The most prominent effect of glucose level was observed during IVM. The presence of 5.6 mm glucose at all stages was most effective to yield highest blastocyst rate in buffalo IVF system.

The effect of sirolimus therapy on vaccine responses in transplant recipients

Different immunosuppressant regimens vary in their effects on antibody responses to vaccination. The combination of prednisolone and azathioprine has only a minor effect, whereas the addition of ciclosporin attenuates protective antibody responses to influenza vaccination. The effect of sirolimus, a new immunosuppressant, on vaccine responses has been little studied. Thirty-two hepatic or renal transplant patients randomized to calcineurin inhibitor-based or sirolimus-based immunosuppression were vaccinated against influenza and pneumococcus. Following tri-valent influenza vaccination, a similar rise in antibody titer occurred in sirolimus and calcineurin inhibitor (CNI) treated patients, though sirolimus treated patients developed a 'protective' titer to more influenza antigens. The pneumococcal polysaccharide vaccine was equally effective in both groups. Hence, vaccination guidelines in place for CNI treated patients are likely to be appropriate for transplant recipients maintained on sirolimus.

Evaluation of liver function impairment and lipid peroxidation induced by lantana camara leaf powder administration in adult rat serum and liver

Lantana camara is a common weed and certain medicinal properties have been attributed to this plant, but most varieties of this plant are reported to be highly toxic to animals. The plant is a native of America but a few varieties are indigenous to tropical Asia and Africa. The present investigation was done to study the hepatotoxic and lipid peroxidative effects of this noxious weed on female Wistar rats. Eighty four percent (84%) increase was observed in the activity of AST in group B and 120% increase was noted in group C in serum. In, liver tissue this increase was 66% and 258%. In the case of ALT, 165% increase was observed in group B and 219% increase was observed in group C in serum. In, liver there was 46% increase in group B and 216% increase in group C in the ALT activity. Similarly, 30% and 50% increase in group B and 120% and 300% increase in group C in the activity of ALP was observed with respect to control group. The overall protein concentration was increased in serum and decreased in liver tissue. Lipid peroxidation in liver tissue was inhibited by 22% in group B and 55% in group C. Thus Lantana camara is a toxic plant which produces severe hepatotoxicity in rats, but it also prevented lipid peroxidation that may suggest that Lantana camara may be acting as antioxidant but, exactly which of its component is responsible for this activity is not known and needs future investigations.

Completely isolated, noncontiguous duplication cyst

Enteric duplication cysts are hollow, epithelium-lined, cystic, or tubular structures that are intimately attached to a portion of the gastrointestinal tract. Completely isolated duplication cysts are an extremely rare variety of gastrointestinal duplications with their own exclusive blood supply. Only two such previous cases have been reported in the literature so far. We report a third case of completely isolated, giant duplication cyst with a vascular pedicle in a four-day-old neonate with a review of the literature.