Critical Evaluation of Lateral Calcaneal Artery Fascio-Cutaneous Flap in Re-Surfacing Posterior Heel Defects: A Review of 24 Cases

Purpose and background

To assess feasibility and functional acceptability of lateral calcaneal artery fascio-cutaneous flap (LCAFCF) in providing cover to posterior heel defects in single stage.

Aims and objectives

To provide stable and sensate cover to small and moderate posterior heel defects.

Materials and methods

This review was conducted in department of Burns & Plastic Surgery of Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana between October 2021 and September 2022 to analyse the clinical outcome of LCAFCF in 24 patients (18 males, 6 females) aged between 20 and 35 years who had chronic dry wounds n = 9, failed primary reconstruction by reverse sural flap n = 1, granulated wounds n = 8, exposed achilles tendons n = 4 and scarred tissue restricting ankle joint movements n = 2 in region of posterior heel following trauma, while riding motor-cycle. Course of lateral calcaneal artery was marked with hand-held doppler. Flap size ranged from 3 to 3.5 cm in width and 5.5-7.5 cm length. The donor sites were split skin grafted. Sutures were removed on 22nd day of surgery. Mean follow up was 13 months.

Results

All flaps survived. Two had partial loss of skin graft and two developed hyperkeratosis on grafted site. Sensations in flap, regain of movements of ankle joint, comfort of walking and driving were acceptable.

Conclusions

LCAFCF is handy, safe and reliable flap for re-surfacing difficult wounds of posterior heel, therefore should be included in surgical armamentarium.

Effects of circadian restricted feeding on parameters of metabolic syndrome among healthy subjects

Experimental studies indicate that energy homeostasis to the circadian clock at the behavioral, physiological, and molecular levels, emphasize that timing of food intake may play a significant role in the development of obesity and central obesity. Therefore, resetting the circadian clock by circadian energy restriction via food intake in the morning or evening, may be used as a new approach for prevention of obesity, metabolic syndrome and related diseases. After ethical clearance and written, informed consent, free living subjects were included if they volunteered to take most of the total daily meals (approximately 2000 Kcal./day) in the evening (4 weeks) or morning (4 weeks). Of 22 adults, half were randomly selected by computer generated numbers to eat in the morning and the other half in the evening, after 8.00 PM. The eating pattern was changed after 4 weeks of intervention and a 4-week washout period, those who ate in the morning were advised to eat in the evening and vice versa. Validated questionnaires were used to assess food intakes, physical activity, and intake of alcohol and tobacco. Physical examination included measurement of body weight, height, and blood pressure (BP) by sphygmomanometer. Data were regularly recorded blindly, in all subjects at start of study and during follow-up. Blood samples were collected after an overnight fast for analysis of blood glucose and Hb1c. Feeding in the evening was associated with significant increase in body weight by 0.80 kg (P < .001), body mass index (BMI) by 0.30 kg/m² (P < .001) and waist circumference by 1.13 cm (P < .05). Feeding the same amount of energy in the morning was not associated with any significant change in weight, BMI or waist circumference (P > .500). Lesser increases in all three variables were associated with AM versus PM feeding (P < .05). Systolic BP slightly increased on PM and decreased on AM feeding, with a difference between the two responses of 1.55 mmHg (P < .05). Fasting blood glucose was lower on AM than on PM feeding (74.86 vs. 77.95 mg/dl, paired t = 4.220, P < .001). Hb1C increased on PM feeding by 0.28 (from 4.45 to 4.73; t = 9.176, P < .001), but decreased on AM feeding by 0.077 (from 4.53 to 4.45; t = -6.859, P < .001). The difference in Hb1C response between AM and PM feeding is also statistically significant (t = -11.599, P < .001). Eating in the evening can predispose to obesity, central obesity and increases in fasting blood glucose and Hb1c that are indicators of the metabolic syndrome. By contrast, eating in the morning can decrease Hb1c and systolic BP, indicating that it may be protective against the metabolic syndrome.

Discerning combining ability loci for divergent environments using chromosome segment substitution lines (CSSLs) in pearl millet

Pearl millet is an important crop for arid and semi-arid regions of the world. Genomic regions associated with combining ability for yield-related traits under irrigated and drought conditions are useful in heterosis breeding programs. Chromosome segment substitution lines (CSSLs) are excellent genetic resources for precise QTL mapping and identifying naturally occurring favorable alleles. In the present study, testcross hybrid populations of 85 CSSLs were evaluated for 15 grain and stover yield-related traits for summer and wet seasons under irrigated control (CN) and moisture stress (MS) conditions. General combining ability (GCA) and specific combining ability (SCA) effects of all these traits were estimated and significant marker loci linked to GCA and SCA of the traits were identified. Heritability of the traits ranged from 53-94% in CN and 63-94% in MS. A total of 40 significant GCA loci and 36 significant SCA loci were identified for 14 different traits. Five QTLs (flowering time, panicle number and panicle yield linked to Xpsmp716 on LG4, flowering time and grain number per panicle with Xpsmp2076 on LG4) simultaneously controlled both GCA and SCA, demonstrating their unique genetic basis and usefulness for hybrid breeding programs. This study for the first time demonstrated the potential of a set of CSSLs for trait mapping in pearl millet. The novel combining ability loci linked with GCA and SCA values of the traits identified in this study may be useful in pearl millet hybrid and population improvement programs using marker-assisted selection (MAS).

Micronutrient formulations for prevention of complications of pregnancy

According to a relatively recent UNICEF report, 15 percent of the infant population of the world is of low birth weight with India accounting for one third of all the world's low-weight newborns. Twenty percent of all low birth weight infants die within a month. This mortality figure is higher in developing countries due to inadequate nutritional intake by pregnant women. Development of a new package of nutrient-rich food based on egg or milk or soy bean proteins, containing multiple micronutrient supplements, available at affordable cost, may protect against morbidity and mortality among pregnant women as well as low birth weight in newborns. These benefits may continue to decrease morbidity and mortality during infancy and childhood and might reduce the risk of chronic diseases in later adult life.

Functional Outcome of Isolated Hoffa Fractures Treated with Cannulated Cancellous Screw

Introduction: Isolated Hoffa fracture is an infrequent injury and little research has been done on this subject. The purpose of this study was to evaluate the functional outcome and complications of surgically managed Hoffa fractures with cannulated cancellous screw.

Materials and Methods: Between 2011 and 2014, eight isolated Hoffa fractures in seven adult patients with mean age 39.8±11.9 years (range 25-60 years) were managed with cannulated cancellous screw of 6.5mm diameter applied in anterior to posterior direction using swashbuckler and medial parapatellar approach for lateral and medial Hoffa fractures respectively. All patients were evaluated using knee evaluation score after two years or longer. Mean follow up was 28±3.8 months (range 24-36 months).

Results: All fractures in the eight patients healed clinicoradiologically by the 16th week with excellent result in 87.5% cases and good in 12.5% cases. By the end of union, the range of motion (ROM) of the knee was 0° to 110° except in two patients. One patient had ROM 10°-100° and other had 15°-90°. Mean knee evaluation score was 87.5±10.4. There was no incidence of non-union, infection or avascular changes in the patients or loss of reduction till final follow up.

Conclusion: Open reduction and fixation with two 6.5 mm cannulated cancellous screws with early mobilization yielded good functional outcome in isolated Hoffa fractures.

Assessment of aerosol optical and micro-physical features retrieved from direct and diffuse solar irradiance measurements from Skyradiometer at a high altitude station at Merak: Assessment of aerosol optical features from Merak

Optical and micro-physical features of aerosol are reported using Skyradiometer (POM-01L, Prede, Japan) observations taken from a high-altitude station Merak, located in north-eastern Ladakh of the western trans-Himalayas region during January 2011 to December 2013. The observed daily mean aerosol optical depth (AOD, at 500 nm) at the site varied from 0.01 to 0.14. However, 75 % of the observed AOD lies below 0.05 during the study period. Seasonal peaks of AOD occurred in spring as 0.06 and minimum in winter as 0.03 which represents the aged background aerosols at the site. Yearly mean AOD at 500 nm is found to be around 0.04 and inter-annual variations of AOD is very small (nearly ±0.01). Angstrom exponent (a) varied seasonally from 0.73 in spring to 1.5 in autumn. About 30 % of the observed a lies below 0.8 which are the indicative for the presence of coarse-mode aerosols at the site. The station exhibits absorbing aerosol features which prominently occurred during spring and that may be attributed by the transported anthropogenic aerosol from Indo-Gangatic Plain (IGP). Results were well substantiated with the air mass back-trajectory analysis. Furthermore, seasonal mean of single scattering albedo (SSA at 500 nm) varied from of 0.94 to 0.98 and a general increasing trend is noticed from 400 to 870 nm wavelengths. These features are apparently regional characteristics of the site. Aerosol asymmetry factor (AS) decreases gradually from 400 to 870 nm and varied from 0.66 to 0.69 at 500 nm across the seasons. Dominance of desert-dust aerosols, associated by coarse mode, is indicated by tri-modal features of aerosol volume size distribution over the station during the entire seasons.

Optimization of process parameters for the production of spray dried Ber (Ziziphus jujube L.) powder

The study covers effect of operating variables of spray dryer i.e. inlet temperature (170, 180, 190, 200 and 210 °C,), aspirator blower capacity (40, 50, 60, 70 and 80 %) and feed pump capacity (9, 12, 15, 18, and 21 %) and processing parameters of feed i.e. total soluble solid (TSS) of feed (7.5 %) and encapsulating material, maltodextrin (4, 6, 8, 10, and 12 %), aerosil (1.0 %), citric acid (0.25 %) upon the physical properties (colour, packed density and hygroscopicity) of powder were observed. After complete evaluation and analysis of all the attributes for physical properties i.e. colour, packed density (0.45 g/cc) and hygroscopicity (0.17 g/g dry matter), it was concluded that best quality of Ber powder were obtained at inlet air temperature 190 °C, aspirator blower capacity 60 %, feed pump capacity 15 %, encapsulating material 8 %.

Yield loss assessment due to Alternaria blight and its management in linseed

Field experiments were conducted during 2010-11 and 2011-12 to assess the yield losses due to Alternaria blight disease caused by Alternaria lini and A. linicola in recently released cultivars and their management with the integration of Trichoderma viride, fungicides and plant extract. Disease severity on leaves varied from 41.07% (Parvati) to 65.01% (Chambal) while bud damage per cent ranged between 23.56% (Shekhar) to 46.12% (T-397), respectively in different cultivars. Maximum yield loss of 58.44% was recorded in cultivar Neelum followed by Parvati (55.56%), Meera (55.56%) and Chambal (51.72%), respectively while minimum loss was recorded in Kiran (19.99%) and Jeevan (22.22%). Minimum mean disease severity (19.47%) with maximum disease control (69.74%) was recorded with the treatment: seed treatment (ST) with vitavax power (2 g kg(-1) seed) + 2 foliar sprays (FS) of Saaf (a mixture of carbendazim+mancozeb) 0.2% followed by ST with Trichoderma viride (4g kg(-1) seed) + 2 FS of Saaf (0.2%). Minimum bud damage (13.75%) with maximum control (60.94%) was recorded with treatment of ST with vitavax power+2 FS of propiconazole (0.2%). Maximum mean seed yield (1440 kg ha(-1)) with maximum net return (Rs. 15352/ha) and benefit cost ratio (1:11.04) was obtained with treatment ST with vitavax power + 2 FS of Neem leaf extract followed by treatment ST with vitavax power+2 FS of Saaf (1378 kg ha(-1)).

Importance of the assessment of coenzyme Q10, alpha-tocopherol and oxidative stress for the diagnosis and therapy of infertility in men

Male infertility is one of the most stressful factors of couples, being present in about 40% cases. It is usually caused by a low number of sperm (oligozoospermia) or poor sperm motility (asthenozoospermia). The sperm motility is used as an indicator of semen quality and male infertility. To the impairment of male reproduction health can contribute genetic, nutritional and environmental factors, smoking and drugs. It is well documented that excessive reactive oxygen species (ROS) production decreases sperm motility, impairs sperm function, damages the morphology of spermatozoa (1, 2). To the decreased sperm motility contribute also disturbances of sperm mitochondrial function and energy production, low levels of coenzyme Q10 and carnitine, as well as sperm mitochondrial deoxyribonucleic acid (DNA) defects. The origin of sperm dysfunction, however, is not well understood.

BACKGROUND

Oxidative stress has been established as a major factor in the pathogenesis of male infertility. Low level of coenzyme Q10 contributes to the decreased sperm motility, which plays a vital role in sperm mitochondrial energy production and neutralization of reactive oxygen species (ROS).The aim of the present study was to find out, if an assessment of coenzyme Q10-TOTAL (CoQ10-TOTAL), α-tocopherol, γ-tocopherol and oxidative stress could contribute to the diagnosis of infertility in men.

SUBJECTS AND METHODS

Two groups of infertile men, according to sperm motility (a+b and b+c) were included in the study. CoQ10-TOTAL, α-tocopherol, γ-tocopherol in plasma and seminal fluid, and parameter of oxidative stress (thiobarbituric acid reactive substances - TBARS) in plasma were determined.

RESULTS

Higher sperm density and decreased sperm pathology were found in group a+b vs b+c (class a and b - fast and weak forward motility, class c - nonprogressive motility). Concentrations of CoQ10-TOTAL and α-tocopherol were significantly increased in seminal fluid of groups a+b vs b+c, opposite results were estimated in plasma. Concentrations of γ-tocopherol in plasma and seminal fluid of both groups were similar. Plasmatic TBARS concentrations were increased in both groups of infertile men.

CONCLUSION

We suppose that incorporation of oxidative stress assessment, CoQ10-TOTAL and α-tocopherol concentrations in seminal fluid and plasma into routine andrology can play an important role for the diagnosis and targeted therapy of male infertility (Tab. 1, Ref. 16).

Association of dietary factors and other coronary risk factors with social class in women in five Indian cities

The association between social classes, food intake and coronary risk factors was determined. Cross-sectional surveys were conducted in 6-12 urban streets in each of five cities, each one from five different regions of India using similar methods of dietary intakes and criteria of diagnosis. We randomly selected 3257 women aged 25-64 years inclusive, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 410), Nagpur (n = 405) and Bombay (n = 780). All subjects, after pooling of data, were divided into social class 1 (n = 985), class 2 (n = 790), class 3 (n = 774), class 4 (n = 602) and class 5 (n = 206) based on various attributes of socioeconomic status. Social class 1 was the highest and 5 was the lowest social class. Social classes 1-3 had greater intake of pro-atherogenic foods; total visible fat, milk and milk products, meat and eggs, as well as sugar and confectionery, compared to social classes 4 and 5. The consumption of wheat, rice, millets, fruits, vegetables and legume/total visible fat ratio were inversely associated with social class. Mean body mass index (BMI), obesity, overweight, central obesity and sedentary lifestyle were also significantly more common among subjects from higher social classes. Spearman's rank correlation showed that bodyweight, BMI, wheat, rice, millets, total visible fat, milk and milk products, meat, eggs, sugar and jaggery intakes were significantly correlated with social class. Social class 5 subjects had a lower intake of all foods and a lower BMI, suggestive of a higher rate of undernutrition among them. The findings indicate that the consumption of pro-atherogenic foods and other coronary risk factors are more common in higher social classes compared to lower social classes.

In patients with mild hypertension, does exercise and a gradual rather than abrupt increase in fatty acid and salt intake cause less rise in cardiovascular risk factors?

In a randomised, single blind controlled trial, 58 patients with mild essential hypertension were administered either a normal diet with a gradual increase in salt and fatty acid consumption (Group A, 30 cases), or an abrupt increase (Group B, 28 cases) for a period of 24 weeks. Group A patients also did more physical activity from weeks 12-24 of the study. At entry to the study, age, sex, risk factors, previous drug therapy and nutrient intakes were comparable between the 2 groups. Adherence to nutrient intakes and exercise was assessed by questionnaires. After 12 weeks, a comparison of changes in mean blood pressure and blood lipids in groups A and B showed no significant difference. However, group B patients showed a significant increase in mean total cholesterol, diastolic pressure and heart rate compared to initial levels. There were no such changes in group A. After 24 weeks, while salt, fatty acids and cholesterol intakes were similar in both groups, there were significantly higher levels of mean total cholesterol, triglycerides, serum sodium, systolic and diastolic blood pressure, and heart rate in group B compared with group A. This may have been due to exercise or to a gradual rather than abrupt increase in salt and fatty acids consumption allowing the body to adapt. Increased physical activity appears to have a positive influence on adaptation leading to prevention of the adverse effects induced by fatty acids and salt loading.

Hydrazones as analytical reagents: a review

Applications of hydrazones in inorganic analysis since 1950 are reviewed.

Nutritional aspects of epigenetic inheritance

The impact of diet and environmental factors on genes concerned with epigenetic inheritance and the mechanism of evolution has grown significantly beyond the Modern Synthesis period. Epigenetic inheritance is the passing of phenotypic change to subsequent generations in ways that are outside the genetic code of DNA. Recently, polymorphisms of the human Delta-5 (fatty acid desaturase, FADS1) and Delta-6 (FADS2) desaturase genes have been described as being associated with the level of several long-chain n-3 and n-6 polyunsaturated fatty acids (PUFAs) in serum phospholipids. Increased consumption of refined starches and sugar increases the generation of superoxide anion in the tissues and free fatty acids (FFA) in the blood. There is an increased amount and activity of nuclear factor-κB (NF-κB), a transcriptional factor regulating the activity of at least 125 genes, most of which are pro-inflammatory. The consumption of glucose may be associated with an increase in 2 other pro-inflammatory transcription factors: activating protein-1 (AP-1), and early growth response protein-1 (Egr-1). AP-1 regulates the transcription of matrix metallo-proteinases and Egr-1 modulates the transcription of tissue factor and plasminogen activator inhibitor-1. It is possible that a complex set of factors, including nutritional factors, come into play during epigenetic inheritance.

Ratio of lipid parameters to coenzyme Q10 could be used as biomarker of the development of early complications of obesity in children

BACKGROUND

Chronic obesity is associated with reduced levels of antioxidants, increased free oxygen radicals, and oxidative stress. Child obesity may lead to the development of complications, such as changes in metabolism, metabolic syndrome, neurological, cardiological, respiratory, renal, gastrointestinal, endocrinological, and musculoskeletal conditions. The aim of the present study is to establish whether there is a correlation between basal CoQ10 plasma concentration and the ratio of lipid parameters to CoQ10 in obese children.

METHODS

The study included 101 obese children and 20 non-obese children, aged 10-18 years. Antioxidants - CoQ10-OX, α-tocopherol, β-carotene - in plasma were measured by HPLC method with UV detector, and plasma malondialdehyde spectrophotometrically.

RESULTS

High correlation was found between plasma concentration of CoQ10 and the ratio of total Chol/CoQ10-OX as well as between CoQ10-OX and the ratio of HDL Chol/CoQ10 in plasma of obese children. The lowest correlation was between plasma concentration of CoQ10-OX and the ratio of LDL Chol/CoQ10 , as well as between CoQ10-OX and the ratio of TAG/CoQ10 in obese children.

CONCLUSION

An increase of the ratios of lipid parameters to CoQ10 is associated with child obesity and could be used as biomarkers of early complications in the development of obesity in children (Tab. 3, Fig. 5, Ref. 22).

Management of female uro-genital fistulas: Framing certain guidelines

BACKGROUND

The study was carried out to discuss the pathogenesis and management protocol of seven different varieties of female uro-genital fistulas (FUGFs).

PATIENTS AND METHODS

During 2000-2007, total of 15 FUGFs were operated, which belonged to seven different varieties requiring different routes and surgical procedures for their repair. Different fistulas with different pathophysiological factors required specific examinations and investigations preoperatively.

RESULTS

The results of the repaired FUGFs, following the general surgical principles, were acceptable with formation of only one residual fistula.

CONCLUSIONS

Successful correction of FUGFs is a surgical challenge. Detailed history, through examination and planning, atraumatic tissue handling, routine use of the interposition or onlay reinforcement flaps and vigilant postoperative care were found the key factors in successful outcome of the repaired fistulas.

Peri-vesical fat interposition flap reinforcement in high vesico-vaginal fistulas

Background and Aim:

The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginal fistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap.

Materials and Methods:

An interposition flap of peri-vesical fat was raised from the anterior, superior and posterior surfaces of the urinary bladder and was interposed between the right angle closed vaginal vault and the urinary bladder to strengthen the repair. This technique was used in two patients of VVFs.

Results:

Both the patients had successful outcome and were able to retain sufficient quantity of urine at 3 months follow-up.

Conclusions:

Peri-vesical fat flap proved an effective interposition flap in the repairs of VVFs in selected cases.

The tsim tsoum approaches for prevention of cardiovascular disease

The Tsim Tsoum Concept means that humans evolved on a diet in which nature recommends to ingest fatty acids in a balanced ratio (polyunsaturated(P) : saturated(S) =w-6 : w-3 = 1 : 1)as part of dietary lipid pattern where monounsaturated fatty acids(MUFA) is the major fatty acid(P : M : S = 1 : 6 : 1) in the background of other dietary factors; antioxidants, vitamins, minerals and fiber as well as physical activity and low mental stress. Several hundred years ago, our diet included natural foods; fruits, vegetables, green vegetables, seeds, eggs and honey. Fish, and wild meat were also available to pre-agricultural humans which shaped modern human genetic nutritional requirement. Cereal grains (refined), and vegetable oils that are rich in w-6 fatty acids are relatively recent addition to the human diet that represent dramatic departure from those foods to which we are adapted. Excess of linoleic acid, trans fatty acids (TFA), saturated and total fat as well as refined starches and sugar are proinflammatory. Low dietary MUFA and n-3 fatty acids and other long chain polyunsarurated fatty acids (LCPUFA) are important in the pathogenesis of metabolic syndrome. Increased sympathetic activity with greater secretion of neurotransmitters in conjunction of underlying long chain PUFA deficiency, and excess of proinflammatory nutrients, may damage the neurons via proinflammatory cytokines, in the ventromedial hypothalamus and insulin receptors in the brain.Since, 30–50% of the fatty acids in the brain are LCPUFA, especially omega-3 fatty acids, which are incorporated in the cell membrane phospholipids, it is possible that their supplementation may be protective.Blood lipid composition does reflect one's health status: (a) circulating serum lipoproteins and their ratio provide information on their atherogenicity to blood vessels and (b) circulating plasma fatty acids, such as w-6/w-3 fatty acid ratio, give indication on proinflammatory status of blood vessels, cardiomyocytes, liver cells and neurones; (a) and (b) are phenotype-related and depend on genetic, environmental and developmental factors. As such, they appear as universal markers for holistic health and these may be important in the pathogenesis of cardiovascular diseases and cancer, which is the main consideration of Tsim Tsoum concept.

Self-inflicted macro urethro-cutaneous fistula

An 18-year-old male having a 3 cm coronal macro urethro-cutaneous fistula, developing as a result of a strangulating rope tied at the coronal sulcus in an attempt to cause penile detumescence, is presented for its rare mode of self-inflicted penile trauma and unexpected postsurgical successful cosmetic and functional outcome.

Characterization of phenolic compounds in some Indian mango cultivars

Mangoes (Mangifera indica) are rich in phenolic acids as detected by high-performance liquid chromatography. The phenolics have prominent medicinal properties. Among six important commercial mango cultivars (Deshi, Langra, Chausa, Mallika, Dashahari and Amrapali) tannic acid was maximal in Mallika, while gallic acid was maximal in Chausa and all other varieties. Caffeic acid was maximal in Langra followed by Chausa and Amrapali. Many of the pharmacological properties attributed to mango might be due to the presence of phenolic acids in fairly significant amounts.

Extra-hepatic biliary-ductal necrosis following acute pancreatitis: 10 years of follow-up

This case report is 10 years follow-up of a child who presented with acute abdomen at the age of 8 years. Exploration revealed acute pancreatitis with the necrosis of common bile duct and almost whole of the common hepatic duct with bile leaking from the junctional stump of the right and left hepatic ducts. The patient was managed successfully by Roux-en-Y hepaticojejunostomy. After 10 years, the patient again presented with a recurrent discharging sinus from the anterior abdominal wall. On exploration, it was found to be a stitch granuloma near the site of hepaticojejunostomy. However, hepaticojejunostomy was found to function normally as seen on MRCP. This rare case highlights that extra-hepatic biliary-ductal necrosis is very unusual complication of acute pancreatitis; and it can be successfully managed by Roux-en-Y hepaticojejunostomy as evident from long-term follow-up.

Chronobiology and chronomics: detecting and applying the cycles of nature

We monitor our streets to prevent assault and rodents to develop drugs, but not those for whom the drugs are intended. It took over half a century to begin to monitor blood sugar values in patients with insulin-dependent diabetes. Monitoring blood pressure is equally timely and technically feasible for individual home- and website-based personalised care. It also serves basic science and someday perhaps the management of societal illnesses.

Forensic characterization of HDPE pipes by DSC

The melting behavior of 28 high density polyethylene (HDPE) pipe samples manufactured and supplied by 13 different manufacturers in India was examined by 'differential scanning calorimetry (DSC)' to find out if this parameter could be used in differentiating between these HDPE pipe samples which are chemically the same and being manufactured by different manufacturer. The results indicate that the melting temperature may serve as the useful criteria for differentiating HDPE (i) pipe samples from different sources and (ii) samples of different diameter from the same source.

Soft tissue reinforcement interposition flaps in hypospadias repair

Purpose: To discuss the role and mechanism of action of soft tissue reinforcement interposition flaps (strifs) in hypospadias repairs (reinforced hypospadiac urethroplasties). Materials and methods: between 2000-2005, 120 consecutive hypospadiacs (distal 85, mid 20, proximal 15), who underwent primary reinforced urethroplasties employing different types of strifs, were retrospectively analyzed. the strifs were highly vascular soft tissue pedicled flaps (devoid of epithelium) interposed between neo-urethras and the covering skin to reinforce the neo-urethras against fistula formation. the strifs were harvested, without much donor site deformity, from: preputial skin, penile skin and scrotal skin by de-epithelialization. those from buck′s fascia, corpus spongiosum and tunica vaginalis are strifs without epithelium anyway, therefore do not need de-epithelialization. redo urethroplasties and micropenises were not included. seven patients were excluded because they had incomplete follow-up. the remaining 113 (distal 84, mid 17, proximal 12) were followed up for nine to 40 months for number, size, location, spontaneous closure and persistence of urethro-cutaneous fistula (ucf), and other complications with regard to the severity of hypospadias, method of neourethral re-construction, types of strifs employed and skin cover used. a total of 158 strifs and 124 skin covers were used in 113 hypospadiac urethroplasties. Results: the first surgery was curative in 74 (65%) of 113 patients. in the remaining 39 (35%), various complications included 12 urethro-cutaneous fistulas (ucfs), 10 urethral strictures, six cases each of penile torsion and meatal stenosis and five cases each of superficial necrosis and poor cosmesis. of these 39 patients, 25 (64%) recovered with conservative treatment and 14 (36%) required re-operation, i.e. ucfs and strictures in four cases each and penile torsion, meatal stenosis and dog-ears in two cases each. all the 12 ucfs were single, pinpointed and were located at the corona in five and at the shaft in seven. eight (67%) of the 12 ucfs healed spontaneously during the follow-up period of 12 weeks.Conclusions: harvesting strifs is technically easy, however, great care is required in their handling, accurate placement and suturing over and around the re-constructed neo-urethras for their secured reinforcement against fistula formation. use of strifs in hypospadias repairs decreases fistula-associated morbidity but does not absolutely prevent fistula formation. the strifs reduce the size and prevent multiplicity of ucfs and locate the ucfs eccentrically well away from the neo-urethra to facilitate their spontaneous (conservative) as well as subsequent (surgical) closure. the mechanism of action of strifs is multi-factorial, like acting as a mechanical barrier; preventing suture line superimposition; inducing neo-angio-genesis; working as biological drain; providing mechanical support; and, filling the dead spaces.

Polysaccharide structure of degraded glucomannan from Abrus precatorius Linn. seeds

Degraded glucomannan was isolated from Abrus precatorius Linn. seed polysaccharide (Papilionaceae). Acid hydrolysis and methylation studies produced certain degraded methyl sugars as, 2, 3, 6-tri-O-methyl-D-glucose and 2, 3, 6-tri-O-methyl-D-mannose in 1:4 molar ratio. On the basis of hydrolysis and methylation experiments, a polysaccharide structure has been assigned to the degraded glucomannan and to the parent glucomannan of Abrus precatorius Linn. seed.