A morphometric study of adult human trachea in West Bengal population

Background: Keeping in view the great variations in different dimensions of the human trachea and its remarkable clinical importance, the present work was undertaken. It included the study of dimensions of adult trachea of both sexes in West Bengal population. In addition, an effort was made to establish their relationship with selected external measurements. Methods: This was a cross-sectional, observational study on 60 cadavers. Relatively disease-free fresh adult cadavers were selected from West Bengal population. Study variables were tracheal length, internal transverse diameter and internal anteroposterior diameter. Selected external measurements were height and sternal length. Results: In males, the highest correlation was observed between tracheal length and height (r = 0.800), and tracheal length and sternal length (r = 0.799). In females, the highest correlation coefficient was found between tracheal length and height (r = 0.809). Conclusion: Different formulae were obtained by linear regression with all measurements being in centimeters. Therefore, it is possible to predict the tracheal dimensions from simple external measurements.

Determination of Age of Epiphyseal Union of Bones Around Knee Joint by Radiological Approach in the Varanasi Region

Background: Age is an important parameter for medico-legal cases. Age of epiphyseal union is an important objective method of age determination. But these ages vary with racial, geographic and various other factors. These variations have suggested need of separate standards of ossification for separate regions. Methods: After approval from institutional ethical committee, present work was undertaken to work out ages of epiphyseal union around knee joint for Kolhapur region. Study was carried out in total 200 healthy subjects aging from 13 to 21 years.  Results: The chronological age was determined & A-P view of right knee joint was taken in each case. These radiographs were studied to determine the age of union of epiphyses of lower end of femur, upper end of tibia & upper end of fibula. Conclusions: These ages were compared with those reported from various states of India & abroad.

"Nonunion of Adult Humerus Fracture" - Management Using the Ilizarov External Fixator.

Humeral shaft fractures occur about three percent of all fractures in adults. A very high union rate is achieved with non-operative treatment, however when nonunion occurs conservative approach or after operative management they are often very difficult to treat, and often requires multiple procedures to achieve union. Even with multiple procedures, true pseudoarthrosis have only a 59% union rate. The aim of this study was to find out the results of such complicated cases treating with Ilizarov's external fixator. We conducted a prospective study of eleven patients with nonunion humeral shaft fracture in adult wherein the outcome of the treatment was analyzed. In our series we achieved union in all of the cases with a mean of 29.1 weeks with negligible complications like pin tract infections and in one case refracture occur due to forceful manipulation. So it can be concluded that Ilizarov's method is an excellent option for the treatment of nonunion of diaphyseal fracture of the humerus.

Food Security in HIV/AIDS Response: Insights from Homa Bay; Kenya

This paper examines the viability and effectiveness of a pilot farming initiative in reversing impacts of HIV/AIDS on the most affected households in Homa Bay; Kenya. The paper argues that once patients are stable; they can effectively be engaged in farming with minimal financial and technical support; resulting in enhanced food security of the affected households. More importantly; it helps to reduce HIV/AIDS-related stigma and improve the individual's self-esteem. Some of the key challenges of the pilot initiative were the limited number of agricultural extension workers and absence of facilities to enable them to deliver services to the farmers; the high cost of farm inputs; the unavailability of farm inputs when they were needed; poorly developed agricultural markets; and the absence of irrigation facilities. The paper recommends the sensitive scaling-up of this approach. However; farming initiatives by HIV/AIDS service NGOs should be linked to at least three key aspects: (a) treatment; care and support to HIV/AIDS affected households; (b) micro grant schemes or subsidies to enable farmers to purchase farming tools and farm inputs; and (c) comprehensive on-farm training support. To ensure effectiveness and wider reach; government needs to view agriculture through an HIV lens and promote a multisectoral approach that recognises the relationship between HIV/AIDS and food security. A number of immediate actions are required to strengthen this relationship; such as increased public investment to augment extension services; subsidise farm inputs; and develop infrastructure including agricultural markets

Role of L-lysine HCl in adoptive immune therapy towards development of suitable tuberculosis vaccination.

L-Lysine HCI is being proposed to be a possible biocompatible adjuvant to enhance immune response by virtue of its probable non-specific bridging action and cellular proliferation properties. This proposal has been tried to be substantiated by designing an in vitro culture protocol, varying the concentration of L-lysine HCI and its further in vivo application. Splenic lymphocyte population has been extracted from mice and co-cultured with extracted mice macrophage population in presence of either Bacille Calmette Guerrin (BCG) or Hepatitis B surface antigen (HbsAg) and added L-lysine hydrochloride in culture media. Post incubation of these cultures, "taught" cell population has been adoptively transferred in naïve mice. These mice were then challenged by respective antigen dose, Change in Immune response with this challenge was noted. Antibody titre was followed in all the experiments as a measure of immune response. In adoptive immune transfer experiment of with HbsAg (AIT-HbsAg), similar to that with BCG (AIT-BCG), after the incubation period, antibody titre was higher in added lysine containing cultures in comparison with the control ones. Post transfer followed by antigen challenge, in AIT-BCG the expected augmentation in immune response was hardly visible. But in AIT-HbsAg, with the help of lysine booster, the animals responded better as far as the antibody titre is concerned.

Effect of addition of proton carriers in culture medium on growth and secretion of hybridoma cell line OKT3.

Monoclonal antibodies (MAb) constitute the centre of all in-vitro diagnostic measures and almost all in-vivo therapeutic manoeuvres now. Production emphasis for these antibodies is having a current shift from animal-based large-scale culture to in-vitro bioreactor-based high-density culture. One of the major difficulties in high-density culture is end-metabolite accumulation in batch and fed-batch cultures in the forms of H+, NH4+ etc.. thereby reducing cellular growth and secretions. In the present study, effects of added proton carries--NAD and NADP--over and above the metabolic pools of the molecules, were examined on the cellular growth and secretion kinetics. Although NADP fortification showed a remarkable improvement in cellular growth (time dependent 200-300% improvements compared to controls) and size, cumulative MAb titre was better with NAD fortification. Combined additional loads of the proton carriers would be interesting to study in high density culture conditions.

Getting higher yields of monoclonal antibody in culture.

Getting higher yields of monoclonal antibody (MAb) is a problem in Hybridoma Technology which has two major bottlenecks: a) poor yield of hybridized cells, b) low cellular productivity of MAb in culture. There are three ways of obtaining high MAb yield in vitro a) Large scale culture, b) high density culture and c) enhancing individual cellular productivity in culture. Currently, the focus is on the correct synergistic combination of fortified nutrient media, bioreactor design and mode of operation. Maximization of cell culture longevity, maintenance of high specific antibody secretion rates, nutrient supplementation, waste product minimization and control of environmental conditions are important parameters for improvement of large scale production of MAb. Though, MAb yields have improved rapidly over the decade, there is a growing concern for the decrease in quality of MAb secreted. Further research is therefore necessary to take full advantage of MAb as a potential diagnostic agent for in vivo therapy.

Monoclonal antibody: high density culture of hybridoma cells and downstream processing for IgG recovery.

Getting higher yields of monoclonal antibody (MAb) is a problem in Hybridoma Technology which has two major bottlenecks--(a) poor yield of hybridized cells; and (b) low cellular productivity of MAb in culture. There are three ways of obtaining high MAb yield in vitro--(a) large scale culture of hybrid cells; (b) high density culture; and (c) enhancing individual cellular productivity in culture. Currently, focus is on correct synergistic combination of fortified nutrient media, bioreactor design and mode of operation. Maximisation of cell culture longevity, maintenance of high specific antibody secretion rates, nutrient supplementation, waste product minimization and control of environmental conditions are important parameters for improvement of large scale production of MAb. Though, MAb yield has enhanced rapidly over the decade, there is a growing concern for decrease in quality of MAb secreted. Further research is therefore necessary to take full advantage of MAb as a potential diagnostic agent for in vivo therapy.

Effect of protein rich diet during acute phase of dysentery.

Ninety six children upto the age of five years suffering from uncomplicated acute dysentery of less than 3 days' duration were studied to find out the impact of feeding of extra-protein rich diet during their acute phase of illness. These children were randomly allocated to either control group (receiving only hospital diet) and study group (receiving hospital diet and extra milk which constituted 30% of ideal total calorie requirement of patients. Patients in the two groups were comparable on admission. Forty percent reduced food intake was observed among the children of both the groups due to severe anorexia which was reflected by no significant differences in clinical outcome, anthropometrical measurements and haematological parameters between the two groups on day 7 of hospitalisation and on day 15 after discharge.