The outcome of head up tilt test in older adults with typical versus atypical features of syncope

Background: Syncope is usually a benign condition preventable by simple measures. Its diagnosis by history and inexpensive tests like head-up tilt table (HUTT) test save the patient unnecessary expenditure and stress. Objectives: To determine the outcome of head-up tilt test in older adult patients aged 60 years and more who present with typical versus atypical history of syncope, along with a study of the prodromal symptoms, association with comorbid burden, medications, grip strength, and cognitive function. Materials and Methods: An observational study of the patients presenting to the department of geriatrics with a history of neurocardiogenic syncope from May 2017 to October 2017 undergoing HUTT test looked at the association of the type of syncope based on the history and outcome of their HUTT test and association with prodromal symptoms, comorbidities, medications, triggering factors, electrocardiography, and Holter. Conclusions: The HUTT positivity rate for patients with a history of syncope was 31.8% with no association between typical or atypical syncope and HUTT positivity. Dizziness, lightheadedness, blurred vision, and sweating were significantly associated with typical syncope. No comorbidity or medication had an association with syncope or HUTT response but the comorbid burden had a significant association with positive HUTT response.

Prevalence of KRAS mutations in metastatic colorectal cancer: A retrospective observational study from India.

BACKGROUND: One of the genetic alterations implicated in tumor progression in colorectal cancers (CRCs) are abnormalities in Kristen Rat Sarcoma (KRAS) gene. Evaluation of KRAS mutation status is an important prognostic factor and has predictive value in deciding first line therapy based on monoclonal antibodies such as Cetuximab and Panitumumab in metastatic CRCs. MATERIALS AND METHODS: In this retrospective study, we analyzed 7 different somatic mutations in Exon 2 of KRAS gene in 299 unselected incidental CRC patients who visited the hospital for clinical management during the period 2009–2013. Most of the tumors were primarily originating from colon and rectum; nevertheless, there were a few from rectosigmoid, sigmoid, ceacum and anal canal in the study group. Genomic DNA extracted from paraffin embedded tumor tissues was screened for 7 point mutations located in Codons 12 and 13 of KRAS gene, using Scorpions amplified refractory mutation system real time polymerase chain reaction technology. Statistical analysis was performed to assess bivariate relationship between different variables that includes: mutation status, mutation type, tumor location, tumor morphology, age and sex. RESULTS: Prevalence of mutation in Codons 12 and 13 was 42.8% in the study group. Well‑differentiated tumors had significantly more mutation positivity than moderately and poorly differentiated tumors (P = 0.001). 92% of the mutations were from Codon 12 and 8% in Codon 13. Glycine to Arginine was relatively more common in rectosigmoid followed by ceacum, while Glycine to Alanine mutation was relatively more prevalent in sigmoid, followed by rectum and rectosigmoid. CONCLUSION: The results suggest a prevalence of KRAS mutation at 42.8% in Indian population indicating that this testing is very crucial for targeted therapy management in metastatic CRC in India. Further analysis on mutation status of other homologues such as NRAS and downstream partner, v‑raf murine sarcoma viral oncogene homolog B1, would add value to understanding the role of anti‑epidermal growth factor receptor therapy in CRC management.

Antimicrobial activity of extracellular metabolite of endophytic fungi Phomopsis spp. Isolated From Four Different Medicinal Plants of India.

The present investigation is on endophytic fungus Phomopsis spp isolated from four Indian medicinal plants like., Artabotrys odoratissimus, Cassia auriculata, Guazuma ulmifolia and Terminalia catappa in four different months. Antimicrobial activity of ethyl acetate extract from the culture filtrate of Phomopsis spp were tested against six human pathogenic bacteria. Isolated three Phomopsis spp. were grown in Czapex Dox Broth for 21-days. The extracellular secondary metabolites present in the culture filtrate were extracted with ethyl acetate solvent. The extracellular bio-active compounds of the isolated fungus were tested for its anti microbial potential in well diffusion method, against three, Gram-positive and Gram-negative bacteria such as Staphylococcus aureus, Bacillus subtilis, Micrococcus luteus, Escherichia coli, Klebsiella Pneumoniae and Pseudomonas aeruginosa. Among all the three Phomopsis spp, the extract obtained from Phomopsis sp.2 exhibited a promising activity against the entire test bacteria. This bioactivity compounds focus on clinical pharmacology to identify a novel therapeutic targets and it can be easily scaled up for the large-scale commercial production.

Micro propagation and tissue culture of the endangered medicinal plant withania somnifera by the direct shoot and root initiation method.

Leaf and Cotyledon explants of Withania somnifera (L). Dunal were used to evaluate the effect of different growth regulators on the in vitro direct shoot and root initiation methods. Four different explants were used to establish callus shoot and root direct regeneration. In the first experiment leaf segments were cultured on MS basal supplemented with 2,4 – Dichlorophenoxyacetic acid (2,4 – D, 0.1-20.0 mg/L), with combination of Naphthalene acetic acid (NAA 0.1-20 mg/L) and Benzylaminopurin (0.1-20 mg/L). This new protocol was standardized for easy mass propagation of W. somnifera medicinal plant. Callus initiation was observed best in MS media with (2,4- D 1.0-5.0 mg/L) after 16-20 days (93%). Highest maximum number of multiple shoots was obtained on MS medium (BAP 3.0 – 5.0 mg/L). The shoots were seaperated from the multiple-shoots, transferred to MS medium supplemented with 1.5 – 20 mg/L NAA favored roots formation occurred in most of the shoot let 88% were successfully achieved in the MS media. The rooted plantlets were transferred to polythene bags which was containing vermi compost, sand and red soil in the ratio of 1:2:2 and kept in a mist house. After acclimatization in the mist house for 2-months, it transferred to greenhouse. The plantlets were successfully planted in the field.

Primary structure of sesbania mosaic virus coat protein: its implications to the assembly and architecture of the virus.

Sesbania mosaic virus (SMV) is a plant virus that infects Sesbania grandiflora plants in Andhra Pradesh, India. The amino acid sequence of the coat protein of SMV was determined using purified peptides generated by cleavage with trypsin, chymotrypsin, V8 protease and clostripain. The 230 residues so far determined were compared to the corresponding residues of southern bean mosaic virus (SBMV), the type member of sobemoviruses. The overall identity between the sequences is 61.7%. The amino terminal 64 residues, which constitute an independent domain (R-domain) known to interact with RNA, are conserved to a lower extent (52.5%). Comparison of the positively charged residues in this domain suggests that the RNA-protein interactions are considerably weaker in SMV. The residues that constitute the major domain of the coat protein, the surface domain (S-domain, residues 65-260), are better conserved (66.5%). The positively charged residues of this domain that face the nucleic acid are well conserved. The longest conserved stretch of residues (131- 142) corresponds to the loop involved in intersubunit interactions between subunits related by the quasi 3-fold symmetry. A unique cation binding site located on the quasi 3-fold axis contributes to the stability of SMV. These differences are reflected in the increased stability of the SMV coat protein and its ability to be reconstituted with RNA at pH 7.5. A major epitope was identified using monoclonal antibodies to SMV in the segment 201-223 which contains an exposed helix in the capsid structure.(ABSTRACT TRUNCATED AT 250 WORDS)