Effect Of AJI-NO-MOTO On Kidney Of Adult Albino Rat: A Histopathological Evaluation

Introduction: Aji-No-Moto (MSG), the wonder flavoring agent, has been reportedly overused in all packed food products and the cuisines being served in restaurants. This salt effect almost all the organs of the body but the evidences regarding its ill effects are very limited. Thus, no guidelines are there for the safe limits of Aji-No-Moto use. In current study we planned to analyses the histopathological effects of Aji-No-Moto on kidney. Methods: The study was conducted on 18 inbred adult albino rats of either sex. The rats of control group (C) received only standard diet with dis?lled water, low dose test group (T1) rats received 0.5mg/kg of MSG dissolved in dis?lled water and high dose test group (T2) rats received 1.5mg/kg of MSG dissolved in dis?lled water per orally for 28 days. A?er the experimental period, the rats were sacrificed to dissect out the renal ?ssue which was later subjected to histological processing and ?ssue sec?oning. Observa?ons: The kidney ?ssue sec?ons of the control group (C) revealed normal renal architecture consis?ng of cor?cal labyrinth and medulla. The cor?cal labyrinth consisted of glomeruli, PCT and DCT whereas the medulla consisted of the ascending and descending limbs of loop of henle and collec?ng ducts. On the other hand, renal sec?ons of low dose group (T1) showed focal shrinkage of renal glomerulus and widening of the Bowman’s space. Furthermore, these changes were more pronounced in high dose group (T2) along with hypercellularity of glomeruli, dilata?on, hyperaemia and conges?on in the intertubular cor?cal blood vessels and mononuclear cell infiltrate. Conclusion: Aji-No-Moto is the most widely used flavoring agent whose minimal dose for use has to be evaluated. The current study was planned to access the minimal low dose limit of MSG for use. The results of aforemen?oned study revealed that even small dose of 0.5mg/kg/day is capable of producing histopathological effects on kidney.

Comparative evaluation of intravaginal slow release Dinoprostone insert, transcervical foley’s catheter, intracervical Dinoprostone gel for induction of labor in patients with poor Bishop’s score: a randomized control study

Background: Induction of labor is indicated when the continuation of pregnancy poses risk to the mother or fetus. A variety of mechanical and pharmacologic methods are available but the best method of labor induction still remains unknown, study aimed at comparing the efficacy and safety among the two agents: transcervical Foley’s balloon catheter (FBC) and intravaginal slow release Dinoprostone E2 insert (DVI) with dinoprostone gel as control.Methods: A total of 174 patients were randomized into three groups of 58 each (Group A: dinoprostone 10 mg slow release intravaginal insert, Group B: transcervical Foley’s 16 French catheters, and Group C as control: 0.5 mg intracervical Dinoprostone gel. The safety and efficacy was compared among the groups. A p value of < 0.05 was considered statistically significant.Results: The mean insertion to active labor time (in hours) was significantly lower in Group A as compared to Group B (5.88±3.06 versus 13.56±2.8, p < 0.0001). Meantime of insertion to delivery (in hours) was significantly lower in Group A as compared to Group B (10.91±5.24 versus 21.17±2.99, p < 0.0001). The requirement of oxytocin for induction and augmentation in Group A was significantly lower as compared to Group B. Majority of the patients had normal vaginal delivery (NVD) in all the three groups. Regarding safety profile we found that slow-release DVI had more incidence of uterine tachysystole, but none of the cases had any fetal heart rate abnormality. Maternal fever was more in the FBC group, however, neonatal outcomes were comparable in both groups.Conclusions: The study concludes that slow release DVI is better in terms of efficacy as compared to transcervical FBC for induction of labor as assessed by improvement in Bishop score, insertion to active labor time and insertion to delivery time and comparable in terms of safety profile.

Postpartum atypical haemolytic uremic syndrome: a rare clinical entity

P-aHUS has incidence of 1 in 25000 pregnancies. It’s characterized by microangiopathic haemolytic anemia, thrombocytopenia and renal failure. Mrs X, 26 year old lady, G2 P1L1 with 39 weeks POG came to emergency of a tertiary care hospital. She underwent LSCS in view of previous caesarean section not willing for trial of labour. Antenatal, intrapartum and immediate post operative period were uneventful. However, she became anuric 36 hours post operatively. Laboratory investigations suggested hemolysis. Complement system evaluation showed decreased complement levels. Diagnosis of p-aHUS was made by taking multidisciplinary approach and renal biopsy. Patient received 4 sessions of plasmapheresis and symptomatic treatment. Gradually her urine output increased and she was discharged with the baby on post operative day 19. Diagnosis of p-aHUS is tricky owing to similar clinical features with many other pregnancy associated conditions. Timely management and diagnosis are imperative to save the mother’s life.

True broad ligament fibroid mimicking ovarian mass in a postmenopausal woman

Fibroids are benign smooth muscle tumors. Large fibroids are known to arise from the uterus, but occasionally from the broad ligament.  Here, we report a case of true broad ligament fibroid which is rare and difficult to diagnose in a 57 year old postmenopausal women with a large mass of 24 weeks size gravid uterus. Patient presented with pain lower abdomen and mass in abdomen with no other co-morbidity. This broad ligament fibroid was mimicking as ovarian tumor on ultrasonography and MRI as left ovary was not visualised separately, thus leading to diagnostic dilemma of ovarian malignancy. Mass resection with total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. No local or distant metastasis observed, and Histopathology showed true broad ligament fibroid of left side weighing 3.57 kilograms.

Association Between Neonatal Thyroid Stimulating Hormone Status and Maternal Urinary Iodine Status

Background: Maternal urinary iodine concentration (MUIC) andpercentage of neonates with Thyroid stimulating hormone (TSH)>5 mIU/L are amongst the parameters suggested for assessingadequate iodine status.Objective: To assess the correlation between MUIC andneonatal TSH levels.Study design: Cross-sectional.Settings: Tertiary care center in Delhi, India, between November2015 to November 2016.Participants: Postnatal mother-neonate dyads.Methods: TSH levels assessed among neonatal samples werestratified as below and above 5 mIU/L. MUIC was measured in544 mothers, 400 mother-neonate dyads with neonatal TSHlevels >5 mIU/L (cases) and 144 mother-neonate newbornmother dyads with neonatal TSH <5 mIU/L (controls).Results: The percentage of mothers with iodine insufficiency(9.8% vs 5.6%) as well as iodine excess (54.3% vs 41.7%) weresignificant higher in cases than controls. Mean TSH was alsohigher (P=0.0002) in both the iodine deficient and iodine excessgroup. There was no correlation between neonatal TSH valuesand MUIC.Conclusions: Lack of correlation between neonatal TSH andMUIC is due to iodine excess together with iodine deficiency.

Adult-onset bilateral optic neuritis: a rare presentation

A rare case of adult-onset bilateral optic neuritis without associated autoimmune or infectious disorders has been reported in this study. A 19-year-old male described sudden bilateral diminution of vision (sequential) with headache with no other remarkable history. Ophthalmological findings revealed asymmetrically reduced visual acuity on the initial visit. Fundus examination showed nerve fibre layer oedema (more in right eye). Radiological examination was suggestive of bilateral, asymmetrical optic neuritis. Visual evoked potential tests suggested asymmetrical and sequential P100 delay. No auto-immune/infectious aetiology was found. The condition was diagnosed as an atypical presentation of optic neuritis with sequential bilateral involvement. Patient was treated with intravenous methyl prednisolone followed by tapering oral doses owing to the bilaterality of the involvement. A careful follow-up is being performed. The condition involving bilateral inflammation of the optic nerves can have hazardous outcome and hence prompt, careful and comprehensive diagnostic and treatment approach is necessitated.

A study to Assess the Effects of Antiperspirant Aluminium Nitrate

This present study was aimed to observe under the research grade compound light microscope thehisto-toxicological effects manifested post-application of 10% and 20% solutions of aluminium nitratethat was topically applied onto the outermost surface of the ear integument of 24 Albino rabbitstreated daily. The animals were then divided into two groups comprising of 12 experimental and 12controls. Initially right sided test areas were excised of the experimental and control animals after 15days of application to observe immediate effects, whereas the left sided test areas of the animalswere kept for another month without any further treatment and then excised on day 45 to elucidateits delayed effects. The results revealed histological features of a thickened epidermis withhyperkeratosis, acanthosis and the presence of epidermal micro-abscesses. The dermis showedfeatures of edema, increase in vascularity, decrease in sweat and sebaceous glands and infiltration ofinflammatory cells.It was significantly noted that the histological features were far more severelymanifested in the integument applied with 20% w/v solution as compared to that applied with 10% w/v solution. However these changes persisted in a moderate form following discontinuation of aluminiumnitrate application.

Ponticuli In Atlas Vertebrae And Its Clinical Aspect

Background: Atlas, the first cervical vertebra, has an oblique ligament which bridges the groove for vertebralartery. This ligament may ossify sometimes converting groove into foramen. These foramina are called asponticulus posterior or arcuate foramen of the atlas. The ponticuli can distort vertebral artery. They havetendency to cause vertebra basic insufficiency. During any manipulation of cervical spine, these variations ofatlas should be kept in mind.Objectives: To study the presence of ponticuli, their other features like whether complete or incomplete, unilateralor bilateral, sidedness- right or left.Material and Methods: A total of 50 fully dried adult human atlas were collected from the Department ofAnatomy, Government Medical College, Jammu and from the students of the first year MBBS, Government MedicalCollege, Jammu. Bones were intact and free from osteophytes. The superior surface of posterior arch was observedcarefully in each atlas for presence of ponticulus.Results: In the present study, 50 human atlas vertebrae were observed out of which 4 atlas (8%) had ponticuli. Itwas incomplete in 2 vertebrae (4%) and was complete in 2 atlas vertebrae (4%). It was unilateral in 3 atlasvertebrae (6%) and bilateral in 1 atlas vertebra (2%). 2 ponticuli were on the right side, 1 on left side and 2 werefound on both sides. All were ponticuli posterior except one which was lateral ponticulus.Conclusion: The presence of ponticuli can cause cervical pain and pressurize vertebral artery leading tocerebrovascular accidents. Detailed knowledge about the variations in the cervical region is very helpful toneurosurgeons, orthopaedicians and otolaryngologists to avoid any mishap. Spinal surgeons must be fullyaware about these ponticulus to prevent any complications during surgeries

Study evaluating chronic abdominal pain and functional abdominal pain syndrome.

Background: Chronic abdominal pain (CAP) is a prevalent condition with a wide etiology and is often associated with significant health care utilization. A functional diagnosis, particularly, Functional abdominal pain syndrome (FAPS) is more challenging and has been a less extensively studied condition in adults as compared to other common functional gastrointestinal disorders. Hence, this study attempts to formulate a definite line of investigations, study various causes of chronic abdominal pain and to evaluate FAPS, in a population from Central India. Methods: 100 patients in the age-group of 10-60 years with chronic abdominal pain were selected. A careful history, clinical examination and investigations were performed and final diagnosis was made on the basis of the available data. Results: Eighty-nine out of hundred patients were found to be having some organic disorder causing CAP while eleven had functional gastrointestinal disorders. FAPS was diagnosed in three patients on the basis of Rome III diagnostic criteria while one had unspecified functional abdominal pain. Conclusions: CAP is a multifactorial condition yet, a thorough history coupled with a complete physical examination and investigative profile help to a great extent in diagnosing the cause. FAPS should be diagnosed on the basis of a careful clinical history and characteristic pain behaviour during physical examination. A cost-effective and conservative approach should be adopted for investigations. Unlike the organic causes, FAPS should be treated with a biopsychosocial approach with a variable combination of pharmacological, cognitive-behavioural and psychological interventions.

Study of voluntary alteration of visual evoked potentials: Evaluating role in functional visual loss.

Background: Pattern reversal visual evoked potentials (PRVEP) are one of the recommended tests for detection of functional visual loss. However, voluntary alterations producing abnormal records have been reported in the normal subjects limiting the role of the test. Hence, this study aimed to record voluntarily altered PRVEP responses and to study the role of various modifications in the technique for detection of the condition. Methods: 20 normal subjects in the age-group of 18-25 years were studied. PRVEP records were obtained in the normal perceiving states and then with voluntary alterations in different stimulus conditions and the changes in the mean P100 latency and N75-P100 amplitude were compared and analysed using paired t-test. Results: 15 out of 20 subjects could voluntarily alter their PRVEP records with 26 out of 30 eyes demonstrating statistically significant abnormal records in terms of latency delay or amplitude reduction or both. Modifications in the technique with increased check size, field size and binocular stimulation reduced the number of abnormal records. But, mean P100 latency and N75-P100 amplitude recorded from the above stimulus conditions in voluntarily altered states were still statistically significantly altered from those in the normal perceiving conditions (p<0.05). Conclusion: Normal subjects can voluntarily produce abnormal PRVEP responses. Various modifications in the technique like increase in the check-size, field size and binocular stimulation should be employed if voluntary alteration is suspected, but interpretation should be made carefully in the context of clinical findings of the subject.

Prenatal Screening: Perspective for the Pediatrician.

Pediatricians are the first contact of a child with genetic disorders such as Down Syndrome. After diagnosis, parents often express and wish that if it was possible to detect it during pregnancy and could it be avoided in the future pregnancy. This makes it essential that pediatricians should have some idea about the basic screening methods and strategy used during pregnancy.

Highly Aggressive Small-cell Neuroendocrine Carcinoma Cervix: A Rare Case Report.

Neuroendocrine tumors consist of a spectrum of malignancies that arise from the diffuse neuroendocrine cell system. Prognosis is dependent on histologic subtype and site of origin. The family of well-differentiated neoplasms (carcinoid and atypical carcinoid) is morphologically and clinically distinct from high-grade neuroendocrine carcinoma (small cell and large cell). This latter entity is closely related to pulmonary small-cell carcinoma, is highly aggressive and is generally managed with a multimodality approach including platinum-based chemotherapy. Neuroendocrine tumors primary to the gynecologic tract are still considered to be uncommon, with limited prospective data available to guide decision making. We are reporting a case of a highly aggressive small-cell neuroendocrine carcinoma cervix in a 38-year-old female with good initial response with chemotherapy and is under our follow-up.

A family with Charcot-Marie-Tooth disease (type 1): evaluating diagnostic role of nerve conduction studies.

We aimed to report a case history of a family with Charcot-Marie-Tooth disease and to assess the role of nerve conduction studies in the diagnosis. A 10-year-old girl presented with difficulty in walking with a history of delayed motor milestones and slowly progressive weakness in distal muscles of both the lower limbs, with similar group of complaints in her father and a younger brother. Clinical examination of the patients was done and nerve conduction studies were performed. Clinical features and nerve conduction studies suggested the diagnosis as Charcot-Marie-Tooth disease with characteristic electro-diagnostic findings of Charcot-Marie-Tooth disease type-1. Charcot-Marie-Tooth disease is a rare disorder found in India. Although genetic tests form the basis of accurate diagnosis, yet nerve conduction studies, to a great extent, prove to be remarkable in approaching the diagnosis and distinguishing the common subtypes of this rare condition.

Pelvic Tuberculosis Mimicking Ovarian Malignancy: A Case Report.

Tuberculosis is a global health problem, primarily seen in developing countries, where there are insufficient health services and high prevalence of human immunodeficiency virus (HIV) has further increased the burden of disease. Pelvic tuberculosis can cause ascites and an abdominal mass that may masquerade as ovarian cancer. CA125 levels are raised in peritoneal tuberculosis. CT scan and MRI also give a similar picture and diagnosis is often difficult. We are presenting an unusual case of pelvic tuberculosis being referred to us as a case of adnexal mass with ascites and raised tumor marker.

Cloning and expression of a small heat and salt tolerant protein (Hsp22) from Chaetomium globosum.

The present study reports molecular characterization of small heat shock protein gene in Indian isolates of Chaetomium globosum, C. perlucidum, C. reflexum, C. cochlioides and C. cupreum. Six isolates of C. globosum and other species showed a band of 630bp using specific primers. Amplified cDNA product of C. globosum (Cg 1) cloned and sequenced showed 603bp open reading frame encoding 200 amino-acids. The protein sequence had a molecular mass of 22 kDa and was therefore, named Hsp22. BlastX analysis revealed that the gene codes for a protein homologous to previously characterized Hsp22.4 gene from C. globosum (AAR36902.1, XP 001229241.1) and shared 95% identity in amino acid sequence. It also showed varying degree of similarities with small Hsp protein from Neurospora spp. (60%), Myceliophthora sp. (59%), Glomerella sp. (50%), Hypocrea sp. (52%), and Fusarium spp. (51%). This gene was further cloned into pET28a (+) and transformed E. coli BL21 cells were induced by IPTG, and the expressed protein of 30 kDa was analyzed by SDS-PAGE. The IPTG induced transformants displayed significantly greater resistance to NaCl and Na2CO3 stresses.

Menstrual pattern and abnormalities in the high school girls of Dharan: a cross sectional study in two boarding schools.

Puberty is the biological transition between the immature and adult reproductive function. This study has been carried out to find out the menstrual pattern, and awareness of the abnormalities in menstrual pattern among school going pubertal age group girls in Dharan. It has been carried out with the aim to follow it with school health education. Cross sectional study was done in 96 girls of two different school of Dharan of the age group ranging from 11 years to 17 years. The median age of menarche was 12 years. There were 6.9% cases of oligomennorhea and 10.0% of hypomenorhea. Menorrhagia was seen in 6.2% of the girls. Spasmodic dysmenorrhea was seen in 67.0% of the girls but the daily activity was hampered only in 20.0%. Out of the 96 students 73.0% were prepared psychologically beforehand. Very less students (8.0%) knew only very little about the abnormalities in menstruation, rest were ignorant about it. Thus, it was seen that these school going girls needed education about the abnormalities of menstruation so that they can differentiate the normal phenomenon from abnormality and report in time in case of aberrance in the menstrual cycle.