Study of patient outcome in endoscopic dacrocystorhinosomy using a microdebrider in chronic dacryocystitis patients

Background: Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with chronic dacryocystitis. In this study authors did endoscopic dacrocystorhinosomy using a microdebrider, which is a recent advancement tool being used successfully in other endoscopic sinus surgeries also. Limited studies are available as of now on this topic.Methods: A total number of 33 patients (with 40 affected eyes) presenting with complains of epiphora having nasolacrimal duct obstruction were selected. They underwent an endoscopic DCR in which dissection of some nasal mucosa and widening of bony ostium was done using a microdebrider. Silicone stent was passed into the nasolacrimal duct through both punctum. Patient outcome was assessed by using both objective (endoscopy and dye test) and subjective (improved symptoms) criteria. Standard follow up time for clinical course was kept 3 months with weekly visits.Results: Patients which got relief from epiphora in 37 eyes (92.5% cases) had no obstruction on endoscopy and positive dye test. Rest (7.5 % cases) had presence of granulation tissue at rhinostoma site and negative dye test, which was cited as the cause of failure.Conclusions: The use of microdebrider is potentially beneficial in endoscopic endonasal dacryocystorhinostomy. By using such an instrument, the minimal amount of tissue damage occurs, a large fistula is formed, and the recurrence due to the formation of adhesions/synechiae/granulations is prevented/reduced thus reducing the time of surgery, complications and failure rate.

New cathepsin V inhibitor from stems of Bowdichia virgilioides

Abstract Bioassay-guided fractionation of Bowdichia virgilioides Kunth, Fabaceae, extracts has led to the isolation of cathepsin V inhibitors. The investigation of the hexane and ethyl acetate extracts allowed the characterization of eleven compounds: lupeol, lupenone, β-sitosterol and stigmasterol in mixture, trans p-coumaric acid ester derivative, syringaresinol, bowdenol, 8-methoxycoumestrol, 3,4-hydroxy-7-methoxyisoflavone, 7,3′-dihydroxy-4′-methoxyisoflavone, and 5,4′-dihydroxy-7′-methoxyisoflavone. Structures of compounds were stablished by 1D and 2D NMR, and MS experiments. Among the isolated compounds, trans p-coumaric acid ester derivative and 8-methoxycoumestrol showed significant inhibition on cathepsin V, which is up to now unexplored.

A new index to discriminate between iron deficiency anemia and thalassemia trait

BACKGROUND: The most common microcytic and hypochromic anemias are iron deficiency anemia and thalassemia trait. Several indices to discriminate iron deficiency anemia from thalassemia trait have been proposed as simple diagnostic tools. However, some of the best discriminative indices use parameters in the formulas that are only measured in modern counters and are not always available in small laboratories. The development of an index with good diagnostic accuracy based only on parameters derived from the blood cell count obtained using simple counters would be useful in the clinical routine. Thus, the aim of this study was to develop and validate a discriminative index to differentiate iron deficiency anemia from thalassemia trait. METHODS: To develop and to validate the new formula, blood count data from 106 (thalassemia trait: 23 and iron deficiency: 83) and 185 patients (thalassemia trait: 30 and iron deficiency: 155) were used, respectively. Iron deficiency, ß-thalassemia trait and a-thalassemia trait were confirmed by gold standard tests (low serum ferritin for iron deficiency anemia, HbA2 > 3.5% for ß-thalassemia trait and using molecular biology for the a-thalassemia trait). RESULTS: The sensitivity, specificity, efficiency, Youden's Index, area under receiver operating characteristic curve and Kappa coefficient of the new formula, called the Matos & Carvalho Index were 99.3%, 76.7%, 95.7%, 76.0, 0.95 and 0.83, respectively. CONCLUSION: The performance of this index was excellent with the advantage of being solely dependent on the mean corpuscular hemoglobin concentration and red blood cell count obtained from simple automatic counters and thus may be of great value in underdeveloped and developing countries.

Serological diagnosis of dengue in laboratory practice in Kolkata.

Purpose: To find out the most suitable serological investigative procedures to diagnose dengue cases effectively in the laboratory practice identifying primary and secondary cases as well as period of suffering. Materials and Methods: Dengue suspected cases sent to the laboratory in 2012 in central Kolkata by the local physicians were categorised into seven panels according to the investigations asked for such as (1) only dengue‑specific NS1 antigen (2) only IgM antibodies, (3) NS1 + IgM + IgG antibodies, (4) only IgM and IgG, (5) NS1 + IgM, (6) NS1 + IgG and (7) only IgG. Results: Out of 1892 suspected cases, dengue was diagnosed in 725 (38.3%). Through panels I, II, III, IV, V, VI and VII, it was possible to diagnose dengue in (I) 35.98% (435/1209), (II) 37.5% (24/60), (III) 49% (173/354), (IV) 30.8% (68/221), (V) 60.5% (23/38), (VI) 40% (2/5) and (VII) 0 of cases respectively. Detail information such as confirmed diagnosis, duration of the disease (whether early or prolonged) and classification of primary and secondary dengue in such early or prolonged stages would only be possible in panel III, which information would be helpful for effective monitoring and treatment of dengue patients. In all other panels, merely fragmentary information would be obtained. Conclusions: Serodiagnostic tests dengue‑specific NS1 antigen and IgM and IgG antibodies when conducted simultaneously would be able to diagnose confirmed dengue cases categorising primary and secondary dengue along with the duration of the disease, whether early or prolonged.

Chemical constituents and evaluation of cytotoxic and antifungal activity of Lantana camara essential oils

The essential oil (EO) of aerial parts of Lantana camara L., Verbenaceae, from Simões, Piaui, Northeast of Brazil, were obtained by hydrodistillation and analyzed by GC-FID and GC-MS techniques. In total, 68 compounds were identified. The most representative compounds of the oil were mono and sesquiterpenes. The main compounds found in the oil of the leaves in different months were β-caryophyllene (10.5%, in June of 2009), sabinene (7.98%, in September of 2008), limonene (7.68%, in September of 2008), spathulenol (11.64%, in September of 2008). The oil from stems of L. camara was characterized by a largest amount of sesquiterpenoids, with spatulenol (15.9%) and caryophyllene oxide (17.1% in June of 2009), as main components. β-Gurjunene (32.7%, in September of 2008) was the most prominent compound in the stems oils, which was absent or at very low relative abundance in leaves. L. camara essential oils from leaves were cytotoxic to V79 mammalian cells and also to Artemia salina, showing 50% lethal concentration (LC50) values from 0.23 µg/mL. The in vitro data obtained in this study suggested that EO may also be effective treating yeast infection in patients infected with fluconazole and terbinafine resistant isolates, but its toxicity must be monitored carefully.

Flavonóides de Piper carniconnectivum C. DC Piperaceae / Flavonoids from Piper carniconnectivum C. DC (Piperaceae)

Os flavonóides 5,3’,4’-triidroxi-7-metoxiflavona, 5,3’-diidroxi-7-4’-dimetoxiflavona, 5,4’-diidroxi-7-metoxiflavona e uma mistura de esteróides (β-sitosterol e estigmasterol) foram isoladas das partes aιreas de Piper carniconnectivumC.DC, Piperaceae. As estruturas desses compostos foram estabelecidas por análises espectroscópicas de UV, IV e RMN de ¹H e 13C, incluindo técnicas uni e bidimensionais.

The flavonoids 5,3’,4’-trihydroxy-7-methoxyflavone, 5,3’-dihydroxy-7-4’-dimethoxyflavone, 5,4’-dihydroxy-7-methoxyflavone and steroids mixture (β-sitosterol and stigmasterol) were isolated from the dried aerials parts of Piper carniconnectivumC.DC. Their structures were established by spectroscopic analyses (UV, IV and ¹H, 13C NMR, including 1D and 2D NMR).

Trypanocidal activity of flavonoids and limonoids isolated from Myrsinaceae and Meliaceae active plant extracts / Atividade tripanocida de flavonoides e limonoides isolados de extratos ativos de plantas de Myrsinaceae e Meliaceae

The activity of crude extracts of three Rapanea species (Myrsinaceae) and Cipadessa fruticosa (Meliaceae) was evaluated in vitro against the trypomastigote forms of Trypanosoma cruzi. Thirty-three extracts from different organs of these species were assayed and eleven of them showed significant activity (lysis percent >50). The fractionation of an active extract from branches of R. lancifolia (99.5 percent) led to the isolation of two flavonoids: quercetin and taxifolin, which have weak trypanocidal activity. Additionally, one active extract from fruits of C. fruticosa (97.7 percent) afforded mexicanolide limonoids: cipadesin, mexicanolide, febrifugin and cipadesin A, that were slightly active on T. cruzi. Moreover, other two flavonoids (flavone and 7-methoxyflavone), previously assayed against T. cruzi, were isolated from the hexane extract from branches of C. fruticosa (100 percent). The results presented here suggest that the plants evaluated could be a source of new active compounds against T. cruzi.

A atividade de extratos brutos de três espécies de Rapanea (Myrsinaceae) e de Cipadessa fruticosa (Meliaceae) foi avaliada in vitro contra formas tripomastigotas de Trypanosoma cruzi. Foram obtidos 33 extratos de diferentes órgãos das espécies estudadas, sendo que onze deles apresentaram atividades significantes ( por cento de lise > 50) nos ensaios realizados. O fracionamento de um extrato ativo dos galhos de R. lancifolia (99,5 por cento) resultou no isolamento de dois flavonoides (quercetina e taxifolina), que apresentaram baixa atividade tripanocida. De um extrato ativo dos frutos de C. fruticosa (97,7 por cento) foram isolados os limonoides mexicanolídeos cipadesina, mexicanolídeo, febrifugina e cipadesina A, que foram moderadamente ativos sobre T. cruzi. Além disso, outros dois flavonoides (flavona e 7-metoxiflavona), previamente ensaiados contra T. cruzi, foram isolados do extrato hexânico dos galhos de C. fruticosa (100 por cento). Os resultados obtidos aqui sugerem que as plantas avaliadas podem constituir fontes de novas substâncias ativas sobre o T. cruzi.

Microbiota associated with tramp ants in a Brazilian University Hospital / Microbiota associada às formigas urbanas em um Hospital Universitário Brasileiro

Our aim was to study the fauna of ants in the Hospital Universitário of the Universidade Federal do Triângulo Mineiro, municipality of Uberaba, Minas Gerais State, Brazil, as well as to identify the microorganisms the ants carry and their patterns of resistance to antibiotics. Sterile tubes (traps) containing honey were used to attract the ants. Traps were exposed for 3h, and those which attracted ants were considered the test group, while the ones that did not attract the insects constituted the control group. Only the ant species Tapinoma melanocephalum (Fabricius) was sampled. Sixty microorganisms were isolated from the sampled ants, including seven Gram-positive bacilli, 14 Gram-negative bacilli, 22 Gram-positive cocci and 17 filamentous fungi. Pseudomonas, Staphylococcus and Group D Streptococcus were the microorganisms with the highest resistance to the tested antibiotics. The ants should be considered an important vector of infections as they carry several pathogenic microorganisms, spreading them on the surface of sterile materials, equipments and uncontaminated food. It is impossible to define the exact role of ants in nosocomial infections at this moment; however, this issue must be better studied and special attention must be given by the commissions of Nosocomial Infection Control.

O objetivo deste estudo foi conhecer a fauna de formigas existente no Hospital Universitário da Universidade Federal do Triângulo Mineiro, Uberaba, MG, bem como as espécies de microrganismos transportadas por elas, além de identificar o padrão de resistência destes microrganismos a antimicrobianos. Para atrair as formigas, utilizaram-se tubos estéreis contendo mel. Após período de exposição de 3h, os mesmos foram tampados. Os tubos que atraíram formigas foram considerados o grupo teste e os que não atraíram o controle. Apenas Tapinoma melanocephalum (Fabricius) foi amostrada. O isolamento de microrganismos dos exemplares de T. melanocephalum apontou 60 espécies, entre as quais sete eram bacilos Gram positivo, 14 bacilos Gram negativo, 22 cocos Gram positivo e 17 fungos filamentosos. Pseudomonas, Staphylococcus e Streptococcus do grupo D foram os microrganismos que apresentaram maior resistência aos antibióticos. As formigas devem ser consideradas um importante vetor de infecções, pois são carreadoras de microrganismos, levando-os na superfície de seu corpo para materiais estéreis, equipamentos e alimentos não-contaminados. Não é possível definir o papel exato das formigas em infecções nosocomiais. No entanto, este deve ser melhor avaliado e atenção especial deve ser dada pelas comissões de Controle de Infecções Hospitalares.

Screening of Trypanosoma cruzi glycosomal glyceraldehyde-3-phosphate dehydrogenase enzyme inhibitors / Busca de inibidores da enzima glicossomal gliceraldeído 3-fosfato desidrogenase de Trypanosoma cruzi

The inhibitory activity of crude extracts of Meliaceae and Rutaceae plants on glycosomal glyceraldehyde-3-phosphate dehydrogenase (gGAPDH) enzyme from Trypanosoma cruzi was evaluated at 100 μg/mL. Forty-six extracts were tested and fifteen of them showed significant inhibitory activity (IA percent > 50). The majority of the assayed extracts of Meliaceae plants (Cedrela fissilis, Cipadessa fruticosa and Trichilia ramalhoi) showed high ability to inhibit the enzymatic activity. The fractionation of the hexane extract from branches of C. fruticosa led to the isolation of three flavonoids: flavone, 7-methoxyflavone and 3',4',5',5,7-pentamethoxyflavone. The two last compounds showed high ability to inhibit the gGAPDH activity. Therefore, the assayed Meliaceae species could be considered as a promising source of lead compounds against Chagas' disease.

Nesse trabalho foi avaliada a atividade inibitória sobre a enzima glicossomal gliceraldeído-3-fosfato desidrogenase de T. cruzi (gGAPDH) de extratos vegetais oriundos de plantas das famílias Meliaceae e Rutaceae, na concentração de 100 μg/mL. Foram testados 46 extratos, dos quais 15 apresentaram atividade inibitória significativa ( por cento AI > 50). A maioria dos extratos de plantas da família Meliaceae (Cedrela fissilis, Cipadessa fruticosa e Trichilia ramalhoi) apresentou grande potencial em inibir a atividade enzimática. O fracionamento do extrato hexânico dos galhos de C. fruticosa permitiu o isolamento de três flavonóides: flavona, 7-metoxiflavona e 3',4',5',5,7-pentametoxiflavona. Os dois últimos foram ativos na inibição da atividade de gGAPDH. Desta forma, as três espécies de Meliaceae testadas podem ser consideradas promissoras na busca de compostos protótipos para o controle da doença de Chagas.

Comportamento de oviposição da mosca-branca Bemisia tabaci (Genn. ) (Hemiptera: Aleyrodidae) biótipo B em tomateiro / Oviposition behavior of the silverleaf whitefly Bemisia tabaci biotype B on tomato

Avaliou-se a influência da face foliar, do comportamento geotrópico do inseto e do tipo de tricoma foliar sobre a oviposição de Bemisia tabaci (Genn.) biótipo B em folhas de tomateiro. Para avaliação desses efeitos foram realizados vários ensaios nos quais as fêmeas foram confinadas em caixas de acrílico. Folíolos de tomateiro foram fixados no topo e na base das caixas, de tal forma a permitir o acesso dos insetos às faces adaxial e abaxial de maneira isolada e concomitante (com e sem chance de escolha). Os insetos sempre depositaram maior número de ovos quando a superfície foliar se encontrava no topo da caixa e, de maneira geral, preferiram depositar seus ovos na face abaxial dos folíolos. Para avaliar o efeito do tipo de tricoma (glandular e não-glandular) sobre a oviposição de B. tabaci, a face abaxial dos folíolos de tomateiro foi oferecida a cerca de 30 fêmeas para oviposição em cada caixa de acrílico. Foram oferecidos folíolos previamente lavados com etanol a 70 por cento (de forma a eliminar os exsudatos glandulares) e sem lavagem prévia. A maior parte da oviposição ocorreu ao lado dos tricomas não-glandulares, demonstrando que o inseto discrimina o tipo de tricoma.

The objective of this work was to evaluate the influence of the leaf surface, the insect geotropic behavior and the type of foliar trichome on Bemisia tabaci (Genn.) biotype B oviposition on tomato leaves. Bemisia tabaci females were confined in acrylic boxes in which tomato leaflets were fixed at the bottom and top part of the boxes to allow insects to access the leaf surface to be tested (adaxial and/or abaxial) in both no-choice and free choice tests. Oviposition was always higher when the leaf was offered at the top of the box and preferably at the abaxial leaf surface. The effects of leaf trichomes (glandular and non glandular) on B. tabaci oviposition was evaluated by offering the abaxial surface of tomato leaflets to females after a 70 percent ethanol wash to remove glandular exsudates against a control treatment (without a ethanol wash). Oviposition was concentrated mostly near to non glandular trichomes, showing whitefly females can discriminate among the trichomes.

A giant vesical calculus.

Massive or giant vesical calculus is a rare entity in the recent urological practice. Males are affected more than the females. Vesical calculi are usually secondary to bladder outlet obstruction. These patients present with recurrent urinary tract infection, haematuria or with retention of urine. We report a young male patient who presented with defaecatory problems along with other urinary symptoms. The patient having an average built, non diabetic but hypertensive. The stone could be palpated by physical examination. His urea levels were within normal limits but urine examination shows infection. USG reveals bilateral hydronephrosis with multiple stones in both kidneys along with a giant vesical calculus. After controlling urinary infection and hypertention he underwent an open cystolithotomy. During operation digital rectal help was needed to remove the stone as it was adherent with bladder mucosa. Post operative period was uneventful. His urinary output was quite normal and had no defaecatory problems. Patient left the hospital 10 days after operation.

Coexistent partial anodontia and supernumerary tooth in the mandibular arch: A rare case.

Coexistent partial anodontia and supernumerary tooth in the lower jaw is a very uncommon condition. Very few cases have been reported in the literature of this condition, etiology of which is still obscure. Presented here is a rare case of simultaneous presence of single supernumerary tooth together with missing permanent central incisor teeth in the lower jaw without any associated systemic condition or syndrome.

Erupted maxillary conical mesiodens in deciduous dentition in a Bengali girl - A case report.

Mesiodens is a midline supernumerary tooth commonly seen in the maxillary arch. It is the most significant dental anomaly affecting permanent dentition mainly and primary dentition rarely. It may occur as an isolated dental anomalous condition or may be associated with a syndrome. Many theories have been promulgated to explain its etiology. But an exact etiology is still obscure. Incidence of mesiodens in children varies from 0.15 to 3.8%. Boys are affected more (2 : 1) than Girls. Morphologically, mesiodens may be of three types: the most commonly seen is conical, while tuberculate and supplementary types.

Comparative randomised controlled clinical trial of a herbal eye drop with artificial tear and placebo in computer vision syndrome.

A comparative randomised double masked multicentric clinical trial has been conducted to find out the efficacy and safety of a herbal eye drop preparation, itone eye drops with artificial tear and placebo in 120 patients with computer vision syndrome. Patients using computer for at least 2 hours continuosly per day having symptoms of irritation, foreign body sensation, watering, redness, headache, eyeache and signs of conjunctival congestion, mucous/debris, corneal filaments, corneal staining or lacrimal lake were included in this study. Every patient was instructed to put two drops of either herbal drugs or placebo or artificial tear in the eyes regularly four times for 6 weeks. Objective and subjective findings were recorded at bi-weekly intervals up to six weeks. Side-effects, if any, were also noted. In computer vision syndrome the herbal eye drop preparation was found significantly better than artificial tear (p < 0.01). No side-effects were noted by any of the drugs. Both subjective and objective improvements were observed in itone treated cases. So, itone can be considered as a useful drug in computer vision syndrome.

In vitro micropropagation of Lawsonia inermis (Lythraceae)

A successful protocol was developed for mass propagation of Lawsonia inermis Linn., an important medicinal plant. Multiple shoots were induced in apical and axillary meristems derived from mature explants of L. inermis on Murashige and Skoog (1962) medium supplemented with 0.25 mg/l 6-benzylaminopurine (BA), 0.25 mg/l Kinetin (Kn), 0.5 mg/l ascorbic acid and 3 (w/v) sucrose. The rate of multiplication was higher when the cultures were incubated under continuous light rather than the 14 hr photoperiod. Rooting was readily achieved upon transferring the microshoots onto MS basal semi-solid medium supplemented with 0.25 mg/l indole-3-butyric acid (IBA) after ten days of culture. Micropropagated plantlets were acclimatized and successfully grown in soil.

Gall bladder agenesis, pancreas divisum and undescended testes: a rare association.

Gall bladder agenesis is a rare congenital biliary anomaly that may be associated with other biliary and extrabiliary congenital anomalies. We report the association of gall bladder agenesis with pancreas divisum and undescended testes.