Kissing microvitreoretinal blade technique: A novel approach for safe and effective endocapsular lens aspiration in microspherophakia

We herein describe the kissing MVR technique in cases of microspherophakia for safe and effective endocapsular lens aspiration. Microspherophakia is associated with abnormally lax and broken zonules, which pose a great challenge to the operating surgeon, especially while creating the openings in the capsular bag. In this novel technique, simultaneous use of two 23 G MVR blades reduces the above problem associated with the severely mobile lens. Here, one MVR blade stabilizes the capsular bag and, at the same time, provides counter-traction for the opposite MVR blade while puncturing the capsular bag. Furthermore, the creation of openings in the lens at the equator or just posterior to it is beneficial as the capsule is relatively thicker and stronger at this location. This also minimizes the risk of premature extension to the anterior or posterior capsule, thereby avoiding complications like dropped lens matter, vitreous prolapse, and vitreous traction.

Malignant middle cerebral artery stroke management in developing world-outcome predictors

@#Background & Objectives: Malignant middle cerebral artery (MCA) stroke constituting 5% of all strokes carries a high mortality across the world. We aimed to study predictors of malignant MCA stroke outcome, especially decompressive surgery in a developing country scenario. Methods: This was a prospective study design where patients with malignant MCA stroke (defined as imaging-CT/ MRI showing infarct involving >2/3rd MCA territory) admitted within 7 days of illness to SCTIMST, between January 2010 and December 2014 (5 years) were recruited. Clinical and imaging data, surgical details, in hospital complications and discharge outcome were collected. Follow-up data was collected at 3 and 12 months post-stroke. Results: We had 74 patients of malignant MCA territory strokes, 42 operated and 32 non-operated, who were comparable at baseline, except for age and stroke severity. At 3 months, deaths were more among the non-operated group (63% in non-operated vs 23% in operated group, p=0.02), while functional outcome was comparable. At 1 year follow-up, age below 60 years, lower stroke severity at onset and decompressive surgery were found to be independent predictors of good outcome. (p=0.04). Delayed surgery group, albeit small had a better 1 year outcome in comparison to the medical arm. Conclusions: Early functional outcome in the decompression group did not differ from the medically treated patients, other than mortality benefit. However, at 1 year, patients with age<60 years, lower stroke severity and decompressive surgery had a better morbidity and mortality outcome, indicating long term benefit of this life saving procedure in developing country scenario as well.

Transforming growth factor beta signaling in hepatocellular carcinoma: as a victim or culprit?

The transforming growth factor-β (TGFβ) signalling pathway control various cellular function and play a pivotal role in tumour suppression. In contrary, overexpression of TGFβ is linked to promote the cancer development. TGFβ facilitate cell-growth and cell-differentiation process which support tumour propagation. In case of hepatocellular carcinoma (HCC), TGFβ signalling pathway is the master regulator of HCCs pathogenesis and functionally involved in the regulation of HCCs phenotype via modulating the downstream signalling pathways. In this article, we have highlighted the contradictory behaviour of TGFβ in hepatocellular carcinoma. Observations suggest that the TGFβ signalling pathway is positively correlated to the expression of genes linked with various hepatic pathological conditions, including fibrosis, cirrhosis, inflammation and cancer. TGFβ pathway play dual role as pro and anti-tumoural activities in cancer cells depending on their context.

Nutritional quality enhancement of plants by improving its methionine content.

Human beings are only capable of synthesizing ten of twenty naturally occurring amino acids. The other essential amino acids are obtained from the diet. Cereal grains are often limiting for lysine, tryptophan and threonine, while the legume seeds have an adequate level of lysine but are limiting for the sulphurcontaining amino acids, methionine and cysteine. Animals can convert methionine into cysteine, but not the reverse. Low level of methionine in plants diminishes their value as a source of dietary protein for human and animals. There are several attempts to improve the methionine level in plants. This study gives an overview of various technology for enhancement of methionine level in plants, including traditional plant breeding methods and selection of mutant; synthesis an artificial gene rich in methionine and cysteine residue; genetic modification to increase methionine storage in protein; genetic modification to increase methionine biosynthesis and co-expressing methionine-rich storage proteins with enzymes that lead to high soluble methionine level, with minimal interference on plant growth, phenotype and productivity. The studies have resulted in the identification of steps important for the regulation of flux through the pathways and for the production of transgenic plants having increased free and protein bound methionine. The goal of increasing methionine content, and therefore nutritive value, of plant protein is presently being achieved and will no doubt continue to progress in the near future.

Changes in bone histology due to capacitive electric field stimulation of ovariectomized rat.

Background & objectives: Postmenopausal osteoporosis leads to a significant decline in bone mass. That complicates the treatment outcome. The objective of the present study was to find out the effects of pulsed modulated low level electric field capacitively coupled on bone histology of induced osteoporotic rats, for screening the potential therapy for osteoporosis. Methods: Osteopororosis was induced by performed by bilateral ovariectomy of female Wistar rats. After one month of surgery electric field stimulation was delivered to one leg of experimatal rats while the other was sham exposed. After 60 days of exposure treated rats were sacrificed and femur and tibia bones were segregated into (i) control (CON), (ii) ovariectomized (OVX) and (iii) ovariectomized + electrical stimulation (OVX+ES). Results: Histopathological analyses showed that capacitively coupled pulsed electric field exposure treatment augmented and restored the bone marrow cell population. Immunohistological localization of alkaline phosphatase (ALP) showed the increased activity of this enzyme after electrostimulation, which showed an enhanced osteoblast differentiation. Collagen histochemistry showed high amount of collagen fiber in exposed rats bones than that of osteoporotic bones. Electron microscopic study revealed the enhancement of microstructural composition and compactness in cortical and trabecular part of treated bones. Interpretation & conclusions: Our results suggest that capacitively coupled pulsed electric field exposure treatment of specified parameters is efficacious in attenuating the effects of ovariectomy induced osteoporosis and restore the bone loss.

Ureteral stump transitional cell carcinoma after radical nephrectomy: a case report with review of literature

Primary transitional cell carcinoma [TCC]] of the ureter accounts for less than 1% of all malignancies of upper genitourinary tract. Ureteral stump after radical nephrectomy may develop malignancy very rarely TCC being the commonest. Definite risk exists if the urinary bladder harbored TCC. Presence of TCC of the urinary bladder and persistent urinary tract infections in a nephrectomized patient may indicate closer evaluation

Effects of low level pulsed radio frequency fields on induced osteoporosis in rat bone.

Effect of modulated pulsed electromagnetic fields (PEMFs; carrier frequency, 14 MHz. modulated at 16 Hz of amplitude 10 V peak to peak) on sciatic neurectomy induced osteoporosis in rat femur and tibia resulted in statistically significant increase in bone mineral density, and deceleration in bone resorption process and consequently further osteoporosis in rat bone. These results suggest that such an effective window of pulsed radio frequency fields may be used therapeutically for the treatment of osteoporosis.