Management of Diabetic Macular Edema Through Ayurveda: A Single Case Study

Diabetic macular edema is one of the leading causes of visual acuity loss in people with diabetes. It produces blurry vision, particularly in the centre of the vision field, floaters and black spots in front of the eyes etc. The treatment recommended by modern science is laser photocoagulation and anti-VEGF injection, which is pricey and does not ensure visual reversal in the patient. In Ayurveda text, diabetic retinopathy and diabetic macular edema are not directly described but etiopathogenesis of eye diseases and Prameha gives an idea of possible correlation between these two diseases. So, DME resembles Timira (Pramehajanya). In Ayurveda, Timira has been explained in detail by our Acharyas. Clinical manifestations of Timira are Vihwal Drishti (blurred vision), Makshika Mashaka Kesha Jaala Pashyati (floaters), Tamasa Darshanam (Scotoma- black spots in front of eyes) and Nasa Akshi Yuktani Vipritani Vikshate (Metamorphopsia or distorted vision) which has similarity with features of DME. Material & Methods: In the present study, a female patient aged 51 years, visited the Shalakya Tantra OPD of National Institute of Ayurveda, Jaipur, with complaining of Blurriness of vision since 6 months and uncontrolled blood sugar level. Result: Blood sugar level was controlled and saw reduction in subjective and objective parameters. Discussion: Following an Ayurvedic drugs and routine will assist to slow the advancement of the condition, prevent further diabetes complications, and improve quality of life.

Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

Comparison of corneal endothelial changes following phacoemulsification in diabetic and non-diabetic patients

Purpose: To study corneal endothelial changes post phacoemulsification in diabetic and non?diabetic patients. Methods: A comparative, prospective, observational study was conducted on 100 diabetic and 100 non?diabetics who underwent phacoemulsification. All patients were operated by the same surgeon by using the phaco chop technique to exclude any surgeon?related bias. Endothelial cell count, CCT, and coefficient of variance (CV) were measured with a specular microscope along with BCVA preoperatively and at 1 week, 4 weeks, and 3 months postoperatively. For statistical analysis, data were analyzed by using SPSS (version 27.0; SPSS Inc., Chicago, IL, USA). Data were summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Chi square test, independent sample T test, and paired T test were used to compare the data. P ? 0.05 was considered statistically significant. Results: Postoperatively at 1 week, 4?week, and 3 months follow?up intervals, the mean endothelial cell count and coefficient of variance were significantly higher, and the mean percentage of hexagonal cells was significantly lower in non diabetic as compared to the diabetic group. A significant difference in mean central corneal thickness of the two groups was observed at 1?week and 4?weeks postoperative intervals; at both these intervals, the mean value was significantly higher in non diabetic as compared to the non?diabetic group. However, at 3?months post?operative interval, the difference between the two groups was not significant statistically. Mean BCVA values were significantly higher in diabetic as compared to the diabetic group at all three follow?up intervals. Conclusion: The findings of the present study show that endothelial cell characteristics are adversely affected in diabetic eyes as compared to non?diabetic patients undergoing phacoemulsification; this might also have an effect on the visual outcomes.

A segmental root development as an unusual healing response to the revitalization of mandibular second premolar

A 15-year-old patient reported persistent pain in the left mandibular second premolar (#35) following a traumatic bite 3 months ago. Clinical examination revealed a fractured central cusp suggestive of dens evaginatus. Intraoral periapical radiograph revealed an immature permanent tooth with a periapical radiolucency. A diagnosis of pulp necrosis with symptomatic apical periodontitis was made. The tooth was treated according to the revised guidelines of regenerative endodontic procedure by the American Association of Endodontics. The follow-up evaluation revealed a complete resolution of periapical pathology. A detached radiopaque tissue was appreciated at the 12-month follow-up. It resembled a broken root tip at the 24-month follow-up. Both the main root body and disjointed root tip developed independently. A cone-beam computed tomography evaluation at the 36-month follow-up confirmed the segmented development of the apical root tip.

Oral Health Consequences of Use of Smokeless Tobacco in North India: A Cross-Sectional Survey

ABSTRACT Objective: To evaluate the effects of commonly used smokeless tobacco forms on oral health at habitual placement sites of smokeless tobacco compared to non-placement sites among the North Indian population. Material and Methods: This cross-sectional study was conducted among 542 individuals using smokeless tobacco recruited from the outpatient wing of the Dental College. Subjects completed a questionnaire and received an oral examination. Periodontal pocket depth, gingival index, plaque index, gingival recession, and oral mucosal changes were assessed. Kendal's Tau test, paired t-test, and chi-square test were carried out to compare different variables among placement and non-placement sites. Results: Most of the subjects were male, reporting an average of 11.26 years of SLT use. Clinical inflammation of gingiva was significantly greater (p=0.01) at placement-sites (1.64 ± 0.53) of SLT in comparison to non-placement-sites (1.40 ± 0.41). The difference in the GR and PPD at placement and non-placement-sites was also statistically significant with p=0.002 and p=0.001, respectively. Clinically, the majority of subjects had mucosal changes at the placement sites, and a statistically significant association (p=0.034) was observed between the duration of the use of smokeless tobacco and the mucosal changes. Conclusion: Smokeless tobacco use predisposes to increased risk of periodontal diseases and oral mucosal changes at the placement sites in an individual due to the local irritant effect.

Clinico-Haematological Profile of Haemophilia in Patients Attending Gandhi Medical College and Associated Hamidia Hospital, Bhopal..

BACKGROUND Haemophilia A and haemophilia B are the commonest form of haemophilia encountered and they result from a defect in Factor VIII and Factor IX gene respectively. This hinders the process of haemostasis and predisposing haemophiliacs to spontaneous or post traumatic bleeding. We wanted to study the clinico-haematological profile of patients with haemophilia.METHODSThis observational study was conducted in Gandhi Medical College and Associated Hamidia Hospital, Bhopal, during the period of March 2017 to June 2018. After clinical evaluation, patients were subjected to a battery of coagulation tests (Bleeding Time, Prothrombin Time, Activated Partial Thromboplastin Time, Correction Studies and whenever possible, Specific Coagulation Factor Assay). The results were analysed.RESULTSDuring the study period, 100 patients of haemophilia were studied. Majority of patients were of haemophilia A (89%). Most common age group was 6 - 15 years (49%) and mean age was 19.02±12.58 years. Most common age of onset was <1 year (62%). Positive family history was present in 57% of cases. 52% patients had severe haemophilia. Most common presentation was haemarthrosis & knee joint was the most common joint involved. APTT was prolonged in all cases.CONCLUSIONSHaemophiliacs are distributed worldwide and have heterogeneous presentation depending upon disease severity. Knowledge of the spectrum of presentation of haemophilia in the population helps in early diagnosis and management planning. Promotion of regular availability of factor concentrate, establishing comprehensive care center and positive public awareness along with good haematology laboratory will help in achieving outcome comparable to that of developed countries.

Binary immobilization: a newer approach for immobilizing lipase from a thermophilic sp. of Thermomyces lanuginosus

We report binary immobilization of Thermomyces lanuginosus lipase enzyme using chitosan as the support. This method of enzyme immobilization is better than cross-linked enzyme aggregate (CLEA) in terms of better enzyme recovery and separation. This method of immobilization resulted in an increase in the thermostability of the binary immobilized lipase as against the crude free enzyme. This preparation could be used for nearly 15 consecutive cycles with 80-100% efficiency. Reusability of the immobilized enzyme makes it an economical alternative to the traditional way. Immobilized lipases in particular are a modern catalytic tool for various industrially significant reactions and applications.

Elemental Mercury Injection Into The Hand: A Case Report

Injecting mercury for suicidal purposes is very uncommon and only a few cases have been reported. Here, we present an unusual case of injection of elementalmercury into the hand by a 27-year-old male leading to cellulitis. The need for debridement and chelation therapy based on the measured blood and urine mercury levels has been discussed.

Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.

The Estimation of Genetic and Phenotypic Parameters of Growth Curve Traits in Sirohi Goat Using Brody Function

The objectives of this study were to investigate growth patterns of Sirohi goat applying the Brody function and estimated the parameters of growth curve including genetic evaluation of growth curve traits. The data used in this study, collected in All India Co-ordinated Research Project (AICRP) on goat improvement, Livestock Research Station, Vallabhnagar, Udaipur, India from year 2009 to 2017 and were included 340 male and 715 female kids body weight measured at birth to 12th month of age in every three months interval. Least-squares means for growth curve parameters of A (Asymptotic weight), B (folding point of growth) and K (maturity rate) were 26.18±3.11 (kg), 0.88±0.00 (kg) and 0.16±0.00 (days), respectively. Fixed effects (cluster, year and season of birth, sex, and type of birth) were significantly influenced the parameters of growth curve. The heritability estimates ranged from 0.02±0.01 (“K”) to 0.40±0.05 (“A”). The genetic correlation between A-K and B-K was negative, which might be due to the compensatory growth effect

Study Of Intra Ocular Pressure In Patients With Type 2 Diabetes Mellitus Of Udaipur District, Rajasthan, India

Background: Intraocular pressure constitutes the most important risk factor for the emergence of glaucoma, apathology often associated with diabetes mellitus.Objective: The purpose of the study was to analyze the relationship between intraocular pressure and type 2diabetes mellitus and to investigate the effects of chronic hyperglycaemia on the intraocular pressure (IOP).Materials and Methods: We prospectively measured the IOP by applanation tonometry in 100 patients with type2 diabetes (Group I) and in 100 Normal subject as a control(Group II). The glycosylated haemoglobin (HbA1c)levels of the subjects with diabetes were determined and based on that, they were divided into 3 subgroups asgroup Ia with HbA1c levels of < 7% (n = 40); group Ib with HbA1c levels of 7 to 8.0%(n = 32); and group Ic withHbA1c levels of > 8.0% (n = 28 ) All the data were expressed as means ± standard deviations.The statisticalanalysis was performed by the Student’s t test. The correlation between HbA1c and IOP was analyzed by thePearson’s correlation coefficient. A p value of < 0 .05 was considered to be significant.Results: We observed that the IOP values were higher in the subjects with diabetes (Mean = 21.50 ± 3.50) than inthe age and sex matched control groups. The mean IOP in the groups Ia, Ib and Ic were 16.32 ± 2.10 , 20.54 ± 2.50mm Hg, and 21.95 ± 3.20 mm Hg respectively. The difference in the IOP between the groups Ib and Ic was found tobe statistically significant (P = .001)Conclusion: Diabetic subjects with elevated HbA1c levels exhibited significantly higher IOPs compared to thosewith lower HbA1c levels. Findings from this study indicate an association between hyperglycemia and elevatedIOP and that poor glycemic control may contribute to increased IOP levels in long-term diabetic patients.

​Assessment For Performance Of Middlebrook 7h9 With Oleic-Albumin-Dextrose-Catalase Culture Media For Isolation Of Mycobacterium Tuberculosis In Ziehl–Neelsen Smear-Positive Sputum Samples In Clinically Suspected Cases Of Tuberculosis

Introduction: Pulmonary tuberculosis (TB) is a second foremost cause of death from a communicable disease, after the HIV.Being communicable should be diagnosed at the earliest. Smear examination is preliminary step for the confirm diagnosis, butculture is still a gold standard method.Materials and Methods: The present study was carried out in the Department of Microbiology on a total of 600 smear sputumsamples from clinically suspected cases of pulmonary TB attending the outpatient and inpatient departments of MMIMSR,Mullana, Ambala, from December 2016 to June 2018. Specimens were subjected to ZN and LED staining before and afterdecontamination. After microscopy, specimens were subjected to culture on LJ and Middlebrook 7H9.Results: Mycobacterium tuberculosis was isolated in 23.33% of samples. 110 (78.57%) were detected by microscopy (ZN andLED), respectively. ZN smear positivity before and after decontamination was maximum in mucopurulent 78% and 76.63% andLED 73.63% and 72.03%. Culture positivity on Middlebrook 7H9 was 100% while 87.85% on LJ media. The rate of contaminationwas 5% and 7% on Middlebrook 7H9 and LJ media, respectively.Conclusions: Middlebrook media was superior to the conventional LJ medium in being rapid, easy to use and interpret, andsignificantly low time-to-growth detection and had lesser contamination rate because the liquid media contains growth supplementoleic-albumin–dextrose-catalase, provides additional nutrition.

A Prospective Study of Post Operative Health Related Quality of Life in Orthopaedic Trauma Patients

Background: Trauma is one of the leading public health problems and the most common avoidable cause of death among children and adults up to age 45 years. For every trauma, several thousand injured people seek medical attention. Survivors incur temporary or permanent impairments and disabilities resulting in human suffering, major social consequences and economic costs for the individual, families and society. Measuring outcome after the Orthopaedic surgery is important for many reasons, particularly its one measure of effectiveness of surgical treatment and support that has been offered and standard of care taken. As trauma care has improved substantially during recent decades and has led to higher survival rates there has also been an increasing focus on the patient’s perceived Health-Related Quality Of Life (HRQOL) as an outcome after trauma. Methods:A prospective cohort study of hospitalized trauma patients who were operated at our centre for different levels of injury was performed during March 2016 to June 2017.We included 200 patients on the basis of inclusion criteria who were enrolled at the outpatient department (OPD), ward & casualty. Informed consent was taken fom all patients and clearance from ethical committee was taken. Preoperative evaluation of HRQOL was done with 36 Item Short Form Health Survey (SF36) questionnaire. Same questionnaire was filled up at the time of follow up after 1 month, 3 months and 6 months. At home interviews were done in selected patients who because of some reasons were unable to come for follow up. Results: Out of 200 patients, lower limb was operated in 133 patients and 67 cases were operated for upper limbtrauma; the most commonly performed surgery being proximal femoral nailing (22 cases). The SF-36 mean score of 200 patients pre operatively was 20.50 which postoperatively at six months improved to 83.59. The highest percentage improvement was recorded for role limitation due to emotional problem.Highest percentage of improvement in SF-36 mean score was seen in 18 to 33 year age group patients (78.77%) while lowest percentage improvement was seen in 50 to 65 year age group(72.74%). Males have shown better improvement in Mean scores as compared to females. There was no significant difference in pre operative mean scores in upper limb trauma patients (20.16) and lower limb trauma patients (20.29). Patients operated with closed reduction internal fixation or external fixation had higher pre operative mean score (21.24) & post operative mean score (85.39) than those who were operated with open reduction internal fixation(19.47 and 83.99 respectively); but the percentage improvement was slightly better in open reduction cases (76.81%) than closed reduction cases (75.13%). Conclusion:The study was conducted to determine whether the patient was satisfied or not after surgery done for Orthopaedic traumatic conditions. It was noted in the study that young age group patients showed better improvement in all aspects of Health. Both physical and mental scale improvement was more in 18 to 33 year age group patients; which decreased in second age group 34 to 50 year age group and was lowest in 50 to 65 year age group patients. The study indicated better and fast improvement in male patients as compared to females. Upper limb trauma patients showed better scores and healing than lower limb trauma patients in post operative period. Patients operated with closed reduction internal fixation or external fixation had higher pre operative mean score & post operative mean score than those who were operated with open reduction internal fixation but the percentage improvement was slightly better in open reduction cases than closed reduction cases. Good functional outcome after Orthopaedic Surgery measured in the form of SF-36 is related to many variables such as Proper surgical procedure, aseptic environment and good choice of implant, timing of surgery, post operative rehabilitation program, proper psychological counseling and regular follow ups. When all the above mentioned variables are managed and planned accordingly, the surgical intervention leads to tremendous improvement in both physical and mental health of the patients which can be measured and recorded in the form of SF-36 Health survey. The study supports the requirement of proper surgical intervention against conservative treatments for the limb injuries involving major Orthopaedic trauma to achieve better long term functional outcomes.

Intermediate Term Outomes of Navigation Assisted Total Knee Arthroplasty

Background: Osteoarthritis of the knee is among the most common contributing causes of global disability, prevalent in 20 to 40 % of those over 75 years of age. Total Knee Arthroplasty (TKA), today; is the final treatment option provided to patients with unsalvageable, severely arthritic, painful and deformed knees. TKA with a postoperative mechanical axis of <3º varus or valgus have better long-term survival. Despite the continuing improvement in mechanical alignment systems, it has been estimated that the error in tibial and femoral alignment of over 3° occurs in about 10% of total knee arthroplasties even when they are carried out by well-trained surgeons using the most up-to-date mechanical alignment tools. Computer Assisted TKA has shown to reduce outliers of mechanical leg axis (>3° valgus/varus deviation) compared to the conventional technique.We hypothesized that Computer Assisted Total Knee Arthroplasty will offer a good clinical and functional outcome in patients. Methods:This was a prospective study done in Department of Orthopaedics at our institute. 53 cases were taken with diagnosis of osteoarthritis of knee joint from May 2015 to June 2017. The study was prospective and observational in nature and informed consent was obtained from each patient. Clearance from scientific and ethical committee of the institute was obtained. The results of navigation assisted total knee replacements were assessed with Visual Analogue Scale, Knee society knee score and Function Score and radiologically by various component angles and Mechanical Axis Deviation. Results: Mean Mechanical Axis Deviation of 18.04° varus preoperatively (range, 15° -24°) was corrected to 0.28° varus (range 3.5° valgus- 3.3° varus) postoperatively. Mean Knee Society score improved from 2.415 (range 0-14) to 82.55 (range 50 -95), and function score from 23.40 (range, 0 -65) to 82.55(range 50-95) at minimum 12 months of follow up. The mean pre-operative VAS was 7.6 and showed linear improvement post operatively to 4.0 at 1 month, 2.37 at 3 months, 1.07 at 6 months and finally 0.64 at 12 months. The mean component angles of implants in Tibia and Femur post-operatively were measured as Coronal femoral angle – 90.025°, Sagittal femoral angle – 90.425°, Coronal tibial angle – 90.311°, Sagittal tibial angle – 88.896°. Conclusion:60.37% excellent and 30.18% good functional outcome along with significant improvements in knee society knee scores and VAS scores was reported. This suggests that computer assisted TKA is a safe, effective and reliable method to alleviate pain and correct deformities in patients with Osteoarthritis of the knee joint. The radiological assessment done Post-operatively confirmed that, CATKA is a significantly accurate tool to correct the deformities.

Qualitative and Quantitative Comparison of Contrast-Enhanced Fluid-Attenuated Inversion Recovery, Magnetization Transfer Spin Echo, and Fat-Saturation T1-Weighted Sequences in Infectious Meningitis

OBJECTIVE: To compare the contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR), the CE T1-weighted (CE-T1W) sequence with fat suppression (FS) and magnetization transfer (MT) for early detection and characterization of infectious meningitis. MATERIALS AND METHODS: Fifty patients and 10 control subjects were evaluated with the CE-FLAIR and the CE-T1W sequences with FS and MT. Qualitative assessment was done by two observers for presence and grading of abnormal leptomeningeal enhancement. Quantitative assessment included computation of net meningeal enhancement, using single pixel signal intensity software. A newly devised FLAIR based scoring system, based on certain imaging features including ventricular dilatation, ependymal enhancement, infarcts and subdural effusions was used to indicate the etiology. Data were analysed using the Student's t test, Cohen's Kappa coefficient, Pearson's correlation coefficient, the intraclass correlation coefficient, one way analysis of variance, and Fisher's exact test with Bonferroni correction as the post hoc test. RESULTS: The CE-FLAIR sequence demonstrated a better sensitivity (100%), diagnostic accuracy (95%), and a stronger correlation with the cerebrospinal fluid, total leukocyte count (r = 0.75), protein (r = 0.77), adenosine deaminase (r = 0.81) and blood glucose (r = -0.6) values compared to the CE-T1W sequences. Qualitative grades and quantitative meningeal enhancement on the CE-FLAIR sequence were also significantly greater than those on the other sequences. The FLAIR based scoring system yielded a diagnostic accuracy of 91.6% and a sensitivity of 96%. A strong inverse Pearson's correlation (r = -0.95) was found between the assigned score and patient's Glasgow Coma Scale at the time of admission. CONCLUSION: The CE-FLAIR sequence is better suited for evaluating infectious meningitis and could be included as a part of the routine MR imaging protocol.

Development of a new single unit dosage form of propranolol HCl extended release non-effervescent floating matrix tablets: In vitro and in vivo evaluation.

The objective of the present investigation was to develop extended release non-effervescent floating matrix tablets of Propranolol Hydrochloride (PPH) to extend the gastric residence time (GRT) and prolong the drug release after oral administration. Different viscosity grades of Hydroxypropyl methylcellulose (HPMC) polymers such as HPMC K4M, HPMC K15M and HPMC K100M were used as drug release retardants. Glyceryl behinate (Compritol 888 ATO) and Glyceryl monosterate (Precirol ATO 5) were used as low density lipids in order to get the desired buoyancy over a prolonged period of time. The drug excipients compatibility study was carried out by using Differential Scanning Calorimetry (DSC). All the formulations were prepared by direct compression technique. The prepared tablets were evaluated for their physical characters, in vitro drug release and in vitro buoyancy. The release and floating property depends on the polymer type, polymer proportion, lipid type and lipid proportions. The drug release profiles of all the formulations were subjected to Zero order, First order, Higuchi and Peppas kinetic models, and the optimized formulation (F7) followed the Peppas model (R2= 0.987) with non-Fickian diffusion mechanism(n>0.5). The optimized formulation was subjected for in vivo radiographic studies in healthy human volunteers (n=3). These studies revealed a mean gastric residence time of 5±1.73 h (n=3).

Characterization of tannic acid- and gallic acid-functionalized single- and multiwalled carbon nanotubes and an in vitro evaluation of their antioxidant properties

Objectives: Carbon nanotubes [CNTs] have powerful oxidative properties that influence their biomedical applications. This study addresses the oxidative potential of both single-walled carbon nanotubes [SWCNTs] and multiwalled carbon nanotubes [MWCNTs] by functionalizing them with tannic acid [TA] and gallic acid [GA], and an in vitro evaluation of their antioxidant properties is presented. Their effective role as antioxidants is influenced by their dual functions of reducing toxicity and inducing antioxidant effects

Methods: Functionalization was confirmed by Fourier transform infrared spectroscopy [FTIR], and the total phenolic content was assessed. The antioxidant properties were analyzed by scavenging di[phenyl]-[2,4,6- trinitrophenyl] iminoazanium, lipid peroxidation, reactive oxygen species [ROS] quantification and quenching externally generated hydroxyl and superoxide radicals

Results: The functionalization of nanotubes with antioxidants was conformed via FTIR and measurement of total phenolic compounds. Higher radical scavenging was observed for TA-functionalized SWCNTs than for other functionalizations and MWCNTs. The lipid peroxidation results revealed that the functionalization of nanotubes with the antioxidant TA significantly decreased lipid peroxidation [36%] compared with naked nanotubes [85%] and the positive control [94%]. Furthermore, antioxidant-functionalized nanotubes showed negligible production of ROS after being irradiated under different conditions, and externally generated hydroxyl and superoxide radicals were quenched

Conclusion: This study showed, using in vitro models, that effective functionalization of CNTs with TA and GA leads to remarkable antioxidant properties. Antioxidantfunctionalized nanotubes showed a reduction in cell lethality correlated with negligible ROS production under different irradiation conditions and quenching of externally generated hydroxyl and superoxide radicals. Further, antioxidant-functionalized nanotubes were more compatible with the cell membrane

Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State

Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures.

Ultrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome

Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time.

An Unusual Case of Massive Splenomegaly in Cirrhotic Portal Hypertension.

Splenomegaly is a common finding in a wide-spectrum of diseases. It is usually reported in myeloproliferative disorders, lymphoma, leukemia, visceral leishmaniasis, tropical malaria and extrahepatic (noncirrhotic) portal hypertension. We describe herein recently encountered one unusual case of massive splenomegaly in a patient of hepatic cirrhosis with portal hypertension. This case report highlights that cirrhotic portal hypertension may be added in the differential diagnosis of massive splenomegaly to facilitate timely diagnosis and treatment.