Fibrin glue assisted amniotic membrane graft reconstruction of conjunctival fornix and canthus following excision of conjunctival tumours

Conjunctival tumors involving non?limbal locations, such as the fornix and canthus, are typically excised using a “non?touch” technique, often with a wide surgical margin. Reconstruction of these large defects can be difficult due to the contour of the ocular surface and are often complicated by shortening of the fornix, symblepharon formation, and restriction of eye movements. In our experience, the use of amniotic membrane grafts combined with the sealant properties of fibrin glue such as Tisseel® has improved our surgical outcomes during the reconstruction phase. We would like to highlight and describe our surgical technique using fibrin glue and squint hooks to aid amniotic membrane graft reconstruction for surgically challenging locations in the fornix and canthus following excision of conjunctival lesions, with excellent surgical outcomes.

Clinico - Laboratory Profile of Enteric fever in Children

Introduction:Enteric fever remains an unresolved public health problem in India chiefly due to improper sanitary conditions and deficient supply of safe drinking water.Aims:The aim of the study was to study the clinical profile, laboratory parameters and antibiotic sensitivity pattern in culture positive enteric fever cases in pediatric age group. Materials and Methods:The study was designed as prospective study in tertiary care hospital in Ahmedabad from April 2015 to September 2015. All the patients who were clinically suspected for enteric fever were investigated by blood culture and Widal test. Results: Culture positivity rate in our study was 65.97%(64,N=97), of which 89.06%(57) were positive for S.Typhi and 10.93%(7) were positive for S.Paratyphi A. Common clinical features seen along with fever were abdominal pain (53.85%), vomiting (41.76%) and diarrhea (19.78%). All the isolates were sensitive to third generation cephalosporins and fluoroquinolones. The mean time to defervescence was 3.98 days. Conclusions: Enteric fever is major cause of febrile illness in children (especially school going). Fever with abdominal pain, vomiting and diarrhea were major clinical manifestations. There was 100% sensitivity to ceftriaxone, which was highly effective as monotherapy.

To Evaluate The Antimicrobial Efficacy Of Green Coffee Bean Extract On Periopathogens- A Clinico-microbiological Study.

Aim - To evaluate the Antibacterial efficacy of three different dilution of green coffee bean extract on periopathogens. Objective- To achieve a dilution of green coffee bean extract which has the maximum inhibitory effect on P. gingivalis and A. actinomycetocomitans. Methods- The sterilised blood agar culture plate was prepared on which colonies of P. gingivalis and A. actinomycetocomitans were cultured by subgingival sample taken from Chronic Generalized Periodontitis cases. Three dilution of green coffee bean extract were prepared i.e 10 -8, 10 -9 and 10 -10 with the serial dilution method using Distilled water. Then streaking of colonies was done on three different areas of culture plate on which different dilution was added. Minimum inhibitory concentration (MIC) on culture plates was observed to see the inhibitory effect of Green Coffee Bean extract on periopathogens by Agar Diffusion Method.Result- 10-9 was found have maximum inhibitory effect on periopathogens especially P.Gingivalis Conclusion- P.Gingivalis is more susceptible to 10-9 concentration of Green Coffee Bean Extract [Sachin M NJIRM 2016; 7(5):56-59]

Red Blood Cell Count: Brief History and New Method.

Introduction: Red blood cells (RBCs) were observed under microscope by Jan Swammerdam in 1658. The RBC count was done in 1852 by Professor Karl Vierordt from Germany for the first time almost after 192 years. After this, the other scientists have also done RBC count with different methods. Hayem used a new diluting fluid (Hayem‖s diluting fluid) for RBC count which is used even today. The present methods have many errors mainly due to sampling, diluting, and pipetting. Materials and methods: In this study, the modified method of RBC counting has been shown. The RBC counting was done using hemoglobinometer pipette and modified diluting fluid - Hayem‖s fluid mixed with Leishman‖s stain (HFLS) RBC diluting fluid - in the ratio of 97.5 mL of Hayem‖s RBC diluting fluid and 2.5 mL of Leishman‖s stain to make 100 mL. Amber colored glass bottle top dispenser was used to dispense 2 and 4 mL of diluting fluid into the glass test tubes .With aseptic precautions, 10 and 20 μL of blood samples were collected by using the hemoglobinometer pipette (marked with black marker pen to get accurate measurement for 10 μL) from finger prick with sterile needle. The blood samples were added to the glass test tubes containing HFLS RBC diluting fluid and mixing was done with a glass stirrer. With the help of glass capillary tube, Neubauer chambers were charged and observed under microscope. Results: Red blood cells were seen better. The RBCs retained their shape and size even after 96 hours when the blood samples mixed with HFLS RBC diluting fluid were kept at room temperature. Conclusion: Red blood cells were seen better with this method and diluting and charging errors were minimized.

Comparative Evaluation Of C-Reactive Protein Levels And Leucocyte Counts In Patients With Sickle Cell Anemia, Chronic Generalized Periodontitis And Sickle Cell Anemia With Chronic Periodontitis: A Clinico-Biochemical Study.

Aim: The aim of this study is to compare the CRP levels and leucocyte counts in patients with Sickle cell anemia, Sickle cell anemia with chronic periodontitis, and chronic periodontitis. Material andMethods: A total of 90 subjects with an age range of 30-50 years having sickle cell anemia and chronic periodontitis with probing depth ≥5mm and clinical attachment level ≥ 5mm were included and three groups: Group I- Sickle cell anemia; Group II- Sickle Cell anemia with chronic periodontitis and Group III: Chronic severe periodontitis. Blood samples for CRP and leucocytes counts estimation were collected. All participants were subjected to quantitative CRP analysis. Results: Mean CRP levels and leucocyte counts were significantly greater in group II as compared to group I and group III. Conclusion: The present study indicates a positive correlation in CRP levels and leucocyte counts in patients with Sickle cell anemia, chronic periodontitis and both.

Ureterocalycostomy - final resort in the management of secondary pelvi-ureteric junction obstruction: our experience

ABSTRACT: Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used. In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit

Better Visualization of Red Blood Cells by Adding Leishman’s Stain to Hayem’s Fluid.

The visualization of red blood cells (RBCs) was compared by the modified method and the conventional method. The RBCs were seen better with the modified method.

Association of OSTA index with bone mineral density (BMD) and its comparison with calcaneal quantitative ultrasound for the prediction of low BMD in peri-menopausal Indian women.

Background: Osteoporosis is characterized by low bone mineral density (BMD) and an increased risk of fractures with advancing age in postmenopausal women. BMD measurements with dual energy X-ray absorptiometry (DEXA) are costly and not widely available The Osteoporosis Self-Assessment Tool for Asians (OSTA) index is a simple tool based on age and body weight to predict low BMD and identify women at risk of osteoporosis. The objective was to study the association of OSTA index with BMD (T-score) and to validate OSTA index in comparison with calcaneal Quantitative Ultrasound (QUS) for the prediction of low BMD in peri-menopausal Indian women. Methods: This was a prospective, cross-sectional, descriptive study carried out in department of physiology of a tertiary care teaching hospital (Navi Mumbai). Seventy two peri-menopausal women between 40 to 55 years with no previous diagnosis of osteoporosis were included. Participants’ socio-demographic detail, anthropometric measurements, OSTA index and QUS-based BMD was recorded. Pearson’s correlation test was used. Sensitivity, specificity, positive and negative predictive value was calculated. Results: OSTA index did not correlate with BMD in the entire samples. On subgroup analysis, OSTA index significantly correlated in a positive direction with BMD (T-score) in women in the age group of 50-55 years. OSTA index had a sensitivity of 70 %, and specificity of 84.62 % at T-score cutoff value of < -1. Conclusions: OSTA index is a simple risk assessment tool that can be used to identify women with low BMD in the age group of 50-55 years.

Determining sensitive stages for learning to detect predators in larval bronzed frogs: Importance of alarm cues in learning.

Successful survival and reproduction of prey organisms depend on their ability to detect their potential predators accurately and respond effectively with suitable defences. Predator detection can be innate or can be acquired through learning.We studied prey–predator interactions in the larval bronzed frogs (Sylvirana temporalis), which have the innate ability to detect certain predators. We conducted a series of experiments to determine if the larval S. temporalis rely solely on innate predator detection mechanisms or can also learn to use more specific cues such as conspecific alarm cues for the purpose. The results of our study clearly indicate that larval S. temporalis use both innate and learned mechanisms for predator detection. Predator-naïve tadpoles could detect kairomones alone as a potential threat and responded by reducing activity, suggesting an innate predator detection mechanism. Surprisingly, predator-naïve tadpoles failed to detect conspecific alarm cues as a potential threat, but learned to do so through experience. After acquiring the ability to detect conspecific alarm cues, they could associate novel predator cues with conspecific alarm cues. Further, post feeding stages of larval S. temporalis are sensitive for learning to detect conspecific alarm cues to label novel predators.

Effect of body mass index on parameters of nerve conduction study in Indian population.

As the adipose tissue in epineurium is related to some extent to amount of body fat, it is possible that the amount of such fat may affect the nerve conduction. In this study, we have analyzed effect of Body Mass Index (BMI) on various parameters of nerve conduction study in one hundred seventy five healthy volunteers between ages of 18 and 66 years. BMI was determined and nerve conduction studies were performed prospectively in all the subjects using standardized techniques. Prolongation of distal motor latency (DML) was observed with increasing BMI except in motor Peroneal nerve. (In Median Nerve, P<0.05). F- Wave minimum latency was also found to be significantly prolonged in (P<0.05) in motor Tibial nerve. Higher BMI was found to be non-significantly associated with lower amplitude (both sensory and motor) except for peroneal nerve. Motor as well as sensory conduction velocity showed non-significant slowing along increasing BMI except sural and motor-sensory ulnar nerve in younger age group. This study demonstrated that various parameters of nerve conduction study can be affected by BMI. So, this biological factor has to be taken into consideration while interpreting nerve conduction studies

BCL2 antagonist of cell death kinases, phosphatases, and ovarian cancer sensitivity to cisplatin / 부인종양

OBJECTIVE: The BCL2 family proteins are critical mediators of cellular apoptosis and, as such, have been implicated as determinants of cancer cell chemo-sensitivity. Recently, it has been demonstrated that the phosphorylation status of the BCL2 antagonist of cell death (BAD) protein may influence ovarian cancer (OVCA) cell sensitivity to cisplatin. Here, we sought to evaluate how kinase and phosphatase components of the BAD apoptosis pathway influence OVCA chemo-sensitivity. METHODS: Protein levels of cyclin-dependent kinase 1 (CDK1) and protein phosphatase 2C (PP2C) were measured by immunofluorescence in a series of 64 primary advanced-stage serous OVCA patient samples. In parallel, levels of cAMP-dependent protein kinase (PKA), AKT, and PP2C were quantified by Western blot analysis in paired mother/daughter platinum-sensitive/resistant OVCA cell lines (A2008/C13, A2780S/A2780CP, Chi/ChiR). BAD pathway kinase CDK1 was depleted using siRNA transfection, and the influence on BAD phosphorylation and cisplatin-induced apoptosis was evaluated. RESULTS: OVCA patient samples that demonstrated complete responses to primary platinum-based therapy demonstrated 4-fold higher CDK1 (p<0.0001) and 2-fold lower PP2C (p=0.14) protein levels than samples that demonstrated incomplete responses. Protein levels of PP2C were lower in the platinum-resistant versus that shown in the platinum-sensitive OVCA cell line sub-clones. Levels of PKA were higher in all platinum-resistant than in platinum-sensitive OVCA cell line sub-clones. Selective siRNA depletion of CDK1 increased sensitivity to cisplatin-induced apoptosis (p<0.002). CONCLUSION: BAD pathway kinases and phosphatases, including CDK1 and PP2C, are associated with OVCA sensitivity to platinum and may represent therapeutic opportunities to enhance cytotoxic efficacy.

Normative data of upper limb nerve conduction in central India.

Nerve conduction study is an important tool to evaluate peripheral nerve abnormality. The primary purpose of this study was to provide normative electrophysiological data for commonly tested upper limb nerves in normal healthy adults. Nerve conduction studies were performed prospectively in upper limbs of 175 carefully screened healthy volunteers between the ages of 18 and 66 years using standardized techniques. There was no statistically significant difference found in conduction velocity and amplitude of motor median and ulnar nerves as well as sensory conduction velocity of median nerve. However, distal and F-minimum latencies of motor nerves, sensory amplitudes and conduction velocity of ulnar nerve was found to be significantly influenced by gender (P<0.05). This study established normative conduction parameters of the commonly tested nerves of upper limb for our clinical neurophysiology laboratory in Central India. This can be of use to evaluate the patients with peripheral nerve abnormalities who reside in this particular geographic set-up. Gender was shown to have an influence on sensory amplitude, distal motor and Fminimum latencies of median and ulnar nerves.

Formulation of mucoadhesive tablet by using aegle marmelos gum.

In the present work, the mucoadhesive tablet of diclofenac (as a model drug) by using Aegle marmelos fruit gum as a binder was formulated. The preliminary evaluation of Aegle marmelos gum showed that bulk density 0.42 ± 0.2 g/cm3, tapped density 0.45 ± 0.3 g/cm3 and angle of repose 290 ± 0.15. The six tablet formulation were prepared by using 0.25%, 0.50%, 0.75%, 1%, 1.25% and 1.50% w/w of Aegle marmelos gum by direct compression (F1,F2,F3,F4 and F5 respectively). Tablets were subjected for evaluation of uniformity of weight, hardness, friability, drug content uniformity, swelling behavior, release rate study, mucoadhesive study, and tensile strength study. Formulation was studied for drug additive interaction (FTIR). F4 is found to be optimized formulation. The in-vitro drug release of F4 formulation exhibits complete release of Diclofenac Sodium with non fiction first order release kinetic. The formulation F4 exhibited tensile strength 0.27 N with 10 hrs of mucoadhesion. From the study it can be conclude that the Aegle marmelos gum used as mucoadhesive sustained release matrix tablet.

Antibiotic susceptibility pattern in urinary isolates of gram negative bacilli with special reference to AMPC beta-lactamase in a tertiary care hospital

Resistance to higher antimicrobial agent is commonly seen in gram negative bacilli. This issue is a challenging problem to the medical practitioners in addition to it is financial impact on the health care system. To document the prevalence of multi drug resistant gram negative bacilli isolated from urine of patients attending the Urology Department of Tertiary care Hospital of western India in year 2008. Out of total 328 isolates, 118 [35.98%] E.coli, 72 [21.95%] Klebsiella, 64 [19.51%] Pseudomonas aeruginosa, 30 [9.15%] Acinetobacter, 18 [5.49%] Proteus vulgaris, 18 [5.49%] Proteus mirabilis, 6 [1.83%] Providencia rettgerii, 2 [0.61%] Citrobacter freundii. Out of these isolates, 228 [69.51%] were b-lactamase positive, while 100 [30.51%] were beta-lactamase negative. Out of 228 beta-lactamase positive, 104 [45.61%] were AmpC beta-lactamase positive. Stringent protocol such as Antibiotic policy and Hospital infection control program are mandatory to curb these microbes in a tertiary care hospital