Indian mustard brassica juncea l. mediated phytoremediation of lead.

The contamination from heavy metals has risen during the last decade due to increase in Industrialization. This has led to a significant increase in health problems. Many of the known remediation techniques to remove heavy metal from soil are expensive, time consuming and environmentally destructive. Phytoremediation is an emerging technology for removal of heavy metals which is cost effective, and has aesthetic advantages and long term applicability. The present study aims at efficiently utilizing Brassica juncea L. to remove lead (Pb). The result of our study indicate that amount of lead in Indian mustard is increased with the amount of EDTA applied to the soil and maximum accumulation was achieved with 5mmol/kg of EDTA. On further increase in EDTA resulted in leaf necrosis and early shedding of leaves. Therefore EDTA at a concentration of 5mmol/kg was considered optimum for lead accumulation by Brassica juncea L.

Alcoholic liver disease and antioxidants.

One of the major mechanisms postulated in production of liver injury in alcoholics is the oxidant stress, which is produced by an imbalance between the pro-oxidants and anti-oxidants. The major sources of oxidants are the enzyme systems which metabolize ethanol and the enzyme systems operating in the inflammatory cells. Further, alcohol, either directly or by means of associated malnutrition also leads to deficiency of anti-oxidants which tips the balance towards oxidative stress. We have also discussed the various anti-oxidants that have been used in alcoholic liver disease and their effect on liver necroinflammation and survival in these patients.

Have hematopoietic growth factors made an impact on the management of liver disease?

It is clear that the major indication for the use of hematopoietic growth factors in hepatology is to counteract the adverse effects of interferons (neutropenia and thrombocytopenia) and ribavirin (hemolytic anaemia) during the treatment of hepatitis C infection. This is important because the probability of SVR depends on proper adherence to therapy (at least 80% of the requisite dose maintained for at least 80% of the requisite duration) and proper adherence can only be achieved if the side effects are reduced to a minimum. Even though the studies have demonstrated beyond doubt that the use of hematopoietic growth factors does indeed reduce the incidence and severity of these adverse effects and helps the patients to complete the course of therapy, the data on improvement of SVR is still limited. There is only one study of darbepoetin and filgrastim showing the beneficial effect on SVR. Even among the hematological side effects, possibly the only significant effect which limits the use of optimal HCV therapy is the hemolytic anaemia induced by ribavirin. The other two main side effects, i.e. neutropenia and thrombocytopenia are not clinically problematic. The use of such growth factors would be particularly effective if patients who have advanced liver disease or cirrhosis are able to receive adequate anti-viral therapy as has been demonstrated in the study of eltrombopag among HCV cirrhotics. Apart from this, other indications of G-CSF or GM-CSF use are still in the experimental stage. So, as of now, apart from erythropoietic factors, the role played by other hematopoietic growth factors in hepatology is limited. But future research, especially in the areas of immunotherapy of liver cancers and stem cell therapy for endstage liver disease, is surely going to give these factors their due place in hepatology.

Removal of self-expandable metallic wallstent--a case report.

Self-expandable metallic stents (SEMS) have become the preferred palliative treatment for patients with malignant biliary obstruction; endoscopic stent placement is less invasive than surgery and is rapidly effective. A longer duration of patency makes SEMS superior to plastic stents for palliation of patients with malignant stricture. Few cases of removal of an uncovered SEMS are reported in case of a blocked stent. We report the first case report of removal of covered biliary SEMS from India.

Reversible cholestatic hepatitis due to carbamazepine in an adolescent.

We report a 13-year-old boy who developed fever, rash and hepatitis with cholestasis (on biochemistry and liver histology) after 10 weeks' use of carbamazepine. Recovery of liver biochemistry occurred 4 months after discontinuing the drug.

Cholestatic liver injury due to ibuprofen.

Ibuprofen is a member of the propionic acid class of NSAID. We report a 35-year-old man with ibuprofen-induced acute severe cholestatic liver injury. He recovered after seven months.

Spectrum of atypical celiac disease in North Indian children.

Atypical celiac disease (ACD) presenting in childhood has rarely been documented from India. The present retrospective study analyzed features of atypical celiac disease over a 5-year period. Patients were diagnosed to have Celiac Disease (CD) as per the standard ESPGHAN criteria. The biochemical and hematological parameters of the cohort of children presenting with atypical features (ACD) were compared with children presenting as typical diarrheal CD. Twelve children were diagnosed to have CD. Seven of them presented with ACD. The two groups did not differ significantly in their age of presentation, hematological and biochemical profile. Osteoporosis as documented on bone mineral densitometry was present in all 6 patients of ACD in whom BMD was done. Short stature (4) and refractory iron deficiency anaemia (3) was the commonest modes of presentation of ACD. Occurrence of these conditions either singly or in combination warrants exclusion of celiac disease in children.

Superimposed acute hepatitis E infection in patients with chronic liver disease.

BACKGROUND: The natural history of infection with hepatitis E virus (HEV) in patients with chronic liver disease (CLD) is not well described. Our study aims to document the presentation, course and outcome of HEV superinfection in patients with CLD. METHODS: Over an 18-month period, ten patients with CLD were diagnosed to have HEV superinfection by detection of anti-HEV IgM antibodies in a setting of acute worsening. These patients were tested for HBsAg, IgM anti-HBc, anti-hepatitis C virus antibodies and IgM anti-hepatitis A virus antibodies, and were followed-up. RESULTS: The etiology of underlying CLD in the 10 patients (9 men; mean [SD] age 42.4 [10.3] years) was alcohol in five patients, hepatitis B in two, hepatitis C in one and cryptogenic in two. Seven patients presented for the first time with recent-onset liver decompensation (median duration 27 days, range 7-45). All 10 had ascites and 7 had hepatic encephalopathy. Four patients developed renal failure during the course of illness. The median (range) bilirubin, ALT and albumin levels at presentation were 18.6 (4.9-32.6) mg/dL, 105 (28-6610) IU/L and 32 (29-41) g/L, respectively. At 8 weeks, only one patient had normalization of serum bilirubin or ALT levels. Three patients (30%) died, including two of renal failure and one of massive upper GI bleed. CONCLUSIONS: Superinfection with HEV in patients with CLD causes severe liver decompensation, which is frequently complicated with hepatic encephalopathy and renal failure. Acute hepatitis E in these patients has a protracted course with high morbidity and mortality.