Influence of phenolic compounds of Kangra tea [Camellia sinensis (L) O Kuntze] on bacterial pathogens and indigenous bacterial probiotics of Western Himalayas

Phenolic compounds of nutraceutical importance viz., catechins (C), (-)-epicatechin (EC), (-)-epigallocatechin (EGC), (-)-epigallocatechin-3-gallate (EGCG) and (-)-epicatechin-3-gallate (ECG) were estimated in fresh green tea shoots of Camellia sinensis (L) O Kuntze cultivar. The total polyphenols and total catechins were in the range of 219.90 to 317.81 and 140.83 to 271.39 g/kg, respectively in monthly samples of tea. The values of C, EC, EGC, EGCG and ECG in tea powders as analyzed through high performance liquid chromatography (HPLC) were in the range of 1.560 to 3.661, 13.338 to 27.766, 26.515 to 39.597, 62.903 to 102.168 and 18.969 to 39.469 mg/g, respectively. Effect of tea extracts and standard flavanols against five pathogenic bacteria viz., Listeria monocytogenes (MTCC-839), Pseudomonas aeruginosa (MTCC-741), Bacillus cereus (MTCC-1272), Staphylococcus aureus (MTCC-96) and Escherichia coli (MTCC-443), and eleven indigenous potential bacterial probiotics belonging to genera Enterococcus, Bacillus and Lactobacillus spp. obtained from fermented foods of Western Himalayas, was investigated. EGCG, ECG and EGC exhibited antibacterial activity but, C and EC did not show this activity. Tea extracts having high concentrations of EGCG and ECG were more potent in antibacterial action against bacterial pathogens. Tea extracts and standard flavan-3-ols augmented viability of potential probiotics in an order of EGCG > EGC > ECG > EC > C. Tea extracts and standard flavanols had no antibacterial activity against Escherichia coli (MTCC-443) but, in combination with probiotic culture supernatants, this activity was seen. The Kangra tea thus, exerts antibacterial effect on bacterial pathogens through EGCG, ECG and EGC constituents while stimulatory effect on growth of indigenous potential probiotics.

Heavy metals accumulation in soils irrigated by municipal and industrial effluent.

Four soil profiles have been exposed in municipal, industrial effluents and municipal wastes mixed with industrial wastes (mixed effluent) and tube well irrigated areas of Indore district of Madhya Pradesh. Soil samples were collected horizon wise and analyzed for pH, electrical conductivity (EC), organic carbon, CaCO3, clay content, cation exchange capacity (CEC), exchangeable sodium percentage (ESP) and heavy metals content viz. Fe, Mn, Zn, Cu, Cd, Cr, Co and Pb. Results showed all the heavy metals content decreased with increase in depth of soil profile. Municipal wastes / untreated sewage affected soil of Bhangarh village depicted highest content of heavy metals. The order of percentage availability of different heavy metals irrespective of the sources of irrigation is Pb>Co>Cr>Cd. However, continuous application of sewage indicated higher accumulation of heavy metals although the rate of accumulation was faster in case of industrial effluent within 2 years of irrigation. Organic carbon content had significant positive correlation with heavy metals except Cu and Zn, and negative correlation with pH and CaCO3. ESP had a negative correlation with all the metals. Zn, Mn, Cd and Co indicated significant negative correlation with the CEC of the soil. Inter-metallic correlation indicates a significant positive correlation in between Fe, Cu, Zn, Mn, Co, and Pb and among themselves.

Sonographic and colour doppler morphology in carcinoma gallbladder.

Conventional radiography has limitations in accurate diagnosis of gallbladder cancer (GBC). Ultrasonography (USG) allows correct diagnosis in 70-80% advanced and 23% early GBC. Present study was initiated to identify morphology and flow characteristics in GBC using conventional USG and Colour Doppler USG (CD-USG). In 100 patients, USG assessed morphology of mass lesion/wall thickening together with associated features. Of these, 60 cases were studied using CD-USG for intralesional/perilesional vascularity, peak systolic flow velocity (V max), resistive index (RI) and pulsatility index (PI). USG identified GB with mass lesion in 44% cases (Group-I) and only mass in GB fossa in 56% cases (Group-II). Findings identified calculi (73%), liver infiltration (74%), intrahepatic ductal dilatation (IHDD) (52%), lymphadenopathy (19%) and ascites (5%). CD-USG revealed vascularity, mainly pulsatile flow, in 78.3% cases (in 91.3% Group-I cases). Mean Vmax was 0.3037 m/sec (0.109 - 0.646 m/sec.), mean RI was 0.6621 (0.526 - 1.000) and PI was 1.282 (0.772 -2.140), Mean Vmax and PI were higher in Group-I compared to Group-II. Presence of calculus in 73% cases suggests a high association between calculus and malignancy. As flow signals were seen in 78% of all cases and 91.3% Group-I cases undergoing CD-USG, USG and CD-USG together can improve pickup rate of GBC.

Pulmonary sarcoidosis: management.

During the last two decades many advances have been made in the field of sarcoidosis. The disease is now recognised as a multisystem disorder occurring in patients with a genetic predisposition and an exposure to yet unknown transmissible environmental agent/s. The diagnosis is based on a compatible clinical and/or radiological picture, histological evidence of non-caseating granuloma and exclusion of other diseases capable of producing a similar clinical or histological picture. Treatment primarily consists of administration of corticosteroids, although there are valuable alternative drugs. Treatment should be considered in symptomatic patients with evidence of radiologic or lung function deterioration. The patients with extra-pulmonary involvement particularly with ocular, myocardial, and neuro-sarcoidosis almost always need treatment. For asymptomatic pulmonary sarcoidosis patients no therapy is needed.

Histoplasmosis: an unusual presentation.

Histoplasma capsulatum (HC) infection is rare in India. We document a case of unilateral adrenal histoplasmosis in a 56 year male. The patient presented with hepatosplenomegaly, unilateral adrenal mass and significant weight loss. Since FNAC of adrenal mass was inconclusive, he underwent splenectomy, adrenalectomy and liver biopsy, histology of these specimens revealed HC only in adrenal mass. Subsequently, histoplasmin test was also performed which was also found to be positive. He responded well to parenteral amphotericin B and is under regular follow-up with no complaints now.

The impact of information technology on the practice of ophthalmology.

Information technology has had a tremendous impact on the outlook of our professional lives. The Internet has revolutionised the speed of access to information with touch of a button. This article discusses the various aspects of information technology which are changing and enhancing our professional lives. It provides tips to enable the busy practising clinician to use the available resources effectively. Problems such as reliability of information on the web and how to assess the quality of such matter are also discussed.

Endoscopic palliation of malignant obstructive jaundice using resterilized accessories: an audit of success, complications, mortality and cost.

OBJECTIVE: To assess the success, complications and cost of endoscopic endoprosthesis placement for palliation of obstructive jaundice caused by malignancy. METHODS: Four hundred and two consecutive patients with obstructive jaundice due to nonresectable malignancy undergoing endoscopic stenting were studied. Commercial or home-made 7F or 10F endoprostheses were placed using minor modifications of the standard technique. The accessories were sterilized and reused. RESULTS: Endoprosthesis placement was successful in 291 patients (72.4%, 95% CI 67.7-76.7)-241 in one attempt, 49 in two attempts, and one in three attempts. Fifty nine patients (14.6%, 95% CI 11.4-18.6) had procedure-related complications, including cholangitis (30), pancreatitis (15), perforation (3) and bleeding (11). The incidence of cholangitis was significantly higher in bifurcation blocks than in other lesions (17.6% vs 4.7%, p = 0.0005). The success rate did not differ between distal and proximal lesions (68.1% vs 72.9%). The procedural cost per patient could be reduced from Rs 14,850 to Rs 6565 by reusing accessories after sterilization, and using home-made stents. CONCLUSIONS: Endoscopic endoprosthesis placement is a safe and effective method for palliation of malignant obstructive jaundice. Preparation of indigenous stents and reuse of accessories can reduce the cost of the procedure by over 50%.

Role of computed tomography in preoperative evaluation of esophageal carcinoma.

The utility of computed tomography in pretherapy assessment of esophageal carcinoma is reviewed. Computed tomographic findings in 78 patients with histologically proved esophageal carcinoma were corelated with findings at surgery and histopathology. Computed tomography (CT) was found to be fairly accurate in assessing tumor extent, invasion of adjacent mediastinal structures and distant metastases but was of no help in detecting periesophageal lymph node involvement. The tracheobronchial tree invasion was detected with an overall accuracy of 96% whereas the same for invasion of aorta, percardium and gastroesophageal junction was 86%, 88% and 78% respectively. The sensitivity for the detection of periesophageal and perigastric lymphadenopathy was low (9% and 0% respectively) but was acceptably high in celiac lymphadenopathy (70%). CT is an excellent non invasive modality in pretherapy assessment of esophageal carcinoma and can guide the surgeon in determining the appropriate therapy.

Fibular shortening in poliomyelitis.

This study arose from observation that in children will leg shortening from paralysis, the relationship between the tibia and fibula is disturbed. This article analyses 76 patients of post polio residual paralysis involving only one lower limb. Sixteen patients had fibular shortening. Several factors that interfere with fibular growth, i.e. anatomical continuity, soleus strength, abnormal forces at distal fibular physis, result in fibular shortening. Early the age at onset of paralysis, more is the fibular shortening which is associated with lateral wedging of distal tibial epiphysis, valgus at ankle, external torsion of tibia and genu valgus.

CT staging of pancreatic and periampullary carcinoma.

Sixteen cases of carcinoma head pancreas and seven cases of periampullary carcinoma are staged together on CT scan because of their morphological similarity and similar parameters. Following parameters are considered for CT staging: tumour mass, involvement of splanchnic vessels, locoregional lymph nodes and presence or absence of hepatic metastases. Findings were confirmed on surgical exploration. A contrast enhanced CT scan was 58.3 percent sensitive and 100 percent specific for the involvement of lymph nodes and 100 percent sensitive and 93.4 percent specific for hepatic metastases. The cases diagnosed as non-resectable on CT staging were found inoperable on exploration. Authors believe that for all practical purposes, pancreatic and periampullary malignancies can be grouped together and a contrast enhanced CT scan can provide reliable information for the staging of the tumor.

Computed tomography of the paranasal sinus and nasal cavity tumours.

One hundred and thirty seven patients with suspected neoplasms of paranasal sinuses and nasal cavity were studied with conventional radiography and C.T. Scan. Significantly greater tumour extent was detected on C.T. due to 3 - Dimensional demonstration of tumours. C.T.Scan was extremely helpful in diagnosing the primary site of tumour and tumour recurrence in treated cases. This information had pronounced effect on patient management and prognosis determination. C.T. was also helpful in differentiating certain benign conditions such as fibro-osseous lesions and inflammation without bony erosion from malignant tumours. The importance of C.T. scan in these neoplasms is discussed here.

Retropharyngeal lipoma.

Lipomata in retropharyngeal region are extremely rare. Accurate preoperative diagnosis is very important to assess invasion of muscles and to prevent local recurrence. A case of retropharyngeal lipoma is being discussed along with review of its clinical, radiological and surgical aspects. The role of CT scan in its definitive diagnosis is also discussed.

Blood helper/suppressor lymphocyte ratio in sarcoidosis.

The blood helper/suppressor ratio was measured in 38 patients with biopsy-proved sarcoidosis. There was no relationship between this peripheral helper/suppressor ratio and the activity of the granulomatous process. This test needs further evaluation before its routine use in assessing activity in sarcoidosis.