Once in a blue moon: A rare case of Duchenne muscular dystrophy complicated by COVID-19

Patients suffering from Duchenne Muscular Dystrophy (DMD) are at higher risk of suffering significant morbidity resulting from COVID-19, considering their pre-existing respiratory insufficiency and immunocompromised state. We present such a case who was admitted to our intensive care unit. A 21-year-old patient, who was a diagnosed case of DMD since the age of 8 and on treatment with steroids, angiotensin-converting enzyme inhibitors, and intermittent home-oxygen support, presented with fever and breathlessness and was diagnosed to have COVID-19 pneumonia. Oxygen support was provided by non-invasive ventilation (NIV), along with therapeutic and supportive treatment, namely, azithromycin, remdesivir, dexamethasone, and heparin. Dyselectrolytemia was corrected and convalescent plasma was transfused. The patient was weaned off NIV and discharged on significant improvement in his general condition. Although the treatment of COVID-19 using convalescent plasma has now fallen out of favor, we found some clinical improvement in our patient. DMD complicated by COVID-19 can seem like a daunting challenge, but providing fundamental, yet, simple treatment measures goes a long way in the patient care

Genetic engineering of crops for insect resistance: An overview

Phytophagous insect incidence is a serious threat for reduction of crop productivity globally. There is anestimation of one fourth of crop is being destroyed by insects annually. Indeed, the development of insectresistant crops is a great milestone in agriculture to increase crop yield and reduce pesticide dependency.Genetic engineering facilitates development of insect resistant crops by expressing bacterial d-endotoxins andvegetative insecticidal proteins and other plant genes like lectins, protease inhibitors, etc. In addition, RNAinterference and genome editing through CRISPR Cas9 also provides new solutions for the development ofinsect-resistant crops. The resultant genetically modified crops showed resistance against lepidopteran, dipteran, homopteran and coleopteran insects. The insect-resistant crops have made a significant economic impactworldwide in terms of higher yield and low pesticide usage. In this review, we focus on different strategies fordeveloping transgenics against insect pest control by expressing different insecticidal proteins in crops

Drainage of External Jugular Vein into an Unusually Wider Internal Jugular Vein: A Rare Case Report.

The superficial veins are of utmost importanceclinically for cannulation, which is required fordiagnostic purposes and intravenous therapy. One suchsuperficial vein in the neck region is the externaljugular vein. The other vein, deeper in this region, isthe internal jugular vein. The internal jugular vein iscommonly used for central venous catheterization.Anomaly in the course and termination of bothexternal and Internal Jugular Veins (IJV) are critical asthey serve as an important route/site to perform variousdiagnostic or therapeutic procedures. Present caseshows a rare variation of termination of the rightexternal jugular vein into an unusually wider IJV.Variation as described in the present case, if found,would ease the clinicians' task to approach a lessaccessible IJV. Ultrasound-guided venouscatheterization would serve as a guide to perform theprocedure with ease and also to be familiar with suchvariations existing in the venous channels

Development of transgenic cotton (Narasimha) using triple gene Cry2Ab-Cry1F-Cry1Ac construct conferring resistance to lepidopteran pest

Silkworm silk protein fibroin is widely exploited to develop novel silk-based biomaterials due to its stable b-sheetstructure, providing high crystallinity and tensile strength. The polymorphic behaviour of silk fibroin provides awindow to modulate its structural transitions during self-assembly for different functional outcomes. Most studiesare therefore mainly focused on formation of well-developed b-sheet structure and self-assembly of silk fibroinwhich are regulated by many parameters. Glyoxal, a highly reactive a-oxoaldehyde, reacts with different proteinsto form advanced glycation end products (AGEs) following Maillard-like reaction. Considering the significanceof protein modification by glyoxal-derived AGEs, in the present study the effect of glyoxal (250, 500 and1000 lM) on the structure of silk fibroin has been investigated. CD and fluorescence studies reveal that higherconcentrations of the a-oxoaldehyde induce considerable alterations of secondary and tertiary structure of theprotein leading to aggregation following incubation with for 3 weeks. The aggregates exhibit fibrillar morphologywith amyloidal nature as evident from SEM, FTIR and XRD experiments. The findings highlight that glycationinduced modification can be a possible approach for modulating the conformation of the silk protein which may berelevant in connection to clinical, biomedical or synthetic biology based applications.

Caesalpinia bonduc Linn Extracts Exhibit Hepatoprotective Effect on HepG2 Cells against Paracetamol by Up-regulating Glutathione Related Genes

Background: Caesalpinia bonduc (CB) is said to ownvarious pharmacological and therapeutic applicationagainst a number of diseases. It is used widely in folkmedicine to treat liver diseases. In the present study,we have made a sincere effort to evaluate thehepatoprotective activity of CB leaf extracts againstParacetamol (PCM) induced toxicity and theirmechanism of hepatoprotection in the humanHepatocarcinoma cells (HepG2 cells) therebyproviding scientific evidence for the same. Materialand Methods:The hepatoprotective activity of CB wasassessed in-vitro by the estimation of glutathione(GSH) and Malondialdehyde (MDA), anti-apoptoticassay/Annexin V and the expressions of genes such asGlutathione Reductase (GS-R) and GlutamateCysteine Ligase, Catalytic (GCLC). Results: Theobtained results suggest that the aqueous extract of CBpossess significant hepatoprotective activity. Thisactivity may be due to the possible antioxidantproperty and the free radical scavenging ability of theextracts, which might clear the toxic metabolites ofPCM. Conclusion: The present study suggests that theaqueous extract of CB have potential hepatoprotectiveactivity, which may prevent the lipid peroxidation ofthe cell membrane by its antioxidant properties.

Persistent fetal superficial middle cerebral vein: an anatomical study / 대한해부학회지

The superficial middle cerebral vein (SMCV) drains the venous blood from most of the superolateral surface of the brain and drains typically into the cavernous sinus as mentioned in standard textbooks. But the drainage of the SMCV is variable as indicated by various radiological studies. Although variations in the drainage of the SMCV exist, there is a shortage in the literature providing cadaveric evidence for the same. The present study was designed to identify the variations in the drainage pattern of the SMCV in fetal cadavers. During the dissection of formalin-fixed full-term fetuses, deviation in the drainage of the SMCV was observed in five out of 30 cases. In three out of 30 specimens (10%), SMCV was observed draining into superior petrosal sinus; and in two specimens (6.6%) into the transverse sinus. In the remaining specimens, the SMCV drained directly into the cavernous sinus. Knowledge of the variations noted in the present study is essential, not only for diagnosing several diseases involving the cavernous sinus or paracavernous sinuses but also in surgeries of paracavernous sinus lesions and endovascular treatment of arteriovenous fistulas. The SMCV and superior petrosal sinus can be a venous refluxing route in patients with arteriovenous fistulas.

A Cadaveric Study Of The Internal Occipital Crest And Vermian Fossa With Its Clinical Significance

Background: The anatomical variabilities of the internal occipital crest (IOC) and vermian fossa (VF) may influencethe related dural venous sinuses and further effect the flow of the cerebrospinal fluid. It is also associated withthe pathologies around the foramen magnum like Arnold Chiari malformation, certain cases of cerebellar corticaldysplasia.Aim: The present study was designed to explore and evaluate the morphological and morphometric details of theIOC and VF.Materials and Methods: The study was conducted on 40 adult cadavers (23 males & 17 females). The morphologyand morphometry of IOC and VF were studied. Based on the observations, the VF was classified into five types:Type 1- classical (well defined fossa), Type II-short triangular, Type III- elongated triangular, Type IV-quadrangularand Type V-deviated.Results: The IOC was found to be variable both in terms of morphology and morphometry. The morphologicalobservations included varied shapes, i.e., sharp (65%), blunt (30 %) and ill-defined (5 %). The length of the IOCwas also variable with a mean length of 2.97 ± 0.16 cm. The mean width at upper, middle and lower levels were0.9 ± 0.10 cm, 0.75 ± 0.17 cm, 1.10 ± 0.12 cm respectively.The incidence of the VF was found to be about 80%. The VF was classified into types based on its varied shape:classical (Type I ;56.25 %), short triangular (Type II ;21.87%), elongated triangular (Type III;12.5%) and quadrangular(Type 1V;6.25 %) respectively. In one specimen, the VF was deviated to the left side (type V ;3.12%). The mean lengthand width of the fossa were 1.67±0.34 cm and 1.80±0.34 cm respectively.Conclusion: The present study on the morphology and morphometry of the IOC and the VF may serve as databaseand further help clinicians to improve the diagnosis and therapeutic performances in the posterior cranialfossa.

Spectrum of Lesions in the Lung – A 2 Year Study Done on Lobectomy Specimens.

Aims : The aims are to study the spectrum of non-neoplastic and neoplastic lesions of lung and to study the incidence of lung cancers with reference to age, gender, lifestyle and occupation. Materials and Methods: The study is done over a period of 2 years (May 2009 to April 2011) in the Department of Pathology, GGH,Guntur. Total of 52 lobectomy specimens were studied. Formalin fixed, paraffin embedded H & E stained tissue sections were studied. Special stains (Gomorri’s methenamine silver stain and Periodic acid schiff) were done whenever necessary. Immunohistochemistry was done in diagnostically difficult cases. Results: Neoplasms constituted 38.4% of total lesions.Majority of lung tumors occurred in the fifth and sixth decade. M:F sex ratio is 4:1. On chest x-ray/CT scan chest, majority of lung tumors presented as mass lesion. Right side of the lung is more commonly affected than the left.Cigarette smoking is the major etiological factor in the causation of lung carcinoma. Among the primary tumors, adenocarcinoma constituted largest group followed by squamous cell carcinoma. Conclusion: from the present study it is concluded that adenocarcinoma is now the most common lung carcinoma in all race and sex groups.There is a strong association between lung cancer and smoking.Chest radiograph and CT scan aid in the diagnosis and anatomical localisation of lung tumor.

Epithelioid trophoblastic tumor: a case report of a rare trophoblastic neoplasm.

Epithelioid Trophoblastic Tumor (ETT) is a rare neoplasm of the chorionic type intermediate trophoblastic cells. It is a neoplasm of reproductive age women and usually follows a gestational event. ETT can occur at both intra uterine and extra uterine sites and can be confused with other entities such as squamous cell carcinoma, placental site nodule, placental site trophoblastic tumor etc. Hence, proper diagnosis of this tumor is necessary to avoid unnecessary, excessive treatment as surgical treatment is considered sufficient for ETT. We present a case of ETT in a 36 year old female, who came with symptoms of pain abdomen, white discharge per vaginum and a cervical mass.

Role of MRI in diagnosis of multiple system atrophy: A case report.

Multiple system atrophy (MSA) is a sporadic, progressive neurodegenerative disorder of unknown etiology, characterized by various combinations of autonomic, cerebellar, pyramidal and extra pyramidal signs. Based on the consensus criteria, patients with MSA are classified as MSA-c and MSA-P. MRI plays an important role in the early diagnosis. The characteristic finding hot "cross bun’’ sign is seen in MSA of cerebellar type Here we present a case of MSA-C in 52 years old male patient.

Cellular blue nevus – A challenging entity: Case report.

Blue nevi can present clinically as blue, gray, brown, or black solitary nodules or plaques on the skin. Histologically, they represent collections of melanocytes and melanophages in the dermis. We presented here a case of a cellular blue nevus in a 20 years old man that presented as an enlarging blue-gray nodule on the right buttock. These cases can be challenging both clinically and histologically because malignant melanoma or malignant transformation of a blue nevus could be considered.

Schwannoma of Tongue, A Rare Intraoral Neoplasm: Case Report.

Schwannomas are truly encapsulated neoplasms of the human body and are always solitary. Only 1-2% occur intraorally with tongue being the most common site. A 20yr old male presented with a painless, slow growing swelling on the left side of the tongue for the past 1 year. Fine needle aspiration cytology was done and a benign mesenchymal lesion, possibility of Schwannoma was given. Biopsy of the tumour was performed and sent for histopathological examination which confirmed the diagnosis of Schwannoma.

A Cross-sectional Study on Binge Drinking among Health Institutional Students in Bagalkot.

Background: Alcohol consumption is a major public health problem worldwide. In 2012, about 3.3million deaths were attributed to alcohol consumption. DALY attributed to alcohol consumption is 139 million. Ad-olescence is the critical period when the first initiation of alcohol intake takes place. Sixteen percent of drink-ers of age more than 15yrs engage in heavy episodic drinking. Due to change in lifestyle a considerable num-ber of social drinking have shifted to binge drinking. Objectives: To know the prevalence of binge drinking among health institution students in Bagalkot. Material and Methods: A cross sectional study was conducted among 380 health institution students. Five different cadre of health institutions were taken, one medical, one dental, one Ayurveda, one nursing and one Pharmacy College. A pre designed, semi structured ques-tionnaires were used. The results were analysed by chi square test. Results: Among total 380 participants, 68% were girls and 32% were boys. Majority of the respondents were staying away from home (83%). More than one fifth (20.53%) of respondents had tasted alcohol at least once, of which more than one third (37.18%) were female. Prevalence of binge drinking was 3.16%. Among binge drinkers, 58.33% had at least one of their family members who consumed alcohol. Conclusion: Existence of risk behaviour like binge drinking among students were seen and it demands integrated approach. Increased awareness among parents and also the respondents is needed to prevent adolescent behaviours from becoming a risk to their health and community.

A Cross-sectional Study on Binge Drinking among Health Institutional Students in Bagalkot.

Background: Alcohol consumption is a major public health problem worldwide. In 2012, about 3.3million deaths were attributed to alcohol consumption. DALY attributed to alcohol consumption is 139 million. Adolescence is the critical period when the first initiation of alcohol intake takes place. Sixteen percent of drinkers of age more than 15yrs engage in heavy episodic drinking. Due to change in lifestyle a considerable num-ber of social drinking have shifted to binge drinking. Objectives: To know the prevalence of binge drinking among health institution students in Bagalkot. Material and Methods: A cross sectional study was conducted among 380 health institution students. Five different cadre of health institutions were taken, one medical, one dental, one Ayurveda, one nursing and one Pharmacy College. A pre designed, semi structured questionnaires were used. The results were analysed by chi square test. Results: Among total 380 participants, 68% were girls and 32% were boys. Majority of the respondents were staying away from home (83%). More than one fifth (20.53%) of respondents had tasted alcohol at least once, of which more than one third (37.18%) were female. Prevalence of binge drinking was 3.16%. Among binge drinkers, 58.33% had at least one of their family members who consumed alcohol. Conclusion: Existence of risk behaviour like binge drinking among students were seen and it demands integrated approach. Increased awareness among parents and also the respondents is needed to prevent adolescent behaviours from becoming a risk to their health and community.

Multiple variations in the branches of the coeliac trunk / 대한해부학회지

Here we present a unique case of variation in the branching pattern of the coeliac trunk. In the present case, the coeliac trunk was replaced by two separate arterial trunks. The first arterial trunk bifurcated into the left gastric and the left hepatic arteries. The second arterial trunk bifurcated into a splenic artery and a hepato-gastroduodenal trunk. The hepato-gastroduodenal trunk presented an unusual course and termination. The right hepatic artery arising from the hepato-gastroduodenal trunk also showed a variant course. Such rare variations are important for gastroenterological surgeons and interventional radiologists due to increase in number of transplantation surgeries and live donor liver transplantations.

Antidiarrheal Activity of Methanolic Extract of Leaves of Gymnosporia Emerginata.

The methanolic leaf extract of Gymnosporia emerginata showed significant antidiarrheal activity on castor oil induced diarrheal model in rats. These results obtained revealed that the leaf extract possess pharmacological activity against diarrhea and may possibly explain the use of the plants in traditional medicine.

Anatomical variations in the left coronary artery and its branches

<p><b>INTRODUCTION</b>Proficiency in the anatomy of coronary arteries and their variations is important for proper interpretation of coronary angiographies. The left coronary artery (LCA) commonly originates at the level of the left posterior aortic sinus and normally bifurcates into the anterior interventricular artery and circumflex artery. This study aimed to determine the variations in the LCA and its branches.</p><p><b>METHODS</b>The study was conducted on 30 heart specimens. We observed the origin, length and branching pattern of the LCA and its coronary dominance.</p><p><b>RESULTS</b>We found a short main LCA trunk in three specimens and a long main LCA trunk in one specimen. In two specimens, the division of the LCA led to three branches. With regard to 'dominance', one specimen showed left dominance while another showed codominance.</p><p><b>CONCLUSION</b>Variations of the LCA are clinically relevant, especially when a perioperative coronary perfusion or coronary arteriography is performed.</p>

Oral manifestations of lipoid proteinosis: a case report and literature review

Lipoid proteinosis is an uncommon autosomal recessive metabolic disorder that presents in early life with hoarseness and pox-like acneiform scars involving the skin and mucous membranes. Previous studies have attributed the prevalence of lipoid proteinosis to consanguineous parents. This paper reports a classical case of lipoid proteinosis with oral manifestations but without a history of consanguinity

Studies on immunomodulatory effects of Salacia chinensis L. on albino rats.

India has a very rich diverse faunal and floral wealth spread across the length and breadth of country. Biodiversity hotspots like Himalayan region and Western Ghats are bestowed with innumerous number of potential medicinally important plants whose scientific research are yet to be taken up. Salacia chinensis is one among them and forms one of the known ethanobotanically used herbal drug for diabetes and aliments. A scientific study on physiological effect of Salacia chinensis can give baseline information about potency of plant drug formulae. Therefore this plant was taken up for the study of immunomodulatory effects on swiss albino rats. Rats were fed with a concentration of 1 mg/kg, 2 mg/kg, 4 mg/kg and 32 mg/kg body weight of aqoues extract of Salacia chinensis for a period of 14 days. Various hematological, serological and immunological parameters were studied at the end of 14days trial and compared with control group. Total leukocyte count, neutrophil percentage, blood glucose hemoglobin, hemagglutination antiboby titer against SRBC and delayed hypersensitivity reaction were found increased along the animals treated with 1mg/kg body weight of animal. On the contrary higher concentration of drug have reduced immune response compared to control group showing the negative effect of the higher concentration of drug on the immune response. The present study of Salacia chinensis evidently shows that concentration of 1mg/kg can boost the immune system and at the same time if used at higher concentration can determine the immune system.

Evaluation of the Truview[TM] EVO2 laryngoscope for nasotracheal intubation

The Truview[TM] EVO2 laryngoscope, with its unique optical lens system and blade tip angulation, has proved its usefulness in providing adequate laryngeal exposure and intubation via the oral route. However, the same has not been evaluated for nasotracheal intubation. We evaluated the suitability of the Truview[TM] EVO2 laryngoscope for nasotracheal intubation. Fifty ASA grade I and II elective surgical patients were studied. Patients aged below 15 years or having difficult airway were excluded. Under standard anesthesia protocol, nasotracheal intubation was performed using a Truvie[TM] EVO2 laryngoscope and, in cases of inability to complete intubation in three attempts, the Macintosh laryngoscope was used. Time taken for intubation, use of Magill's forceps and need for optimization maneuvers were noted. The primary outcome was percentage of successful intubation, while hemodynamic changes and duration of intubation were taken as secondary outcomes. Majority [94%] could be intubated successfully with the Truvie[TM] EVO2 laryngoscope. Average time taken for intubation was 50.1 s. The hemodynamic changes were not clinically significant. Regression analysis revealed lack of association between duration of intubation and hemodynamic changes. There were no serious complications. The Truview[TM] EVO2 laryngoscope is a useful tool in performing nasotracheal intubation, ensuring a high level of success rate among patients with normal airway anatomy