Cochlear Implantation in Isolated Large Vestibular Aqueduct Syndrome: Report of Three Cases and Literature Review

Introduction Large vestibular aqueduct syndrome (LVAS) is characterized by the enlargement of the vestibular aqueduct associated with sensorineural hearing loss. It is the most common radiographically detectable inner ear anomaly in congenital hearing loss. LVAS may occur as an isolated anomaly or in association with other inner ear malformations. Objective To report three cases of isolated LVAS with a focus on preoperative assessment, surgical issues, and short-term postoperative follow-up with preliminary auditory habilitation outcomes. Resumed Report One girl and two boys with LVAS were assessed and cochlear implantation was performed for each. Various ways of intraoperative management of cerebrospinal fluid gusher and postoperative care and outcomes are reported. Conclusion Cochlear implantation in the deaf children with LVAS is feasible and effective.(AU)

Antihypertensive drug utilization pattern and awareness in diabetic hypertensive patients at tertiary care centre.

Background: Patients with diabetes has 2 fold higher chances of suffering from hypertension. Hypertension is risk factor for development of diabetes as well for complications like nephropathy, CAD and neuropathy etc. Hypertension control is vital to prevent and retard progression of microvascular and macrovascular complications. Therefore, we undertook this study to evaluate treatment patterns in diabetic patients with hypertension, those are being followed at our institute. Methods: Study group comprised of diabetic patients who had hypertension as well. All patients with diabetes reporting to medicine OPD from March 2014 to September 2014 at our institute were screened. Patients with follow up of at least 3 months and age more than 18 years of either sex were included. Results: There were 223 patients. Study group comprised of 121 males and 102 females. Mean age of group was 48.6 years. One hundred three patients (46.18%) were on monotherapy and remaining 120 patients were on combination antihypertensive drugs. There were total 398 antihypertensive drug exposures. Patient needed mean antihypertensive drug of 1.78. Angiotensin receptor blockers were the most commonly prescribed drugs. Angiotensin inhibitors (angiotensin receptor blockers and ACE inhibitors) were utilized in 158 (71%) patients. Hypertension control was achieved in 84 (37.66%) patients. One hundred eighty one patients (81.2%) knew about disease. Conclusion: Our study showed that majority of diabetic hypertensive patients needed multiple drug therapy to control hypertension. Most of the patients were on ARBs/ACE inhibitors. This was according to recommendation by ADA or JNC8.

Clinical profile and outcome of Hantavirus infection with renal involvement in India.

Background: Hantavirus infections are found all over world but there is paucity of information about clinical features of Hantavirus infection in India. Aim of current study was to study clinical profile and outcome of patients with Hantavirus infection and renal insufficiency who presented at our institute. Methods: All patients who were admitted in department of medicine with Hantavirus infection and renal insufficiency were included. Their basic demographic profile with relevant laboratory investigations was recorded. They were diagnosed with Hantavirus infection if they had positive IgM antibodies by ELISA test. Results: There were seven patients with mean age of 54 years. They had mean serum creatinine level of 4.37 ± 1.86 mg%. All had thrombocytopenia and hepatic dysfunction as well. Five patients had hypotension. There was need of dialysis in three patients. They also had hypoalbuminemia. No patient had features suggestive of acute respiratory distress syndrome. All patients had recovery of renal function and there was no mortality. Conclusion: Patients with Hantavirus infection presented like hemorrhagic fever with renal syndrome. Their outcome is good. We need to suspect Hantavirus infection in appropriate clinical scenario in India.

Developmental Competence of Buffalo (Bubalus bubalis) Pluripotent Embryonic Stem Cells Over Different Homologous Feeder Layers and the Comparative Evaluation with Various Extracellular Matrices

BACKGROUND AND OBJECTIVES: Use of somatic cells as a feeder layer to maintain the embryonic stem cells (ESCs) in undifferentiated state limits the stem cell research design, since experimental data may result from a combined ESCs and feeder cell response to various stimuli. Therefore, present study was designed to evaluate the developmental competence of the buffalo ESCs over different homogenous feeders and compare with various extracellular matrices using different concentrations of LIF. METHODS AND RESULTS: Inner cell masses (ICMs) of in vitro hatched blastocysts were cultured onto homologous feeders viz. fetal fibroblast, granulosa and oviductal cell feeder layers and synthetic matrices viz. fibronectin, collagen type I and matrigel in culture medium. Developmental efficiency was found higher for ESCs cultured on fetal fibroblast and granulosa layers (83.33%) followed by fibronectin (77.78%) at 30 ng LIF. Oviductal feeder was found to be the least efficient feeder showing only 11.11% undifferentiated primary ESC colonies at 30 ng LIF. However, neither feeder layer nor synthetic matrix could support the development of primary colonies at 10 ng LIF. Expression of SSEA-4, TRA-1-60 and Oct-4 were found positive in ESC colonies from all the feeders and synthetic matrices with 20 ng and 30 ng LIF. CONCLUSIONS: Fetal fibroblast and granulosa cell while, amongst synthetic matrices, fibronectin were found to be equally efficient to support the growth and maintenance of ESCs pluripotency with 30 ng LIF. This well-defined culture conditions may provide an animal model for culturing human embryonic stem cells in the xeno-free or feeder-free conditions for future clinical applications.

The conundrum of lenticular oncology. A review.

It is a long-accepted dogma in ophthalmology that the lens is a tumour-free tissue. Yet, in the lens, there is lifelong mitotic activity in the subcapsular epithelium. Therefore, these subcapsular epithelial cells must have the potential for cellular transformation. How then can we explain the fact that no scientist has ever seen a naturally occurring primary tumour of the lens in vivo? This review discusses the early work of Mann, von Hallermann, Courtois and others who addressed the issue of tumour resistance of the lens.