Comparative-study-of-percutaneous-nephrolithotomy-in-supine-versus-prone-position

Prone positioning in percutaneous nephrolithotomy is more and more being replaced by supine positioning now a days for its various benefits. This is a prospective study which does Comparative study on percutaneous nephrolithotomy in supine versus prone position and their various outcomes were analysed. There were totally 100 patients included in the study with 50 patients each group (supine versus prone). 57 were male and 43 female patients. Age ranging from 18 to 70 years. Right side stones were 58 and left side was 42. Age, gender and side of stones were similar between two groups. Stone burden were 2.6cm and 2.9cm for supine and prone group respectively. But average operating time were 63.5 minutes ( 35 to 120 minutes) for supine group versus 80 minutes ( 45 to 160 minutes) for prone group. fluoroscopy time was 18.9 minutes for supine group versus 29.4 minutes for prone group. Clearance rate in our study were pretty good in both groups around 90% in both groups (90% vs 88%). five had complications in form of sepsis and bleeding requiring blood transfusion in both groups. Five in supine group and six in prone group required second procedures. Thus Supine percutaneous nephrolithotomy group had significant advantage in terms of less operative duration and less fluoroscopy time than prone percutaneous nephrolithotomy . The stone clearance and complication rates were similar in both the groups.

Management of double optic disc pit complicated by maculopathy

Optic disc pit (ODP) is a rare, congenital, cavitary anomaly of the optic disc. Usually, single ODP occurs in an eye and only eleven cases of double ODP have been reported so far in the literature. In the present study, we report a case of unilateral double ODP, with both the pits present in opposite disc segments. They were associated with serous retinal detachment at the macula and retinal pigment epithelium degeneration nasal to disc. The case was managed successfully with vitrectomy, internal limiting membrane peeling, plugging the pits with homologous partial-thickness scleral flaps, and gas tamponade.

Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment

Induction of posterior vitreous detachment (PVD) is one of the most critical steps for the success of retinal detachment (RD) surgery. Failure to completely remove the vitreous can result in re-detachments. We describe a novel technique to induce PVD. After core vitrectomy, perfluorocarbon liquid (PFCL) is injected. The vitreous on the posterior pole is gently stroked, with a diamond-dusted membrane scraper, to create a defect in it. This defect is gradually enlarged to create a ring of rolled out vitreous. The entire vitreous is removed in form of a sheet by lifting the edges of the ring using an internal limiting membrane peeling forceps. PFCL naturally slides into the potential space, gradually extending the vitreous detachment peripherally. With this technique, the vitreous sheet in case of RD can easily, effectively and safely be removed with this technique.

Analysis of Clinical Characteristics and Outcome of Pulmonary Thromboembolism in a Tertiary Care Hospital

Introduction: Pulmonary embolism is a potentially lethalcondition that is frequently underdiagnosed. The severityand clinical presentation of PE are variable, hence clinchingthe correct diagnosis is difficult. Prompt diagnosis of PE isessential to reduce morbidity and mortality. Current researchaimed to study the clinical characteristics, risk factors andclinical outcomes of patients diagnosed with pulmonarythromboembolism.Material and Methods: In this retrospective study data werecollected from baseline clinical characteristics, presentingsigns and symptoms, results of echocardiography and imagingstudies, therapeutic modality and in-hospital course.Results: 52 cases of Pulmonary embolism were reportedwith an incidence of 0.33%. Male predominance (58%) wasnoted. Associated comorbid conditions like HT was presentin 24 patients and DM was present in15 patients. The mostcommon symptom at presentation was dyspnea (31 patients).The overall mortality rate was 3.8% (2 patients).Conclusion: The outcome of PE is improving; however, itremains an important risk factor for mortality in hospitalizedpatients.

Aloe barbadensis Miller peptide/polypeptide fraction alleviates inflammation through inhibition of proinflammatory cytokines and mediators in vitro and in rats with Freund's adjuvant-induced hind paw edema

Objective: To evaluate the anti-inflammatory potential of peptide/polypeptide fraction of Aloe vera through in vitro and in vivo studies. Methods: The peptide/polypeptide fraction from Aloe vera was obtained through trichloroacetic acid precipitation. The anti-inflammatory property of the peptide/polypeptide fraction was tested by protein denaturation, membrane stabilization assays. The effect of the fraction on RAW 264.7 cell viability was examined by MTT assays. The nitric oxide level was determined through Griess reagent. TNF-α and IL-6 levels were estimated using ELISA kits. In vivo studies were carried out in male Wistar rats through injection of Freund's adjuvant in the hind paw. Paw edema was measured through the Vernier scale and levels of alanine aminotransferase, aspartate transaminase, TNF-α, IL-6, and secretory phospholipase A2 were estimated through their respective kits after fourteen days of treatment. GraphPad Prism6 was used for analyzing the results. Results: The peptide/polypeptide extract inhibited protein denaturation with an IC50 value of (218.9±15.6) μg/mL and stabilized the membrane of red blood cells with an IC50 value of (275.9±19.1) μg/mL. The extract showed no changes in cell morphology or cytotoxicity up to the concentration of 20 μg/mL in MTT assays. The peptide/polypeptide fraction markedly reduced the levels of proinflammatory markers and mediators in both in vitro and in vivo studies. Conclusions: The results indicate that the peptide/polypeptide fraction of Aloe vera has antiinflammatory property through inhibition of inflammatory markers and mediators responsible for NF-κB and mitogen-activated protein kinase pathways.

Vasomodulatory effects and mass spectral analysis of Bridelia ferruginea Benth.

Bridelia ferruginea Benth. (Fam. 'Euphorbiaceae) is known to possess potent anti-inflammatory activity. Here, we investigated its vasomodulatory effect, as anti-inflammatory therapy that beneficially impact the cardiovascular system. Extracts (Bf1, Bf-HA) and fraction (Bf2) of B. ferruginea (Bf), were prepared from the bark of Bf to study their vasomodulatory effect using rat aortic rings. The vasorelaxant effect of Bf1 and Bf2 was mediated by the activation of nitric oxide synthase/endothelial isoform (NOS3) as confirmed by EA.hy926 endothelial cells, real-time PCR and Western blotting. Mass spectral analysis of these extracts and fraction was performed to understand the profile of compounds present in them. Mass spectral analysis showed the presence of similar ions in both Bf1 and Bf2 while Bf-HA showed different patterns. Vasorelaxant effect of Bf1 and Bf2 in phenylephrine (PE) pre-contracted endothelium intact aortic rings was blocked significantly in the presence of both N-nitro-L-arginine methyl ester (L-NAME) or soluble guanylate cyclase inhibitor (1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one [ODQ]). However, cyclo-oxygenase (COX) inhibitor (indomethacin) did not exert any change. In contrast, Bf-HA significantly inhibited ACh-induced vasorelaxation, but had no effect on sodium nitroprusside (SNP)-mediated relaxation, thereby suggesting NOS inhibitory activity in the extract. Studies with Bf1 and Bf2 on EA.hy926 cells demonstrated NOS3 mediated nitric oxide (NO) generation. Purified fractions of Bf, thus possess vasorelaxant compounds, which remain to be identified.

Retrospective study of changes in ocular coherence tomography characteristics after failed macular hole surgery and outcomes of fluid-gas exchange for persistent macular hole

Purpose: The aim is to study the changes in ocular coherence tomography (OCT) parameters of large (?400 ?) full-thickness macular holes (FTMHs) after a failed surgery and evaluate the outcome of fluid-gas exchange (FGE) in the treatment of persistent macular hole and role of OCT in predicting outcome after the secondary intervention. Methods: Changes occurring in the OCT parameters of FTMH after a failed vitrectomy were evaluated. FGE was done in an operating room with three pars plana sclerostomy ports. The anatomical and functional outcomes of FGE for these persistent macular holes were also assessed. Anatomical closure was defined as the flattening of the hole with resolution of subretinal cuff of fluid. Anatomical success after FGE was defined as flattening of macular hole with the resolution of subretinal cuff of fluid and neurosensory retina completely covering the fovea. Functional success was defined as an improvement of at least one line of best-corrected visual acuity (BCVA). Results: Twenty-eight eyes (28 patients) were included in the study. After the failed vitrectomy, OCT showed an increase in the base diameter, opening diameter, and height of the hole. After the secondary procedure, anatomical closure was achieved in 89.3% eyes. Mean BCVA improved from logMAR 0.88 � 0.24 (20/152) to logMAR 0.66 � 0.24 (20/91) (P < 0.001). Eight (28.6%) patients achieved final BCVA ?20/60. Functional success was obtained in 19 patients (67.9%). There was no association between anatomical success after FGE and any of the pre-FGE OCT parameters or indices. Conclusion: Unsuccessful surgery causes swelling of the outer and middle retinal layers with retraction of inner layers of the retina. Performing FGE while visualizing the retina is a good option for the treatment of large persistent macular holes as it causes complete drying of the macula, better success rates, and a reduced complication rate. Pre-FGE OCT does not help in predicting the outcome of FGE for persistent macular hole.

Circulating tumor cells in oral squamous cell carcinoma: An insight.

Circulating tumor cells (CTCs) are those cells present in the blood and have antigenic and/or genetic characteristics of a specific tumor type. CTCs can be detected in the peripheral blood of cancer patients. Various techniques are available for detection of CTCs, which provide evidence for future metastasis. CTCs may provide new insight into the biology of cancer and process of metastasis in oral squamous cell carcinoma (OSCC). The detection of CTCs may represent a new diagnostic tool for predicting the occurrence of metastatic disease in OSCC and endow with the treatment strategies to efficiently treat and prevent cancer metastasis. This review gives an insight into the significance of CTCs and different techniques for detection of CTCs.

Title: Development of new spectrophotometric method for estimation of tenofovir disoproxil fumarate using MBTH reagent.

A new simple, sensitive and specific procedure has been developed for determination of tenofovir disoproxil fumarate in bulk and pharmaceutical dosage forms using MBTH reagent. The purpose of this analytical validation procedure is to validate it by laboratory experiments to prove that the method meets the minimum standards for laboratory use. 3-methyl-2-bezothiazoline hydrazone reacts with the secondary amine group of tenofovir in the presence of oxidizing agent, ferric chloride. The resulting apple green coloured chromogen when measured spectrophotometrically in visible region (i.e., 400-800nm) shows a maximum absorbance at 626.5nm. This method can be successfully applied for the determination of drug content in pharmaceutical formulations. The results of analysis have been validated statistically.

Odontogenic Keratocyst of Maxillary Premolar Region: A Case Report.

Odontogenic keratocysts (OKC) are enamel organ or dental lamina derived cysts and are not thought to be associated with any infection. They mainly occur in second and third decades of life. The purpose of this case report is to describe a rare case of OKC in a 10-year-old girl, associated with upper left unerupted maxillary first premolar. It involved maxillary sinus leading to erosion of left orbital floor. It also led to the displacement of adjacent maxillary canine and maxillary left second premolar above the unerupted maxillary left third molar. Due to the aggressive nature of the cyst, it was enucleated and followed-up.

Ameloglyphic, Dermatoglyphic, Sweat Pore Analysis of Hidrotic Ectodermal Dysplasia: A Rare Case Report.

Hidrotic ectodermal dysplasia (ED) is an autosomal dominant genetic disorder characterized by the triad of features such as nail dystrophy, generalized hypotrichosis, and palmoplantar hyperkeratosis. Physical development and life expectancy are not affected. Dermatoglyphics and ameloglyphics have been considered as casement of congenital abnormalities and other conditions. Young adults and children with hidrotic ED need to be evaluated early by a dentist to determine the oral outcome. Stipulated, appropriate care needs to be provided throughout the child’s growth to maintain oral function. According to this study ameloglyphics was found to be beneficial over dermatoglyphics in timely diagnosis and treatment planning.

Development of new spectrophotometric method for estimation of tenofovir disoproxil fumarate using MBTH reagent.

A new simple, sensitive and specific procedure has been developed for determination of tenofovir disoproxil fumarate in bulk and pharmaceutical dosage forms using MBTH reagent. The purpose of this analytical validation procedure is to validate it by laboratory experiments to prove that the method meets the minimum standards for laboratory use. 3-methyl-2-bezothiazoline hydrazone reacts with the secondary amine group of tenofovir in the presence of oxidizing agent, ferric chloride. The resulting apple green coloured chromogen when measured spectrophotometrically in visible region (i.e., 400-800nm) shows a maximum absorbance at 626.5nm. This method can be successfully applied for the determination of drug content in pharmaceutical formulations. The results of analysis have been validated statistically.

Nasopalpebral lipoma coloboma syndrome.

Nasopalpebral lipoma–coloboma syndrome is characterized by nasopalpebral lipoma and eyelid coloboma. We report a case of a 16-year-old Indian girl who reported to us with this rare syndrome. Computed tomography scan showed a significantly hypodense lesion on the right side of nose which was confirmed to be a lipoma on histopathological examination. This condition should be included in differential diagnosis of conditions with congenital eyelid coloboma.

Determination of oxidative stress in vitiligo by measuring superoxide dismutase and catalase levels in vitiliginous and non-vitiliginous skin.

Background: Vitiligo is an acquired disorder characterized by circumscribed depigmented macules devoid of identifiable melanocytes. Complex genetic, immunological, neural and self destructive mechanisms interplay in its pathogenesis. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. Aims: The aim of our investigation was to evaluate the role of oxidative stress by measuring levels of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in lesional and normal skin of patients with vitiligo and in the skin of normal controls. Methods: We determined the activity of SOD in lesional and non-lesional skin and CAT in lesional skin only of 25 vitiligo patients and 25 controls by using the spectrophotometric assay and Aebi's method, respectively. Results: There was statistically significant increase in the levels of SOD in vitiliginous and non vitiliginous skin of patient group compared to the control group ( P < 0.001). No significant difference was found between the levels of SOD in lesional skin and non-lesional skin of vitiligo patients. The levels of CAT in the skin of patients were found to be significantly lower than those of controls ( P < 0.001). Conclusions: There is increased oxidative stress in vitiligo as is indicated by high levels of SOD and low levels of CAT in the skin of vitiligo patients.

Infertility associated with sub clinical salmonellosis.

Subclinical infection of guinea pigs with isogenic wild type and aroA, htrA and aroA-htrA mutants of Salmonella enterica subspecies enterica serovar Abortusequi (S. Abortusequi) induced infertility, while mutants had little or no effect on conception rate in guinea pigs. Conception rate was significantly lower in guinea pigs inoculated with wild type (S-787) and aroA mutant of S. Abortusequi than those inoculated with intracellular survival deficient htrA or aroA-htrA mutants of S. Abortusequi. Chi-test analysis revealed that none of the three mutants could be attributed to low conception rate, but wild type Salmonella inoculation and chronic carriage of the pathogen were significant cause of low conception rate in guinea pigs. Role of S. Abortusequi in causation of infertility was proven from the experiment for the first time.

Mesiodens with an unusual morphology and multiple impacted supernumerary teeth in a non-syndromic patient.

Supernumerary teeth are a relatively frequent disorder of odontogenesis characterized by an excess number of teeth. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between the two central incisors. They can be supplemental (resembling natural teeth), conical, tuberculate or molariform. We present the case of a 19 year-old girl who presented with a mesiodens of an unusual morphology and multiple impacted supernumerary teeth not associated with any syndrome.