Intra-operative cerebral blood flow assessment by indocyanine green video-angiography after temporary arterial occlusion in aneurysm surgery and its clinical implications: a prospective study

Objective@#Indocyanine green video angiography (ICG-VA) is a routine while performing vascular surgery to assess patency of perforators, completeness of clipping and/or to assess patency of anastomosis. Its usefulness in assessing cerebral blood flow and perfusion is not well studied. This study is aimed to assess the cerebral blood flow and perfusion after temporary clipping and to correlate with the risk of ischemia. @*Methods@#Prospective analysis of intra-operative ICG-VA performed during temporary arterial occlusion in 38 patients from January 2014 to December 2018 was conducted. Co-relation with post-operative MR diffusion weighted imaging (MR DWI) in terms of vascular territory of interest within 48 hours of surgery was performed. Clinical outcome was assessed using modified Rankin Scale (mRS) score 1-month post-surgery. @*Results@#43 aneurysms in 38 patients clipped using ICG-VA were included in this study. No side effect of ICG dye was seen in any patients. The number of times temporary clips applied had a direct relationship to the delay in appearance of ICG in the surgical field which became statistically significant after application of 3rd temporary clip. Nine (23.7%) patients developed ischemia following the procedure confirmed by post-operative MR DWI and all the ischemic cases had visible decrease in ICG fluorescence post-temporary clipping. @*Conclusions@#No previous study had tried to assess the intraoperative cerebral blood flow and perfusion during temporary clipping of parent vessels during aneurysm surgery. The use of ICG-VA can be extended to assess perfusion in desired territory by merely assessing the degree of opacification.

Endovascular management of large and giant intracranial aneurysms: Experience from a tertiary care neurosurgery institute in India

Objective@#With the development of endovascular technique and devices, large and giant intracranial aneurysms are increasingly being managed by this less invasive method. Here we discuss our experience on managing such aneurysms via endovascular technique. @*Methods@#Retrospective data on 42 patients with large and giant intracranial aneurysms managed by endovascular techniques between September 2015 to December 2017 at our neurosurgery institute were included in this analysis. @*Results@#There were a total 42 patients with 9 giant and 33 large aneurysms in this study. Eight aneurysms were treated by parent vessel occlusion, 22 aneurysms with coils and rest 12 aneurysms were treated with stent assisted coiling. Following the procedure, Raymond class I occlusion was accomplished in 31 (73.8%) patients while class Ⅱ in 9 (21.4%) and class Ⅲ in 2 (4.8%) patients. Overall morbidity and mortality were 9.5% and 14.3% respectively and favorable outcome was seen in 80.9% patients. Significant correlation was observed with clinical outcome and initial neurological status. @*Conclusions@#The study indicates that endovascular intervention is a safe and effective method in managing large and giant intracranial aneurysms with lesser morbidity and mortality.

Intra-operative cerebral blood flow assessment by indocyanine green video-angiography after temporary arterial occlusion in aneurysm surgery and its clinical implications: a prospective study

Objective@#Indocyanine green video angiography (ICG-VA) is a routine while performing vascular surgery to assess patency of perforators, completeness of clipping and/or to assess patency of anastomosis. Its usefulness in assessing cerebral blood flow and perfusion is not well studied. This study is aimed to assess the cerebral blood flow and perfusion after temporary clipping and to correlate with the risk of ischemia. @*Methods@#Prospective analysis of intra-operative ICG-VA performed during temporary arterial occlusion in 38 patients from January 2014 to December 2018 was conducted. Co-relation with post-operative MR diffusion weighted imaging (MR DWI) in terms of vascular territory of interest within 48 hours of surgery was performed. Clinical outcome was assessed using modified Rankin Scale (mRS) score 1-month post-surgery. @*Results@#43 aneurysms in 38 patients clipped using ICG-VA were included in this study. No side effect of ICG dye was seen in any patients. The number of times temporary clips applied had a direct relationship to the delay in appearance of ICG in the surgical field which became statistically significant after application of 3rd temporary clip. Nine (23.7%) patients developed ischemia following the procedure confirmed by post-operative MR DWI and all the ischemic cases had visible decrease in ICG fluorescence post-temporary clipping. @*Conclusions@#No previous study had tried to assess the intraoperative cerebral blood flow and perfusion during temporary clipping of parent vessels during aneurysm surgery. The use of ICG-VA can be extended to assess perfusion in desired territory by merely assessing the degree of opacification.

Endovascular management of large and giant intracranial aneurysms: Experience from a tertiary care neurosurgery institute in India

Objective@#With the development of endovascular technique and devices, large and giant intracranial aneurysms are increasingly being managed by this less invasive method. Here we discuss our experience on managing such aneurysms via endovascular technique. @*Methods@#Retrospective data on 42 patients with large and giant intracranial aneurysms managed by endovascular techniques between September 2015 to December 2017 at our neurosurgery institute were included in this analysis. @*Results@#There were a total 42 patients with 9 giant and 33 large aneurysms in this study. Eight aneurysms were treated by parent vessel occlusion, 22 aneurysms with coils and rest 12 aneurysms were treated with stent assisted coiling. Following the procedure, Raymond class I occlusion was accomplished in 31 (73.8%) patients while class Ⅱ in 9 (21.4%) and class Ⅲ in 2 (4.8%) patients. Overall morbidity and mortality were 9.5% and 14.3% respectively and favorable outcome was seen in 80.9% patients. Significant correlation was observed with clinical outcome and initial neurological status. @*Conclusions@#The study indicates that endovascular intervention is a safe and effective method in managing large and giant intracranial aneurysms with lesser morbidity and mortality.

[Study on follicular characteristics, hormonal and biochemical profile in norgestomet+PMSG treated acyclic buffaloes]

This research was conducted to study the follicular dynamics, hormonal, biochemical profile and fertility response in acyclic and norgestomet+PMSG treated acyclic buffaloes in summer. The study animals were divided into two groups: group I [control [n=8]: no treatment] and II [treatment group [n=15]]. In group II, seven animals were used for follicular biochemical and hormonal profile and eight animals for fertility studies following Crestar[registered sign] [Intervet, France] treatment [day 0: Crestar[registered sign] insertion; day 8: 500 IU PMSG; day 9: Crestar[registered sign] removal; day 11 AI]. Follicular fluid stradiol [E2] and progesterone [P4] in acyclic and pre-ovulatory follicle in study groups was significantly [P<0.01] higher than peripheral level. Peripheral E2 concentration, during pre-ovulatory period in group II was higher [P<0.05] than group I. Significant correlation between serum and follicular E2 was deduced [r=0.888; P<0.01] as significant difference in serum cholesterol content was shown between groups. Lower follicular total protein [P<0.05] in acyclic animals and higher follicular glucose [P<0.05] in treated group were concluded. Significant correlation [r=-0.770; P<0.05] was observed between follicular cholesterol and triglycerides. Follicular characteristics, post PMSG administration, differed significantly [0.83 +/- 0.20 vs 1.32 +/- 0.12; P<0.01] in all buffaloes exhibiting estrus, out of which four conceived. In conclusion, follicular hormonal and biochemical profile exhibits alteration in protein and glucose level between summer acyclic and treated buffaloes. However, peripheral E2 along with fertility response showed significant difference [P<0.01] between the study groups with significant correlation in E2, cholesterol and triglycerides between peripheral and follicular compartment

Modulation of signal transduction pathways by natural compounds in cancer / 中国天然药物

Cancer is generally regarded as the result of abnormal growth of cells. According to World Health Organization, cancer is the leading cause of mortality worldwide. Mother nature provides a large source of bioactive compounds with excellent therapeutic efficacy. Numerous phytochemicals from nature have been investigated for anticancer properties. In this review article, we discuss several natural compounds, which have shown anti-cancer activity. Natural compounds induce cell cycle arrest, activate intrinsic and extrinsic apoptosis pathways, generate Reactive Oxygen Species (ROS), and down-regulate activated signaling pathways, resulting in inhibition of cell proliferation, progression and metastasis of cancer. Several preclinical studies have suggested that natural compounds can also increase the sensitivity of resistant cancers to available chemotherapy agents. Furthermore, combining FDA approved anti-cancer drugs with natural compounds results in improved efficacy. On the basis of these exciting outcomes of natural compounds against several cancer types, several agents have already advanced to clinical trials. In conclusion, preclinical results and clinical outcomes against cancer suggest promising anticancer efficacy of agents from natural sources.

Glycopeptide and daptomycin susceptibility trends among clinical isolates of methicillin-resistant Staphylococcus aureus in a tertiary care center in North India

Increased vancomycin minimum inhibitory concentration [MIC] levels in Staphylococcus aureus and their association with vancomycin treatment failure are well-known problems. Few studies have recognized progressive increases in glycopeptide MIC levels for S. aureus strains in recent years. This study determined glycopeptide and daptomycin susceptibility among methicillin resistant S. aureus [MRSA] strains. A total of 776 clinical isolates of MRSA recovered from 2009 to 2012 were studied for glycopeptide and daptomycin susceptibility using the E-test method. The vancomycin MIC geometric mean [GM] of the MRSA isolates was 0.923, 0.944, 1.134 and 1.294 mg/L in the years 2009, 2010, 2011 and 2012, respectively, and the trend significantly increased over the years [P< 0.0001]. Similarly, the teicoplanin MIC GM was 1.47, 1.49, 1.8 and 2.04 mg/L in the years from 2009 to 2012, respectively [P< 0.0001]. MIC shifts were not found for daptomycin [P> 0.232]. A significant increase in the MIC for glycopeptides was observed among the clinicalA. MRSA isolates at our center over a 4-year period. However, the daptomycin MIC did not increase in the observed MRSA isolates

Optimization of process variables for enhanced lactic acid production utilizing paneer whey as substrate in submerged fermentation process

In the present study lactic acid production was enhanced by optimizing the three process variables viz; inoculum size, temperature and pH using three factor five level CCRD [central composite rotatable design] by Lactobacillus delbruckii under SMF [submerged fermentation process]. Paneer [dairy byproduct] whey was used as sole substrate for lactic acid production. Design Expert 8.0.2.0 software depicted that an optimum concentration of 8% [v/v] size of inoculum, 5.50 pH and 36.53°C temperature gave lactic acid and biomass yield of 5.61 g/L[-1] and 4.27 g/L[-1], respectively. Lactic acid production was scale up in 7.5 L bioreactor under optimized conditions and it gave lactic acid and biomass yield of 39.2 +/- 1.4 and 47.6 +/- 0.8 g/L[-1], respectively. micro[g], Y[P/S], Y[P/X] and productivity were found to be 0.14 h[-1], 0.66 g/g, 0.7 g/g and 1.98 g/L[-1] h, respectively. Leudking Piret equation deduced that lactic acid production was growth associated which varies from earlier reports. Lactic acid was characterized by FTIR [Fourier transform infrared spectroscopy] and HPLC

The Role of Platelets in Malarial Acute Lung Injury and Acute Respiratory Distress Syndrome: A World of Possibilities.

In recent decades our understanding of platelets’ role in immune response has increased. Traditionally platelets were considered as bleeding-stopping and thrombosis-causing cells. In recent years the platelets’ role in malarial innate and adaptive immune responses is being recognized. Platelets play critical role in pathogenesis of malaria infection leading to variety of outcomes. It is being realized that platelets play dual role in case of malaria (i) by preventing early stage exponential growth of parasitemia (ii) promoting exaggerated immune responses later. Platelets role in pathogenesis of severe and cerebral malaria has been widely studied. However their role in malaria related acute lung injury and respiratory distress has gained less attention. Recently the presence of active megakaryocytes and proplatelets have been explained in human lungs. Simultaneously, the platelets role in pathogenesis of acute lung injury and respiratory distress (ALI/ARDS) was also recognized. This gives a hint that there is a possible association of platelets with malaria related respiratory diseases as well. ALI/ARDS are characterized by lung edema due to increased permeability of the alveolar-capillary barrier and subsequent impairment of arterial oxygenation. In this review we have attempted to establish the importance of role of platelets in malaria related acute lungs injury and malaria acute respiratory distress syndrome and try to explain the underlying mechanism of this process. In ALI/ARDS, including those caused by malaria, platelets participate sequestration to the vascular bundle facilitating the recruitment of immune cells viz. neutrophils. Additionally, they secrete or induce the secretion of chemokines that result into vascular damage.

Idiopathic thrombocytopenic purpura and neuropathy: A case report and review

Mononeuropathy multiplex is a rare disorder associated with idiopathic thrombocytopenic purpura. Extrinsic compression due to hematoma, intraneural bleed and immune mediated nerve injury are reported mechanisms of neuropathy. We report of a case of a girl with recurrent idiopathic thrombocytopenic purpura with mononeuropathy multiplex, along with a brief review of the mechanism of neuropathies in asscociation with idiopathic thrombocytopenic purpura.

Evaluation and comparison of native and recombinant LipL21 protein-based ELISAs for diagnosis of bovine leptospirosis

A 21-kDa leptospiral lipoprotein (LipL21) was evaluated for its diagnostic potential to detect bovine leptospirosis by ELISA. Both native LipL21 (nLipL21) and recombinant LipL21 (rLipL21) proteins were tested and compared regarding diagnostic efficiency, and no statistically significant difference was observed. The sensitivity of rLipL21 ELISA for 62 microscopic agglutination test (MAT) positive sera was 100% and the specificity with 378 MAT negative sera was 97.09%. Thus, rLipL21 protein-based ELISA could be used as an alternative to MAT for the diagnosis of bovine leptospirosis.

Quantitative tumor volume vs. TNM staging: the impact on prognosis in head and neck cancer

To evaluate the prognostic value of tumor volume [TV] by clinical method [CM] and Computerized Tomography [CT] scan in head and neck [H and N] cancer. Total 25 patients' [pts] pretreatment tumor volume [PT TV] was assessed clinically by cuboid volume method. Afterwards contrast enhanced computerized tomography [CECT] images of the pts were transferred to workstation by DICOM software. The computerized tomography tumor volume [CT TV] was obtained on Radworks 6.0, using mouse control cursor. After assessment, the patients were given 3 cycles of neoadjuvant chemotherapy followed by radiotherapy by conventional method on Co-60 Theratron 780 C. After 1 month of treatment, TV was again measured. Statistical analysis was done on MSTAT statistical analysis software. Two-tailed student t test, chi square test and test for two proportions for significance had been used. Large variations in tumor volume were found both in intra as well as inter T-stages. As the tumor size increases with T stages, the differences in measurement of TV by both methods decreases. CT TV results pre as well as post-treatment were more consistent than clinical method. The use of TV as a prognostic factor by CT scan seems to be more useful parameter than the CM. TV should be included in the TNM [tumor, node, and metastasis] classification after setting the strict guidelines for tumor delineation, to solve the discrepancy of treatment outcome in the same clinical stage

Monocular visual loss due to herniation of gyrus rectus: a case report with review of literature

The authors present an unusual case of a polar mass in the frontal lobe of the brain, causing acute monocular visual loss in a 50-year-old woman with history of breast carcinoma treated with surgery, radiation and chemotherapy. Neuroimaging demonstrated herniation of the gyrus rectus into the suprasellar cistern resulting in compression of the anterior visual pathway

Electrokinetic remediation study for cadmium contaminated soil

This paper presents the results of an experimental research undertaken to evaluate different purging solutions to enhance the removal of cadmium from spiked contaminated field soil by electrokinetic remediation. Three experiments were conducted when soil was saturated with deionised water and subsequently deionised water, ammonium citrate and sodium citrate were used as purging solutions at anode end. One experiment was conducted when the soil was saturated with ammonium citrate and itself was used as the purging solution. Results showed that 49% reduction of cadmium concentration was achieved in the case of soil saturated [washed] with ammonium citrate as well as purging solution also was ammonium citrate. The soil pH and washing solutions were the most important factors in controlling the removal of cadmium in electrokinetic remediation process

Sorption and desorption studies of metallic zinc on an alluvial soil

The sorption of metallic zinc from the pH-adjusted aqueous solution at varying initial concentrations onto a clay soil through batch equilibrium experiments has been studied. The pH of the initial concentrations ranging between 50 mg/L to 250 mg/L has been varied from 3 to 7. The sorption data fitted very well with both Langmuir and Freundlich isotherm models and Freundlich model gave higher correlation coefficients. The maximum sorption of metallic zinc occurred at pH=6. The pseudo-second order kinetics model was most agreeable with the experimental sorption data, whereas the pseudo-first order model was found to be insufficient. A nonionic surfactant was tested for its desorption potential and was found to be fairly effective at 2% concentration with removal of more than 60% sorbed Zinc

Pharmacokinetics, urinary excretion and dosage regimen of levofloxacin following a single intramuscular administration in cross bred calves

The pharmacokinetics and urinary excretion following single intramuscular administration of levofloxacin at a dose of 4 mg/kg was investigated in seven male cross bred calves. Appreciable plasma concentration of levofloxacin (0.38 +/- 0.06 microgram/ml) was detected at 1 min after injection and the peak plasma level of 3.07 +/- 0.08 microgram/ml was observed at 1 h. The drug level above MIC(90) in plasma was detected up to 12 h after administration. Rapid absorption of the drug was also evident by the high value of the absorption rate constant (2.14 +/- 0.24 /h). The overall systemic bioavailability of levofloxacin, after intramuscular administration, was 56.6 +/- 12.4%. The high value of AUC (7.66 +/- 0.72 mg.h/ml) reflected the vast area of body covered by drug concentration. Extensive distribution of the drug into various body fluids and tissues was noted by the high value of Vd(area) (1.02 +/- 0.05 l/kg). The high ratio of AUC/MIC (76.6 +/- 7.25) obtained in this study indicated excellent clinical and bacteriological efficacy of levofloxacin in calves. The elimination half-life and MRT were 3.67 +/- 0.4 h and 5.57 +/- 0.51 h, respectively. The total body clearance (Cl(B)) was 204.9 +/- 22.6 ml/kg/h. On the basis of the pharmacokinetic parameters, a suitable intramuscular dosage regimen for levofloxacin in calves would be 1.5 mg/kg repeated at 12 h intervals.

Effect of Iron Availability on Induction of Systemic Resistance to Fusarium Wilt of Chickpea by Pseudomonas spp

Selected isolates of Pseudomonas fluorescens (Pf4-92 and PfRsC5) and P. aeruginosa (PaRsG18 and PaRsG27) were examined for growth promotion and induced systemic resistance against Fusarium wilt of chickpea. Significant increase in plant height was observed in Pseudomonas treated plants. However, plant growth was inhibited when isolates of Pseudomonas were used in combination with Fusarium oxysporum f. sp. ciceri (FocRs1). It was also observed that the Pseudomonas spp. was colonized in root of chickpea and significantly suppressed the disease in greenhouse condition. Rock wool bioassay technique was used to study the effect of iron availability on the induction of systemic resistance to Fusarium wilt of chickpea mediated by the Pseudomonas spp. All the isolates of Pseudomonas spp. showed greater disease control in the induced systemic resistance (ISR) bioassay when iron availability in the nutrient solution was low. High performance liquid chromatography (HPLC) analysis indicated that all the bacterial isolates produced more salicylic acid (SA) at low iron (10microM EDDHA) than high iron availability (10microFe3+ EDDHA). Except PaRsG27, all the three isolates produced more pseudobactin at low iron than high iron availability.

Induction of Defense Related Enzymes and Pathogenesis Related Proteins in Pseudomonas fluorescens-Treated Chickpea in Response to Infection by Fusarium oxysporum f. sp. ciceri

Pseudomonas fluorescens 1-94 induced systemic resistance in chickpea against Fusarium wilt of chickpea caused by Fusarium oxysporum f. sp. ciceri by the synthesis and accumulation of phenolic compounds, phenylalanine ammonia lyase(PAL) and pathogenesis related(PR) proteins(chitinase, beta-1,3-glucanase and peroxidase). Time-course accumulation of these enzymes in chickpea plants inoculated with P. fluorescens was significantly(LSD, P=0.05) higher than control. Maximum activities of PR-proteins were recorded at 3 days after inoculation in all induced plants; thereafter, the activity decreased progressively. Five PR peroxidases detected in induced chickpea plants. Molecular mass of these purified peroxidases was 20, 29, 43, 66 and 97 kDa. Purified peroxidases showed antifungal activity against plant pathogenic fungi.

Studies on transition metal complexes of Schiff's Base derived from salicylaldehyde and 2-amino 4-phenyl oxazole

Recently a large number of work on heterocyclic transition metal complexes and their antifungal activity have been studied in this Laboratory and survey of literature revealed that no work has been done in the structural and fungicidal activity of transition metal complexes of Schiff's base derived from 2-amino 4-phenyl oxazole and salicylaldehyde. This note deals with the study of structural and fungicidal activity of transition metal complexes of Co [II], Cu [II], and Ni[II] with Schiff's base 2-amino-4-phenyl oxazole and salicylaldehyde. The newly synthesised complexes were also screened for their antifungal activity against different fungi viz; Phoma exiaua, Macrophomia phoseoli and Colletatrichum-capsici at 100, 50 and 20 ppm