An interesting case of acute pancreatits

Hypertriglyceridemia(HTG)is the third most common cause of acute pancreatitis but it is relatively rare and requires a highlevel of clinic suspicion. We report a 30 years old male with no co-morbidities who is a non-alcoholic, non-smoker presented with epigastric pain associated with vomiting for two days. His vitals were stable and systemic examination wasunremarkable. Serum lipase levels were elevated [7365 U/l(<40 U/l)]. Computed Tomography of the abdomen suggested acute pancreatitis with extensive peri-pancreatic inflammatory changes with no evidence of pancreatic necrosis. Serum triglycerides were found to be elevated (3450 mg/dl). A diagnosis of HTGinduced acute pancreatitis was made. During evaluation he was found to be diabetic. He was treated with intravenous fluids, IV insulin infusion, and other supportive measures. He was started on statins, fenofibrate and omega3 fatty acids. His condition improved and triglyceride levels after two days were in a declining trend and he was discharged on the same. He was currently under follow up and his serum amylase, serum lipase, serum triglycerides were normal. This case report provides insight into rare cause of acute pancreatitis-HTGwhich if diagnosed at the earliest can be treated promptly.

A rare cause of anaemiain multiple myeloma

Multiple myeloma is a neoplastic plasma cell dyscrasia. Anaemiain multiple myeloma is usually related to many factors, of which the commonest cause being anaemiaof chronic disease. We reporteda 67 years old hypertensive male presented with low back pain and loss of appetite. Investigations revealed severe anaemiaand elevated total serum protein with albumin/globulin (A/G) reversal (1:4). Bone marrow aspiration revealed plasma cell dyscrasia. Skeletal survey evaluation showed multiple osteolytic lesions. Serum protein electrophoresis revealed M spike in gamma globulin region with immunofixation suggestive of IgG and kappa monoclonal gammopathy. He was diagnosed as a case of multiple myeloma.. On evaluating the cause of severe anaemia, interestingly various findings suggestive of Autoimmune hemolytic anaemia(AIHA) were found. Packed red blood cell transfusion along with steroids was done for correction of severe anaemia. Review of literature showed that only about 4% of AIHA patients had multiple myeloma. We reported a rare case of multiple myeloma who presented with AIHA.

Carbohydrate profiling & glycaemic indices of selected traditional Indian foods

Background & objectives: Consumption of high glycaemic index (GI) food is associated with a high risk for diabetes. There is a felt need to understand the GI of common Indian traditional foods using standard GI protocols. The present study was aimed to analyse the carbohydrate profile of common traditional Indian food preparation and to determine their GI using standardized protocols. Methods: Twelve food preparations made of millets, wheat, maize and pulses were evaluated for nutrient composition including detailed carbohydrate profiling and tested for GI in healthy volunteers using standard methodology. Capillary blood glucose responses for the test foods containing 50 g available carbohydrates were recorded and compared to the reference food (50 g glucose). GI was calculated from the incremental area under the curve (IUAC) for the test and reference foods. Results: Available carbohydrate content of the food preparations ranged between 13.6 and 49.4 g per cent. Maize roti showed the highest total dietary fibre (7.5 g%). White chick pea ‘sundal’ showed highest resistant starch content (3.95 g%). Amongst the 12 test foods, five fell in the high GI category (finger millet balls, sorghum, pearl millet and maize roti), four in the medium GI category (sorghum idli, wheat dosa, methi roti and adai) and three in the low GI category (broken wheat upma, white peas sundal and white chick peas sundal). Interpretation & conclusions: Merely being a whole grain-based food does not qualify for a lower GI. The method of processing, food structural integrity and preparation could influence the GI. The type and quality of fibre are important than the quantity of fibre alone. Judicious planning of accompaniments using low GI legumes may favourably modify the glycaemic response to high GI foods in a meal.

Hip pain in children dilemmas in diagnosis and management a case report

Atraumatic hip pain in growing children is of varied etiology from developmental to infection and tumor. Differential clinical presentation of symptoms and investigation modalities like blood parameters and radiological imaging remains inconclusive at times with differential diagnosis. Biopsy remains the final say in conclusive of establishing final diagnosis unless proved otherwise. Bony lytic lesion of proximal femur in children without systemic illness mimicking benign bone tumor initially (osteiod osteoma) turned out to be chronic osteomyelitis on histopathologically following CT guided biopsy of the lesion which alters the course of management.

Encapsulation of fungal extracellular enzyme cocktail in cellulose nanoparticles: enhancement in enzyme stability

We demonstrated the nano-immobilization of fungal enzymes through their encapsulation in cellulose nanoparticles (CNPs). An extracellular enzyme cocktail (a mixture of amylase, protease, lipase, and cellulose) was produced from Aspergillus niger and Phanerochaete chrysosporium through submerged fermentation. The process of encapsulation was carried out through a microemulsion nanoprecipitation method in the presence of a lipid, a surfactant, and a co-surfactant. The morphology of CNPs was determined by field-emission scanning electron microscopy and transmission electron microscopy; CNPs were less than 100 nm in diameter. Fourier transform infrared spectroscopy (FTIR) and energy dispersive spectroscopy demonstrated the successful encapsulation of the fungal enzyme cocktail and revealed C and O as its major components. FTIR peaks of CNPs with encapsulated enzymes occurred at 3421.80, 2828.91, 1649.29, 1450.24, and 1061.61 cm−1 as well as in the range of 1050–1150 cm−1. Encapsulated enzymes showed excellent stability with a peak at −70.91 mV in zeta potential studies. Thermogravimetric analysis proved that the CNP-encapsulated enzymes had an initial weight loss at 250°C. The encapsulated fungal enzyme cocktail exhibited higher catalytic performance and stability than the free enzymes. The encapsulated fungal enzyme cocktail derived from A. niger at the concentration of 100 µg/mL, showed the highest amylase activity with a clear zone of 2.5 cm. Overall, the results of this research reveal the enhancement in the activity of fungal extracellular enzyme cocktail through nanoencapsulation.

Finger millet (Eleusine coracana L.) and white rice diets elicit similar glycaemic response in Asian Indians: Evidence from a randomised clinical trial using continuous glucose monitoring

@#Introduction: Finger millet (FM) or Eleusine coracana L. is considered as a healthier cereal option, especially based on its higher dietary fibre, phytochemical and mineral contents. FM is also recommended for individuals with diabetes, as it is believed to elicit a lower glycaemic response. Methods: The glycaemic response of FM diet was evaluated and compared with white rice (WR) diets using a continuous glucose monitoring system (CGMS™) iPro 2™ among 14 healthy male and female volunteers aged 25-45 years with normal Body Mass Index (≥22.9kg/m2) in a crossover trial. They were recruited from Madras Diabetes Research Foundation volunteers registry. The participants consumed randomised iso-caloric FM or WR based diets for five consecutive days and 24 h interstitial glucose concentrations were recorded. Results: The FM diet had significantly higher dietary fibre than WR (29.9 g vs 15.8 g/1000 kcal, p<0.01) but the other macronutrients were similar. The 5-day average incremental area under the curve (IAUC) of FM diet [Mean (95% CI) = 73.6 (62.1-85.1) mg*min/dl] was not significantly different from that for WR diet [Mean (95% CI) = 78.3(67.9-88.7) mg*min/dl]. Conclusion: Both finger millet and white rice diets showed similar 24 h glycaemic responses, despite the former having higher amounts of dietary fibre. The result suggests that use of FM flour-based food preparations and decorticated FM grains to replace WR in the Indian diets offer no significant benefit with regards to 24 h glycaemic response. Studies of longer duration with larger sample size are needed to verify our findings.

Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147).

Background & objectives: Despite the rising prevalence of non-communicable diseases (NCDs) in rural India, data on the dietary profile of the rural Indian population in relation to the recommendations for prevention of NCDs are scarce. This study was conducted to assess the dietary intake of a rural south Indian population in relation to the current dietary recommendations for the prevention of NCDs. Methods: The dietary profiles of 6907 adults aged ≥ 20 yr, from a cluster of 42 villages in Kancheepuram district of Tamil Nadu State in southern India, were assessed using a validated food frequency questionnaire. Results: The prevalence of general obesity was 27.4 per cent and that of abdominal obesity, 14.0 per cent among this rural population. The median daily energy intake of the population was 2034 (IQR 543) kcals. More than 3/4th of the calories (78.1%) were provided by carbohydrates. Refined cereals, mainly polished rice, was the major contributor to total calories. About 45 per cent of the population did not meet WHO recommendation for protein due to low intake of pulses, flesh foods and dairy products and more than half (57.1%) exceeded the limit of salt intake; 99 per cent of the population did not meet WHO recommendations for fruits and vegetables and 100 per cent did not meet the requirement of n-3 poly unsaturated fatty acids. Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.

Signal enhancement in ELISA: Biotin-streptavidin technology against gold nanoparticles

Objectives: The aim of this study is to compare the use of biotin-streptavidin and gold nanoparticle [GNP] technologies in enzyme linked immunosorbent assay [ELISA] techniques to improve its sensitivity and accuracy

Methods: We evaluated two ELISA methods to improve the sensitivity and accuracy. Biotin-streptavidin technology was selected to enhance the ELISA limit of detection due to the high binding affinity of biotin-streptavidin. GNP-conjugated biomolecules were selected to improve detection by ELISA. To evaluate these two methods, the early secreted antigenic target-6 [ESAT-6] from Mycobacterium tuberculosis and the anti-ESAT-6 antibody were used

Results: The detection limit of ESAT-6 was the same with and without GNP due to the saturation of biotin and streptavidin binding. However, higher absorbance was noticed using GNP only

Conclusion: The proposed modified ELISA can be used to screen different types of common diseases. Additionally, this study showed how several new techniques can improve the detection and accuracy of ELISA

Aptasensors in viral detection

Background: Aptamers are single-stranded nucleic acids, so-called ‘artificial antibodies’, identified from the randomized combinatorial library against the target by the process called ‘SELEX’ (Systematic Evolution of Ligands by EXponential enrichment). Target can have any sizes from small molecules to the whole cell, attests the versatility of aptamers to bind a wide range of targets. Aptamers have several advantages over antibodies, such as they are easy to prepare, cheaper, have no batch variations, are easy to modify, stable and most importantly, non-immunogenic. Because of these positive characteristics, aptamers are incorporated in different fields, and most attractive in the applications involving therapeutics and diagnoses (theranostics). With either aptamers alone or complementing with antibodies, several high sensitive, portable sensors have been demonstrated for use in ‘bedside analysis’. Moreover, aptamers are more amenable to chemical modifications, making them capable of utilization with the most developed aptasensors (aptamerbased sensors). Significance: The development of more sensitive aptasensors could be useful and important for medical diagnosis, identification of pathogens for the quality control of consumable items, and surveillance of emerging diseases. In fact, aptasensors have already shown their efficacy in the detection of life threatening diseases caused by early stage of viral infections. In this review, role of aptasensors in detecting pathogenic viruses are overviewed. Keywords: Anti-virus; aptamer; aptasensor; bedside analysis; SELEX