Dohra- a mixture of potent carcinogens

Background & objectives: Dohra is a areca nut preparation used with or without tobacco in a few of the areas of Uttar Pradesh (UP), India. There is evidence that it causes potentially malignant disorders and oral cancer. This study was undertaken to provide information on dohra by searching through literature and also through a survey in three areas of Uttar Pradesh (UP), India. Methods: The information on dohra was collected through literature search, study tour to different areas of UP, where group discussions with dohra vendors and with community members of different age group were done to obtain information. Results: Dohra was prepared by the users for their personal use or prepared by small-scale industry for sale. It was available mostly in betel shops or any other store/kiosks and was also available in special dohra shops. Dohra was available in both dry and wet form. Its common constituents were areca nut, catechu (Acacia catechu), edible lime, peppermint (Mentha piperita), cardamom (Elettaria cardamomum) and some flavoring agents. Dohra was consumed as such or with tobacco. Interpretation & conclusions: Different varieties of Dohra were available such as sukha dohra, sukha mulethi dohra and geela dohra. Different processing methods for producing dohra existed. As dohra increases the risk of cancer, it needs to be banned or it should be sold in packets with the details of its constituents and also statutory warning about its adverse health effects.

Superoxide dismutase activity in response to heat stress in Jamunapari goats

Superoxide radicals cause damage to cell by inhibiting some critical enzyme activities of the cell, lipid peroxidation in the membranes and DNA damage. Superoxide dismutases (SOD) play a critical role in regulating the oxidative stress and heat stress. As SOD regulates cell defense during heat stress, therefore the present study was designed to analyse the SOD activity in lactating animals and in growing kids of Jamunapari goats during peak heat stress period. Heat stress susceptible and tolerant phenotypes were identified based on distribution of respiration rate (RR) and heart rate (HR), the animals exhibiting RR ≥50 and HR ≥130 are recognised as heat stress susceptible (HSS) phenotype and RR ≤30 and HR ≤100 individuals are recognized as heat stress tolerant (HST) in adult goats during heat stress period. SOD activity (Inhibition percent) was 31.63% and 36.92% in lactating goats and kids at 9 months of age, respectively. Sex and birth type had significant effect (P <0.01) on SOD activity at 9 months of age of growing kids. Males had lower SOD activity than females at 9 month of age. The SOD activity of heat stress susceptible (HSS) individuals was significantly higher (P <0.01) than heat stress tolerant (HST) animals in lactating goats. There was no significant difference (P> 0.01) observed in SOD activity of kids on a within HSS and HST phenotype. Heat stress tolerant individuals had lower SOD activity than heat stress susceptible individuals during lactating stage. SOD play significant role during lactating condition as compared to growth stage in Jamunapari goats.

Current view on biomedical applications of synthetic metal-polymer nanocomposites

Recent advances in the field of nanotechnology led several groups to recognize the promise of recruiting nanocomposities to the ongoing battle against pathogenic gram-positive and gram-negative bacteria and metal-polymer nanocomposites are a typical example. On the basis of recent literature, the nanocomposities are synthesized mainly by two techniques i.e. in-situ and ex-situ technique and these nanocomposities have great biomedical applications in terms of their antibacterial activity. A large battery of newly developed and discovered nanocomposities has been accumulating during the last decade.

Periodontal pathogens in atheromatous plaque.

Background: There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may infl uence the initiation and or progression of systemic diseases. These studies confi rm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in atheromatous plaques. Aim: This study intends to investigate the possible association between periodontal health and coronary artery disease by evaluating periodontal status, association between the periodontal plaque and coronary atheromatous plaques for presence of micro-organisms such as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. Materials and methods: A case-control study was designed with seven patients who had undergone coronary endarterectomy for cardiovascular disease and 28 controls. The periodontal examination for cases was performed 1 day before vascular surgery and the controls were clinically examined. The atheromatous plaque sample collected during endarterectomy and the intraoral plaque samples were subjected to polymerase chain reaction for identifi cation of A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. forsythia. Results: The presence of periodontal bacteria DNA in coronary atheromatous plaques and sub-gingival plaque samples of the same patients was confi rmed by this study. CONCLUSION A correlation was established between putative bacteria contributing to atheromatous plaques and species associated with periodontal disease. One particularly important study to be carried out is the investigation of a possible clinically meaningful reduction in coronary heart disease resulting from the prevention or treatment of periodontal disease.

Clinical and Echocardiographic Study of Hypertrophic Cardiomyopathy in Tanzania

There are few published reports on Hypertrophic Cardiomyopathy (HCM) in Africans. Due to lack of echocardiography machines in most hospital centers; clinical identification of HCM remains confined to those patients with a loud heart murmur associated with the outflow gradient. Between June 1998 and October 2002; 134 patients were studied at Hindu Mandal Hospital; 67.9were male and 32.1were female. Their mean age was 54.8 + 14.2 years. The presenting symptoms were Dyspnoea 62.7; Chest pain 55.9; Palpitations 50.7(Pre-syncope 21.6; Syncope 8.9) Due to the diverse clinical features; only 8(5.9) patients had a correct diagnosis of Hypertrophic Cardiomyopathy in their echocardiography request forms. Others were diagnosed as Ischaemic heart disease 31.8; Dilated Cardiomyopathy 29.9; Mitrol valve prolapse 11.2and Arrhythmias 6.7. Using Echocardiography; the pattern of LVH among these patients was found to be: Asymmetrical septal hypertrophy in 50.7and apical hypertrophy in 3.0. The important role of echocardiography in diagnosis is stressed with a plea for the increasing availability of this non-invasive technique for early and accurate diagnosis of Hypertrophic Cardiomyopathy

Pancreas-sparing duodenectomy for trauma.

The application of pancreas sparing duodenectomy (PSD) in extensive duodenal trauma has not been fully explored. We report 3 caes of duodenal trauma in whom PSD was performed successfully and with good results.

Spleen preserving distal pancreatectomy for blunt abdominal trauma--a case report.

The case of a 22-year-old male who underwent spleen preserving distal pancreatectomy (SPDP) for pancreatic trauma is briefly reported. SPDP was performed by preserving the splenic vessels to maintain a reliable splenic blood flow post-operatively. Although technically demanding, this procedure can be performed safely and easily in the emergency, and avoids splenectomy-related problems in the post-operative period.

Repair of iatrogenic oesophageal perforation using a vascularized diaphragmatic flap.

The use of a pedicle patch of diaphragm to reinforce the primary closure of a large, iatrogenic oesophageal perforation in a patient of achalasia cardia is reported.

Mechanical bowel obstruction: the Chandigarh experience.

Intestinal obstruction is a fairly common surgical emergency in India, but there is little data available regarding the spectrum of intestinal obstruction in India, or its related complications. This paper represents a retrospective review of 97 patients who underwent surgery for intestinal obstruction at Government Medical College and Hospital, Chandigarh, India, over four years (1997-2000). The case files of all these patients were reviewed and analysed for patient particulars, pre-operative clinical examination and investigations, intraoperative findings, final diagnosis, post-operative morbidity, and mortality. The mean age of our patients was 39.46 years, with an overall male to female ratio of 2.46:1. Most of the patients were in the age group of 17 to 60 years (62.89%). A total of 107 causes for the obstruction could be identified at surgery, with intra-abdominal adhesions and bands (27.10%) being the commonest followed by obstructed herniae (22.43%). Strangulation was present in 21 patients at the time of surgery. This group of patients had a significantly higher post-operative morbidity than patients with simple obstruction, although no statistically significant difference was seen in between the mortality rates in these two groups.

Jejunal serosal onlay flap for repair of large common bile duct defect in Mirizzi's syndrome.

Reconstruction of the common bile duct (CBD) has been performed using a variety of materials, ranging from synthetic i.e. teflon, to autogenous tissues such as veins, arteries, appendix, ureter, gallbladder, duodenum, etc. The onlay jejunal serosal patch has been commonly used to cover defects because of duodenal ulcer perforations and injuries. To the best of our knowledge, the use of this technique for choledochoplasty in Mirrizi syndrome has not been reported. We present a case of Mirrizi syndrome type III, in whom nearly three fourths of the CBD was eaten away by a large gallstone and the repair was done using an onlay serosal patch of the jejunum.

A case of sigmoid lipoma presenting with intussusception.

Colonic lipomas are rare, benign tumours that rarely produce symptoms. Presented here is a case where a sigmoid lipoma acted as lead point to produce intussusception.

AgNORs in endometrial lesions.

Silver nucleolar organizer region (AgNOR) staining was employed in one hundred specimens of endometrium. These included fifteen normal controls (Proliferative + Secretory endometrium) and eighty five lesions. Endometrial lesions comprised of endometritis (15), endometrial hyperplasia (25) and endometrial carcinoma (45). Three micron thick sections of paraffin embedded tissue were subjected to AgNOR staining as described by Crocker and Smith with a little modification of 0.01% safranin counterstain--The mean AgNOR scores were found to increase steadily from normal to endometritis to endometrial hyperplasia and carcinoma--The observations revealed statistically significant differences in values between atypical hyperplasia and carcinoma also. AgNOR staining and scoring is simple, inexpensive and a useful adjunct to routine histopathology to evaluate endometrial lesions especially to differentiate borderline lesions. Though scores cannot be standardized and fixed for a particular lesion as there are intralaboratory variations.