Male Gender Assignment of a Child with Aphallia and Associated Complex Urological Anomaly.

A 2-year-old male child presented to us with aphallia. At birth, he was passing urine from the anus and had undergone emergency colostomy and pyelostomy for urinary sepsis at 1 week of life. After a complete evaluation, the child underwent perineal urethrostomy and scrotal phalloplasty followed by buccal mucosal tube urethroplasty in the second stage, which was completed before the child started schooling.

Outcome of Antenatally Presenting Posterior Urethral Valves (PUV) in Children.

BACKGROUND: To analyze the outcome of children with posterior urethral valves who presented with antenatal hydronephrosis. METHODS: A 10-year retrospective review of records of 70 children with posterior urethral valves. RESULTS: The mean (SD) gestational age at diagnosis was 34 (4.48) weeks, and age at intervention was 130.5 (170.9) days. The nadir creatinine was significantly raised (<1.2 mg/dl) in children with oligohydramnios and diversion. CONCLUSION: All boys with antenatally detected hydronephrosis need postnatal evaluation to rule out posterior urethral valves. Short term outcome is improved with postnatal treatments, and longer follow-up is needed to ensure a favourable outcome.

Solid state manipulation of lornoxicam for cocrystals--physicochemical characterization.

CONTEXT: Lornoxicam is an analgesic and anti-inflammatory drug of choice and belongs to Class II (low solubility) of BCS (Biopharmaceutical Classification System). Thus bioavailabilities problems are predominant. OBJECTIVE: Through crystal engineering approach, a method was developed for obtaining multi-component cocrystals of lornoxicam using pharmaceutically acceptable compounds as guests. MATERIALS AND METHODS: Lornoxicam guest-free form was obtained from solution crystallization. Supramolecular synthon approach indicated that lornoxicam was in orthorhombic form. Further presence of intermolecular hydrogen bonding with layered structures was identified. Solvent drop grinding method permitted the formation of cocrystals of lornoxicam with catechol, resorcinol, benzoic acid, hydroxyquinone and 2,4 dihydroxy benzoic acid, all are capable of forming hydrogen bonding. RESULTS AND DISCUSSION: Lornoxicam cocrystals exhibited the difference in melting points and decomposition characteristics. The analysis of infrared (IR) indicated the shifting of characteristic bands of lornoxicam. The XPRD (X-Ray Powder Diffraction) pattern indicated the crystallinity of cocrystals and significant difference in 2θ value of intense peaks. Differential scanning calorimetry spectra of cocrystals denoted the changes in fusion endotherms, which are in agreements with melting points. The pH solubility profile of lornoxicam showed sigmoidal curve, which substantiated the pKa-dependent solubility. Lornoxicam cocrystals also exhibited a similar pH-solubility profile. Thus pairing of lornoxicam and coformers in the solution at high pH media was assumed. The in vitro dissolution studies of cocrystals were conducted at pH 4.0. The rapid rate of dissolution of cocrystals was observed in initial 10 min. The extent of dissolution was enhanced by 20% on account of cocrystallization. CONCLUSION: The lornoxicam cocrystals were obtained with improved physicochemical characteristics.

Fatal case of retropharyngeal abscess associated with Pott's disease.

Retropharyngeal abscess is a rare, deep seated infection of the neck that usually affects young children. Chronic retropharyngeal abscess is rare and results from tuberculosis of the spine. Such swelling in the neck gradually increases in size and is detected during the routine radiological screening for symptoms like pain, dysphagia, fever, dyspnoea, progressive inspiratory stridor (from laryngeal obstruction), neck hyperextension etc, but rarely leads to sudden death due to airway obstruction. Thus the forensic pathologist rarely comes across such type of cases. Present case concerns obstruction of upper airway by a large retropharyngeal cold abscess leading to death in a 13-year-old female child from a lower socio-economic family. The possible explanation for the progression and fatal outcome of such abscesses associated with the Pott's disease is being discussed in the light of available literature.

The prevalence and the characterization of the enterococcus species from various clinical samples in a tertiary care hospital.

BACKGROUND: Enterococci form a part of the normal flora of the intestinal tract, the oral cavity, and the vagina, but in recent times, they have become emerging nosocomial pathogens. Their increasing importance is largely due to their resistance to antimicrobials. The therapeutic failures in enterococcal infections are mainly due to the intrinsic as well as transferable drug resistance. The main aim of our study was to estimate the prevalence of the Enterococcus infection and to determine the antibiogram in a tertiary care hospital. METHOD: Enterococcus was isolated from a total of 5555 clinical samples like urine , pus, tissue, blood and body fluids during the period from January to December 2008. The isolates were speciated by using conventional biochemical tests (Facklam and Collins). The antibiotic susceptibility testing was done by the Kirby Bauer disc diffusion method. Confirmation of vancomycin susceptibility was done by the Epsilometer test (E test) to determine the Minimum Inhibitory Concentration (MIC). RESULT: From various clinical samples, 128 Enterococcus species were isolated in a period of one year and the rate of the infection was estimated to be 2.3%. Among the isolates, those of Enterococcus faecalis (E.faecalis) were 97(76%) and the remaining 31(24%) were of Enterococcus faecium (E.faecium). The maximum number of isolates were from pus 55(43%), followed by the isolates from urine 40(31%). The sensitivity pattern of these isolates showed an increased resistance to penicillin, ampicillin and ciprofloxacin. A High Level of Gentamicin Resistance (HLGR) was present in 60 (47% ) isolates of Enterococcus and 35(27%) isolates were intermediately sensitive to vancomycin by the Kirby Bauer disc diffusion method. All the intermediately sensitive isolates to vancomycin were further tested by the E test and they were found to be vancomycin sensitive. CONCLUSION: Various studies have shown an increase in the rate of infection and the antibiotic resistance in the Enterococcus species. There is also a change in the pattern of the Enterococcus infection, with an increase in the isolation rate of E. faecium and other non faecalis Enterococcus species. The Kirby Bauer disc diffusion method is not an accurate method for detecting the Vancomycin Resistant Enterococci (VRE).

Design and in vivo evaluation of carvedilol buccal mucoadhesive patches.

The buccal region offers an attractive route of administration for systemic drug delivery. Carvedilol (dose, 3.125-25 mg) is beta-adrenergic antagonist. Its oral bioavailability is 25-35% because of first pass metabolism. Buccal absorption studies of a carvedilol solution in human volunteers showed 32.86% drug absorption. FTIR and UV spectroscopic methods revealed that there was no interaction between carvedilol and polymers. Carvedilol patches were prepared using HPMC, carbopol 934, eudragit RS 100, and ethylcellulose. The patches were evaluated for their thickness uniformity, folding endurance, weight uniformity, content uniformity, swelling behaviour, tensile strength, and surface pH. In vitro release studies were conducted for carvedilol-loaded patches in phosphate buffer (pH, 6.6) solution. Patches exhibited drug release in the range of 86.26 to 98.32% in 90 min. Data of in vitro release from patches were fit to different equations and kinetic models to explain release profiles. Kinetic models used were zero and first-order equations, Hixon-Crowell, Higuchi, and Korsmeyer-Peppas models. In vivo drug release studies in rabbits showed 90.85% of drug release from HPMC-carbopol patch while it was 74.63 to 88.02% within 90 min in human volunteers. Good correlation among in vitro release and in vivo release of carvedilol was observed.

Extended Hansen's solubility approach: meloxicam in individual solvents.

The solubility behaviour of meloxicam in individual solvents ranging from non-polar to highly polar was studied. For understanding the solute-solvent interactions, partial solubility parameters concept was utilized. The extended Hansen's method was used for analyzing the solubility data and for obtaining partial solubility parameters of meloxicam. The analysis was not successful though correlations were 81%. The Flory-Huggins size correction term 'B' was found to improve the prediction of solubility. The correlations were high (92%) and total solubility parameter was 11.6 H. The four-parameter approach involving proton-donor and proton-acceptor parameters was also used in fitting the solubility data. The correlations were appreciable (87%) and total solubility parameter was 11.2 H. The term 'B' combined with four-parameter approach was also used in order to improve the data, and was found to be improved the correlations (R2=0.94). This new approach may thus be used in fitting the experimental solubility data and to predict solubility behaviour of meloxicam in untested solvents. The total solubility parameter of meloxicam was assigned at 11.2 H.

Identification of stress-responsive genes in an indica rice (Oryza sativa L.) using ESTs generated from drought-stressed seedlings.

The impacts of drought on plant growth and development limit cereal crop production worldwide. Rice (Oryza sativa) productivity and production is severely affected due to recurrent droughts in almost all agroecological zones. With the advent of molecular and genomic technologies, emphasis is now placed on understanding the mechanisms of genetic control of the drought-stress response. In order to identify genes associated with water-stress response in rice, ESTs generated from a normalized cDNA library, constructed from drought-stressed leaf tissue of an indica cultivar, Nagina 22 were used. Analysis of 7794 cDNA sequences led to the identification of 5815 rice ESTs. Of these, 334 exhibited no significant sequence homology with any rice ESTs or full-length cDNAs in public databases, indicating that these transcripts are enriched during drought stress. Analysis of these 5815 ESTs led to the identification of 1677 unique sequences. To characterize this drought transcriptome further and to identify candidate genes associated with the drought-stress response, the rice data were compared with those for abiotic stress-induced sequences obtained from expression profiling studies in Arabidopsis, barley, maize, and rice. This comparative analysis identified 589 putative stress-responsive genes (SRGs) that are shared by these diverse plant species. Further, the identified leaf SRGs were compared to expression profiles for a drought-stressed rice panicle library to identify common sequences. Significantly, 125 genes were found to be expressed under drought stress in both tissues. The functional classification of these 125 genes showed that a majority of them are associated with cellular metabolism, signal transduction, and transcriptional regulation.

Wilm's tumor in a solitary kidney complicated by chemotherapy induced obstructive uropathy.

A three-year-old male child with Wilm's tumor of left kidney and right sided unilateral renal agenesis is reported. The left renal vein was located posterior to the aorta. He was managed with medical measures alone. The initial phase of treatment was complicated by chemotherapy induced dislodgment of the tumor fragment and subsequent distal obstruction.

Injection site abscess due to Mycobacterium fortuitum: a case report.

Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM) may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB) smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.

Recovery of benthiocarb-inhibited AChE in fish brain: an in vitro study.

The effects in vivo and in vitro of benthiocarb, an organocarbamate, on acetylcholinesterase (AChE) activity and its recovery in vitro in the brain of the freshwater fish Sarotherodon mossambicus have been studied. Findings revealed that the specific activity of AChE was inhibited both in vivo and in vitro in a concentration-dependent manner. Of the different modulators tested, dexamethasone (0.72 mg), prednisolone (0.74 mg), testosterone (0.9 mg), and ADP (9.5 mg) were found to neutralize the inhibitory effect (IC50 = 0.30 microM) of benthiocarb on AChE.

Retinal projections in the catfish, Mystus vittatus (Bloch) as revealed by tracer studies with horseradish peroxidase.

The retinal efferents of the catfish, Mystus vittatus, were investigated with the use of the horseradish peroxidase (HRP) technique. Most retinal fibres extended contralateral to the eye that had received HRP label, while a few fascicles projected to the ipsilateral side without decussation in the optic chiasma. The contralateral fibres projected to the suprachiasmatic nucleus, the nucleus opticus dorsolateralis, the nucleus of the posterior commissure, the nucleus geniculatus lateralis, pretectal nuclear complex, and to two layers of the optic tectum, i.e., stratum fibrosum et griseum superficiale and stratum griseum centrale. The accessory optic tract arose from the inner area of the optic tract and extended ventromedially to the accessory optic nucleus. The ipsilateral fascicles projected to almost all the above mentioned nuclei, but these projections were comparatively sparse. The ipsilateral retinal projection was restricted to the rostral tectum.