Nerve conduction studies through landmark based recording and effects of hand length.

As per existing guidelines, the distance between stimulator and recording electrodes in nerve conduction studies (NCS) should be the same (fixed) in all the subjects, i.e., it should not be based on anatomical landmarks. However, there are no studies comparing fixed distance recordings with landmark based NCS. We postulated that hand length can influence the NCS parameters in fixed distance recordings and this can be nullified using landmark based recordings. To test this theory, we performed NCS in 48 normal subjects as per standard guidelines (standard protocol) and then compared it to NCS with ulnar styloid as the landmark (modified protocol). NCS were performed on median and ulnar nerves of the right upper limb. Three motor NCS parameters including distal latency, compound muscle action potential (CMAP) amplitudes and nerve conduction velocities were measured. Sensory nerve action potential (SNAP) amplitudes and conduction velocities were the two sensory parameters measured. On analysis, ulnar motor conduction velocity was the only parameter affected by hand length in both standard and modified protocols. Modified protocol did not have any additional advantage to the standard protocol advised by NDTF. We conclude that the NDTF guidelines are therefore reasonable when considering the effects of hand length. Possible reasons for this result including anatomical and anthropometric explanations are discussed.

Combined Use of Copernic RC Venous Remodeling Balloon and Aspiration Thrombectomy for Cerebral Venous Sinus Thrombosis.

Cerebral venous sinus thrombosis is a potentially fatal condition. The current first line of treatment for sinus thrombosis is anticoagulation. Endovascular treatment is an alternative for patients whose symptoms progress despite adequate medical management. Mechanical thrombectomy is required in the setting of a large clot burden. Unfortunately, the conventional technique of intraarterial thrombectomy with the use of a stent retriever and/or aspiration is not very effective in sinus thrombosis because of a larger clot burden compared to an intracranial artery. Herein we describe our endovascular approach of mechanical thrombectomy in sinus thrombosis using Copernic 8 × 80 RC (Rene Chapot) balloon and aspiration catheter.

Isolation, Production, and Characterization of Serum Immunoglobulin M (IgM) of Indian Major Carp Cirrhinus mrigal (MRIGAL).

A method for the isolation of immunoglobulin M (IgM) in Indian major carp Cirrhinus mrigal (mrigal) serum to produce polyclonal antibodies is described in the present study. The purified immunoglobulins (IgM) were isolated from the serum of mrigal (Cirrhinus mrigal) by the bovine serum albumin (BSA)-CL affinity column purification method, and the IgM was used to produce a polyclonal rabbit anti-mrigal IgM antiserum. The IgM preparations were employed in the characterization of mrigal serum immunoglobulin. Reduced mrigal IgM on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was shown to consist of two subunits, compatible with heavy and light chains. A single heavy chain at approximately 90 kDa and variant of light chain 30 kDa were found. The dominant form of nonreduced IgM had a MW of approximately 900 kDa, suggesting a tetrameric structure based on estimated molecular weights, the relative protein content, and the reactivity with anti-mrigal IgM antisera, was obtained. The antisera were characterized as to specificity and reactivity by means of the enzyme linked immuno-sorbent assay (ELISA) and western blotting method. The information on the structure and character of immunoglobulin of fishes is essential in health management. The study described here investigates the possibility of using the serological techniques to assess the reactivity of antibody with the anti-mrigal IgM antisera.

Outlook on bismuth-based photocatalysts for environmental applications: A specific emphasis on Z-scheme mechanisms.

Semiconductor photocatalysis is thought to be a viable solution for addressing the growing problem of environmental pollution. Bismuth (Bi) metal oxides can function as a direct plasmonic photocatalyst or cocatalyst to accelerate the photogenerated charge separation and thus improve their photocatalytic activity. Hence, Bi-based photocatalysts have received a lot of attention due to their extensive environmental applications, including pollutant remediation and energy concepts. Massive efforts have been undertaken in the recent decade to find superior Bi-metal oxides (Bi2XO6, X = MO, W, or Cr) and to uncover the corresponding photocatalytic reaction mechanism for the degradation of organic contaminants in water. Herein, the unique crystalline and electronic properties and main synthesis methods, as well as the major Bi-Based direct Z-scheme photocatalysts, are timely discussed and summarized in their usage in water treatment. Besides, the impact of Bi2XO6 in energy storage devices and solar energy conversion is reviewed as an energy application. Finally, the future development and challenges of Z-scheme-based Bi2XO6 photocatalysts are briefly explored, summarized, and forecasted.

Graphene oxide-based nanomaterials for the treatment of pollutants in the aquatic environment: Recent trends and perspectives - A review.

Graphene oxide can be used to store energy, as electrodes and purify industrial and domestic wastewater as photocatalysts and adsorbents because of its remarkable thermal, electrical, and chemical capabilities. Toward understanding graphene oxide (GO) based nanomaterials considering the background factors, the present review study investigated their characteristics, preparation methods, and characterization processes. The removal of contaminants from wastewater has recently been a focus of attention for materials based on GO. Progress in GO synthesis and surface modification has shown that they can be used to immobilize enzymes. It is possible to immobilize enzymes with varying characteristics on graphene-oxide-based substrates without sacrificing their functioning, thus developing a new environmental remediation platform utilizing nano biocatalysts. GO doping and co-doping with a variety of heterogeneous semiconductor-based metal oxides were included in a brief strategy for boosting GO efficiency. A high band-gap material was also explored as a possibility for immobilization, which shifts the absorption threshold to the visible range and increases photoactivity. For water treatment applications, graphene-based nanomaterials were used in Fenton reactions, photocatalysis, ozonation, photo electrocatalysis, photo-Fenton, and a combination of photon-Fenton and photocatalysis. Nanoparticles made from GO improved the efficiency of composite materials when used for their intended applications. As a result of the analysis, prospects and improvements are clear, especially when it comes to scaling up GO-based wastewater treatment technologies.

Sonothrombolysis for acute ischemic stroke - Break on through to the other side.

BACKGROUND: Intravenous (IV) tissue plasminogen activator (tPA) infusion combined with transcranial low-frequency ultrasound waves targeted on the occluded arterial segment (sonothrombolysis) can increase recanalization in large artery-acute ischemic stroke (LA-AIS). AIMS: To evaluate the benefits of sonothrombolysis in LA-AIS. SETTINGS AND DESIGNS: An open-labeled observational study done in a quaternary care teaching hospital. METHODOLOGY: Patients with LA-AIS within the window period (<4.5 h) with no contraindications for IV-recombinant tPA were sonothrombolysed. Recanalization was monitored and graded using the transcranial Doppler thrombolysis in brain ischemia (TIBI) flow criteria and also by time of flight magnetic resonance angiography using a modified thrombolysis in myocardial infarction score. Parenchymal changes were assessed using computed tomography (CT) or diffusion-weighted imaging-Alberta Stroke Programme Early CT Score. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the outcome. RESULTS: Eighteen patients underwent sonothrombolysis and the mean onset to needle time was 138 min (range 65-256). TIBI residual flow grade of ≥2 was seen in 15 of 18 patients (83%). Immediate dramatic improvement (NIHSS score ≤3 points or improvement by ≥10 points) was seen in 6 of 18 patients (30%) and in 9 of 18 patients (50%) within the next 24 h. Two patients (one with TIBI 0, another with re-occlusion) underwent mechanical thrombectomy post-sonothrombolysis. Symptomatic hemorrhage occurred in 5.5% of the patients. At 6 months, 2 of 18 patients (11%) died and 10 of 16 patients (63%) achieved mRS ≤2. CONCLUSIONS: Sonothrombolysis appears to be a safe way to augment the effect of tPA without increasing the door to needle time with the added advantage of observing flow through the occluded artery in real time.

Mechanical thrombectomy for acute ischemic stroke in pregnancy using the penumbra system.

Even though intravenous thrombolysis with tissue plasminogen activator (IV tPA) is the standard of care in acute ischemic stroke, its use in pregnancy is not clearly defined. Mechanical thrombectomy devices can be an option; however, literature on the use of such mechanical devices in stroke in pregnancy is lacking. Here we describe two cases that developed acute embolic stroke during pregnancy who were successfully treated by mechanical clot retrieval using the Penumbra system 28 (Penumbra Inc., Alameda, California, USA). To the best of our knowledge, these are the only case reports on the use of the Penumbra device in pregnant patients with acute ischemic stroke.

Stuck with a drowsy patient, evoke the Percheron.

BACKGROUND: Strokes caused by normal variants of the cerebral circulation can be difficult to diagnose, hence a high index of suspicion is needed. This case series discusses the clinical and radiological aspects of one such stroke caused by occlusion of the artery of Percheron (AOP). MATERIALS AND METHODS: Computerized discharge summaries, outpatient records and imaging from picture archiving and communication system (PACS, GE), of patients with AOP infarction over a period of 12-years (2002-2014) were identified and their clinical and radiological features analyzed. RESULTS: Of 3589 strokes (both ischemic and hemorrhagic), 17 (0.47%) were due to AOP infarction. Their mean age was 50 years (range: 31-72 years). Disorders of consciousness (94%) were the most common presenting symptoms followed by gaze (53%) and memory impairment (24%). At follow-up, 2/17 (12%) patients developed extrapyramidal features. All patients had bilateral paramedian thalamic infarcts on magnetic resonance imaging (MRI). Associated anterior thalamic (5/17; 30%) and mid brain (10/17; 59%) infarcts were also seen. CT scan done in 11/17 patients prior to the MRI picked up only 6/11 (55%) of these infarcts. The most common etiological factors detected using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria were cardio embolic (8/17; 47%) followed by small vessel occlusion (7/17; 41%). Mortality occurred in 2/17 (12%) patients. At 6 months, a modified Rankin score of 2 or less was seen in 8/17 (47%) patients. CONCLUSIONS: Artery of Percheron infarcts should be considered in the differential diagnosis of patients presenting with sudden alterations in consciousness. MRI should be the investigation of choice. An embolic etiology should be actively looked for.

Wound healing promoting activity of stem bark extract of Semecarpus anacardium using rats.

The wound healing promoting property of stem bark methanol extract of Semecarpus anacardium was evaluated at three different dosages by excision, incision and dead space wound models using Wistar albino rats. Framycetin skin ointment was used as standard. LD(50) of methanol extract was determined to be 500 mg kg(-1). In methanol extract (20% ointment) treated group, epithelialisation of the incision wound was faster with a high rate of wound contraction. The tensile strength of the incision wound was significantly increased when compared to other treated groups. The histological examination of the dead space wound model granulation tissue of the methanol extract (100 mg kg(-1)) treated group showed increased cross-linking of collagen fibres and absence of monocytes as compared to control. Methanol extract at 100 mg kg(-1) exhibited significant wound healing activity but was lesser than standard; whereas, in animals treated with 50 and 75 mg kg(-1) showed moderate activity. This investigation supported the ethnomedicinal claims of S. anacardium.

Antinociceptive activity and acute toxicity study of Flaveria trinervia whole plant extracts using mice.

The antinociceptive activity of Flaveria trinervia extracts by tail-flicking and writhing methods was evaluated using mice. The abdominal writhing method was carried out by administering petroleum ether, chloroform and methanol extracts orally. After 1 h of incubation, 0.6% acetic acid (10 mL kg(-1)) was administered intraperitoneally. After 5 min, each group of mice was observed for the amount of writhing for a duration of 20 min. Acetyl salicylic acid was used as the standard reference. The tail-flick method was carried out using a thermal model and the maximum possible analgesia was calculated. The LD50 values of petroleum ether, chloroform and methanol extracts were 700, 700 and 500 mg kg⁻¹, respectively. The methanol extract at 50 mg kg⁻¹ showed significant antinociceptive activity. The petroleum ether and chloroform extracts showed moderate antinociceptive activity at a dose of 70 mg kg⁻¹. The methanol extract showed more significant antinociceptive activity than the other extracts but was less effective than the standard. This investigation finds support for the ethnomedicinal claims of F. trinervia.

Evaluation of acute toxicity and hepatoprotective activity of the methanolic extract of Dichrostachys cinerea (Wight and Arn.) leaves.

BACKGROUND: D. cinerea are the chief source of drug compounds that are active against various ailments such as jaundice, inflammations rheumatism, fever, asthma, body ache, chest problems, toothache, ulcers, wounds, eye diseases and have an aphrodisiac property. In present study, It was aimed to test the hepatoprotective activity of the plant. MATERIAL AND METHODS: The methanolic extract of Dichrostachys cinerea (Mimoseae) leaves was subjected to evaluation of acute toxicity and hepatoprotective property, using albino mice and rats. The parameters for estimation of liver function, based on serum markers such as total bilirubin, total protein, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase with histopathological profile of the liver tissue, were studied consequently. RESULTS: The methanolic extract did not show any mortality up to a dose of 3500 mg/kg body weight. The methanolic extract showed significant hepatoprotectivity. The histopathological profile of the drug-treated liver tissue demonstrated similar morphology as that of controls. CONCLUSIONS: Methanolic extract of Dichrostachys cinerea was found to have significant hepatoprotective activity.

Analgesic activity and acute toxicity study of Semecarpus anacardium stem bark extracts using mice.

BACKGROUND: The analgesic activity of petroleum ether, chloroform and methanol extracts of Semecarpus anacardium was investigated by tail flicking and writhing method using acetyl salicylic acid as the standard reference. MATERIALS AND METHODS: The staircase method was adopted for the determination of the acute toxicity. LD(50) of the petroleum ether extract and the chloroform extract was 700 mg/kg; however, the LD(50) for the methanol extract was 500 mg/kg. After 1 h of oral administration of the extracts, 0.6% acetic acid was administered intraperitoneally and the analgesic activity was evaluated. RESULTS: The number of writhing observed in the control group was 73.33 writhes. The methanol extract showed a significant analgesic activity, with 28.33 writhes, than the petroleum ether extract and the chloroform extract. But, all the extracts showed proved to be less potent than the standard drug which showed 2.33 writhes. Animals pretreated with saline did not show a signify cant effect on the latent period of tail-flick response. The analgesic effect of the petroleum ether extract was comparatively less evident. The maximum possible analgesia (MPA) increased up to 9.1% which remained elevated above the basal levels throughout the observation period. The MPA calculated for the chloroform extract increased to 14.03%. However, the analgesic effect of the methanol extract was also observed at 0.5 h following oral administration and the effect remained significant throughout the 3 h observation period, and was increased to 20.43%. CONCLUSION: Consistent analgesic activity of all the three S. anacardium extracts was observed by both the methods. The methanol extract was more potent than the petroleum ether and chloroform extracts but was less effective than the standard drug. This investigation supported the ethnomedicinal claims of S. anacardium.

Development and validation of a high performance liquid chromatographic method for the separation of exo and endo isomers of granatamine (9-methyl-9-azabicyclo[3.3.1]nonan-3-amine); a key intermediate of granisetron.

A simple and accurate high-performance liquid chromatographic method was developed for the determination of exo-9-methyl-9-azabicyclo[3.3.1]nonan-3-amine in endo-9-methyl-9-azabicyclo[3.3.1]nonan-3-amine, commercially known as grantamine and used as a key intermediate in the preparation of granisetron bulk drug. Chromatographic separation of the exo and endo isomers of 9-methyl-9-azabicyclo[3.3.1]nonan-3-amine was achieved on an Inertsil C8 column using a mobile phase containing 0.3% trifluoroacetic acid. The resolution between the two isomers was found to be more than 4. The limit of detection (LOD) and limit of quantification (LOQ) of exo isomer were 0.8 and 2.5 microg x mL(-1) respectively, for a 10 microL injection volume. The percentage recovery of exo-isomer ranged from 99 to 102% w/w in the endo-9-methyl-9-azabicyclo[3.3.1]nonan-3-amine sample. The test solution and mobile phase were observed to be stable up to 48 h after preparation. The validated method yielded good results for precision, linearity, accuracy, robustness and ruggedness. The proposed method was found to be suitable and accurate for the quantitative determination of exo-isomer in bulk samples of endo-9-methyl-9-azabicyclo[3.3.1]nonan-3-amine.

Oral health care of children: gynecologists and pediatricians' perspective.

UNLABELLED: Gynecologists, pediatricians and other medical professionals are more likely to see expecting mothers and infants much earlier than dentists. Thus, it is essential for these specialists to be aware of the infectious nature of dental caries and its associated risk factors and make appropriate decisions regarding timely and effective intervention. OBJECTIVE: To know the perception of gynecologists and pediatricians towards oral health care of children. METHODS: A cross sectional questionnaire survey was conducted. RESULTS: The present study shows that the pediatrician is more actively involved in the oral health care of children as compared to gynecologists in Bangalore city, India. CONCLUSION: Pediatricians and gynecologists need to update themselves on recent recommendations, regarding infant oral health so as to ensure that all their patients receive timely preventive and restorative dental care.

Antidiabetic Activity of the Ethanol Extract of Capparis sepiaria L Leaves.

Capparis sepiaria L, a profusely branched hedge plant, is used in Indian traditional medicine. Capparis sepiaria leaves were extracted with ethanol and concentrated to dryness. The LD(50) value was determined as 894.43 mg/kg body weight by acute toxicity study. The ethanol extract was investigated for possible hypoglycemic effect produced by single oral administration at various dose levels 100, 200 and 300 mg/kg in the streptozotocin induced diabetic rats and compared against normal saline control and the standard glibenclamide. A maximum fall of plasma glucose level 9.40%; 13.57%; 15.25% and 18.80% was observed after 12 h of treatment when administered with ethanol extract of Capparis sepiaria at 100, 200 and 300 mg/kg, and glibenclamide 10 mg/kg dose, respectively. The findings from the study suggest that the Capparis sepiaria leaves may be prescribed as an adjunct to traditional formulation and drug treatment for controlling diabetes mellitus.

The tale of follitropin receptor diversity: a recipe for fine tuning gonadal responses?

The original concept (dogma) of a single FSH receptor entity coupling to G(s) protein to activate adenylate cyclase and producing cAMP as second messenger appears inadequate to explain pleiotropic actions of the hormone. The identification and expression of alternatively spliced gonadotropin receptors, suggest that alternative splicing could serve as a mechanism for creating receptor diversity. Studies focused on sheep and mouse gonadal tissues show that the single large gene of approximately 250kb is a modular structure whose pre-mRNA undergoes alternative splicing creating several subtypes (at least four FSH-R1 to R4 identified to date). With segments of the N-terminus that are identical different topographies are generated by differing carboxyl termini. The same gene thus produces receptor types with different motifs that can display dominant positive, dominant negative, growth factor/cytokine type and potentially soluble binding protein features. Functional relevance is shown by modulation of receptor variants during hormonal stimulation. Presence of equivalent segments of the gene in the human and bovine suggests conservation and predicts similarity in structures and function. Thus, the complex cellular biology of follitropin receptors that may interact differently with polymorphic forms (glycosylation variants) of FSH represents an intricate scheme to regulate hormone signaling.