Molecular docking analysis of quercetin with known CoVid-19 targets.

Combat and care during CoVid-19 was non-trivial. Therefore, it is of interest to use the pharmacologically active plant component quercetin for the treatment of CoVid-19. Quercetin exhibits favourable ADMET values and abides by Lipinski's rule of five. When quercetin and remdesivir were positioned in relation to the CoVid-19 targets, quercetin exhibited a greater propensity for binding and H-bond interaction in their molecular interactions. Thus, the quercetin molecule can be used to manage CoVid-19.

Cerebral Hyperperfusion Syndrome following Staged Bilateral Internal Carotid Artery Stenting.

Cerebral Hyperperfusion syndrome is a relatively rare event following carotid revascularization. It can occur after both carotid endarterectomy and carotid artery stenting. It is characterized by focal neurodeficit, seizures and headache in the absence of ischemia. It occurs due to ipsilateral cerebral edema secondary to hyperperfusion. CT and MRI of the brain are the main modalities used for diagnosis and to rule out infarct. Prompt recognition and treatment can prevent permanent injury to the brain. We present a case of cerebral hyperperfusion syndrome in an elderly gentleman after a staged bilateral internal carotid artery stenting.

Comparison of resting and adenosine-free pressure indices with adenosine-induced hyperemic fractional flow reserve in intermediate coronary lesions.

OBJECTIVE: Fractional flow reserve (FFR) using adenosine has been the gold standard in the functional assessment of intermediate coronary stenoses in the catheterization laboratory. We aim to study the correlation of adenosine-free indices such as whole cycle Pd/Pa [the ratio of mean distal coronary pressure (Pd) to the mean pressure observed in the aorta (Pa)], instantaneous wave-free ratio (iFR), and contrast-induced submaximal hyperemia (cFFR) with FFR. METHODS: This multicenter, prospective, observational study included patients with stable angina or acute coronary syndrome (>48 h since onset) with discrete intermediate coronary lesions (40-70% diameter stenosis). All patients underwent assessment of whole cycle Pd/Pa, iFR, cFFR, and FFR. We then evaluated the correlation of these indices with FFR and assessed the diagnostic efficiencies of them against FFR ≤0.80. RESULTS: Of the 103 patients from three different centers, 83 lesions were included for analysis. The correlation coefficient (r value) of whole cycle Pd/Pa, iFR, and cFFR in relation to FFR were +0.84, +0.77, and +0.70 (all p values < 0.001), respectively, and the c-statistic against FFR ≤0.80 were 0.92 (0.86-0.98), 0.89(0.81-0.97), and 0.91 (0.85-0.97) (all p values < 0.001), respectively. The best cut-off values identified by receiver-operator characteristic curve for whole cycle Pd/Pa, iFR, and cFFR were 0.94, 0.90, and 0.88, respectively, for an FFR ≤0.80. By the concept of "adenosine-free zone" (iFR = 0.86-0.93), 59% lesions in this study would not require adenosine. CONCLUSION: All the three adenosine-free indices had good correlation with FFR. There is no difference in the diagnostic accuracies among the indices in functional evaluation of discrete intermediate coronary stenoses. However, further validation is needed before adoption of adenosine-free pressure parameters into clinical practice.

Large Scale Mapping of Fractures and Groundwater Pathways in Crystalline Hardrock By AEM.

In hardrocks that cover about 20% of the Earth's surface, it is difficult to locate steady sources for groundwater due to inadequate understanding of the fracture networks. A comprehensive knowledge of fracture distribution at the regional scale is necessary to delineate sustainable aquifers and manage them efficiently. The resistivity maps derived from the airborne electromagnetic (AEM) survey over the Ankasandra watershed in Karnataka, India, reveal sharp and deep zones of low formation resistivity, which indicate groundwater-bearing zones. It is found that some of these zones are hydrogeologically connected through fracture networks resulting in augmented yield. AEM results in combination with an in-depth understanding of the geological structures successfully map these groundwater-saturated fracture networks (or hydrogeological lineaments) that we term as 'Hydrolins'. As groundwater occurrence is generally associated with lineaments, we analyzed the drilling and geophysical logs from 21 wells within a 380 sq.km area to study the relationships of various lineaments with 'Hydrolins', particularly in respect of their groundwater potential. AEM results, though calibrated and correlated with a limited number of well data, revealed a threshold groundwater horizon (TGWH), found to be at 80 m depth for Ankasandra watershed, beyond which a strong correlation exists between the depth of a well and its yield. While the TGWH may differ for different watersheds, the approach presented here can be readily adopted to map sustainable groundwater sources in hardrocks worldwide.

Transcatheter closure of ruptured sinus of Valsalva: Different techniques and mid-term follow-up.

OBJECTIVES: The aim of the present study was to study the feasibility and approaches to device closure of ruptured sinus of Valsalva (RSOV). We have compared the advantages and disadvantages of different devices and techniques and discussed complications which might occur during or after the procedure. BACKGROUND: There are only a few case series of transcatheter closure of RSOV, with most cases being traditionally referred for surgery. We have employed different devices used for treatment of congenital shunt lesions to achieve closure. Reasons for failure and need for surgical referral have also been analyzed. METHODS: Transcatheter closure was attempted in a total of 25 patients of RSOV who presented to us over a period of 4 years. Different devices were deployed using antegrade and retrograde approaches. All patients have been on regular follow-up. RESULTS: The procedural success rate was 84%. Two patients presenting in cardiogenic shock were effectively treated by device closure. There was one case of device embolization and two patients had residual leak. Three patients were referred for surgery. There was one case of device induced severe aortic regurgitation. Ventricular septal defect and RSOV were closed simultaneously in one patient. CONCLUSIONS: Different approaches and devices may be used for transcatheter closure of RSOV. We prefer antegrade closure using duct occluders in most cases while muscular VSD occluders may be used in select situations. ADO II devices should hardly ever be used on their own for device closure of RSOV.

Development and characterization of ethylcellulose based microsphere for sustained release of nifedipine$ / 药物分析学报

This article introduced the work of ethylcellulose based polymeric microsphere loaded with nifedipine for reduction in frequency of administration with low solubility in aqueous medium and high rate of absorption in the stomach. The non-aqueous polymeric suspension was put dropwise into an aqueous medium containing polyvinyl alcohol as a surfactant for the synthesis of microsphere by solvent eva-poration. The microspheres were characterized by different techniques, namely, XRD, SEM, and NMR. The formation of microspheres was confirmed by SEM. XRD analysis revealed the semi-crystallinity nature of microspheres. The NMR study indicated the presence of hetero-aromatic nucleus in the microsphere.

Catastrophic presentation of anomalous origin of right pulmonary artery in a neonate--an interesting differential!

A 36-hour-old term neonate presented with refractory cardiogenic shock and multi-organ dysfunction. On suspecting coarctation of aorta, intravenous prostaglandin was started but without any benefit. Echocardiography revealed isolated anomalous origin of right pulmonary artery from ascending aorta causing massive aortic steal, supra-systemic pulmonary arterial hypertension (PAH), multi-organ dysfunction and right ventricular failure. The main pulmonary artery was solely continued as left pulmonary artery. Emergency surgery at 48 h was life-saving and mid-term follow-up is excellent. The authors present this case as an important alternative diagnosis to duct dependent systemic lesions. The English literature in the last two decades was reviewed to discuss the characteristics, the diagnosis and treatment of neonatal presentation of this rare anomaly. Incidentally, the reported case is the youngest successful survivor of this surgery.

Source speciation resolving hydrochemical complexity of coastal aquifers.

There is a growing concern of seawater intrusion to freshwater aquifers due to groundwater overexploitation in the eastern coastal belt of Southern India. The problem becomes complex in the regions where industrial effluents are also contaminating the freshwater aquifers. In order to understand the hydrochemical complexity of the system, topographic elevation, static water level measurements, major ion chemistry, ionic cross plots, water type contours and factor analysis were applied for 144 groundwater samples of shallow and deep sources from Quaternary and Tertiary coastal aquifers, located within the industrial zone of 25 km(2) area near Cuddalore, Southern India. The ionic cross plots indicates dissolution of halite minerals from marine sources and seawater mixing into inland aquifers up to the level of 9.3%. The factor analysis explains three significant factors totaling 86.3% of cumulative sample variance which includes varying contribution from marine, industrial effluent and freshwater sources.

Innovative endovascular technique for treatment of rare cause of haemoptysis in young.

A 17-year-old boy reported for evaluation of two episodes of massive haemoptysis. His clinical examination was unremarkable and investigations (haemogram, coagulogram, serological tests for connective tissue disorders) were normal. A 64-slice CT angiography revealed a saccular aneurysm of 3.8×3.7×3.3 cm arising from the right lower lobe pulmonary artery which was confirmed by cardiac catheterisation. The aneurysm was successfully blocked with a 16-14 Amplatzer duct occluder. A repeat CT angiogram performed after 15 days revealed the device in situ obliterating the aneurysm. Pulmonary artery aneurysm is an extremely rare cause of massive haemoptysis and indicates imminent rupture of the aneurysm which can be rapidly fatal. This case highlights the importance of using an innovative endovascular technique for treatment of a rare cause of haemoptysis.

Percutaneous device closure of a bifurcated inferior vena cava and completion of the Kawashima procedure for the "difficult" univentricular heart.

Azygos continuation of inferior venacava (IVC) is well known in association with interrupted IVC. We report azygos connection of uninterrupted IVC in a young child with complex univentricular heart. This peculiar anatomy was made suitable for univentricular repair by combining percutaneous device closure of prehepatic right limb of IVC and bidirectional Glenn shunt. The azygos vein acted as a conduit for IVC flow to superior venacava as in Kawashima's operation. This case highlights a rare IVC morphology. Also this innovative strategy allowed simple solution to a challenging problem and is first time described in the literature.

"Transcollateral" renal angioplasty for a completely occluded renal artery.

Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension. A renal angiogram in this patient showed ostial stenosis of the right renal artery, which was filling by way of the collateral artery. Renal angioplasty for chronic total occlusion of right renal artery was successfully performed in a retrograde fashion through a collateral artery, thereby leading to improvement of renal function and blood pressure control.