A rare case of nephrotic syndrome with chylothorax.

Chylothorax is an infrequent cause of pleural effusion that is most commonly caused by the obstruction or disruption of the thoracic duct. Chylothorax is rare in nephrotic syndrome. Unilateral chylothorax of the right side is due to the transdiaphragmatic shunting of chylous ascites. It is usually transient and self-limiting but a massive chylothorax requiring therapeutic thoracentesis can also be encountered. Here, we present a rare cause of chylous ascites-nephrotic syndrome resulting in chylothorax, where initially therapeutic thoracentesis is done followed by the management of nephrotic syndrome with modified Ponticelli regimen. This case highlights the need to consider chylous ascites as a cause of chylothorax via transdiaphragmatic shunting in patients with nephrotic syndrome to institute the appropriate treatment.

Source and Assessment of Metal Pollution at Khetri Copper Mine Tailings and Neighboring Soils, Rajasthan, India.

We present here the results of the study on metal pollution by identifying source, abundance and distribution in soil and tailings of Khetri copper complex (KCC) mines, Rajasthan India. The region is highly contaminated by copper (Cu) with higher values in the soil near overburden material (1224 mg/kg) and tailings (111 mg/kg). The average Cu (231 mg/kg) concentration of soil is ~9, 5 and 32 times higher than upper crust, world average shale (WAS) and local background soil (LS), respectively. However this reaches to ~82, 46 and 280 times higher in case of tailing when compared. The correlation and principal component analysis for soil reveals that the source of Cu, Zn, Co, Ni, Mn and Fe is mining and Pb and Cd could be result of weathering of parent rocks and other anthropogenic activities. The source for Cr in soil is both mining activities and weathering of parent rocks. The values of index of geo-accumulation (Igeo) and pollution load index for soil using LS as background are higher compared to values calculated using WAS. The metal rich sulphide bearing overburden material as well as tailings present in the open environment at KCC mines region warrants a proper management to minimize their impact on the environment.

Treatment of nitrate-rich water in a baffled membrane bioreactor (BMBR) employing waste derived materials.

Nitrate removal in submerged membrane bioreactors (MBRs) is limited as intensive aeration (for maintaining adequate dissolved oxygen levels and for membrane scouring) deters the formation of anoxic zones essential for biological denitrification. The present study employs baffled membrane bioreactor (BMBR) to overcome this constraint. Treatment of nitrate rich water (synthetic and real groundwater) was investigated. Sludge separation was achieved using ceramic membrane filters prepared from waste sugarcane bagasse ash. A complex external carbon source (leachate from anaerobic digestion of food waste) was used to maintain an appropriate C/N ratio. Over 90% COD and 95% NO3-N reduction was obtained. The bagasse ash filters produced a clear permeate, free of suspended solids. Sludge aggregates were observed in the reactor and were linked to the high extracellular polymeric substances (EPS) content. Lower sludge volume index (40 mL/g compared to 150 mL/g for seed sludge), higher settling velocity (47 m/h compared to 10 m/h for seed sludge) and sludge aggregates (0.7 mm aggregates compared to <0.2 mm for seed sludge) was observed. The results demonstrate the potential of waste-derived materials viz. food waste leachate and bagasse ash filters in water treatment.

Second Primary Lung Cancer with Glottic Laryngeal Cancer as Index Tumor - A Case Report.

Patients with laryngeal cancer have a high risk of developing lung cancer in the future. A patient presented with a complaint of left-sided chest pain for the last 3 months. Chest X-ray posterior-anterior view showed a homogeneous opacity in the left upper lung field with elevation of the diaphragm on the left side. CECT thorax revealed a heterogeneously enhancing soft tissue density mass lesion in the superior segment of the lingular lobe. On histopathological examination of the mass lesion, it was diagnosed as adenocarcinoma of the lung. About 10 months previously, the patient was treated for a laryngeal squamous cell carcinoma. Patients with laryngeal cancer should be routinely screened during follow-up with chest X-ray or CT scan for the early detection of lung cancer.

A proximal tissue-specific module and a distal negative regulatory module control apolipoprotein(a) gene transcription.

The apo(a) [apolipoprotein(a)] gene is responsible for variations in plasma lipoprotein(a), high levels of which are a risk factor for atherosclerosis and myocardial infarction. The apo(a) promoter stimulates the expression of reporter genes in HepG2 cells, but not in HeLa cells. In the present study, we demonstrate that the 1.4 kb apo(a) promoter comprises two composite regulatory regions: a distal negative regulatory module (positions -1432 to -716) and a proximal tissue-specific module (-716 to -616). The distal negative regulatory module contains two strong negative regulatory regions [polymorphic PNR (pentanucleotide repeat region) and NREbeta (negative regulatory element beta)], which sandwich the postive regulatory region PREbeta (positive regulatory element beta). The PNR was shown to bind to transcription factors in a tissue-specific manner, whereas the ubiquitous transcription factors hepatocyte nuclear factor 3alpha and GATA binding protein 4 bound to NREbeta to repress gene transcription. The proximal tissue-specific module contains two regulatory elements: an activating region (PREalpha) that activates transcription in HepG2 cells, and NREalpha, which is responsible for repressing the apo(a) gene in HeLa cells. NREalpha binds to a HeLa-specific repressor. These multiple regulatory elements might work co-operatively to finely regulate apo(a) gene expression. Although the tissue-specific module is required for apo(a) gene activation and repression in a tissue-specific manner, the combinatorial interplay of the distal and proximal regulators might define the complex pathway(s) of apo(a) gene regulation.

Definition of structural elements in Plasmodium vivax and P. knowlesi Duffy-binding domains necessary for erythrocyte invasion.

Plasmodium vivax and P. knowlesi use the Duffy antigen as a receptor to invade human erythrocytes. Duffy-binding ligands belong to a family of erythrocyte-binding proteins that bind erythrocyte receptors to mediate invasion. Receptor-binding domains in erythrocyte-binding proteins lie in conserved cysteine-rich regions called Duffy-binding-like domains. In the present study, we report an analysis of the overall three-dimensional architecture of P. vivax and P. knowlesi Duffy-binding domains based on mild proteolysis and supportive-functional assays. Our proteolysis experiments indicate that these domains are built of two distinct subdomains. The N-terminal region from Cys-1-4 (C1-C4) forms a stable non-functional subdomain. The region spanning C5-C12 forms another subdomain, which is capable of binding Duffy antigen. These subdomains are joined by a protease-sensitive linker. Results from deletion constructs, designed for expression of truncated proteins on COS cell surface, show that regions containing C5-C8 of the Duffy-binding domains are sufficient for the binding receptor. Therefore the central region of Duffy-binding domains, which is flanked by two non-functional regions, is responsible for receptor recognition. Moreover, the minimal Duffy-binding region identified here is capable of folding into a functionally competent module. These studies pave the way for understanding the architecture of Duffy-binding domains and their interactions with host receptors.