Ethics of the use of dead human bodies in anatomy teaching in India.

The study of the human anatomy predominantly requires the use of remains of the dead. Unclaimed bodies are easily available in India; however, there is a lack of clear ethical guidelines governing their transport and exchange. We raise pertinent questions about the ethical implications of using unclaimed bodies in teaching anatomy, their transport, transfer and storage, ethical and legal issues regarding the voluntary donation of bodies and dry human bones, as well as the commercial aspects of body donation. We also examine existing practices in anatomy departments in India, and explore the available legal safeguards. We detail practical and ethical challenges in the existing practices and safeguards and attempt to provide solutions.

Radiographic extent of maxillofacial Gorham's disease and its impact on recurrence: A systematic review.

OBJECTIVE: This systematic review assessed the radiographic extent of maxillofacial Gorham's disease and its impact on recurrence. STUDY DESIGN: PubMed and Cochrane databases were searched. The key words were (Gorham Disease OR Vanishing Bone Disease OR Gorham Stout Syndrome) AND (Jaw OR Maxilla OR Mandible OR Maxillofacial). RESULTS: Forty-one cases from 39 articles were included. Based on radiographic extent, the lesions were classified as large or small. Most cases occurred in the mandible (24), followed by a combination of maxilla and/or mandible and other bones (12), both mandible and maxilla (3), and maxilla only (2). Only mandibular cases were analyzed for radiographic extent. Of the 24 mandibular lesions, 16 were large and 8 were small. Nine of the large lesions occurred in the young age group with 2 recurrences, followed by 5 in the middle-aged group with 1 recurrence. Small lesions were nearly equally distributed over the age groups, with 2 recurrences in the middle-aged group and 1 recurrence in the adult age group. Age, sex, and lesion size had no significant effect on recurrence. CONCLUSIONS: Radiographic extent of the lesion does not impact recurrence, suggesting a possible existence of aggressive and nonaggressive variants of maxillofacial Gorham's disease.

Comprehensive characterization of natural cellulosic fiber from Coccinia grandis stem.

The anatomical, physico-chemical, mechanical, thermal and surface characteristics of Coccinia grandis fiber (CGF) were studied for a potential substitute to the harmful synthetic fibers. The anatomical analysis of Coccinia grandis stem reveals the presence of high strength xylem fibers. Polarized light microscopy and scanning electron microscopy of CGF shows a hierarchical cell structure composed of a primary and a secondary cell wall, cell lumen and the middle lamellae. The average cross-sectional area and density of the CGF were 0.0111 mm2 and 1.5175 ± 0.005 g/cm3 respectively. The x-ray diffraction and Fourier transform infrared analyses of the fiber indicates the presence of cellulose Iß with a crystallinity index of 46.09%. The mean Young's modulus and tensile strength of the CGF were 124 GPa and 775 MPa respectively, which is sufficient enough for the reinforcement in polymer composites. The thermogravimetric analysis confirms the thermal stability of CGF up to 250 °C, which is well within the polymerization process temperature.

Magnetic resonance imaging spectrum of perinatal hypoxic-ischemic brain injury.

Perinatal hypoxic-ischemic brain injury results in neonatal hypoxic-ischemic encephalopathy and serious long-term neurodevelopmental sequelae. Magnetic resonance imaging (MRI) of the brain is an ideal and safe imaging modality for suspected hypoxic-ischemic injury. The pattern of injury depends on brain maturity at the time of insult, severity of hypotension, and duration of insult. Time of imaging after the insult influences the imaging findings. Mild to moderate hypoperfusion results in germinal matrix hemorrhages and periventricular leukomalacia in preterm neonates and parasagittal watershed territory infarcts in full-term neonates. Severe insult preferentially damages the deep gray matter in both term and preterm infants. However, associated frequent perirolandic injury is seen in term neonates. MRI is useful in establishing the clinical diagnosis, assessing the severity of injury, and thereby prognosticating the outcome. Familiarity with imaging spectrum and insight into factors affecting the injury will enlighten the radiologist to provide an appropriate diagnosis.

Dental complications of herpes zoster: Two case reports and review of literature.

Herpes zoster (HZ) (shingles) results due to reactivation of varicella-zoster virus. Unusual dental complications like osteonecrosis, exfoliation of teeth, periodontitis, and calcified and devitalized pulps, periapical lesions, and resorption of roots as well as developmental anomalies such as irregular short roots and missing teeth may arise secondary to involvement of 2nd or 3rd division of trigeminal nerve by HZ. Such cases pose both a diagnostic as well as a therapeutic challenge. We report two such rare dental complications of HZ-spontaneous tooth exfoliation and osteonecrosis of the maxilla in a 70-year-old female patient; and multiple periapical pathoses affecting right half of the mandibular teeth in a 45-year-old female patient. Both the patients did not have any associated systemic illness. The aim of this paper was to compare the present cases with all the 46 cases of osteonecrosis and 6 cases of multiple periapical pathoses secondary to trigeminal zoster reported in literature till date The article also throws light that the occurrence of such dental complications of HZ is not entirely dependent on the immune status of the host.

Large-scale production and characterization of biocompatible colloidal nanoalumina.

The rapid uptake of nanomaterials in life sciences calls for the development of universal, high-yield techniques for their production and interfacing with biomolecules. Top-down methods take advantage of the existing variety of bulk and thin-film solid-state materials for improved prediction and control of the resultant nanomaterial properties. We demonstrate the power of this approach using high-energy ball milling (HEBM) of alumina (Al2O3). Nanoalumina particles with a mean size of 25 nm in their most stable α-crystallographic phase were produced in gram quantities, suitable for biological and biomedical applications. Nanomaterial contamination from zirconia balls used in HEBM was reduced from 19 to 2% using a selective acid etching procedure. The biocompatibility of the milled nanomaterial was demonstrated by forming stable colloids in water and physiological buffers, corroborated by zeta potentials of +40 mV and -40 mV and characterized by in vitro cytotoxicity assays. Finally, the feasibility of a milled nanoalumina surface in anchoring a host of functional groups and biomolecules was demonstrated by the functionalization of their surface using facile silane chemistry, resulting in the decoration of the nanoparticle surface with amino groups suitable for further conjugation of biomolecules.

Characterization of new natural cellulosic fiber from Cissus quadrangularis root.

Fiber reinforced polymer composites are replacing many metallic structures due to its high specific strength and modulus. However commonly used man-made E-glass fibers are hazardous for health and carcinogenic by nature. Comprehensive characterization of Cissus quadrangularis root fiber such as anatomical study, chemical analysis, physical analysis, FTIR, XRD, SEM analysis and thermo gravimetric analysis are done. The results are very encouraging for its application in fiber industries, composite manufacturing, etc. Due to its light weight and the presence of high cellulose content (77.17%) with very little wax (0.14%) provide high specific strength and good bonding properties. The flaky honeycomb outer surface and low microfibril angle revealed through electron microscopy contributes for its high modulus. The thermo gravimetric analysis indicates better thermal stability of the fiber up to 230°C, which is well within the polymerization process temperature.

Spectrum of malignancies in human immunodeficiency virus - positive patients at a Tertiary Care Centre in South India.

CONTEXT: India has a very large number of patients living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Opportunistic infections in these patients are commonly encountered. However, malignancies in such patients also do occur. AIM: The aim was to study the spectrum of malignancies in HIV-positive patients at a tertiary health care center. SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: The cases were retrieved from pathology record files at our Institute from January 2003 to December 2008. The follow-up was obtained from Medical oncology records. The morphology of each case was reviewed along with immunohistochemistry wherever done. RESULTS: There were 61 such cases (51 males, 10 females). The age range was 7-78 years with a median of 35 years. The clinical presentation varied according to the malignancy. The largest group was non-Hodgkin lymphoma (18 nodal, 23 extra-nodal). The others included carcinoma breast (4), chronic myeloid leukemia (3), Burkitt Leukemia (2), squamous cell carcinoma anal region (2), multiple myeloma (2) and one each of miscellaneous malignancies (7). CONCLUSION: Malignancies in HIV positive individual occurred in younger individuals. Non-Hodgkin lymphomas, especially extra-nodal lymphomas, were the most common malignancy. There were no cases of proven Kaposi's sarcoma or invasive cervical carcinomas. There were two cases of multiple myeloma which are infrequently reported.

A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India.

BACKGROUND: The converging epidemics of HIV and tuberculosis (TB) pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. OBJECTIVE: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS) assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB) directly from sputum specimens, in the Indian setting. MATERIALS AND METHODS: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. RESULTS: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P<0.001). CONCLUSION: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.

Cowden syndrome- Clinico-radiological illustration of a rare case.

Cowden syndrome (CS) or multiple hamartoma syndrome is an infrequent genodermatoses, which is inherited as an autosomal dominant trait resulting from the mutation in the Phosphatase and Tensin homolog gene on the arm 10q and is principally characterized by multiple hamartomas with an increased risk of development of malignancies. Facial and oral signs are remarkable in the form of multiple papules and trichilemmomas on the face. We report one such rare case of CS in a 19-year-old patient who was diagnosed on the basis of her oral mucosal lesions and was further investigated and diagnosed with other hamartomas. The present case report signifies the responsibility of the oral physician in the early diagnosis of this progressive pathological syndrome as it leaves its footmark in the oral cavity in the form of oral mucosal lesions.

Cysticercosis involving muscle of mastication: a review and report of two cases.

Cysticercosis is a parasitic infection caused by the larval stages of the parasitic cestode, Taenia solium. It is a common disease in developing countries where it is also endemic. The central nervous system (CNS) is the most important primary site of infection and the disease can present with solitary or multiple space occupying lesions. Cases of cysticercosis presenting as isolated muscle mass (pseudotumours) without involvement of the CNS have also been recently described in the literature. We present two cases who presented to us with pain, swelling, and tenderness involving the temporalis muscle along with trismus. Ultrasonography and MRI findings were suggestive of cysticercosis involving the temporalis muscle which resolved after the albendazole therapy.

Non-specific internalization of laser ablated pure gold nanoparticles in pancreatic tumor cell.

We investigate the intracellular uptake of 7.3 nm, 21.2 nm and 31.3 nm average size pure colloidal gold nanoparticles synthesized using femtosecond laser ablation technique in pure water. Dark-field imaging, transmission electron microscopy (TEM) and scanning electron microscopy (SEM) was used to assess the uptake of these pure gold nanoparticles in the pancreatic tumor cell line. We show that these ligand-free gold nanoparticles are non-toxic to these cells. The nanoparticles and cell images indicated that unmodified gold nanoparticles interacted with the cells, despite negative surface charge on both the cells and the nanoparticles. We also demonstrate that the uptake of the gold nanoparticles is size-dependent.

Role of bitewing in enhancing the assessment of DMFS index in a group of Indian adolescents.

CONTEXT: Caries epidemiological studies based on clinical examination alone tend to underestimate proximal caries. AIMS: This study aims to determine the additional value of radiographic examination (bitewings) compared to clinical examination in assessing posterior proximal caries. It also aims to determine the radiographic multiplication/adjusting/correction factors by which a clinical decayed surface (D-S) and decayed-missing-filled surfaces (DMFS) score could be multiplied, to obtain an actual D-S and DMFS score. MATERIALS AND METHODS: Two groups of 100 subjects each, in the age range of 16-20 years, were examined clinically for caries and their DMFS index recorded. Both groups were subjected to bitewing radiographs to detect the clinically undiagnosed posterior proximal caries. The radiographic adjusting factors were determined for group A. To check its repeatability and thus its usefulness, radiographic correction factor was determined for Group B. STATISTICAL ANALYSIS: The results were statistically analyzed with the use of means, standard deviations, regression equation and "Z" test. Level of significance was determined at P > 0.05. RESULTS: A significant number of clinically undetected proximal caries was diagnosed with the help of bitewing radiographs. The difference between the radiographic adjusting/correction factor for D-S and DMFS score for the two groups was statistically not significant (P > 0.05) thus verifying the repeatability of the radiographic correction factors. CONCLUSION: The radiographic correction factors can be used to obtain a more precise estimate of true caries prevalence in a particular study population without having to subject all individuals to radiographic examination.

Non-specific cellular uptake of surface-functionalized quantum dots.

We report a systematic empirical study of nanoparticle internalization into cells via non-specific pathways. The nanoparticles were comprised of commercial quantum dots (QDs) that were highly visible under a fluorescence confocal microscope. Surface-modified QDs with basic biologically significant moieties, e.g. carboxyl, amino, and streptavidin, were used, in combination with surface derivatization with polyethylene glycol (PEG) for a range of immortalized cell lines. Internalization rates were derived from image analysis and a detailed discussion about the effect of nanoparticle size, charge and surface groups is presented. We find that PEG derivatization dramatically suppresses the non-specific uptake while PEG-free carboxyl and amine functional groups promote QD internalization. These uptake variations displayed a remarkable consistency across different cell types. The reported results are important for experiments concerned with cellular uptake of surface-functionalized nanomaterials, both when non-specific internalization is undesirable and when it is intended for material to be internalized as efficiently as possible.

Frosted cylindrical lens induced artefact on Humphrey automated perimetry.

BACKGROUND: The aim of this study was to assess the effect of a cylindrical corrective lens with frosted sides on Humphrey automated perimetry performed with a translucent spectacle occluder in the contralateral eye. METHODS: Ten healthy volunteers with cylindrical refractive errors of more than 1.50 DC had Humphrey visual fields (30-2) measured with the contralateral eye occluded with either a translucent spectacle occluder or an opaque patch. The order of testing with each occluder was randomised. Additionally, visual field examination with the opaque patch was performed on three volunteer subjects with deep-set eyes to establish the clinical significance of the frosted cylindrical lens induced artefact (CLA). The back vertex distances for the correcting lenses were measured for all tests. RESULTS: Eight out of 10 volunteers tested with the translucent occluder demonstrated CLA, which was absent when the opaque patch was used. The presence of an artefact corresponding to the axis of the cylinder was observed, when the vertex distance was more than 15 mm. Three subjects with deep-set eyes presented with CLA, even with the use of an opaque patch. DISCUSSION: Cylindrical lens artefacts can occur with increasing vertex distance when using a translucent spectacle occluder instead of an opaque patch. CLA is also seen in subjects with deep-set eyes.

Flavivirus West Nile (Sarafend) egress at the plasma membrane.

West Nile (Sarafend) virus was distinctly observed to bud from the plasma membrane rather than mature intracellularly. This has been observed with transmission electron microscopy. Using conventional scanning electron microscopy, budding at the plasma membrane especially at the filopodia was clearly illustrated. Immunogold labelling against the virus envelope protein was also performed to confirm this mode of exit. The gold particles were observed to be located at the sites where virus budding was seen under the field emission scanning electron microscope.

Brefeldin A affects West Nile virus replication in Vero cells but not C6/36 cells.

A fungal metabolite brefeldin A (BFA) was used to study virus-host interaction in glycoprotein processing in West Nile virus-infected Vero and C6/36 cells. The results indicated that as little as 1 microgram/ml of BFA resulted in complete breakdown in the Golgi organelle in infected Vero cells. This led to modifications of the glycoproteins which could not be efficiently used in infectious virion formation. In contrast, as much as 10 micrograms/ml of BFA in culture medium did not affect either glycoprotein formation or production of infectious particles in C6/36 cells. The results showed that in Vero cells, the transport of glycoproteins to the Golgi apparatus is important in West Nile virus infection. It also showed that BFA could be used as a tool to understand further the trafficking of glycoprotein from the ER to Golgi in flavivirus infection in Vero cells.