Boerhavia diffusa attenuates podocyte injury in rats with adenine induced chronic kidney disease by enhancing nephrin expression.

Nephrin is a transmembrane protein that maintains the slit diaphragm of renal podocyte. In chronic kidney disease (CKD), podocyte effacement causes damage to glomerular basement membrane barrier leading to proteinuria. Boerhavia diffusa, (BD), an Ayurveda herb, is used in treatment of various diseases particularly in relation to the urinary system. This study attempts to evaluate the effect of ethanolic extract of BD on the expression of nephrin in adenine induced CKD rats. CKD was induced in Wistar albino rats using adenine (600/mg/kg, orally for 10 days). CKD rats were treated with BD (400/mg/kg) and pirfenidone (500/mg/kg) orally for 14 days. The kidneys were harvested from euthanized animals and processed for histopathology, electron microscopy and immunohistochemistry, gene and protein expression of nephrin. Diseased rats treated with BD and pirfenidone showed reduction in the thickening of renal basement membranes and reduced haziness in brush border of PCT and glomeruli. Nephrin gene and protein expressions were higher in BD and pirfenidone treated group when compared to the disease control group. The structural and functional damage brought on by adenine-induced nephrotoxicity was countered by protective action of BD by up regulating the expression of nephrin. Therefore, BD can be utilized as a nutraceutical for the prevention and treatment of CKD.

Evidence of alterations in the learning and memory in offspring of stress-induced male rats.

OBJECTIVES: There is extensive data pointing to offspring outcomes related to maternal life incidents, but there is less research concerning the association between paternal life events and progeny brain development and behaviour. As male gametogenesis is a continuous process, the incidences happening in life can modify the epigenetic regulation, altering the offspring's development and behaviour. The present study evaluates the effects of paternal stress during different life periods on their offspring's learning ability, memory, morphological and biochemical changes in the prefrontal cortex and hippocampus in the rat model. METHODS: Four weeks' old male rats were subjected to five variable stressors at the rate of one per day. Stress received male rats were bred with naive female rats for 1 to 3 nights. The offspring's learning and memory were assessed by the Morris water maze test and automated Y maze. Following behavioural studies, offspring were euthanized to examine global DNA methylation, neurotransmitter levels, namely acetylcholine, glutamate in the hippocampus and frontal cortex. RESULTS: The offspring of stress-induced animals exhibited a delay in acquiring learning and defect in memory and altered global DNA methylation in the hippocampus (p=0.000124). There was significant reduction of acetylcholine and glutamate levels in hippocampus (p=0.000018, p=0.00001, respectively) and in prefrontal cortex (p=0.00001, p=0.00001, respectively). HPA axis of offspring was altered considerably (p=0.00001). The histomorphometry of the prefrontal cortex and different hippocampal regions revealed a statistically significant (p<0.05) reduction in neuronal numbers in the offspring of stressed animals compared to that of control. These impacts were markedly high in the offspring of fathers who received stress during both pubertal and adult periods. CONCLUSIONS: The findings of this study demonstrate that paternal stress can impact offspring learning and memory.

Benign focal liver lesions masquerading as primary liver cancers on MRI.

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the most common primary liver malignancies. HCC and ICC have characteristic imaging findings, but a number of benign entities can appear similar and can cause diagnostic dilemma. Ideally, accurate and timely diagnosis of these conditions can help the patient to avoid a needle biopsy or even unnecessary treatment. In this article, we present various benign liver lesions that display imaging characteristics that are similar to HCC and ICC on magnetic resonance imaging (MRI) and discuss salient features that may assist in accurate diagnosis.

Chlorpyrifos and its metabolite modulates angiogenesis in the chorioallantoic membrane of chick embryo.

Background Chlorpyrifos (CPF) is an organophosphate insecticide, acaricide, and miticide used primarily to control foliage and soilborne insect pests on a variety of food and feed crops. Since trace amounts of these compounds are found in water and food products, they easily enter into the organ system unnoticed. In the same way, the compound or its metabolite gets transmitted from the parent to the embryo mainly through blood vessels. Since blood vessels form the major route of transport, it is pertinent to study the effect of these compounds during angiogenesis. The effect of CPF and 3,5,6-trichloro-2-pyridinol (TCPy) on the angiogenesis of chick embryo was evaluated in the chorioallantoic membrane (CAM) using an ex vivo model. Methods Nine-day-old incubated eggs where inoculated with various doses of CPF and TCPy. After 48 h of incubation, the CAM layers were retrieved and analyzed using angiogenesis software to obtain the density of blood vessels. Histomorphometric studies were performed to measure the thickness of vessel walls. The expression of VEGF, VEGFR2, and N-cadherin genes responsible for angiogenesis were analyzed. Results The exposure to the parent compound CPF and its metabolite TCPy promoted angiogenesis in groups administered with lower concentration of the pesticide and its metabolite, whereas a decline in angiogenesis was observed at higher concentrations. These observations were made by analyzing the density, histomorphometry results, and semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) results. The density, thickness, and lumen size of blood vessels in the groups with low concentration of CPF and TCPy were 28.34, 9 µm, and 30 µm, respectively, whereas in the groups with higher CPF and TCPy concentrations, they were 12, 3 µm, and 9 µm, respectively. Conclusions Hence, CPF and its metabolites interfere with angiogenesis in the CAM of chick embryos. Because of their estrogen-mimicking ability, pesticides are the prime etiological suspects of increasing alteration in blood vessel formation. These results may be of help in future studies on the effect of CPF in embryonic growth, wound healing, diabetes, and tumors.

Clinics in diagnostic imaging (199). Pyometra.

A 92-year-old woman presented to the emergency department with urinary symptoms, fever and suprapubic tenderness. Her inflammatory markers were raised. Urine and blood cultures were negative. Computed tomography performed to look for a source of sepsis showed distension of the uterine cavity with high-attenuation fluid, an air-fluid level and gas locules along the uterine wall. The causes, clinical presentation and imaging features of pyometra are discussed.

Naringin Ameliorates Streptozotocin-Induced Diabetes through Forkhead Box M1-Mediated Beta Cell Proliferation.

BACKGROUND: Adult pancreatic beta cells, though quiescent, can proliferate in response to physiological need. This inherent character is used in exploring the possibilities of expanding the beta cell mass in the treatment of diabetes. Forkhead box M1 (FoxM1) transcription factor is an important regulator in the proliferation and survival of adult beta cell mass. Naringin, a flavanone glycoside, is reported to have antidiabetic activity and exhibited an increase in insulin levels in diabetic animals. OBJECTIVES: The present study tried to evaluate the role of naringin in the regulation of FoxM1 in the pancreas of diabetic rats and to reascertain its antilipidemic and antioxidant properties. METHODS: Diabetes was induced in male rats using streptozotocin and treated with naringin (100 mg/kg) orally for 4 and 8 weeks. Serum biochemical parameters, insulin, gene and protein expression of FoxM1, and antioxidant markers in rat pancreas were analyzed. RESULTS: Naringin administration reduced the blood sugar, urea, creatinine, and cholesterol values and improved the pancreatic antioxidant status in diabetic rats. Naringin-treated diabetic rats showed a significant increase in mRNA and protein expression of FoxM1 compared to the diabetic control rats, indicating regeneration of cells. It also increased the insulin immunopositive cells, indicating functional beta cells. CONCLUSION: Naringin was found to upregulate the FoxM1 transcription factor in diabetic animals, which influenced the proliferation and functional status of beta cells.

Naringin (4',5,7-Trihydroxyflavanone 7-Rhamnoglucoside) Attenuates ß-Cell Dysfunction in Diabetic Rats through Upregulation of PDX-1.

BACKGROUND: Pancreatic duodenal homeobox-1 (PDX-1) is a key transcription factor which regulates Insulin gene expression and insulin secretion in adult ß-cells and helps to maintain ß-cells mass. Naringin, a flavanone, owing to its anti-oxidant property, is reported to have antidiabetic effects. OBJECTIVES: The present study tries to evaluate the role of naringin on the ß-cell-specific transcription factor PDX-1 in diabetic rats. METHODS: Diabetes was induced in male rats using streptozotocin and treated with naringin (100 mg/kg) orally for 4 and 8 weeks. Serum insulin level, Pdx-1 and Insulin gene expression, and PDX-1 protein expression were assessed in the rat pancreas. Histopathological and ultrastructural changes in the islet and ß-cells were observed. RESULTS: Naringin prevented leukocytic infiltration in the pancreas of diabetic rats and recouped the ß-cells with adequate secretory granules. Naringin-treated diabetic rats showed significantly increased mRNA expression of Pdx-1 and Insulin genes, increased expression of transcription factor PDX-1, and higher serum insulin levels than the diabetic control animals. These changes were more pronounced in the 8-week naringin-treated diabetic animals. CONCLUSIONS: Naringin was found to be an effective antidiabetic agent which increased Insulin gene expression and insulin secretion by upregulating the PDX-1 gene and protein expression.

High-Resolution Computed Tomography Imaging in Conductive Hearing Loss: What to Look for?

Conductive hearing loss (CHL) is caused by the disruption of the sound conductive chain that, in turn, may be due to diseases of the external and middle ear. High-resolution computed tomography (CT) is the imaging modality of choice to evaluate CHL because of its excellent spatial resolution. Along with clinical and otoscopic findings, CT also helps in the diagnosis and preoperative planning. This pictorial review aims to illustrate the CT features of common conditions causing CHL that may arise from the external and middle ear, as well as highlights some of the key imaging features that are helpful in management.

Clinics in diagnostic imaging (174). L5 vertebral superior facet osteoblastoma (OB).

A 25-year-old man presented with chronic low back pain and occasional radiation to the right lower limb. Magnetic resonance imaging and computed tomography (CT) of the lumbar spine showed an osteolytic expansile lesion with a central sclerotic nidus in the right superior facet of the L5 vertebra and surrounding marrow oedema. The diagnosis of osteoblastoma was made based on imaging findings and confirmed after CT-guided biopsy. Radiofrequency ablation of the lesion was successfully performed. The patient tolerated the procedure well and showed symptomatic relief. The imaging features and management of osteoblastoma are discussed.

An Approach to Various Gastric Pathologies Using an "Image Appearance-Based Classification" on Computed Tomography.

Although pathologies affecting stomach are commonly encountered in computed tomography imaging of the abdomen, they are frequently overlooked. Their etiologies are often diverse; however, most of them have certain well-documented imaging characteristics. Conventionally the stomach abnormalities were classified according to their etiopathogenesis. This article aims at providing the readers with an easy approach by categorizing abnormalities of stomach using a novel image appearance-based classification. An attempt to illustrate various gastric pathologies using this new classification by means of pictorial examples is made. Basic computed tomography imaging anatomy of the stomach and imaging techniques that need to be adapted are also emphasized in the outset of the discussion.

Os Trigonum - Sheer Incidental or Quite Significant? Single Photon Emission Computed Tomography/Computed Tomography's Role in a Case of Ankle Impingement.

Accessory ossicles are widely prevalent in the ankle and foot. Although they are often asymptomatic, they can present clinically with symptoms at times. When they occur bilaterally in a patient who presents with unilateral complaints, it is clinically difficult to attribute the symptoms to the presence of these common anatomic variants. One needs specific imaging to assess the clinical relevance of the accessory ossicles, in order to tailor the treatment plan. The case presented in this article is one such example, where the patient presented with chronic unilateral ankle pain and initial radiographs revealed bilateral os trigonum and os subtibiale. He underwent a technetium-99m methyl diphosphonate (Tc-99m MDP) bone scan and single photon emission computed tomography/computed tomography (SPECT/CT). The Tc-99m MDP scan showed a focal uptake in the ankle of concern. SPECT/CT complemented the finding by exactly localizing the uptake to the posterior subtalar joint and around the os trigonum, thereby pointing to the diagnosis of os trigonum syndrome.

A Study on The Incidence of Neural Tube Defects in A Tertiary Care Hospital Over A Period of Five Years.

INTRODUCTION: Several congenital malformations affect developing fetuses, among which Neural tube defect (NTD) is most common. Folic acid supplementation brought decline in the incidence of NTDs. The present study aims at finding the incidence of NTDs in a tertiary care hospital and compares the results with the similar Indian studies published earlier. MATERIALS AND METHODS: The study was done at Chettinad Hospital & Research Institute (CHRI), Kelambakkam. The total number of deliveries was recorded for a period of five years from 2009 to 2013. Fetuses which were still born with neural defect were collected and observed in detail externally for the sex, type of NTD and other associated anomalies. Indian studies published between 1987 and 2014 reporting the incidence of NTDs among the births occurred were retrieved from the Internet and their various observations were used for comparison. RESULTS: The number of deliveries conducted between 2009 and 2013 at CHRI was 3220. Of these, babies born with NTDs were nine (5 males and 4 females). The incidence of fetuses with meroanencephaly, holoanencephaly, craniorachischisis, encephalocele and myelocele were 0.62, 0.62, 0.93, 0.31 and 0.31 per 1000 births respectively. Overall incidence of NTDs in the present study was 2.79/1000 births. Fetuses with NTDs also had the following anomalies - Club foot, cleft lip and palate and exomphalos. CONCLUSION: Comparing the results with the previous studies it is clearly evident that the incidence of NTDs have significantly reduced from 11.42/1000 births to 2.79/1000 births. In most of the previous studies NTDs had a female preponderance whereas present study has a male preponderance.In older studies, spina bifida was the most common NTDs followed by anencephaly. But in the present study anencephaly was the common NTD than spina bifida. Incidence of NTDs has reduced due to various reasons like prenatal screening for fetal anomalies and folic acid supplementation.

Imaging findings of swallowed dentures: a case series.

Dental prosthesis is an uncommon ingested non-food foreign body in adults. Once swallowed, it can lead to serious complications and morbidity. Hence, early localization of the offending foreign body is crucial for timely management. As the dentures are usually made up of non-metallic material and often impacted at or below the level of C7 vertebra, conventional radiograph has limited role in their evaluation. We describe the clinical history and imaging findings of swallowed partial dentures in four patients who presented to the emergency department. The dentures were localized using unenhanced CT of the neck that showed the characteristic mildly hyperdense curvilinear or irregular appearance of the dentures within the upper esophagus. Multiplanar CT reconstructions provide an orientation of the ingested denture within the esophagus, thus guiding the endoscopist.

Diverticulitis of the appendix, a distinctive entity: preoperative diagnosis by computed tomography.

Diverticular disease of the appendix is rare and is usually diagnosed during surgery. We report a case of a 50-year-old man who presented to the emergency department with right lower quadrant pain of 1-day duration. A preoperative diagnosis of appendiceal diverticulitis was made by computed tomography of the abdomen. The patient underwent emergency laparoscopic appendectomy, which confirmed the diagnosis.