Impact of nicotine dependence on self-efficacy and readiness to quit among tobacco consumers in rural areas.

Aim and Objectives: The aim of the present study was to determine the impact or effect of nicotine dependence on self-efficacy and readiness to quit. Materials and Method: The current study was performed using a cross-sectional descriptive questionnaire design among tobacco users visiting primary health care facilities in the rural Jaipur district. Jaipur district is divided into four directions: east, west, north, and south. From each direction, two PHCs were selected randomly based on suitable accessibility to patients. Sample size of study is 465. Out of 465 tobacco consumers, 238 were consuming a smoked form of tobacco, and 227 study participants were consuming a smokeless form of tobacco. Results: It was observed that the majority of study participants (145 (31%)) need smoke/smokeless tobacco within 5 minutes of waking up. With regards to internal stimuli, the majority of study participants (179 (38%)) and (203 (44%)) were not very sure that they would refrain from smoking when they were nervous and depressed. It was determined that quitting tobacco products was not at all important for 159 (34%) study participants. In regards to confidence in tobacco product quitting, only 79 (16%) of tobacco consumers were extremely confident. Conclusion: It was concluded that nicotine dependence impacts both self-efficacy and readiness to quit. It was determined that the higher the nicotine dependence, the less self-efficacy and the less would be the readiness to quit.

Clinical Efficacy of Topical Kenacort and Aloe Vera Gel in Minor Aphthous Stomatitis: A Comparative Study.

Aim: The aim of the study is to compare the clinical efficacy of both the topical agents-aloe vera gel and Kenacort oral paste (0.1% triamcinolone acetonide) in patients with minor aphthous stomatitis. Materials and Methods: 60 patients were recruited for the study and were randomly divided into two groups-Group A (aloe vera gel group) and Group B (Kenacort oral paste group). The baseline parameters were taken and recorded on the day of the first visit which included ulcer size, pain, and burning sensation. Evaluation of reduction in ulcer size, pain, and burning sensation were made on day 3 and day 7. Results: The results of the present study revealed that both the study groups showed no significant difference in the size of ulcer at day 1, day 3, and day 7 when compared using independent t-test as P > 0.05 at all study intervals. Therefore, both the agents were found to be equally effective against reducing the size of ulcer, pain, and burning sensation. Conclusion: The present study findings demonstrate that topical application of the aloe vera gel was able to decrease the ulcer size, intensity of pain, and burning sensation, thereby accelerating the healing without any side effects. Thus, topical aloe vera could be safe and a better alternative to topical steroid for RAS.

Unveiling Mysteries of Quid-Induced Lichenoid Reactions: A Cross-Sectional Study.

Lichenoid reactions occur exclusively in people who chew tobacco, areca nut, or both, in raw or any manufactured or processed form. The lesion is described as a lichen-planus-like lesion and is termed as quid-induced lichenoid reaction (QILR). In this cross-sectional study, amongst 935 quid consumers, 82 patients were diagnosed with QILR and it was seen that 65 patients used processed forms of tobacco and areca nut. Thereby, it could be concluded that QILR might occur because of flavors used in processing of tobacco and areca nut.

CofActor: A light- and stress-gated optogenetic clustering tool to study disease-associated cytoskeletal dynamics in living cells.

The hallmarks of neurodegenerative diseases, including neural fibrils, reactive oxygen species, and cofilin-actin rods, present numerous challenges in the development of in vivo diagnostic tools. Biomarkers such as ß-amyloid (Aß) fibrils and Tau tangles in Alzheimer's disease are accessible only via invasive cerebrospinal fluid assays, and reactive oxygen species can be fleeting and challenging to monitor in vivo Although remaining a challenge for in vivo detection, the protein-protein interactions underlying these disease-specific biomarkers present opportunities for the engineering of in vitro pathology-sensitive biosensors. These tools can be useful for investigating early stage events in neurodegenerative diseases in both cellular and animal models and may lead to clinically useful reagents. Here, we report a light- and cellular stress-gated protein switch based on cofilin-actin rod formation, occurring in stressed neurons in the Alzheimer's disease brain and following ischemia. By coupling the stress-sensitive cofilin-actin interaction with the light-responsive Cry2-CIB blue-light switch, referred to hereafter as the CofActor, we accomplished both light- and energetic/oxidative stress-gated control of this interaction. Site-directed mutagenesis of both cofilin and actin revealed residues critical for sustaining or abrogating the light- and stress-gated response. Of note, the switch response varied depending on whether cellular stress was generated via glycolytic inhibition or by both glycolytic inhibition and azide-induced ATP depletion. We also demonstrate light- and cellular stress-gated switch function in cultured hippocampal neurons. CofActor holds promise for the tracking of early stage events in neurodegeneration and for investigating actin's interactions with other proteins during cellular stress.

Correction: Synthesis of 2-deoxy-2,2-difluoro-α-maltosyl fluoride and its X-ray structure in complex with Streptomyces coelicolor GlgEI-V279S.

Correction for 'Synthesis of 2-deoxy-2,2-difluoro-α-maltosyl fluoride and its X-ray structure in complex with Streptomyces coelicolor GlgEI-V279S' by Sandeep Thanna et al., Org. Biomol. Chem., 2015, DOI: 10.1039/c5ob00867k.

Synthesis of 2-deoxy-2,2-difluoro-α-maltosyl fluoride and its X-ray structure in complex with Streptomyces coelicolor GlgEI-V279S.

Streptomyces coelicolor (Sco) GlgEI is a glycoside hydrolase involved in α-glucan biosynthesis and can be used as a model enzyme for structure-based inhibitor design targeting Mycobacterium tuberculosis (Mtb) GlgE. The latter is a genetically validated drug target for the development of anti-Tuberculosis (TB) treatments. Inhibition of Mtb GlgE results in a lethal buildup of the GlgE substrate maltose-1-phosphate (M1P). However, Mtb GlgE is difficult to crystallize and affords lower resolution X-ray structures. Sco GlgEI-V279S on the other hand crystallizes readily, produces high resolution X-ray data, and has active site topology identical to Mtb GlgE. We report the X-ray structure of Sco GlgEI-V279S in complex with 2-deoxy-2,2-difluoro-α-maltosyl fluoride (α-MTF, 5) at 2.3 Å resolution. α-MTF was designed as a non-hydrolysable mimic of M1P to probe the active site of GlgE1 prior to covalent bond formation without disruption of catalytic residues. The α-MTF complex revealed hydrogen bonding between Glu423 and the C1F which provides evidence that Glu423 functions as proton donor during catalysis. Further, hydrogen bonding between Arg392 and the axial C2 difluoromethylene moiety of α-MTF was observed suggesting that the C2 position tolerates substitution with hydrogen bond acceptors. The key step in the synthesis of α-MDF was transformation of peracetylated 2-fluoro-maltal 1 into peracetylated 2,2-difluoro-α-maltosyl fluoride 2 in a single step via the use of Selectfluor®.

Cutaneous angiomyolipoma.

We report a case of cutaneous angiomyolipoma (AML) found on the anterior abdominal wall of a 3-year-old female child. Histologic examination showed a well-circumscribed nodule in the dermis composed of an intimate mixture of convoluted thick-walled blood vessels, smooth muscle, and mature fat. This lesion differs from renal AML in terms of a lack of association with tuberous sclerosis, circumscription, absence of epithelioid cells, and male predominance. We concluded that the unique features of this lesion distinguish it from other lesions such as angiomyoma, angiolipoma, myolipoma, haemangioma, and other mixed mesenchymal tumors. This case report suggests that the features considered diagnostic of AML can occur in extrarenal sites and, therefore, this diagnosis cannot be excluded on the basis of site alone.

Laparoscopic management of small bowel obstruction caused by a Sigmoid Mesocolic hernia.

Internal hernias involve protrusion of viscera through the peritoneum or mesentery into a compartment in the abdominal cavity. Hernias occurring through the meso-sigmoid are rare and the most common presentation of this entity is an acute small intestinal obstruction. Pre-operative diagnosis is often difficult and the diagnosis is usually made at surgery. Traditionally, open surgery is used to manage a meso-sigmoid hernia. We report a patient with meso-sigmoid hernia causing intestinal obstruction managed successfully by the laparoscopic approach.

Co-occurrence of toxic bacterial and fungal secondary metabolites in moisture-damaged indoor environments.

UNLABELLED: Toxic microbial secondary metabolites have been proposed to be related to adverse health effects observed in moisture-damaged buildings. Initial steps in assessing the actual risk include the characterization of the exposure. In our study, we applied a multi-analyte tandem mass spectrometry-based methodology on sample materials of severely moisture-damaged homes, aiming to qualitatively and quantitatively describe the variety of microbial metabolites occurring in building materials and different dust sample types. From 69 indoor samples, all were positive for at least one of the 186 analytes targeted and as many as 33 different microbial metabolites were found. For the first time, the presence of toxic bacterial metabolites and their co-occurrence with mycotoxins were shown for indoor samples. The bacterial compounds monactin, nonactin, staurosporin and valinomycin were exclusively detected in building materials from moist structures, while chloramphenicol was particularly prevalent in house dusts, including settled airborne dust. These bacterial metabolites are highly bioactive compounds produced by Streptomyces spp., a group of microbes that is considered a moisture damage indicator in indoor environments. We show that toxic bacterial metabolites need to be considered as being part of very complex and diverse microbial exposures in 'moldy' buildings. PRACTICAL IMPLICATIONS: Bacterial toxins co-occur with mycotoxins in moisture-damaged indoor environments. These compounds are measurable also in settled airborne dust, indicating that inhalation exposure takes place. In attempts to characterize exposures to microbial metabolites not only mycotoxins but also bacterial metabolites have to be targeted by the analytical methods applied. We recommend including analysis of samples of outdoor air in the course of future indoor assessments, in an effort to better understand the outdoor contribution to the indoor presence of microbial toxins. There is a need for a sound risk assessment concerning the exposure to indoor microbial toxins at concentrations detectable in moisture-damaged indoor environments.

Laparoscopic management of appendicular mass.

BACKGROUND: Laparoscopic appendectomy is becoming the preferred technique for treating acute appendicitis. However, its role in the treatment of complicated appendicitis is controversial. This study was undertaken to assess the feasibility of laparoscopic appendectomy for appendicular mass. MATERIALS AND METHODS: A retrospective review was performed of all the patients who were treated laparoscopically for appendicular mass from March 2007 to October 2009. SETTING: Tertiary care hospital. RESULTS: A total of 120 patients were treated for appendicitis. A retrospective review of the patients' records demonstrated that 19 patients (15.8%) had appendicular mass at the time of admission. The average operative time was 95 minutes (range 45-140 minutes). Pathological evidence of appendicitis was present in all the patients. The average length of hospital stay was six days (rang 6-9 days). Three patients (15.7%) had post- operative complications. Two patients developed wound infections and one patient was re-admitted with pain and a lump below the umbilical port. CONCLUSION: The findings suggest that laparoscopic appendectomy is feasible in patients with appendicular mass. The authors propose a prospective, randomized trial to verify this finding.

Laparoscopic Management of Tubo-Ovarian Stitch Abscess after Tubal Sterilization.

Tubo-ovarian abscess usually results from ascending infection of the lower genital tract. In few cases, it can occur as a result of direct contamination at the time of tubal sterilization. We describe two rare cases of "tubo-ovarian stitch abscess" after post-partum tubal sterilization and managed successfully by laparoscopy at a tertiary care teaching hospital.

Imaging nonequilibrium atomic vibrations with x-ray diffuse scattering.

We use picosecond x-ray diffuse scattering to image the nonequilibrium vibrations in the lattice following ultrafast laser excitation. We present images of nonequilibrium phonons in InP and InSb throughout the Brillouin zone which remain out of equilibrium up to nanoseconds. The results are analyzed using a Born model that helps identify the phonon branches contributing to the observed features in the time-resolved diffuse scattering. In InP this analysis shows a delayed increase in the transverse-acoustic (TA) phonon population along high-symmetry directions accompanied by a decrease in the longitudinal-acoustic phonons. In InSb the increase in TA phonon population is less directional.

Laparoscopic management of large ovarian cysts at a rural hospital.

OBJECTIVE: To assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts at a rural hospital. MATERIALS AND METHODS: Fifteen patients from March 2004 to February 2007, with large ovarian cysts, with diameter >10 cm, were managed laparoscopically. The masses were cystic and were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA-125 levels were within the normal range (35 U/ml). Preoperative evaluation included history, clinical examination, sonographic images and serum markers. The management of these ovarian cysts included aspiration, cystectomy or salphingo-oophorectomy, depending on the patient's age, obstetric history and desire of future fertility. In large, solid, fixed or irregular adnexal masses, suspicious of malignancy, laparotomy was done. RESULTS: Five patients presented with pain in the abdomen and 10 patients with abdominal distension and discomfort. The average maximum diameter of the ovarian cysts was 16.75 cm (range 10-24 cm). The mean duration of the operation was 80 min. The postoperative hospital stay was from 4 to 6 days. No intraoperative complications occurred and the hospital course of all patients was uncomplicated. In one case, laparoscopy was converted to laparotomy. One patient had minor wound infection at umbilical port site. The patients did not report any complaints during follow up and the clinical examination findings were normal in all, up to 9 months after discharge. CONCLUSION: With proper patient selection, the size of an ovarian cyst is not necessarily a contraindication for laparoscopic surgery.

Diffuse nonscarring alopecia of scalp: an indicator of early infantile scurvy?

An infant with diffuse nonscarring alopecia of scalp and radiologic features of scurvy responded dramatically to oral vitamin C therapy. The characteristic cutaneous manifestations of scurvy are usually not seen in infancy. The manifestations of initial stage of scurvy that are not related to collagen synthesis, as in the present case, should alert to the possibility of this potentially fatal condition.

Mesenteric fibromatosis with involvement of the gastrointestinal tract.

Primary mesenteric fibromatosis is a rare condition. The aggressive nature of these tumors and the potential for major morbidity secondary to resection makes it a challenging disease for the surgeon. We report a case of mesenteric fibromatosis with involvement of small bowel.

Occupational mental health: a study of work-related depression among nurses in the Caribbean

This study addresses issues of occupational mental health among nurses in the Caribbean. A linear model linking role, work and social factors, stress, burnout, depression, absenteeism and turnover intention guides the research. Data were collected from 119 nurses working for major hospitals located in St. Vincent and Trinidad & Tobago using a field survey. Psychometrically sound instruments with provencross-cultural validity were utilized in the questionnaire. Descriptive statistics, correlations, and path analysis were used to analyze the data. The results indicated fairly strong support for proposed model which is tested for the first time among a Caribbean population. Role conflict, role overload and social support predicted stress, which along with social support predicted burnout. Burnout was the sole predictor of depression which in turn predicted both absenteeism and turnover intention. Implications of these findings for research and practice are discussed.(AU)

Fate of Mycobacterium tuberculosis inside rat peritoneal macrophages in vitro.

Rat peritoneal macrophages in vitro were infected with Mycobacterium tuberculosis and the fate of M. tuberculosis inside macrophages was monitored. Alteration in the levels of nitric oxide (NO) measured in terms of nitrite formed, hydrogen peroxide (H2O2) and lysosomal enzymes such as acid phosphatase, cathepsin-D and beta-glucuronidase in macrophages following M. tuberculosis infection was also studied. Elevation in the levels of nitrite were observed from 72 h of M. tuberculosis infection. Irrespective of the time point, M. tuberculosis infected macrophages produced elevated levels of H2O2. Maximum increase in the level of acid phosphatase was observed from 72 h of M. tuberculosis infection, whereas maximum elevation in the level of beta-glucuronidase was observed 48 h after M. tuberculosis infection. However these microbicidal agents did not alter the intracellular viability of M. tuberculosis.

Age-related normalization of the browning rate of collagen in diabetic subjects without retinopathy.

The age-related changes in collagen-linked fluorescence (browning) were investigated in skin from subjects with long-standing type I diabetes. Overall browning rates were 2.4 times higher in diabetics than in controls (P less than 0.02) and slope intercept accurately reflected the mean age of onset of diabetes (11.6 vs. 11.2 yr), suggesting that the browning process has the attributes of a biological clock. Browning rates were not different in controls and diabetics without retinopathy (P greater than 0.05) but were 2.4 (P less than 0.05) and 2.7 (P less than 0.01) times increased in the presence of background and proliferative retinopathy, respectively. Compared with subjects with retinopathy, individual browning rates since onset of diabetes decreased with advancing age in subjects free of retinopathy (P less than 0.001). Extrapolation revealed that they would become identical to that of nondiabetic subjects by the age of 66.4 yr. These results suggest the presence of a mechanism that controls the browning rate of collagen in diabetics who do not develop retinopathy.

Glycation of skin collagen in type I diabetes mellitus. Correlation with long-term complications.

Nonenzymatic glycosylation (glycation) of collagen was measured by boronate affinity chromatography in skin biopsies from 41 type I diabetics with mean duration of diabetes of 25 yr (range 20-40 yr) and from 25 age-matched controls. Mean level of Amadori products was significantly increased in diabetic [7.85 +/- 1.78 (SD) nmol/mg collagen] versus control subjects [3.34 +/- 1.06 (SD) nmol/mg collagen, P less than .001] but did not correlate with age, diabetes duration, or severity of retinopathy, nephropathy, arterial stiffness, and joint stiffness. Similarly, mean collagen content per biopsies was 42% increased in diabetic versus control subjects (P less than .001) but did not correlate with age, diabetes duration, or severity of complications. A weak but positive correlation between glycohemoglobin level and glycation of skin collagen was observed. These results indicate that Amadori products cannot explain by themselves the pathogenesis of diabetic complications unless individual tissue response to glycation is different in subjects with and without complication. They do not exclude a role for the late stages of the Maillard reaction, nonenzymatic browning, in the formation of some of these complications.