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1.  Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA 
Introduction
Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1st month of CPAP use.
Aim
To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients.
Materials and Methods
The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1st and 3rd month of CPAP therapy, and statistically analysed for significance.
Results
Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p < 0.001, CI (1.2991-4.5408), respectively after one month of CPAP therapy. Likewise, mean ESS scores among moderate and severe OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p <0.001, CI (2.9414-6.1385), respectively after three months of CPAP therapy.
Conclusion
The result of the present study shows that CPAP therapy is significantly effective in improving ESS scores in Indian patients having moderate to severe OSA. Benefits in daytime sleepiness were observed after short-term as well as long-term use of CPAP therapy.
doi:10.7860/JCDR/2016/23800.8876
PMCID: PMC5198373  PMID: 28050420
Epworth sleepiness scale; Hypopnea; Polysomnography
2.  An Evaluation of the Effect of Therapeutic Ultrasound on Healing of Mandibular Fracture 
The mandible is the most frequently fractured bone in maxillofacial trauma, the treatment of which consists of reduction and fixation of dislocated fragments by open or closed approach. Innovative techniques toward reducing the period of the postoperative intermaxillary fixation (IMF) are being researched. A relatively unknown treatment that may have an effect on fracture healing is ultrasound. Recent clinical trials have shown that low-intensity pulsed ultrasound (LIPUS) has a positive effect on bone healing. The aim of this study was to evaluate the effect of LIPUS on healing by its application in fresh, minimally displaced or undisplaced mandibular fracture in young and healthy individuals. A total of 28 healthy patients were selected randomly from the outpatient department needing treatment of mandibular fractures. They were then randomly allocated to either of the following two groups—experimental group and study group. After IMF, patients in experimental group received pulsed ultrasound signals with frequency of 1 MHz, with temporal and spatial intensity of 1.5 W/cm2, pulsed wave for 5 minutes on every alternate day for 24 days, whereas patients in control group received no therapy except IMF. Radiographic density at the fracture zone was assessed from the radiograph by Emago (Emago, Amsterdam, Netherlands) Image Analysis software before IMF then at 1st to 5th weeks post-IMF. The amount of clinical mobility between fracture fragments was assessed by digital manipulation of fractured fragment with the help of periodontal pocket depth measuring probe in millimeters at pre-IMF and after 3 weeks. Pain was objectively measured using a visual analogue scale at weekly interval. The data collected were subjected to unpaired “t” test. The experimental group showed significant improvement in radiographic density compared with control group at 3- and 5-week interval; pain perception was significantly reduced in experimental group compared with study group in the subsequent weeks. No significant difference was found in clinical mobility between fracture fragments at 3-week interval. The present study provides a basis for application of therapeutic controlled ultrasound as an effective treatment modality to accelerate healing of fresh, minimally displaced mandibular fracture.
doi:10.1055/s-0034-1544104
PMCID: PMC4812795  PMID: 26576234
mandibular fracture; low-intensity pulsed ultrasound; intermaxillary fixation; radiographic density
3.  Midbrain tuberculoma presenting as partial ptosis 
BMJ Case Reports  2014;2014:bcr2014207686.
doi:10.1136/bcr-2014-207686
PMCID: PMC4244482  PMID: 25404254
4.  Ectopic expression of AtDGAT1, encoding diacylglycerol O-acyltransferase exclusively committed to TAG biosynthesis, enhances oil accumulation in seeds and leaves of Jatropha 
Background
Jatropha curcas is an important biofuel crop due to the presence of high amount of oil in its seeds suitable for biodiesel production. Triacylglycerols (TAGs) are the most abundant form of storage oil in plants. Diacylglycerol O-acyltransferase (DGAT1) enzyme is responsible for the last and only committed step in seed TAG biosynthesis. Direct upregulation of TAG biosynthesis in seeds and vegetative tissues through overexpression of the DGAT1 could enhance the energy density of the biomass, making significant impact on biofuel production.
Results
The enzyme diacylglycerol O-acyltransferase is the rate-limiting enzyme responsible for the TAG biosynthesis in seeds. We generated transgenic Jatropha ectopically expressing an Arabidopsis DGAT1 gene through Agrobacterium-mediated transformation. The resulting AtDGAT1 transgenic plants showed a dramatic increase in lipid content by 1.5- to 2 fold in leaves and 20–30 % in seeds, and an overall increase in TAG and DAG, and lower free fatty acid (FFA) levels compared to the wild-type plants. The increase in oil content in transgenic plants is accompanied with increase in average plant height, seeds per tree, average 100-seed weight, and seed length and breadth. The enhanced TAG accumulation in transgenic plants had no penalty on the growth rates, growth patterns, leaf number, and leaf size of plants.
Conclusions
In this study, we produced transgenic Jatropha ectopically expressing AtDGAT1. We successfully increased the oil content by 20–30 % in seeds and 1.5- to 2.0-fold in leaves of Jatropha through genetic engineering. Transgenic plants had reduced FFA content compared with control plants. Our strategy of increasing energy density by enhancing oil accumulation in both seeds and leaves in Jatropha would make it economically more sustainable for biofuel production.
doi:10.1186/s13068-016-0642-7
PMCID: PMC5073959  PMID: 27790288
AtDGAT1; Biodiesel; Jatropha; Leaf; Seed oil; Transgenic; Triacylglycerols (TAGs)
5.  Unexpected functional implication of a stable succinimide in the structural stability of Methanocaldococcus jannaschii glutaminase 
Nature Communications  2016;7:12798.
Protein ageing is often mediated by the formation of succinimide intermediates. These short-lived intermediates derive from asparaginyl deamidation and aspartyl dehydration and are rapidly converted into β-aspartyl or D-aspartyl residues. Here we report the presence of a highly stable succinimide intermediate in the glutaminase subunit of GMP synthetase from the hyperthermophile Methanocaldoccocus jannaschii. By comparing the biophysical properties of the wild-type protein and of several mutants, we show that the presence of succinimide increases the structural stability of the glutaminase subunit. The protein bearing this modification in fact remains folded at 100 °C and in 8 M guanidinium chloride. Mutation of the residue following the reactive asparagine provides insight into the factors that contribute to the hydrolytic stability of the succinimide. Our findings suggest that sequences that stabilize succinimides from hydrolysis may be evolutionarily selected to confer extreme thermal stability.
Succinimide is a post-translational modification susceptible to rapid hydrolysis and generally associated with protein destabilisation. Here, the authors use mass spectroscopy to identify a stable succinimide intermediate that is responsible for the high thermostability of a thermophilic enzyme.
doi:10.1038/ncomms12798
PMCID: PMC5052720  PMID: 27677693
6.  Influenza Research Database: An integrated bioinformatics resource for influenza virus research 
Nucleic Acids Research  2016;45(Database issue):D466-D474.
The Influenza Research Database (IRD) is a U.S. National Institute of Allergy and Infectious Diseases (NIAID)-sponsored Bioinformatics Resource Center dedicated to providing bioinformatics support for influenza virus research. IRD facilitates the research and development of vaccines, diagnostics and therapeutics against influenza virus by providing a comprehensive collection of influenza-related data integrated from various sources, a growing suite of analysis and visualization tools for data mining and hypothesis generation, personal workbench spaces for data storage and sharing, and active user community support. Here, we describe the recent improvements in IRD including the use of cloud and high performance computing resources, analysis and visualization of user-provided sequence data with associated metadata, predictions of novel variant proteins, annotations of phenotype-associated sequence markers and their predicted phenotypic effects, hemagglutinin (HA) clade classifications, an automated tool for HA subtype numbering conversion, linkouts to disease event data and the addition of host factor and antiviral drug components. All data and tools are freely available without restriction from the IRD website at https://www.fludb.org.
doi:10.1093/nar/gkw857
PMCID: PMC5210613  PMID: 27679478
7.  Silencing of Anopheles stephensi Heme Peroxidase HPX15 Activates Diverse Immune Pathways to Regulate the Growth of Midgut Bacteria 
Anopheles mosquito midgut harbors a diverse group of endogenous bacteria that grow extensively after the blood feeding and help in food digestion and nutrition in many ways. Although, the growth of endogenous bacteria is regulated by various factors, however, the robust antibacterial immune reactions are generally suppressed in this body compartment by a heme peroxidase HPX15 crosslinked mucins barrier. This barrier is formed on the luminal side of the midgut and blocks the direct interactions and recognition of bacteria or their elicitors by the immune reactive midgut epithelium. We hypothesized that in the absence of HPX15, an increased load of exogenous bacteria will enormously induce the mosquito midgut immunity and this situation in turn, can easily regulate mosquito-pathogen interactions. In this study, we found that the blood feeding induced AsHPX15 gene in Anopheles stephensi midgut and promoted the growth of endogenous as well as exogenous fed bacteria. In addition, the mosquito midgut also efficiently regulated the number of these bacteria through the induction of classical Toll and Imd immune pathways. In case of AsHPX15 silenced midguts, the growth of midgut bacteria was largely reduced through the induction of nitric oxide synthase (NOS) gene, a downstream effector molecule of the JAK/STAT pathway. Interestingly, no significant induction of the classical immune pathways was observed in these midguts. Importantly, the NOS is a well known negative regulator of Plasmodium development, thus, we proposed that the induction of diverged immune pathways in the absence of HPX15 mediated midgut barrier might be one of the strategies to manipulate the vectorial capacity of Anopheles mosquito.
doi:10.3389/fmicb.2016.01351
PMCID: PMC5006007  PMID: 27630620
Anopheles stephensi; peroxidases; HPX15; mucin barrier; midgut bacteria; Plasmodium; innate immunity; vectorial capacity
8.  Congenital absence of infrarenal inferior vena cava and deep veins of the lower limbs: a case report 
Background
Congenital anomalies of the venous system are known but congenital absence of infrarenal inferior vena cava with absent deep venous system of the lower limbs is extremely rare.
Case presentation
We report the case of an 11-year-old Indian girl who presented with large venous collaterals on her anterior abdominal wall and recurrent non-healing venous ulcers on her left leg with complete absence of infrarenal inferior vena cava and absent deep veins of her lower limbs.
Conclusions
Congenital absence of infrarenal inferior vena cava may occur with absence of the deep venous system of the lower limbs. We have reported this case because of its extreme rarity and to enhance awareness of this entity that has no treatment currently.
doi:10.1186/s13256-016-1015-3
PMCID: PMC4980794  PMID: 27510154
Inferior vena cava; Thrombosis; Congenital anomaly; Vein
9.  Incorporation of Lactobacillus adjuncts culture to improve the quality of Feta-type cheese made using buffalo milk 
Feta-type cheese was made from buffalo milk using commercial adjunct culture of Lactobacillus helveticus and Lactobacillus casei along with standard mesophillic cheese cultures. The sensory, biochemical and texture characteristics of the experimental cheeses were studied during ripening. Expert panellists observed, significant differences (P < 0.01) between the control and the experimental cheeses. The pH, titratable acidity, soluble protein and free fatty acid content of the experimental cheeses were found to be significantly (P < 0.01) higher than those of the control. The texture parameter values of the experimental cheeses were found to be significantly (P < 0.01) lower than values of the control.
doi:10.1007/s13197-014-1560-y
PMCID: PMC4519472  PMID: 26243922
Buffalo milk; Feta-type cheese; Starter adjunct; Sensory characteristics; Textural characteristics
10.  Evaluation of the Serum Levels of Nitric Oxide among Diabetic Patients and its Correlation with Lipid Profile as well as Oxidative Stress in North Indian Setting 
Introduction
Diabetes mellitus is a disease with a rapidly increasing prevalence, needs continue research for novel methods to both prevent and treat this disorder. Obesity and decreased physical activity are the major risk factor for the development of diabetes. Recently the emphasis is focused on oxidative stress in pathogenesis of this disease.
Aim
To assess the serum levels of Nitric Oxide (NO) among diabetic patients and its correlation with lipid profile as well as oxidative stress in north Indian setting.
Materials and Methods
This was a cross-sectional study. Subjects suffering from type 2 diabetes for more than 1 year and age between 30 to 50 years with hyperuricaemia were included in the study. The patients were divided into three groups: Group I- Type 2 diabetics with dyslipidemia and hyperuricaemia, Group II- Type 2 diabetics with dyslipidemia and normouricaemia and Group III- Type 2 diabetics with normolipidemia and normouricaemia.
Results
The nitric oxide level was significantly lower in Group I and Group II than Group III. The oxidative stress parameters had poor correlation with NO level in all the groups.
Conclusion
Our data suggests that there is definite role of Nitric Oxide (NO) in pathogenesis of type -2 diabetes mellitus with dyslipidemia and hyperuricaemia.
doi:10.7860/JCDR/2016/15548.7868
PMCID: PMC4948447  PMID: 27437271
Dyslipidemia; Free radical; HbA1c; Hyperuricaemia; Middle aged
11.  Intractable sacroiliac joint pain treated with peripheral nerve field stimulation 
As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs. Two parallel permanent 8-contact subcutaneous stimulating leads were implanted under the skin overlying their painful SIJ. Adequate stimulation in the entire painful area was confirmed. For implantable pulse generator placement, a separate subcutaneous pocket was made in the upper buttock below the iliac crest level ipsilaterally. During the pain-clinic follow-up period, the patients had reduced their pain medications requirements by half with an additional report of more than 50% improvement in their functional status. The first patient passed away 2 years after the PNFS procedure due to medical causes unrelated to his chronic pain. The second patient has been comfortable with PNFS-induced analgesic regimen during her pain-clinic follow-up during last 5 years. In summary, PNFS can be an effective last resort option for SIJ pain wherein conventional interventional pain techniques have failed, and analgesic medication requirements are escalating or causing unwarranted side-effects.
doi:10.4103/0970-9185.173336
PMCID: PMC5009853  PMID: 27625495
Neuromodulation; peripheral nerve field stimulation; sacroiliac joint pain
12.  A Prospective Study to Assess the Levels of Interleukin-6 Following Administration of Diclofenac, Ketorolac and Tramadol After Surgical Removal of Lower Third Molars 
Introduction
The surgical removal of impacted third molars involves, trauma to soft and bony tissue and can result in considerable pain, swelling, and trismus. The greater the amount of tissue injury the greater is the amount of inflammation in the perisurgical region. Interleukin-6 (IL-6) is both a pro inflammatory and anti-inflammatory cytokine. It is secreted by T cells and macrophages to stimulate the immune response. IL-6 is also an early marker of tissue damage. In addition to NSAIDs, corticosteroids, opioids also have immunomodulatory effects.
Aim
To evaluate the changes in serum IL-6 levels following surgical removal of third molars under local anaesthesia after administration of two NSAIDs diclofenac and ketorolac and opioid tramadol post operatively.
Methods
Patients undergoing surgical removal of impacted mandibular third molar teeth were randomly assigned to three groups. Each group received one of the three analgesics viz diclofenac 50 mg, ketorolac 10 mg and tramadol 50 mg. The mean levels of IL-6 was then estimated by ELISA.
Results
The results of our study showed that all three drugs i.e. diclofenac, ketorolac and tramadol have properties which can downregulate the production of IL-6 in response to surgical trauma.
Conclusion
It is of clinical significance that the suppression of IL-6 values occurs in tramadol group closely following the diclofenac group. Even though the drug ketorolac suppresses the IL-6 levels similar to diclofenac initially but after 7 days tramadol and ketorolac showed similarities in suppression of IL-6 expression which is less compared to diclofenac group.
doi:10.1007/s12663-013-0609-1
PMCID: PMC4444661  PMID: 26028838
Interleukin-6; Diclofenac; Ketorolac; Tramadol; Third molar surgery
13.  Ruptured aneurysm of major aortopulmonary collateral artery: management using amplatzer vascular plug 
Aneurysm of a major aortopulmonary collateral artery (MAPCA) is quite rare. Aneurysmally dilated MAPCA may be complicated with rupture and massive hemoptysis leading to sudden death. Possible pathophysiology for aneurysm formation is persistent high pressure state in collateral circulation. High index of suspicion is necessary to avoid catastrophic complications as the amount of hemoptysis does not correlate with disease severity and etiology. We present a case of large ruptured aneurysm of a MAPCA presenting with massive haemoptysis in a patient of cyanotic congenital heart disease which was salvaged by endovascular deployment of vascular plug.
doi:10.21037/cdt.2016.01.02
PMCID: PMC4880756  PMID: 27280092
Aneurysm; hemoptysis; major aortopulmonary collateral artery (MAPCA)
14.  Chronic empyema thoracis after percutaneous nephrolithotomy 
BMJ Case Reports  2014;2014:bcr2014203637.
Percutaneous nephrolithotomy (PCNL) is presently the treatment of choice for large or multiple kidney stones or stones in the calyx. PCNL is generally safe and associated with low but indisputable complication rate. Pleural injury in PCNL is a rare but severe complication which can occur during or immediately after operation. Pleural injury may lead to chronic empyema thoracis. Until now no such case has been reported in literature.
doi:10.1136/bcr-2014-203637
PMCID: PMC4024573  PMID: 24827658
15.  Inhibition of peroxisome fission, but not mitochondrial fission, increases yeast chronological lifespan 
Cell Cycle  2015;14(11):1698-1703.
Mitochondria are key players in aging and cell death. It has been suggested that mitochondrial fragmentation, mediated by the Dnm1/Fis1 organelle fission machinery, stimulates aging and cell death. This was based on the observation that Saccharomyces cerevisiae Δdnm1 and Δfis1 mutants show an enhanced lifespan and increased resistance to cell death inducers. However, the Dnm1/Fis1 fission machinery is also required for peroxisome division. Here we analyzed the significance of peroxisome fission in yeast chronological lifespan, using yeast strains in which fission of mitochondria was selectively blocked. Our data indicate that the lifespan extension caused by deletion of FIS1 is mainly due to a defect in peroxisome fission and not caused by a block in mitochondrial fragmentation. These observations are underlined by our observation that deletion of FIS1 does not lead to lifespan extension in yeast peroxisome deficient mutant cells.
doi:10.1080/15384101.2015.1029685
PMCID: PMC4614869  PMID: 25840089
chronological aging; Fis1; fission; mitochondria; peroxisome; yeast
16.  Clinical Impact of Selective and Non-selective Beta Blockers on Survival in Ovarian Cancer Patients 
Cancer  2015;121(19):3444-3451.
BACKGROUND
Preclinical evidence suggests that sustained adrenergic activation can promote ovarian cancer growth and metastasis. We examined the impact of beta-adrenergic blockade on clinical outcome of women with epithelial ovarian, primary peritoneal or fallopian tube cancers (collectively, EOC).
METHODS
A multicenter review of 1,425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta blocker use during chemotherapy and those without beta blocker use.
RESULTS
The median age of patients in this study was 63 years (range, 21–93 years). The sample included 269 patients who received beta blockers. Of those, 193 (71.7%) were receiving beta-1 adrenergic receptor (ADRB1) selective agents, and the remaining patients were receiving non-selective beta antagonists. The primary indication for beta blocker use was hypertension but also included arrhythmia and post-myocardial infarction management. For patients receiving any beta blocker, the median overall survival (OS) was 47.8 months versus42 months (P = 0.04) for non-users. The median OS based on beta blocker receptor selectivity was 94.9 months for those receiving non-selective beta blockers versus 38 months for those receiving ADRB1 selective agents (P < 0.001). Hypertension was associated with decreased OS compared to no hypertension across all groups. However, even in patients with hypertension, users of a non-selective beta blocker had a longer median OS than non-users observed (38.2 vs 90 months, P < 0.001).
CONCLUSION
Use of non-selective beta blockers in epithelial ovarian cancer patients was associated with longer OS. These findings may have implications for new therapeutic approaches.
doi:10.1002/cncr.29392
PMCID: PMC4575637  PMID: 26301456
ovarian cancer; beta-blockers; survival
17.  Prevalence and outcome of headache in tuberculous meningitis 
Neurosciences  2016;21(2):138-144.
Objective:
To evaluate headache severity, and its correlation with clinical, cerebrospinal fluid, and neuroimaging parameters of tuberculous meningitis (TBM) patients, and its impact on outcome.
Methods:
This prospective observational study was conducted at King George’s Medical University, Lucknow, India between October 2012 and March 2014. Ninety-five newly diagnosed TBM patients underwent detailed clinical, laboratory, and neuroimaging evaluation. A numeric rating scale was used to assess the headache severity, and patients were grouped into mild, moderate, severe, and intolerable groups. Patient outcome was evaluated at 6-months follow up.
Results:
Holocranial stabbing type headache (p=0.002), modified Barthel index ≤12 (p<0.001), diplopia (p=0.055), seizures (p<0.001), visual impairment (p=0.024), cranial nerve palsy (p=0.002), meningeal signs (p=0.016), definite cases of TBM (p=0.001), British Medical Research Council stage III (p<0.001), and CSF protein >2.5 g/l (p<0.001) were significantly associated with severity of headache. Neuroradiological features significantly associated with severity of headache were meningeal enhancement (p=0.015), basal exudates (p<0.001), and hydrocephalus (p=0.003). Eleven out of 15 patients who died had intolerable headache at admission. Significant predictors of poor outcome in severe and intolerable headache groups were CSF protein>2.5g/L, cranial nerve palsies, paraparesis, and infarcts. Patients of the mild and moderate headache group were headache free at 6 months follow up with good outcome.
Conclusion:
Severity of headache was associated with multiple clinical, CSF protein, and radiological factors. As intolerable and severe headache had an unfavorable impact on outcome, we could prognosticate the TBM patients on the basis of headache severity.
doi:10.17712/nsj.2016.2.2015678
PMCID: PMC5107268  PMID: 27094524
18.  Ambivalent Outcomes of Cell Apoptosis: A Barrier or Blessing in Malaria Progression 
The life cycle of Plasmodium in two evolutionary distant hosts, mosquito, and human, is a complex process. It is regulated at various stages of developments by a number of diverged mechanisms that ultimately determine the outcome of the disease. During the development processes, Plasmodium invades a variety of cells in two hosts. The invaded cells tend to undergo apoptosis and are subsequently removed from the system. This process also eliminates numerous parasites along with these apoptotic cells as a part of innate defense against the invaders. Plasmodium should escape the invaded cell before it undergoes apoptosis or it should manipulate host cell apoptosis for its survival. Interestingly, both these phenomena are evident in Plasmodium at different stages of development. In addition, the parasite also exhibits altruistic behavior and triggers its own killing for the selection of the best ‘fit’ progeny, removal of the ‘unfit’ parasites to conserve the nutrients and to support the host survival. Thus, the outcomes of cell apoptosis are ambivalent, favorable as well as unfavorable during malaria progression. Here we discuss that the manipulation of host cell apoptosis might be helpful in the regulation of Plasmodium development and will open new frontiers in the field of malaria research.
doi:10.3389/fmicb.2016.00302
PMCID: PMC4791532  PMID: 27014225
cell apoptosis; Plasmodium; mosquito; midgut epithelium; hepatocytes; erythrocytes
19.  Perforated isolated jejunal diverticulum: a rare aetiology of acute abdomen 
BMJ Case Reports  2014;2014:bcr2013201533.
In the absence of trauma, perforated jejunal diverticulum (JD) is a rare entity. Perforated isolated JD is rarer. We report a case of perforated isolated JD in a 55-year-old woman who presented with features of peritonitis and had no history of trauma. Resection and anastomosis of the involved jejunal segment was performed.
doi:10.1136/bcr-2013-201533
PMCID: PMC3962902  PMID: 24618865
20.  Effect of coagulants on the quality of chhana and rasogolla obtained from admixture of buffalo milk and butter milk 
A study was carried out to investigate the effect of different coagulant (lactic acid, citric acid and calcium lactate) on yield, sensory and textural characteristics of chhana and rasogolla made from admixture of buffalo milk and sweet cream butter milk (SCBM). The highest yield of chhana was observed with calcium lactate whereas the minimum yield was found with citric acid. There was no significant difference found with respect to flavour and colour and appearances scores, however, significant (p < 0.01) difference found in body and texture of chhana samples prepared with different coagulant. In addition to that, significant (p < 0.05) difference observed with respect to body and texture, flavour and porosity of rasogolla, but no significant difference was observed in colour and appearance as well as sweetness of rasogolla prepared with chhana obtained from varying coagulants. Among different coagulants, citric acid was found best suitable for chhana as well as rasogolla making.
doi:10.1007/s13197-013-1146-0
PMCID: PMC4348269  PMID: 25745249
Buffalo milk; Sweet cream butter milk; Coagulant; Chhana; Rasogolla
21.  Hirayama Disease with Periscapular Involvement: A Rare Association 
Annals of Neurosciences  2016;23(1):56-59.
Hirayama disease (HD) is a rare disease commonly seen in India and Japan typically presenting in adolescent age group with male predominance and asymmetrical distal pure motor, lower-motor neuron-type weakness. We report a patient of HD who had significant involvement of proximal periscapular muscles along with typical distal involvement. The patient also had scapular winging, which is rare in HD. He was treated conservatively with physiotherapy and hard cervical collar and is presently under follow-up during the static phase of disease.
doi:10.1159/000443557
PMCID: PMC4934413  PMID: 27536023
Hirayama disease; MRI; Anterior horn cell disorder
22.  Effect of varying level of dried milk proportion on formulation and reconstitution of Phirni mix powder 
An investigation was undertaken to study the varying proportion of WMP to SMP (25:75, 50:50 and 75:25) for formulation of Phirni mix powder (PMP). The sensory quality of experimental Phirni increased consistently with the increase in the levels of WMP upto 50:50, thereafter, decreased significantly (p < 0.01). The maximum sensory scores were obtained with a proportion of 50:50 for all sensory attributes. The textural characteristics were found significant (p < 0.01) with the increase in the proportion of WMP. Further, the formulation was reconstitute by dispersing the PMP with varying levels of water (50 : 30, 50 : 40 and 50 : 50) and followed by cooked at 85 ± 5 °C for different cooking time (5,10 and 15 min). The results obtained among the reconstituted water on the sensory and textural attributes were found significant (p < 0.01). The maximum sensory scores were observed at 10 min cooking time with 50: 40 proportion of PMP to water.
doi:10.1007/s13197-013-1106-8
PMCID: PMC4325059  PMID: 25694741
Phirni; Mix powder; Sensory quality; Rheological characteristics
23.  Comparison between Transdermal Buprenorphine and Transdermal Fentanyl for Postoperative Pain Relief after Major Abdominal Surgeries 
Introduction
Opioid is generally regarded as an important part of multimodal, perioperative analgesia, especially for moderate to severe pain. Amongst the various modes of delivery transdermal route has several potential benefits over oral and parentral administration. These include noninvasive dosing, better absorption and lack of first-pass metabolism. A transdermal drug delivery system provides steady and continuous drug delivery resulting in steady plasma concentration. Bolus dosing of systemic analgesic results in supra and sub therapeutic plasma resulting in toxic and sub analgesic plasma drug concentration. It also improves patient compliance.
Materials and Methods
Sixty patients undergoing major abdominal surgery under GA were randomly divided in two groups (n=30). Group A received buprenorphine 10 mcg/h TDS and group B received 25 mcg/h fentanyl TDS, 6 hours prior to surgery. Patients were followed for three days for postoperative pain relief and adverse effects.
Results
Baseline and demographic variables are comparable in both groups. The mean level of VAS was significantly lower in group B as compared to group A at Day 1, 2 and 3. The mean level of sedation score was significantly lower in Group B than Group A. Haemodynamic variables in both groups (SBP, DBP and HR), shows comparable values in both groups and no significant difference was observed. Five out of 30 (16.7%) patients in group A required single dose of rescue analgesic while 0 out of 30 patients (0.00%) in group B required rescue analgesic. This difference in rescue analgesic requirement in not quiet statistically significant (p-value 0.0522). Twenty percent patient in fentanyl group and 16.7% patients in buprenorphine group experienced some adverse effects. Nausea and vomiting were main side effects of the drugs. The incidence of nausea and vomiting were 6.7% and 10% in buprenorphine and fentanyl group respectively.
Conclusion
Fentanyl and buprenorphine TDS were effective and safe in controlling postoperative pain. Fentanyl is better than buprenorphine in this respect.
doi:10.7860/JCDR/2015/16327.6917
PMCID: PMC4717684  PMID: 26816973
Fentanyl; Transdermal patch; Pain
24.  Identification of the Temperature Induced Larvicidal Efficacy of Agave angustifolia against Aedes, Culex, and Anopheles Larvae 
Synthetic insecticides are generally employed to control the mosquito population. However, their injudicious over usage and non-biodegradability are associated with many adverse effects on the environment and mosquitoes. The application of environment-friendly mosquitocidals might be an alternate to overcome these issues. In this study, we found that organic or aqueous extracts of Agave angustifolia leaves exhibited a strong larvicidal activity (LD50 28.27 μg/ml) against Aedes aegypti, Culex quinquefasciatus, and Anopheles stephensi larvae within a short exposure of 12 h. The larvicidal activity of A. angustifolia is inherited and independent of the plants vegetative growth. Interestingly, the plant larvicidal activity was observed exclusively during the summer season (April–August, when outside temperature is between 30 and 50°C) and it was significantly reduced during winter season (December–February, when the outside temperature falls to ~4°C or lower). Thus, we hypothesized that the larvicidal components of A. angustifolia might be induced by the manipulation of environmental temperature and should be resistant to the hot conditions. We found that the larvicidal activity of A. angustifolia was induced when plants were maintained at 37°C in a semi-natural environment against the controls that were growing outside in cold weather. Pre-incubation of A. angustifolia extract at 100°C for 1 h killed 60% larvae in 12 h, which gradually increased to 100% mortality after 24 h. In addition, the dry powder formulation of A. angustifolia, also displayed a strong larvicidal activity after a long shelf life. Together, these findings revealed that A. angustifolia is an excellent source of temperature induced bioactive metabolites that may assist the preparedness for vector control programs competently.
doi:10.3389/fpubh.2015.00286
PMCID: PMC4709459  PMID: 26793700
mosquito; vector-borne diseases; larvicidal activity; plant extract; Agave angustifolia
25.  Effect of hypothyroidism on female reproductive hormones 
Objective:
Objective was to evaluate reproductive hormones levels in hypothyroid women and impact of treatment on their levels.
Materials and Methods:
A total of 59 women with untreated primary hypothyroidism were included in this prospective study. Venous blood was taken at baseline and after euthyroidism was achieved for measuring serum free thyroxine, free triiodothyronine (FT3), thyroid stimulating hormone (TSH), prolactin (PRL), follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), and thyroid peroxidase antibody. Thirty-nine healthy women with regular menstrual cycles without any hormonal disturbances served as controls. The statistical analysis was performed using the Statistical Package for the Social Sciences Version 20 ([SPSS] IBM Corporation, Armonk, NY, USA). P < 0.05 was considered statistically significant.
Results:
On an average at diagnosis cases have more serum TSH (mean [M] = 77.85; standard error [SE] = 11.72), PRL (M = 39.65; SE = 4.13) and less serum E2 (M = 50.00; SE = 2.25) and T (M = 35.40; SE = 2.31) than after achieving euthyroidism (M = 1.74; SE = 0.73), (M = 16.04; SE = 0.84), (M = 76.25; SE = 2.60), and (M = 40.29; SE = 2.27), respectively. This difference was statistically significant t (58) = 6.48, P <0.05; t (58) = 6.49, P < 0.05; t (58) = 12.47; P < 0.05; and t (58) = 2.04, P < 0.05; respectively. Although average serum FSH (M = 12.14; SE = 0.40) and LH (M = 5.89; SE = 0.27) were lower in cases at diagnosis than after achieving euthyroidism (M = 12.70; SE = 0.40), (M = 6.22; SE = 0.25), respectively, but these differences were statistically insignificant t (58) = 1.61, P = 0.11; t (58) = 1.11, P = 0.27, respectively.
Conclusion:
The study has demonstrated low E2 and T levels in hypothyroid women which were increased after achieving euthyroidism. Although average serum FSH and LH were increased in hypothyroid women after achieving euthyroidism but this difference was statistically insignificant.
doi:10.4103/2230-8210.172245
PMCID: PMC4743370  PMID: 26904478
Estradiol; follicular stimulating hormone; hypothyroidism

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