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A reliable LULC model aims at predicting the spatial distribution of specific LULC classes for a later year by utilizing the trends from previous years thereby helps in appropriate LULC planning. The Ganga River Basin (GRB) has undergone significant LULC changes during past decades. The changes in LULC pattern was investigated for 1975 and 2010 to have better understanding of the conversion process and thereby predicting the future trend for 2045 using Dyna-CLUE (Conversion of Land-Use and its Effects) model. Four types of data were fed into the model i.e., (a) spatial policies and restrictions; (b) LULC type specific conversion settings; (c) LULC requirements (demands) and (d) location characteristics. The possible and impossible conversions among LULC classes were dealt with through Restrictionand No Restrictionarea. The land conversion allocation was determined by establishing preference between LULC classes and the driving factors using binary logistic regression. Relative Operating Characteristic curves provided an overall value of 0.86 implying acceptability of regression results. The simulated result (with ‘no restriction’ area criteria) showed 578,296 km2agriculture area in 2010 and 579,235 km2for 2045, wherein 575,874 km2(99.58%) of agriculture area could remain unchanged during 2010–2045; while with the restricted area, agriculture area of 577,675 km2in 2010 and 578,516 km2for 2045; whereas 576,242 km2(99.75%) of agriculture area may remain unchanged during 2010–2045. Biophysical drivers namely altitude, slope, aspect, soil types, precipitation and temperature, emerged as major controlling factors for LULC change in GRB. Logistic regression analysis showed that population density is positively related with agriculture and expansion of settlements.

Engineering institutions in India contribute significantly to the rapidly growing e-waste. E-waste management within higher education institutions enables to achieve the goal of becoming a sustainable organisation. The objective of this research is to assess the disposal practices, in-use, and hibernating stocks of mobile phones and information technology (IT) equipment among the students of National Institutional Ranking Framework (NIRF) ranked engineering institutions in India. An online survey was conducted among the students, and the number of devices (million units) in hibernation and the materials (metric tons) presented in them are estimated. From the results, it is found that nearly 0.37 million devices are in hibernation, of which mobile phones account for 38%. The quantity of common metals, precious metals, and plastics present in the hibernating stocks is estimated to be 385, 3.2, and 203 metric tons, respectively. Suggestions to exploit urban mining in engineering institutions to promote sustainability are also provided.

Adversarial perturbations have demonstrated the vulnerabilities of deep learning algorithms to adversarial attacks. Existing adversary detection algorithms attempt to detect the singularities; however, they are in general, loss-function, database, or model dependent. To mitigate this limitation, we propose DAMAD—a generalized perturbation detection algorithm which is agnostic to model architecture, training data set, and loss function used during training. The proposed adversarial perturbation detection algorithm is based on the fusion of autoencoder embedding and statistical texture features extracted from convolutional neural networks. The performance of DAMAD is evaluated on the challenging scenarios of cross-database, cross-attack, and cross-architecture training and testing along with traditional evaluation of testing on the same database with known attack and model. Comparison with state-of-the-art perturbation detection algorithms showcase the effectiveness of the proposed algorithm on six databases: ImageNet, CIFAR-10, Multi-PIE, MEDS, point and shoot challenge (PaSC), and MNIST. Performance evaluation with nearly a quarter of a million adversarial and original images and comparison with recent algorithms show the effectiveness of the proposed algorithm.

The present study was undertaken to investigate the effect of dietary replacement of commonly used vegetable oil (sunflower oil, SFO) with n-3 polyunsaturated fatty acids (PUFA) rich oil sources on broiler chicken performance, carcass yield, meat fatty acid composition, keeping quality and sensory attributes of meat. In the current experiment, 300 day-old Krishibro broiler chicks were randomly distributed to 5 dietary groups (50 replicates with 6 chicks in each) prepared by replacing SFO (2% and 3% of diet during starter and finisher periods, respectively) with n-3 PUFA rich soybean oil (SO), mustard oil (MO), linseed oil (LO) or fish oil (FO) on weight basis. Variation in oil sources had no influence (P > 0.05) on performance and carcass yield. Supplementation of MO, LO or FO significantly (P < 0.01) increased the n-3 PUFA, lowered the n-6 PUFA deposition and n-6:n-3 ratio in breast and thigh without affecting the organoleptic characters (appearance, flavour, juiciness, tenderness and overall acceptability) of meat. However, thiobarbituric acid reacting substances concentration in meat was increased (P < 0.01) with LO and FO supplementation compared with SFO. It is concluded that, dietary incorporation of MO, LO or FO at 2% and 3% levels during starter and finisher phase can enrich broiler chicken meat with n-3 PUFA without affecting the bird's performance and sensory characters of meat.

Diurnal variation of atmospheric CO2and its driving factors are studied using high‐precision in situ mixing ratio measurements and stable carbon isotopic CO2(δ13C‐CO2) for the first time over Shadnagar, a suburban site in India, from November 2018 to October 2019. The annual mean mixing ratios of atmospheric CO2and δ13C‐CO2are observed to be 414.76 ± 4.26 ppm and −11.19 ‰ ± 1.63 ‰. Maximum diurnal variability of atmospheric CO2was observed in summer monsoon (17.30 ± 9.29 ppm), and the minimum was noticed in winter (7.19 ± 0.11 ppm), indicating strong seasonality in diurnal variability of amplitude. To characterize the atmospheric CO2sources, the Miller‐Tans model was implemented separately using the CO2and its δ13C‐CO2isotopic data during day and night. However, a strong source signature of δ13C‐CO2was observed during the night‐time of summer monsoon with a slope of −37.42‰ ± 0.73‰, obtained using a reduced major axis regression. The identified source indicates possible emissions from fossil fuel combustion. Further, a Lagrangian back trajectory analysis was performed to study the influence of transport on the observed CO2mixing ratios. The model trajectory confirms the influence of the Indian summer monsoon on the variations of atmospheric CO2mixing ratios. Our study shows that fossil fuel emissions are one of the major contributors of CO2in the study location (about ∼2 to 4 ppm) with biogenic fluxes adding a clear seasonality ranging from −8 to 4 ppm. At a suburban site in India, the present study looked at the diurnal variation of seasonal atmospheric CO2and its stable isotopes, 13C‐CO2. We used the Miller‐Tans model on seasonal data to capture the driving processes of atmospheric CO2during day and night hours. A high source/sink signature of 13C was identified during the night of the summer monsoon. The presence of C3ecosystem respiration and combustion is attributed as the source. Our research provided clear evidence that, in addition to short‐ and long‐range anthropogenic impacts, changes in the isotopic composition of atmospheric CO2during photosynthesis and biogenic respiration are related to changes in atmospheric CO2concentration. The study focused on the diurnal variability of atmospheric CO2mixing ratio and δ13C‐CO2on a seasonal basisDetermination of δ13C signature of atmospheric CO2sources using Miller‐Tans modelInvestigated the influence of transport on seasonal variability of atmospheric CO2using the Lagrangian transport model and inventory fluxes The study focused on the diurnal variability of atmospheric CO2mixing ratio and δ13C‐CO2on a seasonal basis Determination of δ13C signature of atmospheric CO2sources using Miller‐Tans model Investigated the influence of transport on seasonal variability of atmospheric CO2using the Lagrangian transport model and inventory fluxes

Background and purposeVein of Galen aneurysmal malformation (VGAM) is a rare developmental intracranial vascular malformation. We analyzed the clinical presentations, imaging findings, angioarchitecture, management options, and outcome in a demographically heterogeneous set of VGAM patients.MethodsWe retrospectively analyzed cases of VGAM from our departmental archive collected between 1988 and January 2015. Demographic, clinical, therapeutic, and follow-up details were obtained for each patient from the available records.ResultsWe identified 36 patients with VGAM including 6 neonates, 18 infants, 7 children aged 2–10 years, and 5 adults. Macrocrania was the commonest presenting feature. Type of fistulae was mural in 14 and choroidal in 18 patients while 4 had a thrombosed sac at presentation. In 3 cases the dilated venous sac had connection with the deep venous system. Bilateral jugular atresia and stenosis were seen in 9 and 6 patients, respectively. Giant venous sac (>4 cm) was significantly correlated with mural type (p=0.0001). Dural arterial recruitment was seen in 4 patients including 3 adults. Among the 23 patients treated by endovascular means, 14 had a good outcome, 5 had a poor outcome, and 4 died. A significant correlation was noted between jugular atresia and poor outcome (p=0.003).ConclusionsWe encountered a wide range of demographic, clinical, and angiographic features in VGAM. Mural type malformations were associated with giant venous sacs. Good outcome after embolization was seen in selected neonates and in most of the infants, children, and adults. Jugular atresia was significantly associated with poor outcome.

Stringent mobility restrictions across the world during the COVID 19 pandemic have impacted local economies and, consequently, city carbon budgets, offering a unique opportunity to evaluate the capability of scientific approaches to quantify emissions changes. Our study aims to quantify and map CO2emissions from fossil fuel and biogenic CO2fluxes over the Paris metropolitan area during the first lockdown period (March‐May 2020) in France, in comparison with the same period in 2019. Our inversion system relies on transport model simulations initiated with the Weather Research and Forecasting chemistry transport model combined with a high‐resolution fossil fuel CO2emissions inventory, and biogenic CO2fluxes from a vegetation model. The inversion with atmospheric observations from a network of six towers resulted in a positive re‐adjustment of fossil fuel CO2emissions in 2019 and 2020 compared to prior. In 2020, the inversion resulted in a large emission reduction (43%) compared to 2019, while the reductions were estimated to be 37% based on the prior inventory itself. By assimilating CO mixing ratios in addition to CO2, the trafficemission estimates were reduced by 68% in 2020, compared to nontraffic(29%). Various sensitivity tests show that prior emission uncertainty and different background conditions significantly impacted the emissions estimates. We conclude that our current inversion system with atmospheric CO2monitoring makes it possible to identify the emission decrease in 2020 partly over the urban region. However, additional information on prior emission errors and a dense network will be needed to map emissions precisely. The study aims to quantify the Paris region's CO2emissions using a Lagrangian‐based inversion system during the spring season (March‐May) of 2019–2020, using CO2and co‐emitted CO observations from a network of six ground‐based stations. Our Inversion system tends to increase the emissions with respect to prior in 2019 and 2020. A significant increase (about 150 g CO2m‐2 day‐1) in the fossil fuel emissions compared to prior was identified in the central Paris region across all our inversion experiments. Sectoral inversion shows an increase in the traffic emissions from the high‐resolution inventory by about 17% in 2019 and 10% in 2020. However, the impact of COVID 19 lockdown on the emissions were −37% to −46% (reduction) depending on the configuration of the inversion system. We also identified that the lack of information relative to inventory uncertainties remains a major limitation in quantifying the aggregated emissions. Precise mapping of fossil fuel emissions at the urban scale will require additional information to quantify both the high‐resolution inventory errors and their spatial structures. However, we confirmed the impact of lockdown restrictions on CO2fossil fuel emissions to −12% ({plus minus}4%) over the Paris region through inversion. Quantification and mapping of fossil fuel CO2emissions over the Paris metropolitan area during the COVID‐19 pandemic lockdownLockdown has resulted in an emission decrease of about 43% in 2020, with a 37% contribution from the inventory itselfSpatial error correlations, different background conditions and prior uncertainty impact the posterior emission estimates Quantification and mapping of fossil fuel CO2emissions over the Paris metropolitan area during the COVID‐19 pandemic lockdown Lockdown has resulted in an emission decrease of about 43% in 2020, with a 37% contribution from the inventory itself Spatial error correlations, different background conditions and prior uncertainty impact the posterior emission estimates

A novel, simple, economical reverse-phase high-performance liquid chromatography (RP-HPLC) method was developed for quantifying clopidogrel in bulk and tablet form with greater precision and accuracy. Separation was achieved on a Develosil ODS HG-5 RP C18(15cm×4.6mm, i.d. 5μm) column in isocratic mode with a mobile phase consisting of acetonitrile:phosphate (65:35) buffer (pH 2.85) with a flow rate of 1mL/min. Detection was carried out at 225nm. The retention time of clopidogrel was 7.48min. The method was validated as per the guidelines of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Linearity was established for clopidogrel in the range 10–60μg/mL, with an r2value of 0.999. The recovery of clopidogrel was 99.71–100.03%. The high recovery and low relative standard deviation confirm the suitability of the proposed method for estimating the concentrations of the drug in bulk and tablet dosage forms. Validation studies demonstrated that the proposed RP-HPLC method is simple, specific, rapid, reliable and reproducible for the determination of clopidogrel for quality control.

Introduction:Type 1 diabetes is an organ-specific autoimmune disease, characterized by selective destruction of insulin-producing pancreatic β-cells by T-cell-mediated inflammation. Beginning with studies of cyclosporin A in the 1980s, but with more activity in the past decade, there have been a number of clinical trials to test whether immunotherapies can arrest the decline in C-peptide, which is associated with progression of type 1 diabetes leading to the metabolic instability that characterizes the disease. One of the most promising agents, teplizumab, is an FcR-nonbinding anti-CD3 monoclonal antibody that has been tested in Phase II – III clinical trials and was shown to preserve the C-peptide levels and reduce the need for exogenous insulin.Areas covered:In this review, we discuss the recent update on clinical data obtained from trials of teplizumab in type 1 diabetes, the drug’s postulated mechanism of action and the identification of responders to therapy. We highlight the results of recent trials as well as the lessons that have been learned from the clinical trials involving selection of end points and the inclusion of diverse study populations.Expert opinion:Teplizumab has been shown to preserve β cell function in patients; however, it does not represent a ‘cure’ for patients, and its efficacy does entail a significant advance in arresting the progression of the disease toward complete insulin deficiency and reliance on exogenous insulin.

Purpose:To examine the clinical and gonioscopic findings in patients with glaucoma associated with Sturge–Weber syndrome.Methods:Retrospective review of clinical findings of all patients with Sturge–Weber syndrome who presented between January 1978 and December 2003. Koeppe gonioscopy was performed under general anesthesia and findings were photographed when feasible. Iris color was documented by color sketch or photograph at initial presentation. Fisher exact test was used to determine whether the presence of heterochromia was statistically higher in the glaucomatous group.Results:Fifty-five patients who met inclusion criteria were identified, of whom 44 (80%) had glaucoma. Unilateral glaucoma was diagnosed in 30 eyes and bilateral glaucoma in 14 eyes, yielding 58 eyes with glaucoma and 52 eyes without. Gonioscopic examination revealed distinct anatomic abnormalities in the anterior chamber angle in 32 (55%) of the glaucomatous eyes in contrast to the normal fellow eyes in patients with unilateral glaucoma and to the patients without glaucoma. Heterochromia iridis with darker iris on the glaucomatous side was present in 11 of the 30 patients with unilateral glaucoma (37%, Fifty-five patients who met inclusion criteria were identified, of whom 44 (80%) had glaucoma. Unilateral glaucoma was diagnosed in 30 eyes and bilateral glaucoma in 14 eyes, yielding 58 eyes with glaucoma and 52 eyes without. Gonioscopic examination revealed distinct anatomic abnormalities in the anterior chamber angle in 32 (55%) of the glaucomatous eyes in contrast to the normal fellow eyes in patients with unilateral glaucoma and to the patients without glaucoma. Heterochromia iridis with darker iris on the glaucomatous side was present in 11 of the 30 patients with unilateral glaucoma (37%, P< .001) but in none of the patients without glaucoma.Conclusion:The characteristics observed in the anterior chamber angle in this large, uniquely examined series are the first reported to the authors’ knowledge and may support a role for neural crest derived anomalies in the pathogenesis of glaucoma in these infant eyes. Careful examination for heterochromia iridis may be judicious in these patients.

To identify the incidence of and risk factors for intraocular pressure (IOP) elevation after Descemet stripping automated endothelial keratoplasty (DSAEK).

Background: A randomized double-blind placebo controlled clinical study was undertaken to investigate the safety and efficacy of a plant-based formulation (DCBT1234-Lung KR), which earlier through 2 trials was found to improve FEV"1 and the quality of life of COPD patients. Objective: The efficacy of DCBT1234-Lung KR was assessed using pulmonary function tests, arterial blood gas (ABG) analyses and the clinical symptoms of COPD in a 6-month study period against a matching placebo and a biomedical drug combination (salbutamol+theophylline+bromhexine). Methods: One hundred and five subjects aged between 35 and 85 years with a smoking history of more than 20 pack years, showing little or no improvement in FEV"1 upon a bronchial challenge of 200@mg of inhaled salbutamol and exhibiting ABG percentage of less than 85% of oxygen saturation were taken up for the study. The study had 3 arms viz., the plant-based formulation (DCBT1234-Lung KR), placebo and salbutamol (12mg/day) plus theophylline (300mg/day) plus bromhexine (24mg/day). The end point of the study was determined as an improvement of FEV"1 by 200mL and/or increased ABG values (>90% PaO"2) and clinical symptoms like dyspnoea, wheezing, cough, expectoration, disability, and sleep disturbances. Results: DCBT1234-Lung KR patients showed statistically significant (95% level) improvement in FEV"1 and PaO"2 in comparison with salbutamol+theophylline+bromhexine and placebo patients. Twenty-three per cent of DCBT1234-Lung KR patients, 19% of salbutamol+theophylline+bromhexine group and 12% of placebo group patients showed the desired 200mL improvement in FEV"1 values in comparison with the other 2 arms. Improved PaO"2 was observed in 15.4% of the DCBT1234-Lung KR patients while no improvement was seen with patients in any other arms. Symptoms like dyspnoea, wheezing, cough, expectoration, disability and sleep disturbances also significantly reduced in DCBT1234-Lung KR and the biomedical group patients, but not in the placebo arm. Conclusions: DCBT1234-Lung KR was equivalent, if not better than the present day treatment with salbutamol, theophylline and bromhexine combination in COPD patients and this was ascertained using FEV"1 and ABG values.

Haemolysis is the major cause of anaemia in acute Plasmodium falciparummalaria, destroying both parasitized and non-parasitized erythrocytes. Oxidative stress on erythrocytes is considered an important mechanism of haemolysis. Since non-parasitized erythrocytes are also destroyed, the extracellular environment of the erythrocyte may be a contributor to the oxidative stress. To examine the influence of extracellular factors on oxidative stress and haemolysis, baseline values of erythrocyte thio-barbituric acid-reactive substance (ETBAR) and haemolytic indices such as plasma haemoglobin and lactate dehydrogenase (LDH) were estimated in 19 children in Orissa (India) with acute P. falciparummalaria (haemoglobin level ?70 g/L). The indices were measured after incubating cross-matched isogroup adult control erythrocytes with patient's plasma, and patient's erythrocytes with adult control plasma both in presence of and in absence of t-butyl hydroperoxide (t-BHP). The procedure was repeated in the blood of 19 age- and sex-matched non-malarial children. Baseline plasma LDH, haemoglobin and ETBAR concentrations were significantly greater in malaria patients than non-malarial children (P< 0·001 for all). Post-incubation values of ETBAR and plasma haemoglobin were significantly higher (P< 0·05) when adult control erythrocytes were incubated with patient plasma, and plasma haemoglobin was significantly higher (P< 0·05) in incubates of patient erythrocytes with adult control plasma, than their respective pre-incubation values when incubated in absence of t-BHP. These differences were not noticed in the incubates of non-malarial children with healthy adult control samples. When incubated in presence of t-BHP all the post-incubation values in the patients were significantly higher than their respective pre-incubation values and post-incubation values without t-BHP (P< 0·001). In non-malarial control samples, only ETBAR concentration was higher than their respective pre-incubation and post-incubation values without t-BHP (P< 0·01). All the values for post-incubation samples with t-BHP were significantly higher in patients than controls (P< 0·001). In post-incubation samples of control erythrocytes and patient plasma in presence of t-BHP, ETBAR correlated inversely with pre-incubation haptoglobin values (P< 0·001). Thus, plasma of acute malaria patients appears to contain pro-oxidants, which may contribute to extracellular oxidative stress on both parasitized and non-parasitized erythrocytes.

To assess the extent of oxidative stress in erythrocytes of patients with acute Plasmodium falciparummalaria, erythrocyte thiobarbituric acid-reactive substance (ETBAR), and intracellular, membrane and extracellular antioxidants were estimated in 102 cases of P. falciparummalaria and 50 control subjects. The mean concentration of ETBAR was significantly higher (P< 0·001) and many of the antioxidants were significantly lower in patients than controls. Among the erythrocyte antioxidants, catalase, reduced glutathione (GSH) and tocopherol were significantly lower in the patients (P< 0·05, 0·001, 0·001, respectively). Erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were not reduced to a statistically significant level. Similarly, the plasma antioxidants ascorbate and albumin were significantly lower (P< 0·001) but not urate. ETBAR correlated inversely with erythrocyte GSH and tocopherol (P< 0·001), and plasma ascorbate and albumin (P< 0·001) but not with the erythrocyte enzymic antioxidants. However, on multiple regression analysis only tocopherol correlated strongly with ETBAR, followed by GSH and plasma ascorbate. ETBAR also correlated well with haemolytic indices such as haemoglobin, plasma unconjugated bilirubin and haptoglobin concentrations (P< 0·001, for all). On follow-up after 2 weeks, ETBAR and different antioxidants reached near control levels. These observations indicate an enhanced oxidative stress on erythrocytes in acute falciparum malaria that may contribute substantially to haemolysis and anaemia.

Administration of Ca2+ channel blockers in cardiac disorders and the central role of Ca 2+ in modulating neutrophil functions, prompted us to investigate whether administration of nifedipine to mice would alter their natural resistance to infectious agents like Salmonella typhimurium. Neutrophil chemiluminescence (CL) in response to S. typhimurium was significantly (p < 0.01) decreased in mice fed with nifedipine (0.015 mg/kg body weight) over a period of six months. Intracellular killing of S. typhimurium by isolated neutrophils also decreased significantly (p < 0.01) and exponentially with nifedipine administration, representing a 42% fall at six months. In addition the drug administration lowered the survival rate of animals following challenge by a lethal dose of S. typhimurium (LD50 = 1 × 104 bacteria/animal). Our data suggest that long term administration of nifedipine lowers the natural resistance of mice to S. typhimurium owing to impaired neutrophil functions.

Superoxide production by mice neutrophils was inhibited by nifedipine exposure in a dose dependent manner. The inhibition of Ca2+ uptake elicited by nifedipine did not appear to account for the observed effect as the extracellular Ca2+ enrichment and depletion did not produce a significant reversal of the inhibition. Cytosolic free Ca2+ as measured by Quin 2AM fluorescence did not show any significant change, indicating that the effect was independent of the inhibition of Ca2+ influx. In addition nifedipine caused a significant inhibition (p < 0.01) in NADPH oxidase activity. Our data indicates that nifedipine inhibits superoxide production independent of inhibiting Ca2+ inflow and supports the hypothesis that Ca2+ antagonists affect cellular functions by non Ca2+ mediated process as well.

A rapid and simple isocratic chromatographic procedure for the determination of insulin in human and rat plasma using reversed-phase (RP) high-performance liquid chromatography with an ultraviolet/visible detector is described. The method includes extraction of insulin from human and rat plasma into dichloromethane, followed by back-extraction into 0.05 N hydrochloric acid. The organic phase was evaporated under a stream of nitrogen. The aqueous phase was filtered and a 100 μl aliquot was analyzed on a RP-C18column eluted with a mobile phase consisting of a mixture of 74 vol of 0.2 M sodium sulfate anhydrous adjusted to pH 2.3 with phosphoric acid and 26 vol of acetonitrile. The flow rate was 1.2 ml/min and the wavelength was set at 214 nm. The calibration curve was linear over the range of 75–800 μIU/ml. The precision of the assay expressed as coefficients of variation was less than 6% over the entire concentration range. The recovery for insulin ranged from 79 to 81% from human and rat plasma, with coefficients of variation less than 6%. The intra- and interassay coefficients of variation were less than 5.7%. The limit of detection was 50 μIU/ml.

The chronic effects of orally administered 2-pyrrolidone acetamide (piracetam) on one-trial, passive avoidance task were studied in albino rats. The effects on the contents of norepinephrine (NE), dopamine (DA), and serotonin (5-HT) in the brain and on the levels of their metabolites both in the brain and urine were also assessed. Significant improvement was observed in the retention ability compared with saline-administered controls. The contents of NE, DA, and 5-HT and their metabolites in the brain were significantly decreased after piracetam administration. The urinary metabolite levels were also significantly decreased except total 3-methoxy-4-hydroxyphenyl glycol (MHPG). These data indicate that piracetam causes an overall decrease in the turnover of central monoamines. Thus, the results of this study implicate the involvement of NE, DA, and 5-HT systems in learning and memory processes. Piracetam did not exert any GABAergic effect as shown by the absence of change in the brain GABA levels.

The exposure of cardiac cells to OFR generated artificially, showed a marked decrease (p < 0.01) in cellular utilization of glucose alongwith a significant decrease in calcium uptake (p < 0.05). We have also provided evidence for a direct relationship of neutrophil OFR production with the extent of myocardial ischemia in patients of myocardial infarction. Our data provides evidence for implication of OFR in myocardial injury and the pivotal role played by modulators like calcium, ECGF and prostaglandins in potentiating damage to the myocardium.

A healthy 42 yr-old woman presented with a left keratitis which she had had for 3 months. No organisms could be grown by culture of corneal scrapings for bacteria and fungi, and the condition failed to respond to topical therapy. Amebic keratitis was diagnosed following corneal biopsy and cultures which grew Acanthamoebaof a species similar to, but not identical with, Acanthamoeba polyphaga. Medical treatment was continued for 6 mth. During this time the corneal infiltrate became less prominent but visual acuity remained impaired by both corneal opacity and cataract.

To report a case of Ahmed tube exposure secondary to Prokera implantation

The article presents the poem "walking glassy-eyed in the don valley at twilight," by Nalini K. Singh. First Line: throughout the green tunnel leaves whisper dirt on both sides of; Last Line: f##k it I yank my shoes out of the sucking sand and walk on.

A 63-year-old man presented with marked swelling and inability to open the left eye immediately after laparoscopic nephrectomy for a left renal mass. A diagnosis of periorbital emphysema was made, and within 3 days, the emphysema spontaneously improved. This case demonstrates that periorbital emphysema, a rare condition, can be a benign complication of laparoscopic nephrectomy.

To identify factors predicting outcome of patients admitted to intensive care (ICU) following allogeneic haematopoietic stem cell transplantation (allo-HSCT).Retrospective audit of all allo-HSCT patients requiring ICU admission.Between 2000 and 2009, 392 patients underwent allo-HSCT. Of these, 106 (27%) had 129 ICU admissions. The median age was 47 (range 16-65) with myeloablative transplant in 89 and reduced intensity in 40 patients. Respiratory failure was the main reason for admission (54.6%) followed by sepsis (41.5%).During the period of ICU admission, 29.2% demonstrated improvement in organ failures, 39.2% remained stable and 28.4% deteriorated. Sixty-seven patients (51.9%) were discharged from ICU but only 48 (37%) were subsequently discharged from the hospital (ICU). Univariate analysis identified ICU admission within 30 days post HSCT, number of organ failures at admission, progression of organ failure during ICU admission, APACHE II score at admission, steroid refractory GVHD, and requirement for inotropic support or dialysis as significant predictors for survival in ICU. Patients requiring intubation and mechanical ventilation had a poorer outcome than the group who did not (84.4% Vs 20.0%, p=0.001). Those who required only non-invasive ventilation generally had a good outcome with 84.4% surviving til ICU discharge. While bacterial infection prior to ICU admission did not alter the outcome (p=0.221), the onset of a new infection in ICU was associated with a poor outcome (p=0.0001). Logistic regression analysis identified steroid refractory GvHD (P=0.027; 95% CI of 1.17-14.8), APACHE II score > 30 (p=0.003; 95% CI 1.5-10.5), admission <30 days post HSCT (p = 0.015; 95% CI 0.12-0.8), requirement of invasive ventilatory support (p = 0.005, 95% CI 2.58 – 223.83) and dialysis (p = 0.011; 95%CI 1.401 – 13.20) as significant factors for a poor outcome.More than 50% of patients admitted to ICU following allogeneic HSCT survive. A high APACHE II score, steroid refractory GVHD, admission into ICU within 30 days of HSCT, multiorgan failure, progression of organ failure during ICU stay, and the need for ventilation or dialysis, carries a dismal prognosis. Identification of risk factors associated with a poor outcome will assist in clinical management and may ultimately improve the outcome of patients requiring ICU admission following allogeneic HSCT.No relevant conflicts of interest to declare.

Flow cytometric analysis of eosin-5′-maleimide-labeled red blood cells has been proposed as a method of identifying hereditary spherocytosis (HS). The flow cytometric test measures the fluorescence intensity of intact red cells labelled with the dye eosin-5-maleimide (EMA), which reacts covalently with Lys-430 on the first extra cellular loop of band 3 protein. Patients with HS have reduced fluorescence compared to other patient groups and normal controls. The aim of the present study was to assess the utility of flow cytometry in the diagnosis of hereditary spherocytosis. Fresh peripheral blood from 40 normal controls was collected in Lithium Heparin, stained with the dye EMA and analysed by flow cytometry. The normal range was established as 55–74 channel numbers. On 7 known cases of Hereditary Spherocytosis the MFI range was 35.6–44.6 channel numbers, and therefore samples falling into this range were considered to be positive for a diagnosis of HS by EMA. Equivocal results were defined when the MFI was in the range of 45–54 channel numbers. A total of 98 samples were sent for investigation or exclusion of HS. Clinical problems were grouped into the following categories: peripheral blood spherocytosis with negative Coomb’s test and no family history of HS, positive family history of HS, Neonatal hyperbilirubinaemia, haemolytic anaemia of unknown origin. Indications Coomb’s −ve, Spherocytosis, no FH (n=50) (51%) Positive family history (FH) (n=18) (17%) Neonatal hyperbilirubinemia (NNH) (n=8) (8%) Haemolytic anaemia (HA) (n=16) (17%) Results of EMA Pos Neg Equi Pos Neg Equi Pos Neg Equi Pos Neg Equi Number 19 17 13 9 7 2 2 4 2 0 14 2 Percentage 38 34 26 50 39 11 25 50 25 0 87.5 12.5 Within this cohort the group with FH of HS had the highest positive and least equivocal results. The group with suspected HS (peripheral blood spherocytosis with negative coomb’s test) resulted in positive in 38% and equivocal in 26% cases. The group with NNH had positive results in 25% of cases and the group with HA had no positive results. Equivocal results occurred in 20% of cases suggesting further investigations are required to confirm or exclude HS. The EMA dye method by flow cytometry is a useful test for diagnosing red cell membrane abnormalities due to band 3 defects, but the assay produces a substantial number of equivocal results, and has poor utility in the investigation of haemolytic anaemia of unknown origin.

Background: Bone marrow (BM) has been utilized as a source of stem cells for transplantation for many years. Although the use of BM has decreased with the advent of mobilized stem cells, utilization is increasing once again due to the lower rate of chronic GVHD associated with BM as a stem cell source. There is no generally accepted technique for harvesting BM. Protocols vary both in relation to the volume of each aspirate, the number of aspirates performed at each puncture site and the total volume of harvests. Method: BM was collected from the posterior iliac crests (PIC) in 2 separate bags: 10ml aspirates from the left and 20 ml aspirates from the right. Samples taken at the start and after 100, 150, 200, 250, & 500 ml were analyzed for TNC, CD34+ and CD3+ cell counts. Results: The following table shows cell number (mean ± SEM ×106) for the parameters indicated. Aspirate Volume (mls) Parameter Start (n=4) 100mls (2) 150mls (2) 200mls (2) 250mls (4) 500mls (4) 10 TNC 555 ± 28 286 ± 38 257 ± 40 226 ± 8 199 ± 11 158.5±18.5 CD34 5.8 ± 0.05 1.8 ± 0.1 1.7 ± 0.2 1.3 ± 0.4 1.1 ± 0.2 0.8 ± 0.1 CD3 65.8 ± 12.0 35.8 ± 6.9 32.8 ± 8.0 29.9 ± 1.5 28.4 ± 5.1 29.8 ± 6.2 20 TNC 914 ± 52 627 ± 137 458 ± 44 429 ± 113 391 ± 81 264 ± 24 CD34 9.1 ± 0.5 3.8 ± 0.2 2.4 ±0.2 2.7 ± 0.1 2.3 ± 0.7 1.0 ± 0.2 CD3 106.9 ±22.1 64.6 ± 5.3 55.0±14.1 56.5±14.7 53.7±14.6 41.2 ± 9.6 There is a rapid fall in the yield of CD34+ cells obtained with increasing harvest volume (19 and 25% of the initial number after 250 ml for 10 and 20 ml aspirates respectively; 14 and 11% respectively after 500 ml). In contrast the CD3+ cell numbers fall more slowly (43 and 50% after 250 ml, 45 and 38% after 500 ml). By the time 500 ml has been aspirated, there is no difference in the total number of CD34+ cells obtained from a 10 ml versus a 20 ml aspirate of bone marrow. Conclusion: CD34+ cell yields fall rapidly when BM is harvested along the PIC. Using additional areas such as the anterior iliac crests may be preferable to a large volume PIC harvest for optimizing CD34+ stem cell collection. After 500 ml of BM has been harvested, 20 ml BM aspirates do not increase CD34+ cell numbers and 10 ml aspirates should be taken to minimize unnecessary blood loss and reduce T cell contamination.

INTRODUCTION: In many centers an initial period of induction treatment followed by peripheral blood stem cell (PBSC) harvest and autologous stem cell transplantation (ASCT) has become standard of care for multiple myeloma (MM) in patients =< 65 years of age. Commonly induction regimens contain intravenous cytotoxic agents and oral corticosteroids. There are interests in oral regimens, including thalidomide-containing combinations (1). Recently Spencer et al from Australia reported a small multicenter study in which the induction treatment prior to ASCT comprised an outpatient-based oral chemotherapeutic regimen CID-- cyclophosphamide, idarubicin, dexamethasone, in previously untreated MM patients (2). AIM: To evaluate the efficacy of oral CID in MM in our own institution. METHODS: thirteen patients with MM (relapsed n=2, previously untreated n=11) were treated with CID. Courses were repeated every four weeks, with the aim of harvesting PBSC after 3 to 6 courses, depending on response. Efficacy of treatment was assessed on the following parameters: paraprotein level, b2 microglubulin and bone marrow plasma cell content. Wilcoxon Signed Ranks Test was used to analyze treatment outcomes and Kaplan-Meier curves were used for analysis of overall survival and event free survival. RESULTS: All 13 patients (median age 61 yrs, range-41–72 yrs; male-7, female-6) were evaluable for response, with a median follow up of 40 (12–84) weeks. In total, eleven patients (10 previously untreated, and one relapsed) were planned to have an elective ASCT. All had successful stem cell mobilization after 3–6 cycles of chemotherapy, and subsequently received an ASCT. One patient died 42 days post transplantation due to infection and ARDS. The median time between completion of CID and ABMT was 6 weeks (range 4–16). One previously untreated patient and one relapsed patient, both aged >65, received CID only without an ASCT. Comparison of pre and post chemotherapy levels of paraprotein, b2 microglubulin and bone marrow plasma cell content showed statistically significant results with p values of 0.002, 0.001 and 0.002 respectively. According to International standard criteria, 3/13 achieved complete response (CR), 7/13 had very good partial response (VGPR) or partial response (PR), 1/13 stable disease (SD) and 2/13 had relapse or progressive disease (PD), resulting in an overall response rate (>/=SD) of 84%. The median time to maximum response was 4 months. The Kaplan-Meier estimates of event-free survival and overall survival at 1 year were 64% and 84%, respectively. There were no major toxicities except weight gain (National Cancer Institute Common Toxicity Criteria Grade III) was seen in 23% of the patients, possibly due to the dexamethasone component in CID. CONCLUSIONS: Our results confirm the efficacy and safety of this outpatient based all oral induction regimen for patients with MM. The favorable side effect profile, the convenience of drug delivery with oral dosing, and the ease of PBSC mobilisation are the main advantages.

In spite of the recent development of many rapid methods of diagnosing viral and mycoplasmal disease, serology still remains an important diagnostic tool, being the only method readily available in many laboratories. The serological response to most viral and mycoplasmal infections is such that at least a few days must elapse before it can be detected even by the most sensitive tests presently available.