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Novel 6-arylethyl-1,2,4-trioxanes6a-i and 7a-i are easily accessible in one step from the diimide reduction of 6-arylvinyl-1,2,4-trioxanes 5a-i. All of these new trioxanes were assessed for their oral antimalarial activity against multidrug-resistant Plasmodium yoelii nigeriensis in a Swiss mice model. Most of the saturated trioxanes 6c, 6f, 6g, 6h, and 6i, the active compounds of the series, provided 100% protection to the malaria-infected mice at a dose of 24 mg/kg × 4 days. Further, trioxane 6i, the most active compound of the series, also showed 100% protection even at a dose of 12 mg/kg × 4 days and 20% protection at a dose of 6 mg/kg × 4 days. In this model, β-arteether provided 100% protection at a dose of 48 mg/kg × 4 days and only 20% protection at a dose of 24 mg/kg × 4 days via the oral route, which was found to exhibit 4-fold antimalarial activity compared with the currently used drug β-arteether.

Present investigation was made to evaluate effect of PGRs on shoot and root length of Fagopyrum esculentum. Results revealed that there was increase in shoot length by GA at 100 mg l-1 and root length by IAA at 50 mg l-1 at 30, 60 and 90 days of plant growth. ABA at 25 mg l-1 and 100 mg l-1 decreased shoot length as well root length. BAP at 100 mg l-1 also decreased root length. In combinations, IAA+GA 100 mg l-1 treatment enhanced shoot length as well as root length. Decrease in shoot length was observed in IAA+ABA, ABA+BAP (50 and 100 mg l-1) and root length by ABA+BAP (100 mg l-1) treatment.

Introduction: Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality in India as well as worldwide. CT angiography is an excellent imaging modality for evaluation of CAD. Previous studies with 64 or lesser slice CT scanner have failed to show consistent and optimal Image Quality (IQ) at Heart Rate (HR) more than 70 bpm and required beta blockers. Aim: To evaluate the diagnostic accuracy of 256-slice Dual Source CT Angiography (DSCTA) in comparison with Catheter Coronary Angiography (CCA) in evaluation of Coronary Arteries (CA) in patients with clinical suspicion of CAD and to study its effectiveness at higher HR without using beta blockers. Materials and Methods: This cross-sectional study was conducted on patients (n=46) with suspected CAD using ECG triggered 256-slice Dual Source Computed Tomography (DSCT) over a period of nine months. Patients were sub grouped according to HR (Group I: 50-70 (18 patients), Group II: 71-90 (24 patients) and Group III ≥91 (8 patients). A total of 48% patients had HR of 71-90 bpm while 16% had HR ≥91 bpm. Scan protocols included prospective ECG triggering (HR 75 bpm). CA segments were analysed for IQ on a 4 point scale (1 is worst while 4 is best) by two independent readers who were blinded to the patient details. Accuracy to detect significant luminal stenosis was correlated with CCA (gold standard). Statistical significance of the study was established by Chi-square test (p

Here we present a rare case of spontaneous pneumomediastinum complicated with pneumorrhachis (PR) in a young man who is a known case of carcinoma rectosigmoid region. Our young male was diagnosed with novel coronavirus disease 2019 (COVID-19) and remained asymptomatic for any respiratory complaints. Though an association of pneumomediastinum has been reported in COVID 19 patients, to the best of our knowledge, this is the first report of PR in a COVID-19 oncological case. The role of a radiologist is to identify this condition as cases reported earlier may have serious neurological consequences. Pursuing the cause can be a diagnostic challenge but it reaps the clinical benefit in the appropriate management.

The aim of current study is to provide a significant traditional knowledge on wild medicines used for ethnoveterinary purposes in the rural area of Maraog region in district Shimla. The medicinal plants have played a significant role in the treatment of human as well as animal’s diseases. The rural people of the Maraog region were interviewed through a questionnaire and extensive field surveys were conducted from June 2020 to July 2021. The discussion, observations and interviews were conducted in study site and included 96 informants. The information gathered from the residents is presented in a table format and includes scientific and local names, different parts used, diseases treated and mode administration. The most commonly used taxa are calculated with used value. The study revealed 100 plants in which trees (7), shrubs (26), herbs (56), ferns (5), grasses (3) and climbers (3) were identified. The most commonly documented livestock diseases were found to be hoof infections, eyes infections, poisoning and skin infections. In the current study, the Rosaceae family was reported as being the highest number (11), followed by Asteraceae (10) and then Lamiaceae (6). It was found that leaves, roots, flowers and fruits are the commonly used parts for ethnoveterinary medications. The phytochemicals present in the plant, such as alkaloids, sterols, glycosides, flavonoids, lignin, coumarins and terpenoids, etc., may be responsible for their medicinal properties. In this documentation, it was observed that the younger generation does not have good knowledge of medicinal plants as compared to the older ones. Therefore, it is necessary to preserve the traditional knowledge of these medicinal plants before their permanent loss. The documentation and conservation of medicinal plants can be a good start for novel phytopharmacological research in the veterinary field.

Objectives: To explore the potential of Radiomics alone and in combination with a diffusion-weighted derived quantitative parameter, namely the apparent diffusion co-efficient (ADC), using supervised classification algorithms in the prediction of outcomes and prognosis. Materials and Methods: Retrospective evaluation of the imaging was conducted for a study cohort of uterine cervical cancer, candidates for radical treatment with chemo radiation. ADC values were calculated from the darkest part of the tumor, both before (labeled preADC) and post treatment (labeled postADC) with chemo radiation. Post extraction of 851 Radiomics features and feature selection analysis—by taking the union of the features that had Pearson correlation &gt, 0.35 for recurrence, &gt, 0.49 for lymph node and &gt, 0.40 for metastasis—was performed to predict clinical outcomes. Results: The study enrolled 52 patients who presented with variable FIGO stages in the age range of 28–79 (Median = 53 years) with a median follow-up of 26.5 months (range: 7–76 months). Disease recurrence occurred in 12 patients (23%). Metastasis occurred in 15 patients (28%). A model generated with 24 radiomics features and preADC using a monotone multi-layer perceptron neural network to predict the recurrence yields an AUC of 0.80 and a Kappa value of 0.55 and shows that the addition of radiomics features to ADC values improves the statistical metrics by approximately 40% for AUC and approximately 223% for Kappa. Similarly, the neural network model for prediction of metastasis returns an AUC value of 0.84 and a Kappa value of 0.65, thus exceeding performance expectations by approximately 25% for AUC and approximately 140% for Kappa. There was a significant input of GLSZM features (SALGLE and LGLZE) and GLDM features (SDLGLE and DE) in correlation with clinical outcomes of recurrence and metastasis. Conclusions: The study is an effort to bridge the unmet need of translational predictive biomarkers in the stratification of uterine cervical cancer patients based on prognosis.

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients suspected to have or having Crohn’s disease. The 29 consensus statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

Ethnomedicinal plants have a significant role in the lives of people of rural and tribal areas. Thousands of medicinal plant species are used to treat various diseases, including jaundice, and are considered an important therapeutic resource to minimize these diseases. Jaundice (icterus) is a chronic disease that occurs when the amount of bilirubin in the blood increases. This review describes different ethnomedicinal plants used for curing jaundice by tribal and rural people of Himachal Pradesh. The study reveals 87 ethnomedicinal plant species belonging to 51 different families, which are used for treating jaundice in Himachal Pradesh. These plants are arranged in a systematic way, which includes a description of their common name, botanical name, along with its family, plant parts used, region, and mode of use in tabulated form. Some of the plant extracts have already been explored for their phytochemical and pharmacological significance and proved their potential in the preparation of new medicines or drugs against the treatment of jaundice. This review is an attempt to highlight the indigenous knowledge of medicinal plants, which are specifically used for the treatment of jaundice. The data mentioned in the present review is compiled from various sources like existing literature, books, Google Scholar, and Scopus publications. Among all the observed plant species, most used medicinal plants for the treatment of jaundice include Justicia adhatoda, Emblica officinalis, Ricinus communis, Saccharum officinarum, Terminalia chebula, Berberis aristata, Cuscuta reflexa, and Tinospora cordifolia. Plants that are mostly utilized for the treatment of jaundice need to be scientifically validated by pharmacological analysis and should be subsequently used for the preparation of new drugs, which may prove far more beneficial than the existing one.

Extra-axial cavernous sinus haemangioma are rare extra-axial parasellar lesions. These are non-neoplastic lesions, but can behave in a manner like that of neoplastic lesions as their slow growth with progressive enlargement of thin-walled vascular channels may result in extrinsic compression on adjacent retro-orbital neural structures. It is important to diagnose these lesions preoperatively as surgery in these lesions is often complicated by incomplete removal, severe intraoperative haemorrhage and significant operative morbidity and mortality. A parasellar lesion showing homogeneous markedly increased signal on T2 or proton density weighted images with progressive centripetal “filling-in” with contrast on dynamic Magnetic Resonance Imaging (MRI) should suggest the diagnosis. We are presenting three interesting cases of cavernous sinus haemangioma.

Aging is a complicated biological process in which functional and structural alterations in a living organism take place over time. Reactive oxygen species is one of the main factors responsible for aging and is associated with several chronic pathologies. The relationship between aging and diet is quite interesting and has attained worldwide attention. Healthy food, in addition to dietary antioxidants, are required to delay the process of aging and improve the quality of life. Many healthy foods such as fruits are a good source of dietary nutrients and natural bioactive compounds which have antioxidant properties and are involved in preventing aging and other age-related disorders. Health benefits linked with healthy consumption of fruit have drawn increased interest. A significant number of studies have documented the advantages of fruit intake, as it suppresses free-radical development that further reduces the oxidative stress created in the body and protects against several types of diseases such as cancer, type 2 diabetes, inflammatory disorders, and other cardiovascular diseases that ultimately prevent aging. In addition, fruits have numerous other properties like anti-inflammatory, anti-cancerous, anti-diabetic, neuroprotective, and have health-promoting effects. Mechanisms of various bioactive compounds that aids in preventing various diseases and increases longevity are also described. This manuscript provides a summary of various bioactive components present in fruits along with their health-promoting and antiaging properties.

We aimed to interpret MR mammography (MRM) using the Kaiser scores for equivocal or inconclusive lesions on mammography (MG).Retrospective IRB-approved evaluation of 3623 MG for which MRM was deployed as a problem-solving tool, after inclusion-exclusion criteria were met. Three readers with different levels of experience assigned a final score from 1 to 11 based on the previously established tree classification system. Area under the curve (AUC) derived from receiver operating characteristic (ROC) analysis was used to determine the overall diagnostic performance for all lesions and separately for mass and non-mass enhancement. Sensitivity, specificity, and likelihood ratio values were obtained at different cut-off values of4,5, and8 to rule in and rule out malignancy.Histopathology of 183 mass and 133 non-mass enhancement (NME) lesions show benign etiology in 95 and malignant in 221. The AUC was 0.796 [0.851 for mass and 0.715 for NME]. Applying the Kaiser score upgraded 202 lesions with correct prediction in 77 %, and downgraded 28 lesions with correct prediction in 60.8 %. Using a score5 instead of4 to rule out malignancy improved our diagnostic ability to correctly identify 100 % benign lesions. Applying Kaiser score correctly downgraded 60.8 % (17/28) lesions; thus avoiding biopsies in these. Using a high cut-off value8 to rule-in malignancy, we correctly identified 59.7 % of lesions with 80 % specificity and positive likelihood ratio of 3.The Kaiser score has clinical translation benefits when used as a problem-solving tool for inconclusive MG findings.

The present study was carried out in Himachal Pradesh of the Western Himalayas, India to obtain information on the wild edible plants used by the migratory shepherds. The shepherds started their migration in July from Chitkul, Rakchham, Batseri, Sangla and Kamru of district Kinnaur (Himachal Pradesh). Questionnaire for the survey, personal field visits and participatory observations were used to collect information about the use of various plants by the migratory shepherds. The shepherds move in a group of 5 to 6 comprising their own family members and size of the flock (of sheep and goats) varied from 654 to 990. The migration route followed from their villages to Churdhar ranges (mid hills) and to Sirmour ranges (low hills). It was observed that in all 50 species were used by shepherds enroute from high hills to low hills. In high hills, 23 species, in mid hills 31 species and in low hills 34 species were found to be used as livelihood source. Some of the plants, besides being used as fruits and vegetables, are also used as herbal tea (bark of Betula utilis) and condiments. Morchella esculenta was found to be one of the delicacies used for food in their tribe. The documentation of plant resources and the indigenous knowledge of shepherds highlighted in the present study is a step in raising awareness about the importance of these edible plants and their further conservation. Key words: Edible plants, sheep, goats, shepherds, seasonal migration, Himachal Pradesh.

A series of short chain 4-aminoquinoline-imidazole derivatives have been synthesized in one pot two step multicomponent reaction using van leusen standard protocol. The diethylamine function of chloroquine is replaced by substituted imidazole derivatives containing tertiary terminal nitrogen. All the synthesized compounds were screened against the chloroquine sensitive (3D7) and chloroquine resistant (K1) strains of Plasmodium falciparum. Some of the compounds (6, 8, 9 and 17) in the series exhibited comparable activity to CQ against K1 strain of P. falciparum. All the compounds displayed resistance factor between 0.09 and 4.57 as against 51 for CQ. Further, these analogues were found to form a strong complex with hematin and inhibit the β-hematin formation, therefore these compounds act via heme polymerization target.

Segmental dilatation of ileum (SDI) is a less known uncommon entity with a confusing clinical scenario and no definite etiopathogenesis. The preoperative diagnosis is of exclusion. However, it has an excellent prognosis after surgery. We describe a case of a young patient who presented with anemia without any overt gastrointestinal (GI) bleed. Thorough radiological examinations were needed to reach the diagnosis of SDI which was confirmed postoperatively.

Gastric duplication cysts are rare and mostly present in the first year of life. In adulthood presentation is in the form of obstruction, ulceration, bleeding, fistulization etc. Malignancy is extremely rare with only 12 cases reported to date. We came across a gastric duplication cyst with papillary adenocarcinoma in a 63 year old man. He underwent cyst excision with radical subtotal gastrectomy. The awareness of such a condition made it possible for us to have a suspicion of malignancy preoperatively based on imaging and thus a radical surgery was performed. High index of suspicion is necessary to diagnose this condition preoperatively on CT scan. Literature review revealed that this is the first case to be reported from India.

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

A survey of wild edible plants of Gaddi tribes of Himachal Pradesh was carried out in Chamba and Kangra districts of Himachal Pradesh located in Western Himalayas. The inhabitants subsisted primarily on pastoralism and agriculture and have traditional knowledge on wild edible plants. A total of 49 edible plants belonging to 24 families were recorded in the study area. These were commonly used as vegetables, fruits, spices, and chutney. Nearly half of the species belong to Polygonaceae and Rosaceae families. Herbs, shrubs, climbers, and trees form the habit of these plants. The highest proportion of edible species were herbs (29) followed by trees (10), shrubs (8), climber (1), and Morchella esculenta (fungi) (1).

Context: Pancreatic masses are routinely encountered on imaging and often present as a diagnostic dilemma. These masses range from benign inflammatory masses, requiring no intervention to malignant masses, which carry grave prognosis and hence require aggressive management. Aims: Compare the diagnostic accuracy of 256 multislice CT and endoscopic ultrasound (EUS) in characterization and assessment of resectability of pancreatic masses and compare the multidetector computed tomography (MDCT) and EUS findings with histopathological findings. Settings and Design: Prospective study. Subjects and Methods: 36 patients with pancreatic masses were included who underwent dual phase CT using pancreatic protocol and EUS using 5–13 MHz transducer. Fine needle aspiration cytology (FNAC) was done wherever feasible. Parameters regarding tumor size, location, imaging morphology, and vessel involvement were recorded. Findings were compared with histopathological/operative diagnosis/clinical follow-up. Statistical Analysis Used: Descriptive statistics with percentages and proportions and Chi-square test. Results: Multidetector computed tomography (MDCT) and EUS established diagnosis consistent with tissue diagnosis in 30 (83%) and 22 (61%) patients, respectively. However, the best results were obtained with the combined use of MDCT and EUS. The number of patients categorized as inconclusive by MDCT were lower compared to EUS. Assessing resectability for pancreatic adenocarcinoma, MDCT showed specificity and positive predictive value (PPV) of 100% compared to EUS, which had specificity and PPV of 75% and 92.3%, respectively. MDCT is the first-line imaging modality in detection, characterization of pancreatic masses, and assessment of resectability in malignant neoplasms. EUS is beneficial in the detection of masses

In a focused exploration, we designed, synthesized, and biologically evaluated chiral conjugated new chloroquine (CQ) analogues with substituted piperazines as antimalarial agents. In vitro as well as in vivo studies revealed that compound 7c showed potent activity (in vitro 50% inhibitory concentration, 56.98 nM for strain 3D7 and 97.76 nM for strain K1; selectivity index in vivo [up to at a dose of 12.5 mg/kg of body weight], 3,510) as a new lead antimalarial agent. Other compounds (compounds 6b, 6d, 7d, 7h, 8c, 8d, 9a, and 9c) also showed moderate activity against a CQ-sensitive strain (3D7) and superior activity against a CQ-resistant strain (K1) of Plasmodium falciparum. Furthermore, we carried out docking and three-dimensional quantitative structure-activity relationship (3D-QSAR) studies of all in-house data sets (168 molecules) of chiral CQ analogues to explain the structure-activity relationships (SAR). Our new findings specify the significance of the H-bond interaction with the side chain of heme for biological activity. In addition, the 3D-QSAR study against the 3D7 strain indicated the favorable and unfavorable sites of CQ analogues for incorporating steric, hydrophobic, and electropositive groups to improve the antimalarial activity.

In the present study we have synthesized a new class of 4-aminoquinoline derivatives via replacement of the diethylamine functionality of chloroquine (CQ) with acyclic and/or cyclic amine groups containing basic tertiary terminal nitrogen and bioevaluated them for antimalarial activity against Plasmodium falciparum in vitro (CQ-sensitive strain-3D7 & CQ-resistant strain-K1) and Plasmodium yoelii in vivo (N-67 strain). Among the series, thirteen compounds showed superior antimalarial activity against K1 strain as compared to CQ. In addition, all these analogs showed 100% suppression of parasitaemia on day 4 in the in vivo mouse model against N-67 strain when administered orally. Further, biophysical studies suggest that these compounds act on the heme polymerization target.

A field experiment was conducted at Indira Gandhi Agricultural University, Raipur Chattisgarh India to evaluate the growth and yield of wheat varieties under Ceiba pentandra (L.) Gaertn based on agrisilviculture system. The experiment consisted of 76 treatments combination of three tree spacing treatments (4×4m, 4×6m and 4×8m), four wheat varieties ( Sujata, GW-173, GW-273 and HD-2004) , two pruning regime, three distances (0.5 to 1.0 m, 1.0 to 3.0 m and >3.0 m) and four control plots (for each wheat variety). The experiment was laid out in a factorial randomized block design and it was replicated four times. After 9 years, Growth parameter of Ceiba tree stands revealed that the tree height, diameter at breast height, crown width and length, Number of pod tree -1 , Pod length, seed and floss yield decreased numerically from the lower tree density to higher density. Growth and yields were significantly higher in sole wheat than in wheat grown with C. pentandra. Shoot length in wheat decreased by 4.5-17.1%, while root length decreased by 29.8-35.9% at 60 days after sowing. The leaf area index of wheat did no t exhibit any significant variation, but photo synthetically active radiation (PAR) interception was significantly higher in sole wheat and wheat intercrops under 4×8m spacing. The grain yield ranged from 24.0 to 29.1q/ha, Grain yield was highest in HD-2004 variety. The order of yield reduction in different verities was HD-2004 (34.5 %)>GW-173 (17.6 %)> Sujata (14.5%) when compared with HD-2004 variety. Higher grain yield (28.7 q/ha) was obtained in 4x8m tree spacing , while in other two tree spacings the grain yield was ( 25.40 q/ha) in 4x6m and (24.90 q/ha ) 4x4m spaicng. Growth parameters and Grain yield also varied with distance from the tree base.

As part of Drugs for Neglected Diseases initiative's lead optimization program for the development of new chemical entities to treat visceral leishmaniasis (VL), a series of aminothiazoles were synthesized and screened for in vitro efficacy, solubility and microsomal stability. The primary aim of identifying a lead structure with sub-micromolar activity was achieved. Out of 43 compounds synthesized, 16 compounds showed in vitro activity at less than 1 μM against VL. Compound 32 showed excellent antileishmanial potency (IC50 = 3 nM) and had all the acceptable properties except for metabolic instability. Blocking the metabolic soft spots in compound 32, where the 4-methoxy pyridine substituent was replaced by 5-ethoxy group, led to compound 36 (IC50 = 280 nM) with improved stability. To understand the disposition of 36, in vivo pharmacokinetic study was conducted in a mouse model. Compound 36 showed high clearance (91 mL/min/kg); short half-life (0.48 h) after intravenous administration (1 mg/kg) and exposure (AUC0-24) following oral administration was 362 ng h/mL with absolute bioavailability of 8%. To summarize, 43 analogs were synthesized out of which 15 compounds showed very potent sub-nanomolar efficacy in in vitro systems but the liability of metabolic instability seemed to be the major challenge for this chemical class and remains to be addressed.

The choledochal cysts, which refer to the cystic dilatation of the biliary duct, are rare lesions generally seen in children. Choledochal cyst of the cystic duct is an uncommon entity. Often, it is associated with the choledochal cyst of the rest of the biliary tree. Isolated cystic duct choledochal cyst is quite rare. Most of these lesions have been recognized only on surgery. Modern cross-sectional imaging methods have facilitated preoperative recognition and characterization of cystic duct cyst enabling formulation of appropriate management strategy. We report the imaging findings in three cases of choledochal cyst involving the cystic duct. All these cases were correctly diagnosed preoperatively. A review of cases reported in the literature and the role of imaging in guiding the management are also presented.

Malaria parasite resides within the host red blood cells, where it degrades vast amount of haemoglobin. During haemoglobin degradation, toxic free heme is liberated which subsequently gets converted into hemozoin. This process is facilitated by action of various proteins viz. heme detoxification protein (HDP), and histidine rich proteins II and III (HRP II & III). Out of these, HDP is the most potent in hemozoin formation and plays indispensible role for parasite survival. Despite this, the detailed study of HDP from rodent and simian parasite has not been performed till date. Here, we have cloned and sequenced hdp gene from different malaria parasites Plasmodium vinckei, Plasmodium yoelii, Plasmodium knowlesi, and Plasmodium cynomolgi. Furthermore, HDP from P. vinckei (PvHDP) was over-expressed and purified for detailed characterization. The PvHDP is cytosolic, expressed throughout the intra erythrocytic stages and its expression is higher in late trophozoite and schizont stages of parasite. The PvHDP interacts with free heme (KD = 89 nM) and efficiently converts heme into hemozoin in a time and concentration dependent manner. Moreover, PvHDP showed activity in acidic pH and over a broad range of temperature. Histidine modification of PvHDP using DEPC showed reduction in heme binding and hemozoin formation, thus emphasizing the importance of histidine residues in heme binding and subsequent hemozoin production. Furthermore, applicability of PvHDP to screen anti-plasmodial agents (targeting heme to hemozoin conversion) was also determined using chloroquine, and mefloquine as reference antimalarials. Results showed that these drugs inhibit heme polymerization effectively in a concentration dependent manner. In conclusion, our study identified and biochemically characterized HDP from rodent malaria parasite P. vinckei and this will help to develop a high throughput assay to evaluate new antimalarials targeting hemozoin pathway.

Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a syndrome mimicking diverse clinical and radiological conditions. Pathologically there is altered cerebral vascular tone without histological evidence of active inflammation or vasculitis. Most common clinical presentation is hyper acute thunderclap headache with or without neurological deficit. It poses a great diagnostic dilemma; however knowledge of symptoms and radiological manifestations can help in accurate diagnosis and treatment.

Aneurysm of sinus of valsalva is a rare disorder. Rupture of sinus of valsalva into the right atria, right ventricle and the left ventricle is more commonly seen. Dissection of sinus of valsalve into the interventricular septum is rare, moreover right ventricular outflow tract obstruction due to it is still rarer. We present a case of ruptured sinus of valsalva aneurysm into the interventricular septum causing right ventricular outflow tract obstruction presenting with heart block.

Aortopulmonary window is a rare congenital communication between ascending aorta and main pulmonary artery. The condition carries poor prognosis in absence of early corrective surgery. Few case reports exist in literature where adult survival is seen in untreated patients. We present such a case of a 27-year-old male who had developed irreversible pulmonary hypertension secondary to aortopulmonary window and is thus being managed medically.

Osteochondroma is the most common benign skeletal tumour. It frequently causes pain and local symptoms, however, vascular complications are rare. The popliteal artery is more commonly affected and there are isolated case reports of popliteal artery pseudoaneurysm in literature. However, venous complications are extremely rare. We hereby report a case of 21-year-old male patient with distal femoral osteochondroma complicated by a popliteal venous aneurysm and deep vein thrombosis. This association has not been described in the past. The patient was put on anticoagulants as he refused surgery and was asymptomatic at six months follow-up. Awareness of this complication is important for timely diagnosis and surgical management as it is a source of life threatening pulmonary thromboembolism.

In the present study we have synthesized a new class of 4-aminoquinolines and evaluated against Plasmodium falciparum in vitro (3D7-sensitive strain & K1-resistant strain) and Plasmodium yoelii in vivo (N-67 strain). Among the series, eleven compounds (5, 6, 7, 8, 9, 11, 12, 13, 14, 15 and 21) showed superior antimalarial activity against K1 strain as compared to CQ. In addition, all these analogues showed 100% suppression of parasitemia on day 4 in the in vivo mouse model against N-67 strain when administered orally. Further, biophysical studies suggest that this series of compounds act on heme polymerization target.

We report an interesting case of coronary cameral fistula with associated aneurysmal dilatation of coronary artery. The complete evaluation including anatomical relationships with surrounding vascular and non-vascular structures can be achieved with ECG gated multi-detector computed tomography (MDCT). MDCT has many advantages over echocardiography and digital subtraction catheter angiography, because of its ability to demonstrate the fistula separate from surrounding cardiovascular structures along with any aneurysm or obstruction in its course. Thus, MDCT is emerging as the initial non-invasive imaging technique for comprehensive preoperative evaluation of these rare congenital anomalies for cardiovascular surgeons to achieve better operative assessibity and outcome.

Current guidelines for gastroduodenal tuberculosis suggest that surgery in conjunction with anti-tubercular therapy (ATT) is the primary therapy. We determined the efficacy of endoscopic balloon dilatation along with ATT as the primary treatment for this condition. Patients with gastric outlet obstruction at endoscopy seen over a two-year period underwent multiple biopsies from the involved area. Those in whom mucosal biopsy revealed non-specific inflammation, underwent endoscopic mucosal resection (EMR). Patients showing granulomatous inflammation with/without acid-fast bacilli (AFB) underwent endoscopic balloon dilatation under fluoroscopic guidance along with ATT. End point of dilatation was taken as dilatation with 18 mm balloon. The time taken to resume normal diet post endotherapy was determined. Thirteen patients were diagnosed to have gastroduodenal tuberculosis. Granulomatous inflammation with or without demonstration of AFB was documented in 92 % of the patients by endoscopic biopsy and EMR. Endoscopic balloon dilatation of the strictures was successful in 11/12 patients (92 %); these patients could resume their normal diet at a median of 11 days (range 7-60) post-dilatation. Retroperitoneal perforation in 1 patient was managed conservatively. Endoscopic therapy in combination with ATT is recommended as the first line therapy for gastroduodenal tuberculosis. Surgical intervention is reserved for the minority in whom endoscopic therapy fails.

The present study describes the synthesis of a series of new 4-aminoquinoline-derived thiazolidines and evaluation of their antimalarial activity against a NF-54 strain of Plasmodium falciparum in vitro and N-67 strain of Plasmodium yoelii in vivo. Among the series, two compounds, 2-(4-chloro-phenyl)-thiazolidine-4-carboxylic acid [2-(7-chloro-quinolin-4-ylamino)-ethyl]-amide hydrochloride (14) and 2-(2,6-dichloro-phenyl)-thiazolidine-4-carboxylic acid [2-(7-chloro-quinolin-4-ylamino)-ethyl]-amide hydrochloride (22) exhibited significant suppression of parasitaemia in the in vivo assay. All the analogues were found to form strong complex with haematin and inhibited the β-haematin formation in vitro. These results suggest that these compounds act on heme polymerization target.

Budd Chiari syndrome (BCS) is a condition arising from hepatic venous outflow tract obstruction (HVOTO) arising at the level of hepatic veins, inferior vena cava, right atrium or a combination of these. It can be classified as primary or secondary depending upon the underlying pathophysiology. Regardless of the cause of HVOTO, there is lack/complete absence of hepatic venous drainage leading to constellation of symptoms pertaining to portal hypertension with radiologically visible intrahepatic and extrahepatic porto-systemic collaterals. The presence of these collateral systems provide imaging diagnostic clue in chronic cases with cirrhosis labelled as chronic liver disease and thereby establishing the primary cause of cirrhosis to be BCS. Current essay aims to provide in depth knowledge of collateral pathways of BCS.

Aneurysm of celiac artery is an uncommon occurrence with nearly 180 cases being reported in the literature so far [1]. These have been attributed to traumatic, iatrogenic and inflammatory being amongst few associated etiological factors. Spontaneous isolated dissecting aneurysm of celiac trunk is a rare occurrence with very few cases being mentioned in the published literature. Although the rate of rupture was 72% to 87% during the 1st half of the 20th century, advances in diagnostic imaging and early surgical intervention have reduced the rupture rate to 7% in recent years [1]. Early recognition and urgent intervention is required to prevent fatal complications like intraperitoneal rupture. Authors present a case of isolated spontaneous dissecting aneurysm of distal celiac artery in a fifty five year old male patient with alcoholic cirrhosis.

Choline kinase is the first enzyme in the Kennedy pathway (CDP-choline pathway) for the biosynthesis of the most essential phospholipid, phosphatidylcholine, in Plasmodium falciparum . In addition, choline kinase also plays a pivotal role in trapping essential polar head group choline inside the malaria parasite. Recently, Plasmodium falciparum choline kinase (PfCK) has been cloned, overexpressed, and purified. However, the function of this enzyme in parasite growth and survival has not been evaluated owing to the lack of a suitable inhibitor. Purified recombinant PfCK enabled us to identify an inhibitor of PfCK, hexadecyltrimethylammonium bromide (HDTAB), which has a very close structural resemblance to hexadecylphosphocholine (miltefosin), the well-known antiproliferative and antileishmanial drug. HDTAB inhibited PfCK in a dose-dependent manner and offered very potent antimalarial activity in vitro against Plasmodium falciparum . Moreover, HDTAB exhibited profound antimalarial activity in vivo against the rodent malaria parasite Plasmodium yoelii (N-67 strain). Interestingly, parasites at the trophozoite and schizont stages were found to be particularly sensitive to HDTAB. The stage-specific antimalarial effect of HDTAB correlated well with the expression pattern of PfCK in P. falciparum , which was observed by reverse transcription-PCR and immunofluorescence microscopy. Furthermore, the antimalarial activity of HDTAB paralleled the decrease in phosphatidylcholine content, which was found to correlate with the decreased phosphocholine generation. These results suggest that inhibition of choline kinase by HDTAB leads to decreased phosphocholine, which in turn causes a decrease in phosphatidylcholine biosynthesis, resulting in death of the parasite.

A 55-year-old male patient presented with a slowly enlarging, painless, large soft mass lesion in left scrotal sac for 6 month. On clinical examination the mass lesion could not be separated from testis, hence provisional diagnosis of testicular tumour was made. For further evaluation scrotal ultrasound was performed. In the region of the clinically palpable lump, ultrasound revealed a unilocular, well-circumscribed cystic lesion with moderately thick wall and fine internal echoes [Table/Fig-1]. The size of lesion was approximately 4.5 x 5 cm. It was located cranial to testis, partially replacing left epididymis. No internal or peripheral flow was detected on colour Doppler study. Mild fluid was also noted in scrotal sac, which was consistent with hydrocele. Right testis and epididymis were normal. [Table/Fig-1]: Gray scale ultrasound image of left scrotal sac shows a well circumscribed, rounded, unilocular cystic lesion with low level internal echoes located superior to left testis consistent with the diagnosis of spermatocele Ultrasound examination also revealed a cluster of multiple, small, anechoic cysts located in the region of testicular mediastinum [Table/Fig-2]. No solid component or calcification was seen. No evidence of any obvious arterial or venous flow was noted in the cysts on colour Doppler study [Table/Fig-3]. [Table/Fig-2]: Transverse (A), longitudinal (B) gray scale ultrasound images of left testis shows a cluster of multiple small anechoic cystic structures noted in the region of testicular mediastinum with hydrocele [Table/Fig-3]: Transverse colour Doppler ultrasound image of left testis shows numerous small cysts with no colour flow On the basis of characteristic ultrasound and Doppler findings final diagnosis was made of tubular ectasia of rete testis and spermatocele. Because of benign nature of this condition patient was reassured and ask for 6 monthly follow up. Tubular ectasia of the rete testis is a benign clinical entity in which cystic dilation of rete testis results from partial or complete obliteration of the efferent ducts [1]. The obstruction may occur at different levels and may be classified into intra- or extra-testicular. In testicular lesions, the obstruction generally resulting from previous inflammatory episodes like orchitis, while in extra-testicular lesions, traumatic tearing of epididymis, obstruction from epididymitis, spermatoceles and tunica albuginea cyst and post-vasectomy or other scrotal surgeries are the common causes [2]. Typically this condition affects patients older than 50 year of age. Bilateral lesions have been reported in 29 to 69% of cases [3]. Spermatocele and epididymis cysts are commonly associated with this condition. Ultrasonography is usually the first and only modality needed to diagnose this condition. Sonographic findings of tubular ectasia of rete testis consists of a cluster of several anechoic rounded and serpiginous tubular structures located in the mediastinum testis without any solid areas or calcific foci. They do not cause mass effect on the adjacent testicular parenchyma. Colour Doppler shows no arterial or venous flow within cystic lesions [4]. Spermatoceles are common extra-testicular lesions caused by cystic dilation of efferent ductules in the region of head of epididymis. On ultrasonography, it appears as a unilocular or multilocular hypoechoic cystic lesion located superior to and separate from testis. It is usually small in size ranging from 1-2cm in size. However large lesions upto 8 cm in size have been reported in the literature [5]. Spermatocele may show low-level echogenic internal echoes due to proteinaceous fluid containing dead sperms. MRI is usually not indicated because of typical appearance on ultrasound. However, if done in doubtful cases, reveals a cluster of round or serpiginous lesions in the hilum of testis, which appear hypointense TI-weighted and hyperintense on T2- weighted images. The main differential diagnosis includes intra-testicular varicocele and cystic dysplasia of testis. Intra-testicular varicocele is a rare entity, which can give similar appearance on B-mode ultrasonography, however colour Doppler and pulsed Doppler evaluation shows colour flow with characteristic venous spectral waveform that augments during Valsalva maneuver [6]. Cystic dysplasia of testis is thought to be a congenital condition unlike tubular ectasia of rete testis which is an acquired condition. It is seen in children and has similar appearance to tubular ectasia of rete testis [7]. Other differential diagnosis includes epididymal cystadenoma, teratoma, non-Hodgkin’s lymphoma and seminiferous tubules dilatation secondary to testicular neoplasms [1]. Tubular ectasia of rete testis and spermatocele are benign entities With characteristics features on gray scale and colour Doppler examination. This condition should be recognized in older individuals and its awareness can prevent unnecessary investigations and surgical intervention.

Environmental, technological and societal factors continue to have a dramatic effect on infectious diseases worldwide and are considered to be facilitating the emergence of several infectious diseases at a time. Co-infection with different species of viral and malaria infections are currently emerging problems of dual infection in the developing as well as developed countries. Understanding of interactions between the host, malaria and virus infection is of current concern and we have initiated studies to delineate the mechanisms involved during the progression of Semliki forest virus (SFV) and Plasmodium yoelii (P. yoelii) infection in mice. Enhanced virus multiplication and up-regulation of cytokine mRNA level in P. yoelii and SFV co-infected mice were observed on day 4 post-infection compared to respective controls. Collectively, our observations indicate that malaria infection may influence virus multiplication, pathogenesis and up-regulation of cytokine mRNA during co-infection in mice.

The mechanism of antimalarial activity of clotrimazole was studied placing emphasis on its role in inhibiting hemoperoxidase for inducing oxidative stress in Plasmodium falciparum. Clotrimazole, in the presence of H2O2, causes irreversible inactivation of the enzyme, and the inactivation follows pseudo-first order kinetics, consistent with a mechanism-based (suicide) mode. The pseudo-first order kinetic constants are ki = 2.85 microM, k(inact) = 0.9 min(-1), and t(1/2) = 0.77 min. The one-electron oxidation product of clotrimazole has been identified by EPR spectroscopy as the 5,5'-dimethyl-1-pyrroline N-oxide (DMPO) adduct of the nitrogen-centered radical (aN = 15 G), and as DMPO protects against inactivation, this radical is involved in the inactivation process. Binding studies indicate that the clotrimazole oxidation product interacts at the heme moiety, and the heme-clotrimazole adduct has been dissociated from the inactivated enzyme and identified (m/z 1363) by mass analysis. We found that the inhibition of hemoperoxidase increases the accumulation of H2O2 in P. falciparum and causes oxidative stress. Furthermore, the inhibition of hemoperoxidase correlates well with the inhibition of parasite growth. The results described herein indicate that the antimalarial activity of clotrimazole might be due to the inhibition of hemoperoxidase and subsequent development of oxidative stress in P. falciparum.

Red cell invasion by Plasmodium merozoites involves multiple steps such as attachment, apical reorientation, junction formation and entry into a parasitophorous vacuole. These steps are mediated by specific molecular interactions. P. vivax and the simian parasite P. knowlesi require interaction with the Duffy blood group antigen to invade human erythrocytes. P. vivax and P. knowlesi Duffy binding proteins (PvDBP and PkDBP), which bind the Duffy antigen during invasion, share regions of sequence homology and belong to a family of erythrocyte binding proteins (EBPs). By deletion of the gene that encodes PkDBP, we demonstrate that interaction of PkDBP with the Duffy antigen is absolutely necessary for invasion of human erythrocytes by P. knowlesi. Electron microscopy studies reveal that PkDBP knockout parasites are unable to form a junction with human erythrocytes. The interaction of PkDBP with the Duffy antigen is thus necessary for the critical step of junction formation during invasion. These studies provide support for development of intervention strategies that target EBPs to inhibit junction formation and block erythrocyte invasion by malaria parasites.

A chronosequence of Gmelina arborea Roxb. stands ranging from 1 to 6 years old was measured to document changes in growth, biomass and nutrient (N, P and K) contents for three red lateritic sites in Chhattisgarh, India. The stand's density, survival and growth parameters (DBH, total height, crown diameter and number of branches) varied significantly with age and site. The number of stems was highest (789 trees/ha ) in a 1-year-old plantation at site 3 (Kusumi) and lowest (724 trees/ha ) in a 6-year-old stand at site 2 (Anandgoan). Allometric equations for stem wood, branches, leaves and roots to tree diameter at breast height were developed to estimate above ground and below ground tree biomass. The total biomass ranged from 3.9 Mg ha −1 in 1-year-old to 53.7 Mg ha −1 in 6-year-old stand. The stem wood contributed from 55.3% (site 3) to 56.3% (site 1), branch wood from 18.3% (site 2) to 19.8% (site 3), roots from 17.9% (site 3) to 18.5% (site 2) and foliage from 6.6% (site 2) to 7.0% (site 3) of the total biomass. The growth and biomass production were poor from establishment to 3 years age and it increased by 1.5–2 times as the plantation aged from 4–6 years. Nutrient accumulation in tree biomass increased with stand age, following the pattern of biomass accumulation. The total nitrogen accumulation in 6-year-old stands at three sites ranged from 212.9 to 279.5 kg ha −1 with a mean annual storage of 238.4 kg ha −1 and total K ranged from 170.8 to 220.5 kg ha −1 with a mean annual storage of 189.9 kg ha −1 . Phosphorous storage was lowest which ranged from 15.0 to 19.6 kg ha −1 with a mean storage of 16.8 kg ha −1 . The organic matter and nutrients in the soils improved significantly after 6 years of planting. Available N enhanced by 14.9%, 12.0% and 11.3%, K by 10.0%, 9.1% and 10.6%, whereas phosphorous declined by 2.6%, 23.0% and 20.0%, respectively, at soil depths of 0–20, 21–40 and 41– 60 cm . The paper discusses the implications of whole tree harvest at 6 years age for fire/pulpwood.