Search

Background/Aim: The recent pandemic of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) is yet another scourge from the coronaviridae family that causes illnesses ranging from common cold to more severe diseases such as Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). The numbers are still on the rise, despite a country wide lockdown and yet no definitive drugs and or/vaccines are available to manage the active COVID-19 cases. Methods: The present research design was a hospital based observational descriptive study conducted at S. M. S. Medical College and Attached hospitals, Jaipur, that analysed data of all the patients with COVID-19 related mortality, admitted between 1 April to 4 May 2020. Patients included in this study were RT-PCR confirmed cases of SARS-CoV-2 using nasopharyngeal and oropharyngeal swab samples. Results: The mean age of patients with COVID-19 related mortality was 53.41 ± 18.42 year with majority of patients belonging to age group of more than 60 years (41.18 %) followed closely by COVID-19 positive patients in age range of 45 to 60 years (33.33 %). The male to female ratio was 1.68: 1. Mean time lag between hospitalization and death reported was 6.18 days. Majority of the patients admitted (72.5 %) succumbed within 3 days of hospitalization. Eleven patients (21 %) were brought dead to the hospital who were tested COVID-19 positive after death. Most common comorbidity reported in patients with COVID-19 related mortality was hypertension (30 %) followed by diabetes mellitus (27.5 %). Conclusion: Hypertension and diabetes mellitus might be independent risk factors making an individual susceptible to COVID-19 related death. Elderly patients also have a greater risk of mortality. The non-availability of definitive management protocol and/or vaccine against COVID-19 makes public health preventive measures of social distancing, use of masks and frequent handwashing an important modality in the fight against COVID-19.

Background and Objectives: Childhood and adolescent anxiety is generally associated with a varied somatic symptom pattern thought to reflect autonomic system activity. Few studies have examined the autonomic characteristics of generalized anxiety disorder (GAD). This omission is at odds with contemporary models of autonomic cardiovascular control. The current study aimed to find differences in autonomic functions between children with a diagnosis of childhood anxiety disorder and a control group using a case-control design. Design and Setting: A cross sectional experimental study conducted in the years 2004-2005 in the psycho-physiology lab of a tertiary care multi-speciality teaching hospital. Methods: Assessments were carried out using a semistructured interview, K-SADS (Schedule for Affective Disorders and Schizophrenia for Children and Adolescents); STAIC (State and Trait Anxiety Inventory for Children); CDRS (Childhood Depression Rating Scales); SCARED (Self-Report for Childhood Anxiety-Related Disorders). Autonomic reactivity was tested using the standard battery of tests. RESULTS: There were differences between 34 children and adolescents (age range, 8-18 years) with a diagnosis of childhood anxiety disorder and a control group of 30 age- and sex-matched subjects from a nearby school in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects. Our finding is suggestive of autonomic rigidity or diminished physiologic flexibility in children with anxiety disorder. Conclusions: The study is probably the first of its kind to look into the issue in detail using a detailed battery of the autonomic function tests, and the results are of help in better understanding the condition. The result of the present experiment supports differences in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects.

Pediatric cardiac surgery is undergoing a metamorphosis, with more and more critical patients being operated in our country today. Although the principles of physiology have not changed, it is imperative that care providers continue to stay abreast with developments and newer drugs that may help modify the outcome. The team dynamics have also become more complex, which necessitates the need for all care providers (surgeons, cardiologists, anesthesiologists, and intensivists) to better understand the interactions and benefits of newer drugs. Vasopressin has been used in our adult patients for more than a decade and recently has found its rightful place in the pediatric armoury. The objective of this article is to review the physiology of vasopressin and the rationale of its use in critically ill children with shock, in context of the available published data.

Manifestations of anomalous left coronary artery from the pulmonary trunk may be masked in the presence of an associated shunt lesion that prevents fall of pulmonary artery pressures and allows perfusion of the anomalous coronary artery. We present such a patient with a large ventricular septal defect associated with the anomalous coronary artery from the pulmonary artery.

Abstract Introduction Tuberculous meningitis is a frequent extrapulmonary disease caused by Mycobacterium tuberculosis and is associated with high mortality rates and severe neurological sequelae. In an earlier study employing DNA microarrays, we had identified genes that were differentially expressed at the transcript level in human brain tissue from cases of tuberculous meningitis. In the current study, we used a quantitative proteomics approach to discover protein biomarkers for tuberculous meningitis. Methods To compare brain tissues from confirmed cased of tuberculous meningitis with uninfected brain tissue, we carried out quantitative protein expression profiling using iTRAQ labeling and LC-MS/MS analysis of SCX fractionated peptides on Agilent’s accurate mass QTOF mass spectrometer. Results and conclusions Through this approach, we identified both known and novel differentially regulated molecules. Those described previously included signal-regulatory protein alpha (SIRPA) and protein disulfide isomerase family A, member 6 (PDIA6), which have been shown to be overexpressed at the mRNA level in tuberculous meningitis. The novel overexpressed proteins identified in our study included amphiphysin (AMPH) and neurofascin (NFASC) while ferritin light chain (FTL) was found to be downregulated in TBM. We validated amphiphysin, neurofascin and ferritin light chain using immunohistochemistry which confirmed their differential expression in tuberculous meningitis. Overall, our data provides insights into the host response in tuberculous meningitis at the molecular level in addition to providing candidate diagnostic biomarkers for tuberculous meningitis.

Abstract Introduction Injury to the ulnar nerve following humerus shaft fracture is a very rare entity because the ulnar nerve is well protected from the bone by muscle and soft tissue, and thus remains unaffected in these fractures. We report what is, to the best of our knowledge, the first case of ulnar nerve injury due to a comminuted humeral shaft fracture. The injury manifested and was diagnosed the day after a high-velocity accident. The paucity of related literature and the necessity for early diagnosis and subsequent treatment of such injuries in high-velocity accidents urged us to document this case. Case presentation A 30-year-old Indian man presented to our Emergency Department after a road traffic accident. Our patient complained of right arm pain and the inability to move his extremity. The following morning he developed clawing. Nerve conduction studies on the peripheral nerves of his arm in addition to an X-ray confirmed the diagnosis of a possible injury to the ulnar nerve. Our patient was taken to our Operating Room for surgery, during which a fragment of bone was found abutting the ulnar nerve after penetrating his triceps. This fragment of bone was replaced and the fracture was reduced by open reduction and internal fixation using a dynamic compression plate and screws. Postoperatively, our patient received physical therapy and was discharged two weeks after surgery with no neurological deficit. Conclusions This case emphasizes the urgency and importance of careful neurological examination of all the peripheral nerves supplying the arm in patients with a fracture of the shaft of the humerus. In the setting of injury to the arm in high-velocity accidents, a differential diagnosis of ulnar nerve injury should always be considered.

Abstract Background Targeting Induced Local Lesions in Genomes (TILLING) is a high throughput reverse genetics tool which detects mismatches (single point mutations or small indels) in large number of individuals of mutagenized populations. Currently, TILLING is intensively used for genomics assisted molecular breeding of several crop plants for desired traits. Most commonly used platform for mutation detection is Li-COR DNA Analyzer, where PCR amplified products treated with single strand mismatch specific nuclease are resolved on denaturing gels. The molecular size of any cut product can be easily estimated by comparing with IR dye labeled markers of known sizes. Similar fluorescent dye labeled size markers are also used for several genotyping experiments. Currently, commercially available size standards are expensive and are restricted up to only 700 bp which renders estimation of products of sizes greater than 700 bases inaccurate. Findings A simple protocol was developed for labeling 5' end of multiple DNA size markers with fluorescent dyes. This method involves cloning a pool of different size markers of DNA in a plasmid vector. PCR amplification of plasmid using IR dye labeled universal primers generates 5' fluorescent labeled products of various sizes. The size of products constituting the ladder can be customized as per the need. The generated size markers can be used without any further purification and were found to be stable up to one year at -20°C. Conclusions A simple method was developed for generating fluorescent dye labeled size standards. This method can be customized to generate different size standards as per experimental needs. The protocol described can also be adapted for developing labeled size standards for detection on platforms other than Li-COR i.e. other than infra red range of the spectrum.

Abstract Scurfy mice display the most severe form of multi-organ inflammation due to total lack of the CD4+Foxp3+ regulatory T cells (Treg) resulted from a mutation of the X-linked transcription factor Foxp3. A large repertoire of Treg-suppressible, inflammation-inducing T cells was demonstrated by adoptive transfer experiments using Rag1-/- mice as recipients and by prolongation of lifespan through breeding with Faslpr/lpr mutant. Inflammation in the ear, eyes, skin, tail, salivary glands, lungs, stomach, pancreas, liver, small intestine, colon, skeletal muscle, and accessory reproductive organs are identified. Genetic and cellular regulations of specific organ inflammation are described. Sf mice may be useful for the identification of organ-specific antigens and Treg capable of suppressing inflammation in an organ-specific manner. Sf mice are also useful to determine the important inflammation process at the checkpoint after Treg regulation using genetic analysis through breeding.

Abstract Background Nerve growth factor (NGF) helps in the healing and survival of ganglion cells, photoreceptors, and optic nerve after injury and has been implicated to have a role in pathophysiology of glaucoma. So far, in animal studies, injury to iris in vitro has revealed an increase in NGF levels in aqueous. There is a great interest in investigating the levels of NGF in human aqueous in glaucomatous eyes, as suggested by animal studies, to gain a better understanding of the pathophysiology of glaucoma. Findings In this study, we examined the presence of NGF levels in aqueous humor collected from human eyes and the limitations in determining the NGF levels in human samples. NGF was assessed by ELISA immunoassay in undiluted aqueous samples collected from 32 consecutive patients undergoing surgery for cataract (control) or primary open angle glaucoma (POAG). Recombinant NGF was used as positive control. NGF levels were below undetectable levels in aqueous humor from eyes with POAG and controls by immunoassay. Less than 10% of samples had detectable NGF levels and these were considered outliers. Conclusion Our result highlights the undetectable levels of NGF in human aqueous samples.

Abstract Background Colon cancer is the second leading cause of cancer deaths in the western world. If detected early, colorectal cancer is one of the most treatable forms of cancer. Unfortunately, very few people are screened. N-myristoyltransferase (NMT) catalyzes myristoylation of various proteins including oncoproteins. We have demonstrated earlier the alteration of NMT activity during the progression of colorectal cancer and established NMT as a putative therapeutic target for cancer. Methods Peripheral blood samples and bone marrow were collected from the colon cancer patients and azoxymethane induced colonic tumor rats and their controls respectively. NMT activity and expression was determined as reported earlier. Immunohistochemical studies were carried out using standard procedures. Results In this study we demonstrate for the first time altered expression and localization of NMT in the peripheral blood and bone marrow in colon cancer patients. Immunohistochemical analysis revealed weak to negative staining for NMT in peripheral blood mononuclear cells (PBMC) of controls, whereas strong positivity was observed in PBMC colon cancer patients. In addition, we observed that NMT was localized mostly in the nuclei of the bone marrow (BM) mononuclear cells of the colon cancer patients, whereas NMT remained cytoplasmic in the control bone marrow specimens. Conclusion The strikingly different NMT expression offers the basis of a potential adjunct investigative tool for screening or diagnosis of patients at risk for or suspected of having colon cancer. Furthermore, altered localization of NMT in BM of tumor bearing hosts may serve as an added investigative tool for the diagnostic purpose.