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A new series of 6-(aryl/heteryl)-3-(5-methyl-1-phenyl-1H-4-pyrazolyl)[1,2,4]triazolo[3,4-b][1,3,4]thiadiazoles (7a-j) has been synthesized by the reaction of 4-amino-5-(5-methyl-1-phenyl-1H-4-pyrazolyl)-4H-1,2,4-triazol-3-yl-hydrosulfide (6) with POCl(3) and the corresponding aryl/heteryl carboxylic acid, in ethanol at reflux temperature for 12 h. All the synthesized compounds were tested for in vitro activities against certain strains of bacteria such as Staphylococcus aureus, Bacillus subtilis, Escherichia coli and fungi such as Aspergillus niger, Aspergillus nodulans, Alternaria alternate. Compounds having 4-chlorophenyl (7d), 4-aminophenyl (7f), 4-nitrophenyl (7h) and 3-pyridyl (7i) substituents at 6-position of thiadiazole ring, showed marked inhibition of bacterial and fungal growth nearly equal to the standards. The other new compounds also showed appreciable activity against the test bacteria and fungi.

Introduction: Dermatoglyphics is the study of dermal ridge configurations on palmar and plantar surfaces of hands and feet. Dermal ridges and craniofacial structures are both formed during 6-7th week of intra-uterine life. It is believed that hereditary and environmental factors leading to malocclusion may also cause peculiarities in fingerprint patterns., Objective: To study and assess the relationship between fingerprints and malocclusion among a group of high school children aged 12-16 years in Dharwad, Karnataka, India., Design: A total of 696 high school children aged 12-16 years were randomly selected. Their fingerprints were recorded using duplicating ink and malocclusion status was clinically assessed using Angle's classification., Results: Chi-square analysis revealed statistical association between whorl patterns and classes 1 and 2 malocclusion (p < 0.05). However, no overall statistical association was observed between fingerprint patterns and malocclusion (p > 0.05)., Conclusion: Dermatoglyphics might be an appropriate marker for malocclusion and further studies are required to elucidate an association between fingerprint patterns and malocclusion.

Aim: Large pancreatic ductal calculi and pain are a feature of chronic calcific pancreatitis (CCP) in the tropics. This large single center study evaluates the role of extracorporeal shock wave lithotripsy (ESWL) in fragmentation of large pancreatic stones and relief of pain in patients with CCP., Methods: Patients with CCP presenting with pain and large pancreatic duct (PD) calculi (>5 mm diameter) not amenable to extraction at routine endoscopic retrograde cholangio pancreatography (ERCP) were taken up for ESWL using a 3rd generation lithotripter. Stones in the head and body of pancreas were targeted at ESWL; 5,000 shocks were given per session. The calculi were fragmented to <3 mm size and then cleared by endotherapy. Pancreatic duct stents were deployed when indicated. A total of 1,006 patients underwent ESWL. Complete clearance was achieved in 762 (76%), partial clearance in 173 (17%) and unsuccessful in the rest. More than 962 (90%) of patients needed less than three sessions of ESWL. At 6 months, 711 (84%) of 846 patients who returned for follow up had significant relief of pain with a decrease in analgesic use. Complications were mild and minimal., Conclusion: ESWL is an effective and safe modality for fragmentation of large PD calculi in patients with CCP.

Objective: A parallel design clinical study evaluated reduction in hypersensitivity after brushing for 12 weeks with Anchor toothpaste (containing potassium citrate, zinc citrate, triclosan and sodium monofluorophosphate) (test) and Colgate Total (sodium fluoride, silica, triclosan and copolymer) (control) dentifrices., Materials and Methods: Sixty adults with sensitivity to hot and cold stimulus in at least two tooth surfaces were stratified at the baseline examination by tactile, hot and cold stimuli scores in two balanced groups. Subjects were randomly allocated the test and control dentifrices and evaluated after 6 and 12 weeks of dentifrice use for hypersensitivity., Results: The two teeth that were selected in each patient were designated as two different sets. The 12th-week scores as compared to baseline scores for tactile, heat and cold tests in the test group showed a reduction in tooth hypersensitivity by 36.67% (P < 0.01), 20.35% (P < 0.01) and 53.64 % (P < 0.01), respectively, in the first set of teeth and 43.75% (P < 0.01), 24.48% (P < 0.01) and 59.78% (P < 0.01), respectively, in the second set of teeth. The 12th-week scores as compared to baseline scores for tactile, heat and cold tests in the control group showed a reduction in tooth hypersensitivity by 42.86% (P < 0.01), 13.02% (P < 0.01) and 45.14% (P < 0.01), respectively, in the first set of teeth and 40% (P < 0.01), 16.59% (P < 0.01) and 44.16% (P < 0.01), respectively, in the second set of teeth., Conclusions: Both the products reduced dentinal hypersensitivity in the study subjects at the end of the 12-week period. However, there was no statistically significant difference in reduction in hypersensitivity between the two products.

Angiogenesis is a key process needed for the growth and survival of solid tumors. Anti-angiogenesis may arrest the tumor growth and keep check on cancer metastasis. Developing antiangiogenic agents have remained a significant hope in the mainstream of anticancer research. The free radical implications in the initiation of cancers are well established. In the present studies, simple flavone and flavones with hydroxyl substitution in 'A' and 'C' ring at 3, 5, 6, and 7 were studied for antiangiogenic activities using chorioallantoic membrane (CAM) model and kinetics of DPPH (2,2-diphenyl-1-picryl hydrazine) and superoxide anion radical (SOR) scavenging activities. The docking of selected flavones with specific angiogenic targets such as vascular endothelial growth factor (VEGF), hypoxia inducible factor (HIF-1alpha) and vascular endothelial growth factor receptor-2 (VEGFR2) from human origin was carried out to focus the possible underlying mechanism of anti-angiogenesis. The result of the present studies shows that the 3-hydroxy substitution of the flavone was found to be the most promising lead for antiangiogenic activity in CAM model. The same was true for DPPH reduction with greater velocity as compared to other hydroxyl substitutions. However the 7- and 6-hydroxy substitution were observed to be more favourable for SOR scavenging activities as compared to other hydroxyl substitutions. The docking experiments shows that the VEGFR2 seems to be a structurally compatible target for tight binding of the flavones especially with 3-hydroxy substitution (-9.78 kcal/mole) as compared to VEGF (-8.47 kcal/mole) and HIF-1alpha (-8.99 kcal/mole). The quantum chemical descriptors of the test flavones related to free radical scavenging and other biological activities were calculated using computational tools. The data is discussed in the light of structure-activity relationship., (Copyright 2009 Elsevier B.V. All rights reserved.)

Objectives: Homocysteine has been implicated in vascular dysfunction and thrombosis, as well as inflammatory conditions. This study was aimed to find out whether chronic pancreatitis (CP) is associated with hyperhomocysteinemia and derangements of transmethylation and transsulfuration pathways., Methods: We estimated homocysteine and its metabolites in 45 alcoholic CP patients, 45 tropical CP patients, and 48 healthy controls., Results: Significant increases in plasma total homocysteine and decreases in red blood cell folate, reduced glutathione, plasma methionine, cysteine, and urinary inorganic sulfate/creatinine ratio were observed in both alcoholic and tropical CP patients in comparison with healthy controls. Red blood cell glutathione and plasma cysteine levels were significantly lower in alcoholic than in tropical CP patients. However, plasma vitamin B12 levels were comparable between CP patients and controls. No significant differences in these parameters were observed between diabetic patients and nondiabetic patients. Multivariate regression analysis showed a significant negative correlation between homocysteine and folate (r = -0.415, P = 0.001) and a positive correlation between glutathione and cysteine levels (r = 0.37, P = 0.003)., Conclusions: Chronic pancreatitis is associated with hyperhomocysteinemia and derangements in transmethylation and transsulfuration pathways. Low folate levels observed in these patients seem to have a key role in this derangement.

Objective: This investigation assessed regional differences in dental plaque and gingivitis within the human dentition in conjunction with microbiological analyses of dental plaque., Methods: Forty-one adults (23 males and 18 females; age range 19-44 years) were enrolled, and a calibrated dental examiner completed whole mouth examinations for dental plaque (PI) and gingivitis (GI) using the Turesky modification of the Quigley-Hein Index (TMQH) and the L6e-Silness (LS) Index, respectively. Dental plaque samples were collected from the anterior surfaces and posterior teeth to determine viable anaerobic bacteria. During this visit, subjects underwent a whole mouth dental prophylaxis and were provided a marketed fluoride dentifrice for twice-daily oral hygiene. Subjects were recalled on day 15 and day 30 for whole mouth assessments of PI and GI, followed by the collection of dental plaque from the anterior and posterior teeth for microbiological analyses during these visits., Results: Low plaque and gingival scores were common on anterior surfaces, in contrast to greater frequencies of higher PI and GI scores on the posterior regions or the entire dentition. Correspondingly, mean scores for PI and GI were significantly lower among the anterior surfaces in comparison to all other regions of the mouth (posterior, Ramfjord surfaces, or the entire dentition) over each phase of the study (p < 0.0001). While prophylaxis resulted in lower clinical scores from baseline to the day-15 recall visit (p < 0.05), anterior surfaces demonstrated lower scores than posterior regions during this recall visit (p < 0.05). Although dental plaque scores increased from the day-15 to the day-30 evaluations, gingival scores maintained broad reductions, with anterior scores consistently lower than the corresponding posterior regions (p <0.05). Microbiological analyses indicated significantly lower numbers of viable bacteria from the anterior surfaces in comparison to posterior regions at both recall visits (p < 0.05)., Conclusion: Anterior surfaces routinely demonstrated lower levels of dental plaque scores than the other regions of the dentition. Higher gingival inflammation levels were also correlated with increased plaque deposits associated with posterior teeth. Microbiological analyses confirm clinical observations with significantly higher numbers of viable bacteria in the dental plaque collected from the posterior regions. The human dentition demonstrates significant regional differences in the prevalence of dental plaque, gingivitis, and corresponding anaerobic bacteria, with posterior surfaces consistently reporting higher scores than the anterior regions. These consistent differences should be taken into account in performing plaque and gingivitis studies when assessing the efficacy of oral health products for controlling dental health.

Background: The Government of India issued an undertaking in the Supreme Court mandating pictorial health warnings (PHWs) on packages of tobacco products from 31st May, 2009 under " Cigarettes and Other Tobacco Products Act " (COTPA) guidelines. This constitutes a key economic channel for educating people on devastating health impacts of deadly products within in a vivid and memorable way. Few studies have investigated PHWs on tobacco products marketed in India., Objectives: To assess met guidelines for pictorial health warnings under packaging and labeling rules on packages of collected tobacco products specified by COTPA., Materials and Methods: Snowball/network sampling design was followed to obtain samples of 37 different tobacco brands, 18 in smoking form (12 cigarette, 6 bidi brands) and 19 in smokeless form (4 chewing tobacco, 11 Gutkha and 4 Khaini brands) marketed at retail outlets at Muradnagar. They were analyzed for their compliance with guidelines through checklist by one calibrated examiner., Results: PHWs were absent on packages of 5 tobacco brands. Fifteen tobacco brands had PHWs smaller than stipulated 40% of principal display area; 6 brands of bidis had PHWs on deceptive backgrounds, 3 of which were placed on a curved axis. Misleading descriptors and promotional messages were also present., Conclusion: Locally marketed tobacco products were not compliant with packaging and labeling rules specified by COTPA. This highlights the need for more stringent implementation of COTPA guidelines to combat the ever-growing tobacco menace.

Background: Measurement of pancreatic exocrine function and steatorrhea in chronic pancreatitis in the clinical setting has not received much attention., Aim: To assess pancreatic exocrine function and fecal fat excretion in a cohort of patients with chronic pancreatitis., Methods: Stool elastase1 levels were measured in 101 patients using polyclonal ELISA and acid steatocrit was measured in 86 chronic pancreatitis patients. Associations with etiology, clinical and radiological features, and diabetic status were examined., Results: Low pancreatic stool elastase1 (<200 microg/g stool) was observed in two-thirds of chronic pancreatitis patients and correlated with ductal dilatation, pancreatic atrophy and calcification (p<0.05). Diabetes was more prevalent in chronic pancreatitis patients with low elastase1 (p=0.045). There was no difference in mean acid steatocrit between diabetics and non-diabetics (p=0.069). Elastase1 levels had a negative correlation with acid steatocrit (r=-0.606, p<0.001), and a positive correlation (r=0.412) with body mass index (p=0.013). Fifty-three percent of chronic pancreatitis patients with normal BMI had low elastase1., Conclusions: Fecal elastase1 levels correlated with fecal fat excretion and BMI. Fecal elastase1 estimation may be helpful in early detection of malabsorption in chronic pancreatitis.

Context: A major role of the pancreas in zinc homeostasis has been suggested., Objective: To assess erythrocyte zinc status in chronic pancreatitis and to correlate it with pancreatic exocrine and endocrine insufficiency., Patients: One hundred and one patients with chronic pancreatitis (34 alcoholic chronic pancreatitis, 67 tropical chronic pancreatitis) were prospectively studied., Main Outcome Measure: Disease characteristics and imaging features were recorded. Erythrocyte zinc was estimated by flame atomic absorption spectrophotometry. Exocrine insufficiency was assessed using polyclonal antibody ELISA for pancreatic stool elastase1. Endocrine insufficiency was assessed by serum glucose levels and insulin requirement., Results: Erythrocyte zinc was significantly lower in chronic pancreatitis patients than in the controls (26.5+/-9.5 microg/g Hb vs. 38.0+/-6.6 microg/g Hb; P<0.001), and in tropical chronic pancreatitis than in alcoholic chronic pancreatitis (25.0+/-10.4 microg/g Hb vs. 29.6+/-6.5 microg/g Hb, P=0.001). In chronic pancreatitis patients who had exocrine insufficiency, erythrocyte zinc positively correlated with stool elastase1 (r=0.587, P<0.001). Erythrocyte zinc levels were significantly lower in diabetic patients as compared to non-diabetics (P=0.036)., Conclusions: This study demonstrates zinc deficiency in chronic pancreatitis patients, and that zinc deficiency correlates with exocrine and endocrine insufficiency. Further studies may clarify the possible benefits of zinc supplementation in chronic pancreatitis.

The etiopathogenesis of tropical chronic pancreatitis (TCP) remains unclear. Malnutrition, dietary toxins like cyanogens in cassava and micronutrient deficiency are proposed factors. The description and characterization of genetic factors in TCP has added a new dimension to the understanding of pathogenesis of the disease. However, there is sparse data on the association of TCP with cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations. We report 8 patients of TCP with CFTR gene mutations, including one with a novel mutation, and describe the clinical profile of these patients. Further prospective genetic studies on the association of CFTR gene mutations are essential in order to unravel the genetic basis of TCP.

Objective: This investigation evaluated extrinsic stain removal efficacy after brushing for one and two weeks with a commercially available fluoride dentifrice relative to Colgate Total Advanced Clean, a new dentifrice formulated with dual-phase silica., Methods: At the baseline visit, one-hundred and forty-four adult subjects were stratified by Lobene Stain Index scores and randomized to two treatment groups using either Total Advanced Clean dentifrice (0.3% triclosan, 2% copolymer, dual phase silica) or a commercially available fluoride dentifrice, and instructed to brush twice daily. Tooth stain evaluations were conducted on stain area, stain intensity, and a composite score of both, after one and two weeks of dentifrice use., Results: Baseline scores demonstrated no significant differences between the two treatment groups for all evaluated stain parameters (p > 0.05). At both the one- and two-week post-use evaluations, subjects brushing with Total Advanced Clean demonstrated significant reductions for all stain parameters versus the control (p < 0.05). The Total Advanced Clean group demonstrated mean reductions in stain intensity of 0.37 and 0.74 at the one- and two-week evaluations, respectively, versus the control group. Corresponding mean reductions in stain area for the Total Advanced Clean group versus the control were 0.12 and 0.24 at the one- and two-week evaluations, respectively. The two post-use evaluations also demonstrated significant reductions in stain composite scores for the subjects assigned Total Advanced Clean (p < 0.0001)., Conclusion: In comparison to the control dentifrice, the results demonstrated significantly more stain removal following the use of Total Advanced Clean at each recall visit. Subjects assigned Total Advanced Clean demonstrated continued reductions in stains from baseline to one week, and from one week to two weeks.

Tropical pancreatitis and fibrocalculous pancreatitic diabetes are usually considered two ends of the same disease although some studies suggest the likelihood of distinct entities. We report the occurrence of these two diseases in two siblings. The literature comparing the similarities and differences between them is briefly reviewed.

Isolated cases and small series of acute pancreatitis complicating viral infections have been reported. However, data on the natural history of such patients are sparse. We report a series of five patients of acute pancreatitis complicating diverse viral infections. During follow-up ranging from 6 to 36 months, two of these five patients developed evidence of chronic pancreatitis.

Purpose: To assess a protected mobilisation programme (dynamic treatment) for proximal phalangeal fracture of the hand, irrespective of the geometry., Methods: Clinical and radiological results of 32 consecutive patients with proximal phalangeal fracture of the hand treated from January 2001 to February 2007 were evaluated. Our supervised rehabilitation programme was strictly followed to gain full range of movement of the proximal interphalangeal joint and to prevent the development of an extension lag contracture. Patients were followed up for a mean period of 15 (range, 13-16) months. Results were evaluated using the Belsky classification., Results: The results were excellent in 72% of the patients, good in 22%, and poor in 6%. Some patients defaulted follow-up, which made long-term assessment difficult. The poor results may have been related to patient non-compliance or default from rehabilitation. Many good results upgraded to excellent following further rehabilitation., Conclusion: Skeletal stability, not rigidity, is necessary for functional movements of the hand. Proximal phalangeal fractures can be effectively treated by closed methods, using the stabilising effect of soft tissues (zancolli complex-metacarpophalangeal retention apparatus) and external devices (metacarpophalangeal block splint), thus enabling bone healing and movement recovery at the same time.

Mitral valve abnormalities have been described in Ebstein's anomaly, but acquired rheumatic mitral valve disease is an extremely rare association. We describe a classical case of Ebstein's anomaly of tricuspid valve with severe rheumatic mitral stenosis. This patient had mild mitral regurgitation, pulmonary hypertension and atrial fibrillation.

We report a 32-year-old man with acute myeloid leukemia presenting as obstructive jaundice. Imaging revealed dilated common bile duct with abrupt narrowing at the lower end, distended gall bladder, and dilated intrahepatic biliary radicles. In addition he had a mass lesion in the urinary bladder. On evaluation he was found to have the eosinophilic variant of M4 subtype acute myeloid leukemia. He expired before chemotherapy could be instituted.

We report three cases of an unusual aggressive type of Mycobacterium marinum infection of the hand which had been a nightmare both for us and the patient. These were the patients in which even after repeated thorough surgical debridement and appropriate (drug sensitive) medical treatment over a period had resulted in amputation or devastation of the soft tissues so extensively that almost only the neurovascular bundle, bone and the skin were the only structures left (cosmetic fingers - no function) at the last debridement after which the infection has not recurred. By presenting this article we want to stress on certain points pertaining to diagnosis, management, varied presentation and of course the dreadful complications of deep-seated M. marinum infection.

There are few reports of skeletal infections in patients with cirrhosis. We present two such cases, both with alcoholic liver disease, seen over a period of one year. The first, a 46-year-old man, presented as pyrexia of unknown origin, and was found to have pyogenic discitis; he responded to antibiotic and surgery. The second, a 42-year-old man, presented with chest wall abscess and was diagnosed to have tubercular osteomyelitis; he expired despite treatment with non-hepatotoxic anti-tubercular drugs.

The metabolic syndrome, as described by Reaven, is a combination of obesity, insulin resistance, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperinsulinemia. The syndrome was recognized as a very high pro-atherogenic risk causing coronary heart disease. More recently, other features like an elevated plasma PAI -1 and CRP have been added to the syndrome. In view of the recent data demonstrating that insulin exerts an anti-inflammatory effect while macronutrients exert a pro-inflammatory effect, we are in a better position to explain not only why an insulin resistant state like the metabolic syndrome is pro-inflammatory but also to explain how it develops. This review discusses the relevance of these recent observations and puts into perspective the pathogenesis of various features of the metabolic syndrome and also predicts some features which may get incorporated into it in the future.

Background: Left atrial compliance is an important determinant of symptoms in mitral stenosis. About one-third of patients with mitral stenosis have reduced left ventricular compliance. We measured the net atrioventricular compliance in rheumatic mitral stenosis patients noninvasively and analyzed if there were any clinical, electrocardiographic, roentgenographic or echocardiographic correlates of net atrioventricular compliance., Methods and Results: Seventy-six patients with mitral stenosis were analyzed and as many normal subjects were taken as control group. Patients were divided into two groups--those 20 years and below were grouped as juvenile mitral stenosis and those above 20 years as adult mitral stenosis patients. The net atrioventricular compliance in patients with mitral stenosis was significantly impaired compared to normal population. Mean compliance in juvenile group was 4.66+/-2.18 ml/mmHg (range 2.17-9.6) and in adult group it was 4.79+/-1.99 ml/mmHg (range 2.04-8.9) (p = ns). There was no difference in net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. Mitral valve area showed an independent positive correlation with net atrioventricular compliance., Conclusions: The net atrioventricular compliance was significantly reduced in patients with rheumatic mitral stenosis; however, there was essentially no difference in the net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. The net atrioventricular compliance may not be responsible for the more severe symptoms observed in juvenile mitral stenosis.