A Study Of Orbital Fractures In A Tertiary Health Care Center

A retrospective study of patients with orbital fractures had 48% patients in the age group of 20 – 40 years with male : female ratio of 10:1. Road traffic accidents (71.43%) were the most common cause followed by injury due to fall (20%). Eighty five percent of patients had normal visual acuity at presentation and 65.57% patients had no ocular complaints. Diplopia was present in 14.2% of patients. Of the orbital fractures infraorbital rim was involved in 43.13%, floor in 19.6%, lateral wall in 13.7%, pure blow out in 14.28% and the roof in 2.9%. Important ocular findings were extraocular movements restriction in 9 (10.3%), infraorbital dysaesthesia in 3 (3.4%), enophthalmos in 2, RAPD and globe rupture in 1 patient each. 32 patients underwent surgical management. At the end of 4 months of follow up, 3 had restriction of EOM, 1 patient had vision loss due to globe rupture, 2 had RAPD (optic nerve compression), 1 had lagophthalmos, 1 had exotropia and 1 had atrophic bulbi

Role of ocean initial conditions to diminish dry bias in the seasonal prediction of Indian summer monsoon rainfall: A case study using climate forecast system

Coupled models tend to underestimate Indian summer monsoon (ISM) rainfall over most of the Indian subcontinent. Present study demonstrates that a part of dry bias is arising from the discrepancies in Oceanic Initial Conditions (OICs). Two hindcast experiments are carried out using Climate Forecast System (CFSv2) for summer monsoons of 2012-2014 in which two different OICs are utilized. With respect to first experiment (CTRL), second experiment (AcSAL) differs by two aspects: usage of high-resolution atmospheric forcing and assimilation of only ARGO observed temperature and salinity profiles for OICs. Assessment of OICs indicates that the quality of OICs is enhanced due to assimilation of actual salinity profiles. Analysis reveals that AcSAL experiment showed 10 reduction in the dry bias over the Indian land region during the ISM compared to CTRL. This improvement is consistently apparent in each month and is highest for June. The better representation of upper ocean thermal structure of tropical oceans at initial stage supports realistic upper ocean stability and mixing. Which in fact reduced the dominant cold bias over the ocean, feedback to air-sea interactions and land sea thermal contrast resulting better representation of monsoon circulation and moisture transport. This reduced bias of tropospheric moisture and temperature over the Indian land mass and also produced better tropospheric temperature gradient over land as well as ocean. These feedback processes reduced the dry bias in the ISM rainfall. Study concludes that initializing the coupled models with realistic OICs can reduce the underestimation of ISM rainfall prediction. © 2018. The Authors

DEVELOPMENT AND VALIDATION OF RP-HPLC METHOD FOR THE DETERMINATION OF BAMIFYLLINE HYDROCHLORIDE IN TABLET DOSAGE FORM

Objective: The objective of the current study was to develop and validate a novel RP-HPLC method for determination of bamifylline hydrochloride in pharmaceutical dosage form.Methods: Chromatographic separation was conducted on Agilent technologies-1260 series with the G1311C quaternary pump, eclipse XDB C18 column (4.6 mm i.d. X 250 mm, 5 µm particle sizes) and equipped with photodiode array detector G1315D. Mobile phase consisted of methanol and acetonitrile were mixed in the ratio of 90:10 v/v, was used at a flow rate of 1 ml/min and detection wavelength was set at 263 nm.Results: The retention time for bamifylline hydrochloride was found to be 2.913 min. The calibration was linear (r2= 0.9996) in the concentration range of 2-10 µg/ml. The limit of detection and the limit of quantitation were found to be 0.4825 μg/ml and 1.4621 µg/ml respectively. Recovery of bamifylline hydrochloride in tablet formulation was observed in the range of 99.6-99.8 %. Percentage assay of bamifylline hydrochloride (Bamifix) was found to be 99.4 % w/w.Conclusion: Thus the novel proposed method for bamifylline hydrochloride was found to be feasible for the estimation of bamifylline hydrochloride in bulk as well as a pharmaceutical dosage form.Â

Metastatic breast neuroendocrine tumor from the rectum-a needle in hay stack

Neuroendocrine tumors metastazing to the breast are exceedingly rare and account for less than 2% of tumors in the breasts. They are usually initially diagnosed as primary breast carcinoma and the correct treatment is delayed. Accurate preoperative identification of the tumor will result in the avoidance a major surgery including axillary lymphnodal clearance. We here report a case of a metastatic neuroendocrine deposit in the breast following a Laparoscopic Anterior Resection(for neuroendocrine tumor of rectum) and Right Hepatectomy (for synchronous liver metastasis)

Fibrinolytic abnormalities in acute respiratory distress syndrome (ARDS) and versatility of thrombolytic drugs to treat COVID‐19

The global pandemic of coronavirus disease 2019 (COVID‐19) is associated with the development of acute respiratory distress syndrome (ARDS), which requires ventilation in critically ill patients. The pathophysiology of ARDS results from acute inflammation within the alveolar space and prevention of normal gas exchange. The increase in proinflammatory cytokines within the lung leads to recruitment of leukocytes, further propagating the local inflammatory response. A consistent finding in ARDS is the deposition of fibrin in the air spaces and lung parenchyma. COVID‐19 patients show elevated D‐dimers and fibrinogen. Fibrin deposits are found in the lungs of patients due to the dysregulation of the coagulation and fibrinolytic systems. Tissue factor (TF) is exposed on damaged alveolar endothelial cells and on the surface of leukocytes promoting fibrin deposition, while significantly elevated levels of plasminogen activator inhibitor 1 (PAI‐1) from lung epithelium and endothelial cells create a hypofibrinolytic state. Prophylaxis treatment of COVID‐19 patients with low molecular weight heparin (LMWH) is important to limit coagulopathy. However, to degrade pre‐existing fibrin in the lung it is essential to promote local fibrinolysis. In this review, we discuss the repurposing of fibrinolytic drugs, namely tissue‐type plasminogen activator (tPA), to treat COVID‐19 associated ARDS. tPA is an approved intravenous thrombolytic treatment, and the nebulizer form has been shown to be effective in plastic bronchitis and is currently in Phase II clinical trial. Nebulizer plasminogen activators may provide a targeted approach in COVID‐19 patients to degrade fibrin and improving oxygenation in critically ill patients

Built in refuge for the management of Pink Bollworm, Pectinophora gossypiella Saunders (Gelichidae: Lepidoptera) in Bt cotton

Field experiment was conducted at the Main Agricultural Research Station, University of Agricultural Sciences, Raichur during 2012-13 to identify and evaluate the suitable refuge strategy systems for pink bollworm resistance management in Bt cotton (Gossypium hirsutum L.) cultivation. The experiment was laid out in randomized complete block design with nine refuge systems : 0 % N-Bt (BIR), 5 % N-Bt (BIR), 10 % N-Bt (BIR), 15 % N-Bt (BIR), 20% N-Bt perimeter refuge, 100% Non Bt, 50% Non Bt, 10% structured refuge and 20% structured refuge as treatments with three replications in replacement series. Significantly lowest incidence (3.55 larvae/plant) and number of bolls with exit holes (11.22) due to pink bollworm was recorded in 0% BIR (41.25 q/ha) followed by 5 % N-Bt (BIR) with yield of 38.74 q/ha and this was on par with 10 % N-Bt (BIR) with yield of 37.79 is next best refuge systems with Bt cotton for higher production and greater economic benefits

Differences in wild-type– and R338L-tenase complex formation are at the root of R338L-factor IX assay discrepancies

Adeno-associated virus (AAV) gene therapy has the potential to functionally cure hemophilia B by restoring factor (F)IX concentrations into the normal range. Next-generation AAV therapies express a naturally occurring gain-of-function FIX variant, FIX-Padua (R338L-FIX), that increases FIX activity (FIX:C) by approximately eightfold compared with wild-type FIX (FIX-WT). Previous studies have shown that R338L-FIX activity varies dramatically across different clinical FIX:C assays, which complicates the monitoring and management of patients. To better understand mechanisms that contribute to R338L-FIX assay discrepancies, we characterized the performance of R338L-FIX in 13 1-stage clotting assays (OSAs) and 2 chromogenic substrate assays (CSAs) in a global field study. This study produced the largest R338L-FIX assay dataset to date and confirmed that clinical FIX:C assay results vary over threefold. Both phospholipid and activating reagents play a role in OSA discrepancies. CSA generated the most divergent FIX:C results. Manipulation of FIX:C CSA kits demonstrated that specific activity gains for R338L-FIX were most profound at lower FIX:C concentrations and that these effects were enhanced during the early phases of FXa generation. Supplementing FX into CSA had the effect of dampening FIX-WT activity relative to R338L-FIX activity, suggesting that FX impairs WT tenase formation to a greater extent than R338L-FIX tenase. Our data describe the scale of R338L-FIX assay discrepancies and provide insights into the causative mechanisms that will help establish best practices for the measurement of R338LFIX activity in patients after gene therapy

Impact of sequence variation in the ul128 locus on production of human cytomegalovirus in fibroblast and epithelial cells

The human cytomegalovirus (HCMV) virion envelope contains a complex consisting of glycoproteins gH and gL plus proteins encoded by the UL128 locus (UL128L): pUL128, pUL130, and pUL131A. UL128L is necessary for efficient infection of myeloid, epithelial, and endothelial cells but limits replication in fibroblasts. Consequently, disrupting mutations in UL128L are rapidly selected when clinical isolates are cultured in fibroblasts. In contrast, bacterial artificial chromosome (BAC)-cloned strains TB40-BAC4, FIX, and TR do not contain overt disruptions in UL128L, yet no virus reconstituted from them has been reported to acquire mutations in UL128L in vitro. We performed BAC mutagenesis and reconstitution experiments to test the hypothesis that these strains contain subtle mutations in UL128L that were acquired during passage prior to BAC cloning. Compared to strain Merlin containing wild-type UL128L, all three strains produced higher yields of cell-free virus. Moreover, TB40-BAC4 and FIX spread cell to cell more rapidly than wild-type Merlin in fibroblasts but more slowly in epithelial cells. The differential growth properties of TB40-BAC4 and FIX (but not TR) were mapped to single-nucleotide substitutions in UL128L. The substitution in TB40-BAC4 reduced the splicing efficiency of UL128, and that in FIX resulted in an amino acid substitution in UL130. Introduction of these substitutions into Merlin dramatically increased yields of cell-free virus and increased cell-to-cell spread in fibroblasts but reduced the abundance of pUL128 in the virion and the efficiency of epithelial cell infection. These substitutions appear to represent mutations in UL128L that permit virus to be propagated in fibroblasts while retaining epithelial cell tropism

The structure of Herpesvirus Fusion Glycoprotein B-Bilayer Complex reveals the protein-membrane and lateral protein-protein interaction

Glycoprotein B (gB) is a key component of the complex herpesvirus fusion machinery. We studied membrane interaction of two gB ectodomain forms and present an electron cryotomography structure of the gB-bilayer complex. The two forms differed in presence or absence of the membrane proximal region (MPR) but showed an overall similar trimeric shape. The presence of the MPR impeded interaction with liposomes. In contrast, the MPR-lacking form interacted efficiently with liposomes. Lateral interaction resulted in coat formation on the membranes. The structure revealed that interaction of gB with membranes was mediated by the fusion loops and limited to the outer membrane leaflet. The observed intrinsic propensity of gB to cluster on membranes indicates an additional role of gB in driving the fusion process forward beyond the transient fusion pore opening and subsequently leading to fusion pore expansion

Hypercoagulability progresses to hypocoagulability during evolution of acetaminophen-induced acute liver injury in pigs

Increases in prothrombin time (PT) and international normalised ratio (INR) characterise acute liver injury (ALI) and failure (ALF), yet a wide heterogeneity in clotting abnormalities exists. This study defines evolution of coagulopathy in 10 pigs with acetaminophen (APAP)-induced ALI compared to 3 Controls. APAP administration began at 0 h and continued to ‘ALF’, defined as INR >3. In APAP pigs, INR was 1.05 ± 0.02 at 0 h, 2.15 ± 0.43 at 16 h and > 3 at 18 ± 1 h. At 12 h thromboelastography (TEG) demonstrated increased clot formation rate, associated with portal vein platelet aggregates and reductions in protein C, protein S, antithrombin and A Disintegrin and Metalloprotease with Thrombospondin type 1 repeats–13 (ADAMTS-13) to 60%, 24%, 47% and 32% normal respectively. At 18 ± 1 h, INR > 3 was associated with: hypocoagulable TEG profile with heparin-like effect; falls in thrombin generation, Factor V and Factor VIII to 52%, 19% and 17% normal respectively; further decline in anticoagulants; thrombocytopenia; neutrophilia and endotoxemia. Multivariate analysis, found that ADAMTS-13 was an independent predictor of a hypercoagulable TEG profile and platelet count, endotoxin, Protein C and fibrinogen were independent predictors of a hypocoagulable TEG profile. INR remained normal in Controls. Dynamic changes in coagulation occur with progression of ALI: a pro-thrombotic state progresses to hypocoagulability