118 research outputs found
Puerperal Group A Streptococcal sepsis: a case report
Group A Streptococcal (GAS) sepsis in puerperium is one of the recognised causes of maternal mortality. Though the onset is often insidious, it can progress rapidly to a life-threatening invasive infection, toxin-mediated shock, and end-organ failure, even before clinical signs become apparent. We report a case of puerperal GAS sepsis that was successfully managed. 24-years-old para 1 was readmitted to the intensive care unit requiring non-invasive ventilation on postnatal day 6 with clinical and biochemical features of sepsis. Blood culture, episiotomy wound swab, and high vaginal swab grew GAS. Broad-spectrum antibiotics initiated. She developed ascites that progressively increased and needed therapeutic paracentesis. She was discharged after four weeks of hospitalization. Early identification and prompt treatment are the keys to prevent severe morbidity and maternal mortality
Risk factor profile of calcific aortic stenosis
AbstractBackgroundCalcific aortic stenosis and coronary artery disease share common risk factors. In some of the previous studies statins have been used to retard the progression of aortic stenosis, but the results were inconsistent.MethodsOne hundred and ten patients of CAS above the age of 40 years have undergone clinical, biochemical and echocardiographic evaluation. Coronary angiograms were done in 66% of them.ResultsMale to female ratio was 2:1. Patients of CAS with CAD showed higher prevalence of diabetes, hypertension, dyslipidemia, smoking and family history of CAD. Prevalence of obesity and bicuspid aortic valve by echocardiogram was high in those without CAD.ConclusionsOn comparison of prevalence of risk factor in those with and without associated CAD, there was higher prevalence of diabetes (65% vs 30%), hypertension (52% vs 43%), dyslipidemia (69% vs 52%), smoking (24% vs 18%) and family history of CAD (34% vs 16%) in those with associated CAD. The incidence of obesity was higher in those without CAD (20% vs 30%). The difference observed in diabetes alone was found to be statistically significant
Mechanism of Activation and Inhibition of the HER4/ErbB4 Kinase
SummaryHER4/ErbB4 is a ubiquitously expressed member of the EGF/ErbB family of receptor tyrosine kinases that is essential for normal development of the heart, nervous system, and mammary gland. We report here crystal structures of the ErbB4 kinase domain in active and lapatinib-inhibited forms. Active ErbB4 kinase adopts an asymmetric dimer conformation essentially identical to that observed to be important for activation of the EGF receptor/ErbB1 kinase. Mutagenesis studies of intact ErbB4 in Ba/F3 cells confirm the importance of this asymmetric dimer for activation of intact ErbB4. Lapatinib binds to an inactive form of the ErbB4 kinase in a mode equivalent to its interaction with the EGF receptor. All ErbB4 residues contacted by lapatinib are conserved in the EGF receptor and HER2/ErbB2, which lapatinib also targets. These results demonstrate that key elements of kinase activation and inhibition are conserved among ErbB family members
Structural studies and luminescence properties of CeO2:Eu3+ nanophosphors synthesized by oxalate precursor method
H3K9me2/3 Binding of the MBT Domain Protein LIN-61 Is Essential for Caenorhabditis elegans Vulva Development
MBT domain proteins are involved in developmental processes and tumorigenesis. In vitro binding and mutagenesis studies have shown that individual MBT domains within clustered MBT repeat regions bind mono- and dimethylated histone lysine residues with little to no sequence specificity but discriminate against the tri- and unmethylated states. However, the exact function of promiscuous histone methyl-lysine binding in the biology of MBT domain proteins has not been elucidated. Here, we show that the Caenorhabditis elegans four MBT domain protein LIN-61, in contrast to other MBT repeat factors, specifically interacts with histone H3 when methylated on lysine 9, displaying a strong preference for di- and trimethylated states (H3K9me2/3). Although the fourth MBT repeat is implicated in this interaction, H3K9me2/3 binding minimally requires MBT repeats two to four. Further, mutagenesis of residues conserved with other methyl-lysine binding MBT regions in the fourth MBT repeat does not abolish interaction, implicating a distinct binding mode. In vivo, H3K9me2/3 interaction of LIN-61 is required for C. elegans vulva development within the synMuvB pathway. Mutant LIN-61 proteins deficient in H3K9me2/3 binding fail to rescue lin-61 synMuvB function. Also, previously identified point mutant synMuvB alleles are deficient in H3K9me2/3 interaction although these target residues that are outside of the fourth MBT repeat. Interestingly, lin-61 genetically interacts with two other synMuvB genes, hpl-2, an HP1 homologous H3K9me2/3 binding factor, and met-2, a SETDB1 homologous H3K9 methyl transferase (H3K9MT), in determining C. elegans vulva development and fertility. Besides identifying the first sequence specific and di-/trimethylation binding MBT domain protein, our studies imply complex multi-domain regulation of ligand interaction of MBT domains. Our results also introduce a mechanistic link between LIN-61 function and biology, and they establish interplay of the H3K9me2/3 binding proteins, LIN-61 and HPL-2, as well as the H3K9MT MET-2 in distinct developmental pathways
Visualization of transcoronary ablation of septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: a comparison between cardiac MRI, invasive measurements and echocardiography
The limits of India’s ethno-linguistic federation: understanding the demise of Sikh nationalism
From 1984 until 1993, the Indian state of Punjab witnessed a sustained insurgency by Sikh militants campaigning for a separate sovereign state. This insurgency was ultimately defeated by the overwhelming use of security force that officially resulted in the deaths of 30,000 people. By the mid-1990s, a ‘normalcy’ had returned to Punjab politics, but the underlying issues which had fuelled the demand for separatism remain unaddressed. This paper examines critically the argument that India’s ethno-linguistic federation is exceptional in accommodating ethno-nationalist movements. By drawing on the Punjab case study, it argues that special considerations apply to the governance of peripheral regions (security, religion). Regional elites in these states struggle to build legitimacy because such legitimacy poses a threat to India’s nation and state-building. In short, India’s ethno-linguistic federation is only partially successful in managing ethno-linguistic demands in the peripheral Indian states
Can OCT change the therapeutic strategy in ACS due to plaque erosion?
The pathophysiology of acute coronary syndromes was thought to be coronary thrombosis over a plaque rupture. Autopsy studies revealed that not all cases were due to plaque rupture, even denuded endothelium or calcific nodule can beget a thrombus. Introduction of OCT made, in vivo recognition of lesion morphology clear. Plaque ruptures are most common and need primary angioplasty. Recent studies established plaque erosion is responsible for ACS in one third of the cases and majority of them present as Non ST elevation myocardial infarction and commonly found in young patients without major risk factors. Evidence from recent studies suggested that stenting can be deferred and they can be managed conservatively with good long term outcomes. More randomized trials are needed comparing plaque rupture and plaque erosion as regards conservative versus invasive management. If these studies substantiate the concept of conservative management, it will lead to a paradigm shift in their management
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