Isolation and Characterization of Different Aggregates of Lipid from Bovine Milk

Bovine milk fat globules naturally vary from less than 0.2 µm to 15 µm in diameter. Milk has at least two distinct distributions of fat globules. While the majority (~90%) of globules in milk are of the smaller distribution (average diameter of 0.4 µm), virtually all the fat is carried in the larger globules (average diameter 3.5 µm). This distribution suggests some compositional and/or functional significance might exist between the two populations of fat globules, which may be related to origin of these globules in the lactating cell. Milk fat globules have a unique structure, composed of a core droplet of non polar lipids (triacylglycerol) surrounded by a lipid bilayer membrane known as milk fat globule membrane (MFGM). Other than MFGM, there is another source of membrane that has been identified in skim milk. It has been hypothesized that this skim milk membrane (SMM) is derived from MFGM, but little data are available to support this idea, and the membrane may also have alternate origins. In this study, different aggregates of lipids (small and large fat globules, SMM, skim milk) from milk were isolated and characterized for their lipid contents. Isolation of small and large fat globules fractions was verified by laser diffraction particle size analysis. The lipids were extracted from isolated different lipid aggregates and individual classes were separated using thin layer chromatography. Lipids were transesterified to fatty acid methyl esters and analyzed by gas chromatography-mass spectrometry. The results indicate that there are some compositional differences between native milk fat globule membranes of different sizes. For example, the total phospholipid fraction of small fat globules (SFG) contained significantly more unsaturated C18:1n9 and C18:2n6 than large fat globules (LFG). Conversely, sphingomyelin composition of SFG contained less C18:1n9 and C18:2n6cc, but more long chain fatty acids C22:0, C23:0, and C24:0. Phosphatidylethanolamine composition of SMM contained more C17:1 than SFG and LFG. The composition of C18:1n9 in triacylglycerol increased with fat globule size. Clear differences were also found in lipid profile of SMM and small and large fat globules from milk. Composition differences between SMM and native milk fat globules of different sizes suggest that origin of this membrane material in skim milk might have some different source than that of MFGM

Outcome analysis of holmium laser and pneumatic lithotripsy in the endoscopic management of lower ureteric calculus in pediatric patients: a prospective study

ABSTRACT Objective: To analyse outcomes of holmium laser and pneumatic lithotripsy in treatment of lower ureteric calculus in pediatric patients. Materials and methods: Prospective study conducted between August 2013 and July 2015. Inclusion criteria were lower ureteric calculus with stone size ≤1.5cms. Exclusion criteria were other than lower ureteric calculus, stone size ≥1.5cms, congenital renal anomalies, previous ureteral stone surgery. Patients were divided into two groups. Group A underwent pneumatic and group B underwent laser lithotripsy procedure. Patient's baseline demographic and peri-operative data were recorded and analysed. Post operatively X-ray/ultrasound KUB (Kidney, ureter and bladder) was performed to assess stone free status. Results: A total of 76 patients who met the inclusion criteria to ureteroscopic intracorporeal lithotripsy were included. Group A and B included 38 patients in each. Mean age was 12.5±2.49 in Group A and 11.97±2.74 years in Group B respectively (p=0.38). Overall success rate was 94.73% in Group A and 100% in Group B, respectively (p=0.87). Conclusion: Holmium Laser lithotripsy is as efficacious as pneumatic lithotripsy and can be used safely for the endoscopic management of lower ureteric calculus in pediatric patients. However, holmium laser requires more expertise and it is a costly alternative

Foreign Bodies in the Urinary Bladder and Their Management: A Single-Centre Experience From North India

Purpose This study was performed to characterise the nature, clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital. Methods Between January 2008 and December 2014, 49 patients were treated for intravesical foreign bodies at King George Medical University, Lucknow. All records of these patients were retrospectively analysed to characterise the nature of the foreign body, each patient’s clinical presentation, the mode of insertion, and how the case was managed. Results A total of 49 foreign bodies were retrieved from patients’ urinary bladders during the study period. The patients ranged in age from 11 to 68 years. Thirty-three patients presented with complaints of haematuria (67.3%), 29 complained of frequency of urination and dysuria (59.1%), and 5 patients reported pelvic pain (10.2%). The circumstances of insertion were iatrogenic in 20 cases (40.8%), self-insertion in 17 cases (34.6%), sexual abuse in 4 cases (8.1%), migration from another organ in 4 cases (8.1%), and assault in 4 cases (8.1%). Of the foreign bodies, 33 (67.3%) were retrieved by cystoscopy, while transurethral cystolitholapaxy was required in 10 patients (20.4%), percutaneous suprapubic cystolitholapaxy was performed in 4 patients (8.1%), and holmium laser lithotripsy was performed in 2 patients (4.08%). Conclusions Foreign bodies should always be included in the differential diagnosis when evaluating a patient who presents with chronic lower urinary tract symptoms. A large percentage of foreign bodies can be retrieved using endoscopic techniques. Open surgical removal may be performed in cases where endoscopic techniques are unsuitable or have failed

Intraoperative breakage of Sachse’s knife blade: a rare complication of optical internal urethrotomy (one case managing experience)

ABSTRACT Optical internal urethrotomy (OIU) is the most common procedure performed for short segment bulbar urethral stricture worldwide. This procedure most commonly performed using Sachse’s cold knife. Various perioperative complications of internal urethrotomy have been described in literature including bleeding, urinary tract infection, extravasation of fluid, incontinence, impotence, and recurrence of stricture. Here we report a unique complication of breakage of Sachse knife blade intraoperatively and its endoscopic management

Prospective study to evaluate the clinical outcome of intralesional interferon-α2b in the management of Peyronie's disease

Context: Interferon (IFN)-α2b in Peyronie's disease (PD). Aims: This study aims to evaluate clinical efficacy of the IFN-α2b in both subjective and objective manner for the treatment of PD and compared with previously used intralesional verapamil in terms of cost-benefit analysis. Settings and Design: Prospective study. Materials and Methods: A prospective study conducted from January 2013 to July 2016 in the Department of Urology, Government Medical College, Kota, Rajasthan, India. We included patients with identifiable Peyronie's plaque with or without pain, curvature ranging between 30 and 90 degrees. We excluded patients with a calcified plaque and the ventral location of the plaque, any infective foci over the penis, erectile dysfunction due to other etiologies and patients who had received previous intralesional therapy. Patients were evaluated by clinical history, physical examination including plaque location, size, consistency, and penile curvature. Patients received intralesional IFN-α2b in a dose of 3 × 106 IU. Patients completed the visual analogue pain (VAS) score for pain, and International Index of Erectile Function-5 (IIEF-5) questionnaire at first visit as well as at follow-up of 1 month and 3 months. Statistical Analysis Used: Comparisons were performed using the paired Student's t-test and Chi-square tests as appropriate. Patient's objective and subjective clinical characteristics were described as a means (standard deviation). Results: We included 86 patients in this study. Patients had a mean age of 48.6 years, mean plaque volume 256 mm3, and disease duration of 15.2 years. After 1 month of treatment, there was a significant change in plaque volume 256–60.8 mm3; P < 0.01) and penile curvature 34.8–24.6°; P < 0.01). The patients reported significant improvement in pain score VAS and IIEF-5. Conclusions: IFN-α2b, as minimal invasive (intralesional) options for the treatment of PD, demonstrated significant improvement in plaque volume, penile curvature with minimal complications. Patients subjectively reported significant improvement in pain on erection and sexual activities. IFN-α2b and verapamil had an almost similar clinical outcome, but verapamil at much lower cost