Pheochromocytoma associated with von Hippel-lindau disease in a Pakistani family

Objectives: The aim was to study the presentation, disease characteristics, operative outcome, and prognosis in patients with familial Pheochromocytoma associated with von Hippel-Lindau (VHL) disease.Materials and Methods: There were six patients belonging to two generations of a single family who developed features of VHL over a period of 13 years and were treated at our institute. Patients\u27 characteristics, that is, age, gender, presenting complaints and clinical signs, laboratory and biochemical evaluation, and the presence of associated conditions was gathered from medical records. The preoperative and postoperative radiological imaging and histopathological results were also collected.Results: Out of six cases, five were male, and one was female. The mean age at first presentation was 25 years (16-40). All patients presented with uncontrolled hypertension and were found to have Pheochromocytoma on workup. Three patients had unilateral adrenal tumor, and three had bilateral disease. None of the patients had extra-adrenal Pheochromocytoma. All patients were managed with adrenalectomy and had benign pathology. Two patients subsequently had craniotomy for excision of cerebellar hemangioma, and one patient had bilateral partial nephrectomy at the time of adrenalectomy. There was no peri- post-operative mortality and all patients are being followed by the surgeon(s) and endocrinologist.Conclusion: Pheochromocytoma can be a part of familial conditions including VHL. Other associated features should be suspected, investigated, and treated in these patients that can influence patients\u27 clinical course and prognosis. Family members should also be screened to achieve early diagnosis

Advances in role of organic acids in poultry nutrition: A review

Anti microbial drug resistance concerns scientists all around the world epically one used as livestock feed additives. Feed grade antibiotics are given in non therapeutic doses which lead to survival of pathogenic microbes which in turn develop drug resistance, thus necessitating researchers to search for alternative ways to feed grade antibiotics besides doing least compromise on growth parameters. Organic acids are used in poultry to lower the pH of intestinal tract which favours good microbes which in turn suppress pathogenic microbes thus evicting the use of antibiotics. They are used in poultry diets and drinking water to elicit a positive growth response, improving nutrient digestibility, performance and immunity in poultry. Literature shows that organic acids have more or less pronounced antimicrobial activity, depending on both the concentration of the acid and the bacterial species that is exposed to the acid. The variability in response of organic acids and its possible mechanisms are discussed. Scope of this paper is to provide a view of the use of organic acids in the prevention of enteric disease in poultry, the effect on the gastrointestinal tract (GIT), immunity and performance of broiler or laying hens. In the current review beneficial as-pects of organic acids along with different dose combinations are discussed to promote its optimum utilization in poultry nutrition and production

Nephron sparing surgery for renal tumors-Comparison of off-clamp partial nephrectomy with hilar clamping

Background and objective: Open partial nephrectomy (PN) is still considered gold standard procedure for T1 localized renal tumors. Conventional technique involves clamping of the renal artery with or without vein however, renal ischemia produces a certain level of damage to the kidneys. This study aims to investigate potential effect of off-clamp vs. hilar clamping PN on renal function.Methods: This is a retrospective cohort study of patients who underwent unilateral, open partial nephrectomy for renal tumors b/w January 2009 December 2016 at our institution. A total of 90 partial nephrectomies were performed of which 65 cases were eligible for analysis. Non clamping technique was used in 43 while clamp was applied in 22 patients. Variables studied were patients\u27 demographics, clinical variables, the laterality, tumors size and location, R.E.N.A.L nephrometry score, blood loss, tumor histology and surgical margins. Patients\u27 renal function (serum creatinine and eGFR) were determined pre-operatively, at 3 and 12 months follow up. Data was analyzed on SPSS v. 22.Results: Both the groups were comparable with regards to pre-operative renal function. Mean radiological size of tumor was 4.71±1.31 and 3.81±1.0 (0.003) in two groups respectively. Mean R.E.N.A.L nephrometry score was 6.1±1.5 in off-clamp group compared to 7.05 ± 1.7 in clamp group (p=0.04). No statistically significant difference was found in operative duration, blood loss, positive surgical margins and intra/ peri-operative complications. At three months and one year, renal function was better preserved in non-clamp group compared to clamp group (p=0.001 and 0.007 respectively).Conclusion: Off clamp open partial nephrectomy is safe and feasible option leading to less decline in renal function

Adrenalectomy for solitary metastasis of hepatocellular carcinoma post liver transplantation: case report and literature review

Abstract Liver transplantation (LT) is the treatment of choice for localized hepatocellular carcinoma (HCC) associated with cirrhosis. Extra hepatic metastasis is the most common cause of death in these patients. There is very little evidence regarding the natural history and treatment options for patients developing HCC recurrence after LT. Surgical resection offers a unique opportunity for solitary metastasis. We report a 61 year old male with solitary right adrenal metastasis 15 months post LT which was managed with open adrenalectomy. The patient is alive and disease free 24 months after the surgery. The case, histo-pathological findings and literature review is discussed

Carbon−Phosphorus Bond Activation of Tri(2-thienyl)phosphine at Dirhenium and Dimanganese Centers

Reaction of [Re2(CO)9(NCMe)] with tri(2-thienyl)phosphine (PTh3) in refluxing cyclohexane affords three substituted dirhenium complexes: [Re2(CO)9(PTh3)] (1), [Re2(CO)8(NCMe)(PTh3)] (2), and [Re2(CO)8(PTh3)2] (3). Complex 2 was also obtained from the room-temperature reaction of [Re2(CO)8(NCMe)2] with PTh3 and is an unusual example in which the acetonitrile and phosphine ligands are coordinated to the same rhenium atom. Thermolysis of 1 and 3 in refluxing xylene affords [Re2(CO)8(μ-PTh2)(μ-η1:κ1-C4H3S)] (4) and [Re2(CO)7(PTh3)(μ-PTh2)(μ-H)] (5), respectively, both resulting from carbon−phosphorus bond cleavage of a coordinated PTh3 ligand. Reaction of [Re2(CO)10] and PTh3 in refluxing xylene gives a complex mixture of products. These products include 3−5, two further binuclear products, [Re2(CO)7(PTh3)(μ-PTh2)(μ-η1:κ1-C4H3S)] (6) and [Re2(CO)7(μ-κ1:κ2-Th2PC4H2SPTh)(μ-η1:κ1-C4H3S)] (7), and the mononuclear hydrides [ReH(CO)4(PTh3)] (8) and trans-[ReH(CO)3(PTh3)2] (9). Binuclear 6 is structurally similar to 4 and can be obtained from reaction of the latter with 1 equiv of PTh3. Formation of 7 involves a series of rearrangements resulting in the formation of a unique new diphosphine ligand, Th2PC4H2SPTh. Reaction of [Mn2(CO)10] with PTh3 in refluxing toluene affords the phosphine-substituted product [Mn2(CO)9(PTh3)] (10) and two carbon−phosphorus bond cleavage products, [Mn2(CO)6(μ-PTh2)(μ-η1:η5-C4H3S)] (11) and [Mn2(CO)5(PTh3)(μ-PTh2)(μ-η1:η5-C4H3S)] (12). Both 11 and 12 contain a bridging thienyl ligand that is bonded to one manganese atom in a η5-fashion. The molecular structures of eight of these new complexes were established by single-crystal X-ray diffraction studies, allowing a detailed analysis of the disposition of the coordinated ligands

Interaction of palmitic acid with losartan potassium at the binding sites of bovine serum albumin

The binding of losartan potassium, an angiotensin II receptor antagonist, to bovine serum albumin was studied by equilibrium dialysis method (ED) in presence or absence of palmitic acid. The study was carried out using ranitidine and diazepam as site-1 and site-2 specific probe, respectively. Different analysis of binding of losartan to bovine serum albumin suggested two sets of association constants: high affinity association constant (k1 = 11.2 x 105 M-1) with low capacity (n1 = 2) and low affinity association (k2 = 2. 63 x 105 M-1) constant with high capacity (n2 = 10) at pH 7.4 and 27°C. During concurrent administration of palmitic acid and losartan potassium in presence or absence of ranitidine or diazepam, it was that found that palmitic acid causes the release of losartan potassium from its binding site on BSA resulting reduced binding of losartan potassium to BSA. The increment in free fraction of losartan potassium was from 13.1% to 47.2 % upon the addition of increased concentration of only palmitic acid at a concentration of 0 x 10-5 M to 16 x 10-5 M. In presence of ranitidine or diazepam as site specific probes, palmitic acid further increases the free fraction of losartan potassium were from 22.8% to 53.4% and 35.3 to 65.5%, respectively. This data provided the evidence of interaction of higher concentration of palmitic acid at the binding sites on BSA changing the pharmacokinetics properties of losartan potassium

Global changes in the proteome of Cupriavidus necator H16 during poly-(3-hydroxybutyrate) synthesis from various biodiesel by-product substrates

Additional file 1: Table S1. P-scores of proteomic runs of C. necator H16 grown with different substrates

Efficacy of postural awareness by booklet on back pain among the sweet makers

Background: The purpose of the study was to identify the efficacy of postural awareness by a booklet on back pain among sweet makers. Objective was to explore socio-demographic (age, gender, educational status, occupation) characteristics of sweet-makers with back pain. To compare the rating of pain intensity before and after postural awareness by a booklet with the back pain of sweet-makers. Methods: This study was conducted by pre-test post-test experimental study in which a total of 25 sweet-makers were selected with back pain from January 2021 to December 2022. Data were collected by using the functional rating index questionnaire to evaluate the activity of daily living and pain measured by the visual analogue scale questionnaire. Statistical package for the social sciences (SPSS) was used for data analysis. Results: In this study, the results showed significant improvement in the reduction of back pain and increase functional activities of daily living by postural awareness with an educational booklet among sweet-makers. The NPRS score in pair sample t-test before and after 15 days of postural awareness by booklet was the level of significant 0.000123, the mean of 0.640±0.700. The pattern of pain before and after 15 days of postural awareness by booklet was the level significant 0.042896 when the mean difference was -0.160±0.374. The referred pain before and after 15 days of postural awareness by booklet was 0.000032 level significant where the mean difference was -0.520±0.510. Conclusions: The result of this study suggests that postural awareness through a booklet on back pain was effective and it also improves activities of daily living among sweet-makers.