Spectrum of clinical and biochemical profile and its importance in diabetic ketoacidosis: a tertiary care hospital experience in Gujarat

Background: Diabetes mellitus (DM) is a disorder of multiple etiologies, and diabetic ketoacidosis (DKA) is one of the life-threatening complications of DM. This study was aimed to study the clinical and biochemical profile of DKA patients. Methods: We conducted this retrospective study at a tertiary care hospital in Gujarat. We included total 100 patients above the age of 18 years having DM, presented with DKA. A detailed history, clinical examination and biochemical tests were carried out: random blood sugar, urinalysis, arterial blood gas analysis, serum ketone, HbA1c, serum creatinine, serum electrolytes- potassium and sodium and serum osmolality. The results were analysed using Microsoft excel. Results: Out of total 100 patients, 76 (76%) patients had type 1 DM and 24 (24%) had type 2 DM, 42 (42%) were in the age group of 18-30 years. The mean age was 39.75±12.14 years. There were 56 (56%) males and 44 (44%) females with male: female ratio of 1.3:1. Most common clinical features of DKA were nausea/vomiting (88%), breathlessness (43%) and fever (35%). The main biochemical parameters altered were blood sugar (>400 mg/dl in 41%) and serum ketones (≥5 in 84%) as well as majority of patients (64%) had their HbA1c level between 11-15% with the mean HbA1c value of 12.25±2.43%. Conclusions: DKA is a frequently observed emergency with high mortality rate. Education regarding symptoms of ketoacidosis, not missing insulin doses especially during illness, strict adherence to treatment and lifestyle modifications can greatly reduce DKA occurrence

A rare case of retroperitoneal leiomyosarcoma

Leiomyosarcoma, a rare malignancy of smooth muscle may arise from the retroperitoneum. They often reach a large size before diagnosis is made. Patient presents with vague symptoms, as such retroperitoneal malignancies are related to displacement of organs and obstructive phenomenon. The present paper is one of the very few case reports of retroperitoneal leiomyosarcoma which illustrates the presenting symptoms, gross and microscopic findings, treatment modalities and prognostic indicators of a 70 years old male seen at Government medical college, New Civil Hospital, Surat

Antimicrobial and anti-inflammatory screening of four indian medicinal plants

Inflammatory diseases including different types of rheumatic diseases are very common throughout the world. The greatest disadvantage in the presently available potent synthetic drugs lies in their side effects, toxicity and reappearance of the symptoms after discontinuation. Hence search for new antimicrobial and anti-inflammatory agents are needed. Antimicrobial study was done by agar disc diffusion method against 5 Gram positive, 7 Gram negative and 3 fungal strains and acute anti-inflammatory activity was studied by carrageenan induced paw edema in rats. Plants screened were Aristolochia indica, Argemone mexicana, Alpinia speciosa and Gymnema sylvestre. Methanolic extract of these plants were studied at 200 mg/kg and 400 mg/kg dose level. The results were compared with standard drug indomethacin. All the plant extracts showed better antibacterial activity than antifungal activity. The Gram positive bacteria were more susceptible than Gram negative bacteria. Argemone mexicana gave more antimicrobial and anti-inflammatory activity than the other three plants.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Measurement of H₂O₂ within living drosophila during aging using a ratiometric mass spectrometry probe targeted to the mitochondrial matrix

Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) is central to mitochondrial oxidative damage and redox signaling, but its roles are poorly understood due to the difficulty of measuring mitochondrial H<sub>2</sub>O<sub>2</sub> in vivo. Here we report a ratiometric mass spectrometry probe approach to assess mitochondrial matrix H<sub>2</sub>O<sub>2</sub> levels in vivo. The probe, MitoB, comprises a triphenylphosphonium (TPP) cation driving its accumulation within mitochondria, conjugated to an arylboronic acid that reacts with H<sub>2</sub>O<sub>2</sub> to form a phenol, MitoP. Quantifying the MitoP/MitoB ratio by liquid chromatography-tandem mass spectrometry enabled measurement of a weighted average of mitochondrial H<sub>2</sub>O<sub>2</sub> that predominantly reports on thoracic muscle mitochondria within living flies. There was an increase in mitochondrial H<sub>2</sub>O<sub>2</sub> with age in flies, which was not coordinately altered by interventions that modulated life span. Our findings provide approaches to investigate mitochondrial ROS in vivo and suggest that while an increase in overall mitochondrial H<sub>2</sub>O<sub>2</sub> correlates with aging, it may not be causative

Indirect Determination Of Hydroxyl Radicals In Fine Particle Mist Generated From An Odor Control Technology Via Hplc

Size distribution analysis of microsized water particle mist generated from an odor control technology showed the majority of particles to be in the low micron range. The indirect detection and determination of hydroxyl radicals generated by their reaction with benzene to produce phenol was performed through UV-Vis spectrophotometry (UV-Vis) and high performance liquid chromatography (HPLC). These techniques gave verification of the presence of hydroxyl radical species in the water samples collected via this odor control technology. This technology is currently being utilized at various wastewater treatment plants. © 2013 Copyright 2013 International Ozone Association

Dego's disease in a female child with Anti-Scl-70 antibody positivity

Degos' disease (DD) also known as malignant atrophic papulosis is considered to be a disorder of abnormal coagulation with obliterative arteritis. Its association has been described with connective tissue disorders, human immunodeficiency virus infection (HIV) and wegener's granulomatosis. Gastrointestinal, neurological, ocular, cardiovascular, and pulmonary involvement can also occur in DD. Benign version of DD with only cutaneous manifestations has been described. We are presenting a case of 7-year-old female with multiple irregular-shaped crusted tender lesions with porcelain white scars of healed lesions mainly over the trunk and upper limb and few lesions involving face and legs for the last 6 months. There was a history of occasional headache. Other systemic examination by experts was within normal limit. On further investigation, antinuclear antibody, and anti-Scl-70 antibody were positive with histopathology suggestive of DD. The patient had reduced peak expiratory flaw rate (PEFR). The patient was given oral prednisolone without much improvement. With oral aspirin for a month, the patient had mild improvement. The patient is presently under follow-up for future systemic involvement and response to therapy. Anticipated mortality in DD is 50%–60%. Earlier diagnosis and proper management at such a younger age might benefit the patient; however, they need to be followed up for complications. DD is very rare and very few cases have been reported in children. Ours is unique with anti-Scl-70 antibody positivity

A cross-sectional study of clinical, histopathological and direct immmunofluorescence diagnosis in autoimmune bullous diseases

Background: Immunobullous diseases are morphologically heterogeneous and the differentiation between various subtypes is essential for proper treatment and prognosis. Aim of our study was to analyze and correlate clinical, histopathological and immunofluorescence findings in autoimmune bullous diseases. Materials and Methods: A cross-sectional study was done over a period of two years (2010-2012) after approval of the ethics committee. Sixty patients, who met the inclusion criteria of immunobullous disease, were included in the study. Skin biopsy for histopathology and direct immunofluorescence (DIF) examination was taken. DIF using salt-split technique was done in few of the cases. The final diagnosis was based on clinical, histopathology and DIF findings. Pearson′s coefficient of correlation (r) was calculated. Statistical Analysis was done using Epi info version. 7.0. Results: Fifty-three cases with clinical diagnosis of autoimmune bullous diseases were evaluated. In 88.6% of cases, histopathology diagnosis was consistent with clinical diagnosis and in 75.5% of cases, DIF findings were consistent with clinical diagnosis. A positive relation was seen between clinical and DIF findings with r = 0.65 and between histopathology and DIF findings with r = 0.75. DIF positivity was seen in 100% cases of bullous pemphigoid (BP) and pemphigus foliaceous and 94.7% cases of pemphigus vulgaris, which was statistically significant with p < 0.05. In DIF salt-split test, deposition was seen on roof of blister in BP whereas on floor in epidermolysis bullosa acquisita. Conclusion: Our study provides evidence-based guidance for the diagnosis and classification of various immunobullous disorders. DIF test should be done in conjunction with histopathology for definitive diagnosis and to minimize both: False-positive and false-negative results

Oral manifestations in patients with gastro-esophageal reflux disease: A hospital-based case-control study

Aim: To analyze the occurrence and correlation of oral manifestations of patients affected by gastro-esophageal reflux disease (GERD), especially with dental erosion. Materials and Methods: With a simple randomization method, a total of 120 patients, GERD-diagnosed patients (group 1, n = 60), based on complaints and reviewed by gastroenterologists through proper history, clinical pictures, and established investigations, and healthy individuals (group 2, n = 60), were enrolled in the study. Oral manifestations such as xerostomia, oral acid/burning sensation, subjective halitosis, dental sensitivity, and dental erosion were evaluated in both groups. The Chi-square test and continuous variables were compared by the Mann–Whitney test and the Kruskal–Wallis test (P value < 0.05, significant). Results: The Mann–Whitney U test on the distribution of the gastric complaints between two groups revealed a significant difference in all the variables. A significant difference was found in the distribution of all the oral manifestations except halitosis and dentinal hypersensitivity between both groups. The Chi-square test between the heartburn and dental erosions revealed a significant association (c2 = 293.761, df = 1, P < 0.001), whereas there was no significant association between heartburn and dentinal hypersensitivity. Conclusion: GERD and dental erosions had no significant correlation, whereas other oral manifestations and mucosal changes were found significant with GERD