Importance of the Levothyroxine Absorption Test in an Adolescent Girl

Hypothyroidism is a commonly encountered problem in daily clinical practice. Although the management of hypothyroidism may seem straightforward, it can become challenging when patients’ Thyroid-Stimulating Hormone (TSH) values remain elevated despite treatment. Various factors, including non-adherence and malabsorption, can contribute to this issue. Consequently, it is crucial to identify the underlying cause of increased levothyroxine demand, as this will prevent unnecessary dosage adjustments of levothyroxine tablets. In this case, a 13-year-old girl patient, presented with a TSH level greater than 200 and an fT4 level of 0.34, along with absent secondary sexual characteristics, impaired memory, delayed puberty, easy susceptibility to anxiety, difficulty with memorisation, and poor academic performance. Despite repeated inquiries, neither she nor her mother reported any instances of non-compliance. Additionally, there were no signs suggestive of malabsorption, such as diarrhoea or oedema. Therefore, a levothyroxine absorption test was conducted to rule out pseudo-malabsorption. This test aids in distinguishing patients with non-compliance from those with true malabsorption, thereby avoiding unnecessary dosage adjustments of levothyroxine supplementation, a problem frequently encountered in day-to-day clinical practice

Nanodomain cubic cuprous oxide as reusable catalyst in one-pot synthesis of 3-alkyl/aryl-3-(pyrrole-2-yl/indole-3-yl)-2-phenyl-2,3-dihydro-isoindolinones in aqueous medium

An environmentally benign one-pot protocol has been developed for the syntheses of 3-alkyl/aryl-3-(pyrrole/indole-2/3-yl)-2-phenyl-2,3-dihydro-isoindolinones via a multi-component one-pot reaction involving 2-iodo-N-phenylbenzamides, terminal alkyne and substituted indoles/pyrroles in aqueous medium using cubic cuprous oxide nanoparticles as catalyst. It involves domino Sonogashira-5-exo-dig-cyclization followed by regioselective nucleophilic addition of indoles or pyrroles, in aqueous medium without using any surfactants or additional ligands

Isolation of indigenous <i>Staphylococcus sciuri</i> from chromium-contaminated paddy field and its application for reduction of Cr(VI) in rice plants cultivated in pots

<p>Accumulation of Cr(VI) in rice seeds cultivated in Cr-contaminated soil of the Sundarbans (India) is an environmental problem. Cr(VI) concentration in this soil was 6.2 ± 0.3 mg/kg, whereas total chromium was 32.04 ± 1.60 mg/kg. A Cr(VI)-removing bacterium isolated from Cr-contaminated paddy field soil of Sundarbans was identified as <i>Staphylococcus sciuri</i>. Enrichment culture of <i>S. sciuri</i> was applied to pot cultivation of rice in Cr-contaminated soil. After 8 weeks, 71 ± 3% Cr(VI) (final concentration 2.15 ± 0.01 mg/kg) and 65 ± 2% total Cr removal (end concentration 11.3 ± 0.5 mg/kg) were attained in bacterium-treated soils. Growth parameters indicated healthy development of plants cultivated in bacterium-treated soils that was not observed in control plants. Total Cr removal attained in rice seeds of plants cultivated in bacterium-treated soils compared with control rice seeds was 78 ± 4%. Total Cr concentration in test seeds was 0.72 ± 0.05 mg/kg (World Health Organization [WHO] permissible limit: 1.30 mg/kg), whereas the same in control seeds was 3.27 ± 0.16 mg/kg. Cr(VI) reduction achieved in rice seeds cultivated in bacterium-treated soil compared with control rice seeds was 95 ± 5%. Cr(VI) concentration in rice seeds cultivated in treated soil was 0.050 ± 0.003 mg/kg, whereas the same in untreated control was 0.93 ± 0.05 mg/kg. Successful paddy field soil bioremediation by any <i>Staphylococcus</i> species was demonstrated for the first time.</p

Disease-associated glycosylated molecular variants of human C-reactive protein activate complement-mediated hemolysis of erythrocytes in tuberculosis and Indian visceral leishmaniasis

Human C-reactive protein (CRP), as a mediator of innate immunity, removed damaged cells by activating the classical complement pathway. Previous studies have successfully demonstrated that CRPs are differentially induced as glycosylated molecular variants in certain pathological conditions. Affinity-purified CRPs from two most prevalent diseases in India viz. tuberculosis (TB) and visceral leishmaniasis (VL) have differential glycosylation in their sugar composition and linkages. As anemia is a common manifestation in TB and VL, we assessed the contributory role of glycosylated CRPs to influence hemolysis via CRP-complement-pathway as compared to healthy control subjects. Accordingly, the specific binding of glycosylated CRPs with erythrocytes was established by flow-cytometry and ELISA. Significantly, deglycosylated CRPs showed a 7–8-fold reduced binding with erythrocytes confirming the role of glycosylated moieties. Scatchard analysis revealed striking differences in the apparent binding constants (104–105M−1) and number of binding sites (106–107sites/erythrocyte) for CRP on patients’ erythrocytes as compared to normal. Western blotting along with immunoprecipitation analysis revealed the presence of distinct molecular determinants on TB and VL erythrocytes specific to disease-associated CRP. Increased fragility, hydrophobicity and decreased rigidity of diseased-erythrocytes upon binding with glycosylated CRP suggested membrane damage. Finally, the erythrocyte-CRP binding was shown to activate the CRP-complement-cascade causing hemolysis, even at physiological concentration of CRP (10μg/ml). Thus, it may be postulated that CRP have a protective role towards the clearance of damaged-erythrocytes in these two disease