Neurocysticercosis: clinical presentations, serology and radiological findings: experience in a teaching institution

Background: The objective of the study was to study the clinical presentations, serological evidence and radiological findings in cases of neurocysticercosis in a teaching institution with attached tertiary care hospital settings.Methods: A total of 60 paediatric age group patients were enrolled in the study and their clinical presentations, serological profile and radiological findings were recorded. Study data was evaluated in a retrospective analysis of the descriptive hospital based observational study conducted at Safdarjang hospital (SJ) hospital, New Delhi.Results: Generalised seizures were the most predominant clinical presentation in 28/60 cases (47%). Majority of the patients had single lesions in parietal lobe in CT head. 90% of the patients showed perilesional oedema on CT scan. Differences in IgG positivity rate in the various age groups were not significant either for serum or CSF - the p values were 0.67 & 0.052 respectively. Seropositivity was also not significantly associated with presence of active NCC lesions on CT (p= 0.254). In further analysis, diet was not found to have any significant influence on either seropositivity (p value=0.673) or on the pattern of presentation on CT (p=0.260). NBM-It is disappointing to know that only 20% urban 45%rural is aware of 8 hours NBM before surgery.Conclusions: Observations suggest there is variability in the clinical, serological and radiological presentation of neurocysticercosis when compared with standard criteria.

Triple-Vessel Percutaneous Coronary Revascularization In Situs Inversus Dextrocardia

Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population

Regulation of expression of the rat orthologue of mouse double minute 2 (MDM2) by H2O2-induced oxidative stress in neonatal rat cardiac myocytes.

The Mdm2 ubiquitin ligase is an important regulator of p53 abundance and p53-dependent apoptosis. Mdm2 expression is frequently regulated by a p53 Mdm2 autoregulatory loop whereby p53 stimulates Mdm2 expression and hence its own degradation. Although extensively studied in cell lines, relatively little is known about Mdm2 expression in heart where oxidative stress (exacerbated during ischemia-reperfusion) is an important pro-apoptotic stimulus. We demonstrate that Mdm2 transcript and protein expression are induced by oxidative stress (0.2 mm H(2)O(2)) in neonatal rat cardiac myocytes. In other cells, constitutive Mdm2 expression is regulated by the P1 promoter (5' to exon 1), with inducible expression regulated by the P2 promoter (in intron 1). In myocytes, H(2)O(2) increased Mdm2 expression from the P2 promoter, which contains two p53-response elements (REs), one AP-1 RE, and two Ets REs. H(2)O(2) did not detectably increase expression of p53 mRNA or protein but did increase expression of several AP-1 transcription factors. H(2)O(2) increased binding of AP-1 proteins (c-Jun, JunB, JunD, c-Fos, FosB, and Fra-1) to an Mdm2 AP-1 oligodeoxynucleotide probe, and chromatin immunoprecipitation assays showed it increased binding of c-Jun or JunB to the P2 AP-1 RE. Finally, antisense oligonucleotide-mediated reduction of H(2)O(2)-induced Mdm2 expression increased caspase 3 activation. Thus, increased Mdm2 expression is associated with transactivation at the P2 AP-1 RE (rather than the p53 or Ets REs), and Mdm2 induction potentially represents a cardioprotective response to oxidative stress

A study to determine the three-dimensional (3D) facial shape characteristics for a successful FFP3 mask fit

A reported 20% of dental staff will fail their fit test for a disposable FFP3 respirator. This needs to be factored into future pandemic workforce and PPE supply planning. At present there are no scientifically or universally accepted facial shape criteria to design and produce facial masks that will fit the entire work force. This study presents differences in facial shape, volume and surface area between individuals who passed on several FFP3 masks (pass group) and participants who passed on only one FFP3 mask (fail group). Three dimensional images of 50 individuals, 25 in each group, were taken at rest and at maximum smile using a DI4D SNAP 6200 camera system. The images were processed, and four “average faces” were produced—pass group at rest, fail group at rest, pass group at maximum smile and fail group at maximum smile. Simple Euclidian linear and angular measurements, geodesic surface distances and volume and surface area enclosed within the mask were analysed. The results of the study show that individuals who are more likely to pass a mask fit test have longer faces, wider mouths, greater geodesic surface distances and a greater volume and surface area of soft tissue enclosed within the mask boundary. This would suggest that some manufactures masks may be too large, and they need to reduce the size of their masks or produce a category of sizes, accepting the fact that one size does not fit all

Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry:a systematic review

ObjectiveTo systematically review the literature for mid-sagittal plane establishment approaches to identify the most effective method for constructing the mid-sagittal plane for the evaluation of facial asymmetry.Materials and methodsSix electronic databases (PubMed, Medline (via Ovid), EMBASE (via Ovid), Cochrane Library, Web of Science, and Scopus) and grey literature were searched for the studies that computed the mid-sagittal reference plane three-dimensionally, using a combination of MeSH terms and keywords. The methodological quality and the level of evidence for the included studies were analyzed using QUADAS-2 and GRADE, respectively.ResultsThe preliminary search yielded 6746 records, of which 42 articles that met the predefined inclusion criteria were included in the final analysis. All the included articles reported the construction of the mid-sagittal reference plane (MSP) using varied methods. The risk of bias and concerns regarding the applicability of the included studies were judged to be ‘low’. The level of evidence was determined to be ‘low’ for the effectiveness of the technique and ‘moderate’ for the ease of clinical applicability.ConclusionDespite methodological heterogeneity, this review substantiates the comparable efficacy of cephalometric and morphometric MSP construction methods. A fully automated morphometric MSP holds promise as a viable option for routine clinical use. Nevertheless, future prospective studies with an emphasis on the impact, accuracy, and clinical applicability of MSP construction techniques in cases of facial asymmetry are required.Clinical relevanceThe present review will assist clinicians in selecting the most suitable method for MSP construction, leading to improved treatment planning and ultimately more favorable treatment outcomes.<p/

Comparative Analysis of Molecular Structure, Function and Expression of Buffalo (Bubalus bubalis) Toll-Like Receptor 9

Toll-like receptor 9 (TLR9) has been characterized as a receptor that recognizes unmethylated CpG motif and triggers a pro-inflammatory cytokine response that influences both innate and adaptive immunity. Buffalo is an economically important livestock species in many Asian and Mediterranean countries, but there is little information available on its TLR9 structure and response to stimulation with its agonist CpG-ODNs. Hence in this study, we report the analysis of newly sequenced buffalo TLR9 gene fragment. In this study, buffalo TLR9 amino acid sequence revealed close association of TLR9 proteins within other bovines and small ruminants; but high divergence from other species. Multiple alignment of deduced amino acid sequence of Bubalus bubalis TLR9 with other species showed that 156/201 (74.28%) amino acids were conserved in all species. Leucine rich repeat (LRR) motifs in the ectodomain of TLR9 are responsible for molecular recognition of its agonist. The LRR pattern of Bubalus bubalis TLR9 protein was predicted towards N-terminal sequence and was found to be conserved among all species except Rattus norvegicus and Equus caballus. Blast analysis of buffalo TLR9 sequence with single nucleotide polymorphisms (SNPs) database revealed 13 SNPs out of which 7 were cds-synonymous and 6 were of the functional significance. Furthermore, kinetics of TLR9 and proinflammatory IL-beta and TNF-alpha cytokine expression by buffalo PBMCs influenced by CpG-ODN is also discussed