Diagnostic laparoscopy in isolated torison of hydrosalpinx: a likely cure for an unlikely disorder

Isolated torsion of fallopian tubes is a rare cause of acute abdomen. It is a diagnosis that is often reached after much delay. This is primarily because it has no pathognomonic clinical, radiological or laboratory signs. In such cases, it is advisable to have a low threshold for diagnostic laparoscopy. We managed a middle-aged lady with acute abdomen and after initial tests were inconclusive, we proceeded to diagnostic laparoscopy without much delay and found a twisted right hydrosalpinx. We performed a right salpingectomy as her family was complete. The fallopian tube and ovary usually act as a unit and an isolated torsion of the fallopian tube is a rare occurrence with few tell-tale sign. After cross sectional imaging, we can be fairly certain of an adnexal pathology. A delay in making a diagnosis can lead to catastrophic consequences in such conditions. An early laparoscopy can be both diagnostic and therapeutic in these cases

ASSESSMENT OF IONIZED CALCIUM STATUS IN FEBRILE SEIZURES

Introduction: Epilepsy is one of the most common disorders of the brain1. One of every ten people will have at least one epileptic seizure during a normal lifespan, and a third of these will develop epilepsy. In children the most common forms of convulsion are febrile seizures. Water electrolyte imbalance occurs during acute febrile illness and hypocalcaemia is one of them. Hypocalcaemia is also present in cases of seizures. To find out significance of calcium levels in cases of seizures this study was conducted. Aims and objectives: To assess the level of ionized calcium in cases of febrile seizure. Methods: This Case - Control study was conducted on fifty cases of febrile seizures and fifty age, weight matched controls at Department of Biochemistry, Varun Arjun Medical College, Shahjahanpur,U.P., India. Results: Mean ionized calcium level was 4.62 ±0.26mg/dl and 4.88 ±0.27 mg/dl in study and control groups respectively and this difference was found statistically highly significant (p<0.001). Conclusion: The findings suggest that a considerable percentage of children having febrile seizures suffer from calcium deficiency

Mapping the Strengths and Difficulties Questionnaire onto the Child Health Utility 9D in a large study of children

Purpose Non-preference-based measures cannot be used to directly obtain utilities but can be converted to preference-based measures through mapping. The only mapping algorithm for estimating Child Health Utility-9D (CHU9D) utilities from Strengths and Difficulties Questionnaire (SDQ) responses has limitations. This study aimed to develop a more accurate algorithm. Methods We used a large sample of children (n = 6898), with negligible missing data, from the Longitudinal Study of Australian Children. Exploratory factor analysis (EFA) and Spearman’s rank correlation coefficients were used to assess conceptual overlap between SDQ and CHU9D. Direct mapping (involving seven regression methods) and response mapping (involving one regression method) approaches were considered. The final model was selected by ranking the performance of each method by averaging the following across tenfold cross-validation iterations: mean absolute error (MAE), mean squared error (MSE), and MAE and MSE for two subsamples where predicted utility values were  0.90 (healthy). External validation was conducted using data from the Child and Adolescent Mental Health Services study. Results SDQ and CHU9D were moderately correlated (ρ = − 0.52, p < 0.001). EFA demonstrated that all CHU9D domains were associated with four SDQ subscales. The best-performing model was the Generalized Linear Model with SDQ items and gender as predictors (full sample MAE: 0.1149; MSE: 0.0227). The new algorithm performed well in the external validation. Conclusions The proposed mapping algorithm can produce robust estimates of CHU9D utilities from SDQ data for economic evaluations. Further research is warranted to assess the applicability of the algorithm among children with severe health problems

ASSESSMENT OF IONIZED CALCIUM STATUS IN FEBRILE SEIZURES

Introduction:&nbsp;Epilepsy is one of the most common disorders of the brain1. One of every ten people will have at least one epileptic seizure during a normal lifespan, and a third of these will develop epilepsy. In children the most common forms of convulsion are febrile seizures. Water electrolyte imbalance occurs during acute febrile illness and hypocalcaemia is one of them. Hypocalcaemia is also present in cases of seizures. To find out significance of calcium levels in cases of seizures this study was conducted. Aims and objectives:&nbsp;To assess the level of ionized calcium in cases of febrile seizure. Methods:&nbsp;This Case - Control study was conducted on fifty cases of febrile seizures and fifty age, weight matched controls at Department of Biochemistry, Varun Arjun Medical College, Shahjahanpur,U.P., India. Results:&nbsp;Mean ionized calcium level was 4.62 ±0.26mg/dl and 4.88 ±0.27 mg/dl in study and control groups respectively and this difference was found statistically highly significant (p&lt;0.001). Conclusion:&nbsp;The findings suggest that a considerable percentage of children having febrile seizures suffer from calcium deficiency

GASTRORETENTIVE FLOATING TECHNOLOGY FOR ERADICATION OF HELICOBACTER PYLORI: AN INSIGHT VIEW

Helicobacter pylori is a virulent human pathogen infecting about 50% of the population worldwide. Being a leading cause of gastric ulcer, duodenal ulcer, gastritis, dyspepsia, gastric tumorigenesis etc., this organism has been the focus of concerted study to establish uncertainty of its genetics, immunopathogenesis and cell biology. Scientists have tried to effectively eradicate this pathogen from the gastrointestinal tract in various manners. Inquest of this venture, gastroretentive drug delivery systems including floating dosage forms have emerged as a boon and offer significantly improved therapeutic effects of different antimicrobial drugs. This article presents an evocative review of the structural features, epidemiological evidences and various pharmacotherapeutics vistas. In addition, various novel gastroretentive dosage forms developed so far to combat Helicobacter pylori infection are also discussed. Comprehensive literature review has been performed for this manuscript by utilizing relevant databases like PubMed, SCOPUS, Web of Science, Science Direct, Google Scholar etc., from 1997 up to the year 2020

Cross‐Talk Between Hypoxia and the Tumour via Exosomes

Cancer is one of the leading causes of death worldwide, and this is often attributed to the nonspecific symptoms. Additionally, delayed diagnosis and a lack of treatment options negatively impact prognosis. Recently, the role of extracellular vesicles in cancer progression, specifically, in metastasis and in the capacity of several tumours to invade and colonise specific organs has been established. Reduced oxygen tension due to imbalanced oxygen supply and consumption is termed hypoxia and is one of the most commonly observed features in solid tumours. This is often correlated with poor cancer prognosis. Several reports have established that low oxygen tension (i.e. hypoxia) is a common feature of the tumour microenvironment often enhancing the process of epithelial‐to‐mesenchymal transition (EMT) in cancer cells, thus promoting tumourigenesis and metastasis. Furthermore, hypoxia increases the number of extracellular vesicles released from cancer cells and also modifies their bioactivity and function. The aim of this chapter is to review the association between the tumour microenvironment and extracellular vesicles (EVs), focusing on a specific subpopulation of EVs of endocytic origin, termed exosomes

Genetic Models Reveal cis and trans Immune-Regulatory Activities for lincRNA-Cox2

An inducible gene expression program is a hallmark of the host inflammatory response. Recently, long intergenic non-coding RNAs (lincRNAs) have been shown to regulate the magnitude, duration, and resolution of these responses. Among these is lincRNA-Cox2, a dynamically regulated gene that broadly controls immune gene expression. To evaluate the in vivo functions of this lincRNA, we characterized multiple models of lincRNA-Cox2-deficient mice. LincRNA-Cox2-deficient macrophages and murine tissues had altered expression of inflammatory genes. Transcriptomic studies from various tissues revealed that deletion of the lincRNA-Cox2 locus also strongly impaired the basal and inducible expression of the neighboring gene prostaglandin-endoperoxide synthase (Ptgs2), encoding cyclooxygenase-2, a key enzyme in the prostaglandin biosynthesis pathway. By utilizing different genetic manipulations in vitro and in vivo, we found that lincRNA-Cox2 functions through an enhancer RNA mechanism to regulate Ptgs2. More importantly, lincRNA-Cox2 also functions in trans, independently of Ptgs2, to regulate critical innate immune genes in vivo

Intra-household evaluations of alcohol abuse in men with depression and suicide in women: A cross-sectional community-based study in Chennai, India.

BACKGROUND: Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India. METHODS: This community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into 'low-risk', 'harmful', 'hazardous' and 'alcohol dependence' drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as 'mild', 'moderate', 'moderate-severe' and 'severe'. Multivariate logistic regression models estimated the association of depression in women with men's drinking patterns in the same household. RESULTS: A significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were 'alcohol-dependent' compared to non-drinkers (OR = 2.53; 95% CI: 1.26, 5.09). However, there was no association between men's drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose-response relationship with increasing hazard-level of men's drinking (p = 0.08). CONCLUSION: No significant intra-household association was observed between men's alcohol consumption and women's depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways

cGAS-STING Pathway Does Not Promote Autoimmunity in Murine Models of SLE

Detection of DNA is an important determinant of host-defense but also a driver of autoinflammatory and autoimmune diseases. Failure to degrade self-DNA in DNAseII or III(TREX1)-deficient mice results in activation of the cGAS-STING pathway. Deficiency of cGAS or STING in these models ameliorates disease manifestations. However, the contribution of the cGAS-STING pathway, relative to endosomal TLRs, in systemic lupus erythematosus (SLE) is controversial. In fact, STING deficiency failed to rescue, and actually exacerbated, disease manifestations in Fas-deficient SLE-prone mice. We have now extended these observations to a chronic model of SLE induced by the i.p. injection of TMPD (pristane). We found that both cGAS- and STING-deficiency not only failed to rescue mice from TMPD-induced SLE, but resulted in increased autoantibody production and higher proteinuria levels compared to cGAS STING sufficient mice. Further, we generated cGAS(KO)Fas(lpr) mice on a pure MRL/Fas(lpr) background using Crispr/Cas9 and found slightly exacerbated, and not attenuated, disease. We hypothesized that the cGAS-STING pathway constrains TLR activation, and thereby limits autoimmune manifestations in these two models. Consistent with this premise, mice lacking cGAS and Unc93B1 or STING and Unc93B1 developed minimal systemic autoimmunity as compared to cGAS or STING single knock out animals. Nevertheless, TMPD-driven lupus in B6 mice was abrogated upon AAV-delivery of DNAse I, implicating a DNA trigger. Overall, this study demonstrated that the cGAS-STING pathway does not promote systemic autoimmunity in murine models of SLE. These data have important implications for cGAS-STING-directed therapies being developed for the treatment of systemic autoimmunity