A Study of Clinical Profile of Oleander Seed Poisoning in Adults

Deliberate self harm is on the increasing trend and poisoning with yellow oleander seed is common in our region. So our study was directed to assess the clinical profile of yellow oleander seed poisoning in adult patients. This is a prospective study conducted at the Thanjavur Medical College hospital from January 2014 to August 2014. All adult patients with yellow oleander seed poisoning were included. 49 patients with 20 male and 29 female were admitted. The mean number of seeds consumed was 4.65±2.41. 80 % of patients had gastrointestinal symptoms. Paste form is the most toxic form of ingestion, while chewed was the most common form consumed. ECG changes were noticed in 30 patients with sinus bradycardia being the most common variant. The lethal dose in our study was between 4-8 seeds. Patients who had ECG changes had significantly high potassium levels. There was no in hospital mortality in our study

Seroprevalence of Herpes Simplex Virus 1 and 2, Hepatitis B and Chlamydia Trachomatis among the Patients attending Sexually Transmitted Diseases Department.

INTRODUCTION : Sexually transmitted diseases (STDs) are a major cause of morbidity in developed as well as developing countries. STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can rapidly render patients with many STDs noninfectious and cure most. In 1996, the World Health Organization estimated that more than 1 million people were being infected daily. About 60% of these infections occur in young people <25 years of age, and of these 30% are <20 years. Between the ages of 14 and 19, STDs occur more frequently in girls than boys by a ratio of nearly 2:1; this equalizes by age 20. An estimated 340 million new cases of syphilis, gonorrhoea, chlamydia and trichomoniasis occurred throughout the world in 1999. Centre for Diseases Control and Prevention (CDC) has estimated that nearly 20 million STD cases occur every year, with half among people less than 25 years. Changing cultural values, changing sexual morals, increase in travel, all had contributed for increase in STDs. Additionally, development and spread of drug resistant bacteria (e.g., penicillinresistant gonococci) makes some STDs harder to cure. Commonly reported prevalence of Sexually Transmitted Infections (STI) among sexually active adolescent girls both with and without lower genital tract symptoms include Chlamydia (10–25%), gonorrhoea (3–18%), syphilis (0–3%), Trichomonas vaginalis (8–16%), and herpes simplex virus infection (2–12%). Among adolescent boys with no symptoms of urethritis, isolation rates include chlamydia (9– 11%) and gonorrhea (2–3%). AIM OF THE STUDY : To determine the seroprevalence of Herpes Simplex virus (HSV1 and HSV2), Hepatitis B and Chlamydia trachomatis among the patients attending the outpatient department of Institute of Venerology, Madras Medical College. CONCLUSION : The seroprevalence of HBsAg is 6.5%, Herpes simplex virus 1 antibodies is 50.5%, Herpes simplex virus type 2 antibodies is 45.05% and Chlamydial antibody is 38.46%. * Most of the HSV antibodies are of IgG type indicating past infection. * Infection with one STI increases the risk of acquiring other STIs. 42.8% of the patients studied had co infections. * HSV 1 and HSV 2 are the most common co infections. * The seroprevalence of HIV in this study is 10.9%. HSV 2 and Chlamydia are the most common co infections in patients with HIV. * The prevalence of HSV 1 and 2 antibodies and Chlamydial antibodies are high in asymptomatic patients. * Most of the seropositive patients in this study are married, educated upto secondary school and urban residents

Recent Emergence of Bovine Coronavirus Variants with Mutations in the Hemagglutinin-Esterase Receptor Binding Domain in U.S. Cattle

Bovine coronavirus (BCoV) has spilled over to many species, including humans, where the host range variant coronavirus OC43 is endemic. The balance of the opposing activities of the surface spike (S) and hemagglutinin-esterase (HE) glycoproteins controls BCoV avidity, which is critical for interspecies transmission and host adaptation. Here, 78 genomes were sequenced directly from clinical samples collected between 2013 and 2022 from cattle in 12 states, primarily in the Midwestern U.S. Relatively little genetic diversity was observed, with genomes having \u3e98% nucleotide identity. Eleven isolates collected between 2020 and 2022 from four states (Nebraska, Colorado, California, and Wisconsin) contained a 12 nucleotide insertion in the receptor-binding domain (RBD) of the HE gene similar to one recently reported in China, and a single genome from Nebraska collected in 2020 contained a novel 12 nucleotide deletion in the HE gene RBD. Isogenic HE proteins containing either the insertion or deletion in the HE RBD maintained esterase activity and could bind bovine submaxillary mucin, a substrate enriched in the receptor 9-O-acetylated-sialic acid, despite modeling that predicted structural changes in the HE R3 loop critical for receptor binding. The emergence of BCoV with structural variants in the RBD raises the possibility of further interspecies transmission

Takayasu arteritis in pregnancy: A case series

Takayasu arteritis is a disease of unknown etiology which is a primary systemic vasculitis leading to stenotic and occlusive changes. Takayasu arteritis is a chronic inflammatory disease in progressive pattern which chiefly affects the aorta and its main branches. The diagnosis of the disease is mainly based on the clinical suspicion, history, physical examination and vascular imaging. We present here three cases of takayasu arteritis in pregnancy that were treated at our institute in the last 5 years. 1st case had complications like severe preeclampsia, abruption, temporary loss of vision, and intra uterine death of fetus. In 2nd case there was brain sparing effect of fetus, but other than that she did not have any other complications and neonatal outcome was also good without any neonatal complications. In the 3rd case antenatal and postnatal periods were uneventful and with good neonatal outcome. Pregnancy with takayasu arteritis needs to be timely diagnosed and treated for best maternal and fetal outcome

Ethyl 4-hy­droxy-2,6-diphenyl-1-[2-(piperidin-1-yl)acet­yl]-1,2,5,6-tetra­hydro­pyridine-3-carboxyl­ate

In the title compound, C27H32N2O4, the piperidine and tetra­hydro­pyridine rings adopt chair and half-chair conformations, respectively. The dihedral angle between the two phenyl rings is 32.9 (1)°. The mol­ecular structure is stabilized by a strong intra­molecular O—H⋯O hydrogen bond, generating an S(6) motif. In the crystal, inter­molecular C—H⋯O inter­actions form a ribbon-like structure along the a axis

Novel Vector Design and Hexosaminidase Variant Enabling Self-Complementary Adeno-Associated Virus for the Treatment of Tay-Sachs Disease

GM2 gangliosidosis is a family of three genetic neurodegenerative disorders caused by the accumulation of GM2 ganglioside (GM2) in neuronal tissue. Two of these are due to the deficiency of the heterodimeric (α–β), “A” isoenzyme of lysosomal β-hexosaminidase (HexA). Mutations in the α-subunit (encoded by HEXA) lead to Tay-Sachs disease (TSD), whereas mutations in the β-subunit (encoded by HEXB) lead to Sandhoff disease (SD). The third form results from a deficiency of the GM2 activator protein (GM2AP), a substrate-specific cofactor for HexA. In their infantile, acute forms, these diseases rapidly progress with mental and psychomotor deterioration resulting in death by approximately 4 years of age. After gene transfer that overexpresses one of the deficient subunits, the amount of HexA heterodimer formed would empirically be limited by the availability of the other endogenous Hex subunit. The present study used a new variant of the human HexA α-subunit, μ, incorporating critical sequences from the β-subunit that produce a stable homodimer (HexM) and promote functional interactions with the GM2AP– GM2 complex. We report the design of a compact adeno-associated viral (AAV) genome using a synthetic promoter–intron combination to allow self-complementary (sc) packaging of the HEXM gene. Also, a previously published capsid mutant, AAV9.47, was used to deliver the gene to brain and spinal cord while having restricted biodistribution to the liver. The novel capsid and cassette design combination was characterized in vivo in TSD mice for its ability to efficiently transduce cells in the central nervous system when delivered intravenously in both adult and neonatal mice. This study demonstrates that the modified HexM is capable of degrading long-standing GM2 storage in mice, and it further demonstrates the potential of this novel scAAV vector design to facilitate widespread distribution of the HEXM gene or potentially other similar-sized genes to the nervous system

Ethyl 1-(2-bromo­propano­yl)-4-hydr­oxy-2,6-diphenyl-1,2,5,6-tetra­hydro­pyridine-3-carboxylate

The title compound, C23H24BrNO4, crystallizes with two independent mol­ecules per asymmetric unit. The methyl group of the ethoxy­carbonyl unit is disordered over two positions, with occupancies of 0.715 (12) and 0.285 (12) in one of the independent mol­ecules, and 0.529 (11) and 0.471 (11) in the other mol­ecule. In one of the independent mol­ecules, the tetra­hydro­pyridine ring adopts a half-chair conformation, while in the other it is in a distorted envelope conformation. In each independent mol­ecule, an intra­molecular O—H⋯O hydrogen bond generates an S(6) ring motif. The two independent mol­ecules are linked via C—H⋯O hydrogen bonds, forming a chain along the c axis

Genome-wide multi-omics profiling of colorectal cancer identifies immune determinants strongly associated with relapse

The use and benefit of adjuvant chemotherapy to treat stage II colorectal cancer (CRC) patients is not well understood since the majority of these patients are cured by surgery alone. Identification of biological markers of relapse is a critical challenge to effectively target treatments to the ~20% of patients destined to relapse. We have integrated molecular profiling results of several “omics” data types to determine the most reliable prognostic biomarkers for relapse in CRC using data from 40 stage I and II CRC patients. We identified 31 multi-omics features that highly correlate with relapse. The data types were integrated using multi-step analytical approach with consecutive elimination of redundant molecular features. For each data type a systems biology analysis was performed to identify pathways biological processes and disease categories most affected in relapse. The biomarkers detected in tumors urine and blood of patients indicated a strong association with immune processes including aberrant regulation of T-cell and B-cell activation that could lead to overall differences in lymphocyte recruitment for tumor infiltration and markers indicating likelihood of future relapse. The immune response was the biologically most coherent signature that emerged from our analyses among several other biological processes and corroborates other studies showing a strong immune response in patients less likely to relapse

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for the practice of cardiovascular magnetic resonance during the COVID-19 pandemic

The aim of this document is to provide general guidance and specific recommendations on the practice of cardiovascular magnetic resonance (CMR) in the era of the COVID-19 pandemic. There are two major considerations. First, continued urgent and semi-urgent care for the patients who have no known active COVID-19 should be provided in a safe manner for both patients and staff. Second, when necessary, CMR on patients with confirmed or suspected active COVID-19 should focus on the specific clinical question with an emphasis on myocardial function and tissue characterization while optimizing patient and staff safety

Evolving narratives on signal functions for monitoring maternal and newborn health services: A meta-narrative inspired review

Emergency obstetric care (EmOC) signal functions are a shortlist of key clinical interventions capable of averting deaths from the five main direct causes of maternal mortality; they have been used since 1997 as a part of an EmOC monitoring framework to track the availability of EmOC services in low- and middle-income settings. Their widespread use and proposed adaptation to include other types of care, such as care for newborns, is testimony to their legacy as part of the measurement architecture within reproductive health. Yet, much has changed in the landscape of maternal and newborn health (MNH) since the initial introduction of EmOC signal functions. As part of a project to revise the EmOC monitoring framework, we carried out a meta-narrative inspired review to reflect on how signal functions have been developed and conceptualised over the past two decades, and how different narratives, which have emerged alongside the evolving MNH landscape, have played a role in the conceptualisation of the signal function measurement. We identified three overarching narrative traditions: 1) clinical 2) health systems and 3) human rights, that dominated the discourse and critique around the use of signal functions. Through an iterative synthesis process including 19 final articles selected for the review, we explored patterns of conciliation and areas of contradiction between the three narrative traditions. We summarised five meta-themes around the use of signal functions: i) framing the boundaries; ii) moving beyond clinical capability; iii) capturing the woods versus the trees; iv) grouping signal functions and v) measurement challenges. We intend for this review to contribute to a better understanding of the discourses around signal functions, and to provide insight for the future roles of this monitoring approach for emergency obstetric and newborn care