Changes in anterior segment parameters of normal subjects during accommodation using a Scheimpflug imaging system

Background: Accommodation changes ocular parameters, such as the anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD), which can reflect a risk of angle-closure glaucoma. Previous studies of changes in ocular anterior segment parameters, have used high diopters or maximum amplitude. Here, we focused on normal accommodation at a reading distance of 30‒40 cm. The aim of this study was to assess changes in anterior segment parameters during a normal accommodative state, using a Scheimpflug imaging system. Methods: In this cross-sectional study, 40 emmetrope subjects (mean ± SD of age: 22 ± 4.0 years) who met the inclusion criteria and provided informed consent were enrolled. Clinical history, refraction, amplitude of accommodation, slit lamp examination, Goldman applanation tonometry, and Pentacam investigations were performed on all subjects. Accommodative and non-accommodative targets were induced via the Pentacam. Two seconds were allowed for accommodation or relaxation prior to measurements in each eye. Results: Eighty normal eyes were evaluated; a small but statistically significant change in ACV, ACA, and PD during accommodation (P < 0.01, < 0.01, and < 0.05, respectively) was observed. The ACD did not change substantially with accommodation (P = 0.29). The mean ± SD values of ACV, ACD, ACA, and PD before and after accommodation were 151.85 ± 24.04 mm3 and 145.38 ± 23.30 mm3, 2.87 ± 0.28 mm and 2.86 ± 0.27 mm, 35.06° ± 3.68° and 33.84° ± 3.72°, and 3.46 ± 0.57 mm and 3.41 ± 0.53 mm, respectively. Conclusions: Accommodation changes ocular parameters, such as ACV, ACA, and PD, in healthy young emmetropes. Interestingly, the ACD remains unaltered during accommodation. Nevertheless, although these changes were statistically significant, they were not clinically significant in our study

Percutaneous trigger finger release using 18G hypodermic needle

Introductions: Patients of stenosing tenosynovitis or trigger finger presents with pain, swelling, limitation of finger movement, and triggering. Thickening of the A1 pulley, with resultant entrapment of flexor tendons, is the primary pathology. In failed conservative treatment, surgical release by open or percutaneous technique is used. The aim of this study was to evaluate the results of percutaneous release of trigger fingers using hypodermic 18-gauge needle under local anesthesia. Methods: A cross sectional study of percutaneous release of trigger fingers using hypodermic 18-gauge needle under local anesthesia was performed in outpatient clinic at Janaki Medical College Teaching Hospital, Janakpur, Nepal, from July 2016 to September 2017. Informed consent was obtained. All the patients were followed up on 3rd day, 1st week and one month in outpatient department, and further telephone follow up at three and six months after surgery. Results: There were 38 patients, female 25 and male 13, age 24 to 67 years. Successful release was achieved in 36/38 (95%) with normal activities within 48 hours. None had complications like digital neurovascular injury or tendon bowstringing. One patient had superficial skin infection and was treated successfully with oral antibiotics. Two (5.2%) had pain and recurrent triggering requiring open release in the first week. At one, three and six months follow up patients reported no triggering of released fingers. Conclusions: Percutaneous release with hypodermic 18-gauge needle under local anesthesia was an effective and convenient method with a low complication rate. Keywords: percutaneous release, trigger finger, 18-gauge hypodermic needl

Malrotation with Distal Duodenal Necrosis in a Neonate

Malrotation with midgut volvulus often results in gangrene of midgut with relative sparing of duodenum. An extremely unusual case of Malrotation with isolated necrosis of distal duodenum is described with brief review of literature. Isolated duodenal necrosis in association with malrotation is very rare; it increases the complexity of surgery and prolongs hospital stay

Phase transformation, Mechanical Properties and Corrosion Behavior of 304L Austenitic Stainless Steel Rolled at Room and Cryo Temperatures

The present work investigates the effect of rolling (90% thickness reduction) on phase transformation, mechanical properties, and corrosion behaviour of 304L-austenitic stainless steel through cryorolling and room temperature rolling. The processed steel sheets were characterised through X-ray diffraction (XRD), electron backscattered diffraction (EBSD), and vibrating sample magnetometer (VSM). The analysis of XRD patterns, EBSD scan, and vibrating sample magnetometer results confirmed the transformation of the austenitic phase to the martensitic phase during rolling. Cryorolling resulted in improved tensile strength and microhardness of 1808 MPa and 538 VHN, respectively, as compared to 1566 MPa and 504 VHN for room temperature rolling. The enhancement in properties of cryorolled steel is attributed to its higher dislocation density compared to room temperature rolled steel. The corrosion behaviour was assessed via linear polarisation corrosion tests. Corrosion resistance was found to decrease with increasing rolling reduction in both room temperature rolled and cryorolled specimens

Black Tea and Theaflavins Assist Healing of Indomethacin-Induced Gastric Ulceration in Mice by Antioxidative Action

The healing activities of black tea (BT) and the theaflavins (TF) against the indomethacin-induced stomach ulceration were studied in a mouse model. Indomethacin (18 mg/kg, p.o.) administration induced maximum ulceration in the glandular portion of the gastric mucosa on the 3rd day, accompanied by increased lipid peroxidation and protein oxidation, depletion of thiol-defense and mucin, as well as reduced expressions of cyclooxygenases (COX) and prostaglandin (PG) E synthesis in the gastric tissues, and plasma total antioxidant status of mice. Treatment with BT (40 mg/kg), TF (1 mg/kg), and omeprazole (3 mg/kg) produced similar (74%–76%) ulcer healing, as revealed from the histopathological studies. Treatment with all the above samples reversed the adverse oxidative effects of indomethacin significantly. BT and TF also enhanced the PGE synthesis by augmenting the expressions of COX 1 and 2, but did not modulate acid secretion

Случай раннего выявления метастазов в бедренной кости у больного раком полового члена

Background. Bone metastasis is very common in the advanced stage of numerous carcinomas. In penile carcinoma, lymph nodes metastasis is somehow common but it is very rare reported to be secondary from penile cancer. till the date, there are only few cases of penis carcinoma reported bone metastasis in literature worldwide.Case Presentation. Herein, We presented a 51-year-old Nepalese male with squamous cell carcinoma of penis. computed tomography (ct) scan of the patient revealed that there was carcinoma involving glans penis and precure with bilateral external & internal inguinal lymphadenopathies. After then, the patient was under gone for partial penectomy and bilateral inguinal lymphadenectomy and complete 6-cycle chemotherapy. After one year of treatment, patient developed thigh pain and headache and he advised to have magnetic Resonance imaging (mRi) of brain, 99mTc-MDP whole body bone scan and ct scan of pelvis and thigh. The examination report reveals that there was a sclerotic change in vertex of skull bone and moderate 99mTc-MDP uptake in right proximal shaft of femur just below the neck d/d metastasis. The histopathological examination of the true cut biopsy taken from the lesion of the femur showed metastatic keratinizing squamous cell carcinoma which is rare case of femoral shaft bone metastasis secondary from penile carcinoma. Then patient was sent for surgical reconstruction of femur. Based on the case studies review femur shaft bone metastasis from penile cancer is extremely rare.Conclusion. The best of our knowledge; this is the first early detected bone metastases to shaft of the femur in a patient with penile cancer. early diagnosis helps to radical treatment as well as palliative treatment. surgery is the preferred option of the treatments, especially for metastatic foci in the long bones.Аннотация Метастазы в кости часто встречаются на поздних стадиях разных злокачественных новообразований. Для рака полового члена характерно лимфогенное метастазирование, костные метастазы встречаются очень редко. На данный момент в мировой литературе зарегистрировано лишь несколько случаев рака полового члена с метастазами в кости.Описание клинического случая. Мы представляем описание клинического случая плоскоклеточного рака полового члена у 51-летнего мужчины из Непала. Компьютерная томография (КТ) выявила рак полового члена, локализованный на головке и крайней плоти с двусторонней паховой лимфаденопатией. Пациенту выполнена частичная пенэктомия, двусторонняя паховая лимфаденэктомия, проведено 6 курсов адъювантной химиотерапии. Через один год после завершения лечения у пациента появились боли в бедре и головная боль, рекомендована МРТ головного мозга, сканирование костей скелета с 99mTc-MDP и КТ таза и бедра. Обследование показало наличие склеротических изменений в теменной кости черепа и умеренное накопление 99mTc-MDP в проксимальном отделе правом бедренной кости ниже шейки. Гистологическое исследование биоптата, взятого из очага в бедренной кости, выявило метастаз ороговевающего плоскоклеточного рака, что является редким случаем метастазирования рака полового члена в диафиз бедренной кости. Пациент был направлен на хирургическую реконструкцию бедренной кости. Согласно обзору клинических исследований, метастазы в диафизе бедренной кости при раке полового члена встречаются крайне редко.Заключение. Представлен первый случай раннего выявления костных метастазов в диафизе бедренной кости у пациента с раком полового члена. Ранняя диагностика помогает как радикальному, так и паллиативному лечению. Хирургическое вмешательство является предпочтительным вариантом лечения, особенно при метастатических очагах в длинных костях

Role of Nephrostomy in poorly functioning kidneys in patients with ureteropelvic junction obstruction (UPJO)

Introduction: Several studies have addressed the unique management challenges in poorly functioning kidneys of patients with ureteropelvic junction obstruction. Trial with percutaneous drainage of such kidneys as a guide to choose the type of surgical management would be a solution to this dilemma. We aimed to evaluate the role of percutaneous nephrostomy in treatment of poorly functioning kidneys in pediatric patients with UPJO.Materials and Methods: A prospective study was performed on patients with poorly functioning kidneys (split renal function<10% on renal dynamic scan) and unilateral ureteropelvic junction obstruction from August 2016 to January 2018. Ultrasound-guided nephrostomy was inserted for these patients. Data regarding the differential renal function and glomerular function rate (GFR) was collected before and after nephrostomy insertion. Decision regarding pyeloplasty or nephrectomy of the involved kidney was made based on changes seen in differential function and Glomerular filtration rate following the drainage.Results: Thirty three patients with unilateral UPJO with poorly functioning kidneys were treated during this period. Thirty patients had significant increase in differential function and glomerular filtration rate. These patients underwent pyeloplasty. In 2 patients, these parameters did not increase much and they underwent nephrectomy. One patient had an infected kidney which did not improve significantly on drainage and had to be removed. Of the 30 patients who had pyeloplasty, two developed obstruction after 3 months of removal of double-J stent and needed reoperation.Conclusion: Percutaneous nephrostomy in poorly functioning kidneys with ureteropelvic junction obstruction helps to identify potentially salvageable kidneys which merit pyeloplasty. Kidneys which do not improve with nephrostomy are unlikely to improve with pyeloplasty and therefore nephrectomy is done in such cases.

Effect of Zn doping on the Magneto-Caloric effect and Critical Constants of Mott Insulator MnV2O4

X-ray absorption near edge spectra (XANES) and magnetization of Zn doped MnV2O4 have been measured and from the magnetic measurement the critical exponents and magnetocaloric effect have been estimated. The XANES study indicates that Zn doping does not change the valence states in Mn and V. It has been shown that the obtained values of critical exponents \b{eta}, {\gamma} and {\delta} do not belong to universal class and the values are in between the 3D Heisenberg model and the mean field interaction model. The magnetization data follow the scaling equation and collapse into two branches indicating that the calculated critical exponents and critical temperature are unambiguous and intrinsic to the system. All the samples show large magneto-caloric effect. The second peak in magneto-caloric curve of Mn0.95Zn0.05V2O4 is due to the strong coupling between orbital and spin degrees of freedom. But 10% Zn doping reduces the residual spins on the V-V pairs resulting the decrease of coupling between orbital and spin degrees of freedom.Comment: 19 pages, 9 Figures. arXiv admin note: substantial text overlap with arXiv:1311.402

Diverting intracellular trafficking of Salmonella to the lysosome through activation of the late endocytic Rab7 by intracellular delivery of muramyl dipeptide

Previously, we showed that live Salmonella-containing phagosomes (LSP) recruit early acting Rab5 and promote fusion with early endosomes, thus avoiding transport to the lysosomes. Therefore, live Salmonella survive in a specialized compartment. Here we show that scavenger-receptor-mediated intracellular delivery of muramyl dipeptide (MDP) to macrophages leads to efficient killing of Salmonella both in vitro and in vivo. To understand the intracellular trafficking modulation of Salmonella by delivery of MDP, we investigated the levels of endocytic Rab proteins, which are the major regulators of vesicular transport. Western blot analysis reveals reduced Rab5 and enhanced Rab7 content in the maleylated bovine serum albumin-MDP (MBSA-MDP)-treated cells. The reduced content of Rab5 in the treated cells and on phagosomes inhibits the fusion of Salmonella-containing phagosomes with early endosomes, and the enhanced Rab7 content in these cells facilitated targeting of LSP to lysosomes, which contain cathepsin D and vacuolar ATPase, for killing. In vitro reconstitution of lysosomal transport demonstrated that a reduced content of Rab5 and an enhanced level of Rab7 in MBSA-MDP-treated cells is primarily responsible for targeting Salmonella to lysosomes. Intracellular delivery of MDP thus offers a general strategy against macrophage-associated infections caused by intracellular pathogens that survive in the host cell by resisting transport to lysosomes

Fresnel zone plate telescopes for X-ray imaging II: numerical simulations with parallel and diverging beams

We present the results of simulations of shadows cast by a zone plate telescope which may have one to four pairs of zone plates. From the shadows we reconstruct the images under various circumstances. We discuss physical basis of the resolution of the telescope and demonstrate this by our simulations. We allow the source to be at a finite distance (diverging beam) as well as at an infinite distance (parallel beam) and show that the resolution is worsened when the source is nearby. By reconstructing the zone plates in a way that both the zone plates subtend the same solid angles at the source, we obtain back high resolution even for sources at a finite distance. We present simulated results for the observation of the galactic center and show that the sources of varying intensities may be reconstructed with accuracy. Results of these simulations would be of immense use in interpreting the X-ray images from recently launched CORONAS-PHOTON satellite.Comment: 17 pages, 36 figures, Published in Experimental Astronom