Biological properties of the digestive vacuole of Plasmodium falciparum: Activation of complement and coagulation

Plasmodium falciparum is an intracellular protozoan parasite that has been associated with humans since the dawn of time and causes severe forms of malaria. It is a major health problem around the globe and causes highest toll of death among children less than five years of age in developing countries. An infected female Anopheles mosquito injects malaria sporozoites into the skin while taking a blood meal. The sporozoites, which are released into the blood stream, reaches the liver where they undergo exoerythrocytic schizogony. After exoerythrocytic schizogony, millions of merozoites are released into the blood stream and infect new red blood cells, where they undergo erythrocytic schizogony in a cyclic manner. The erythrocytic schizogony stage of Plasmodium life cycle is where all clinical manifestations of malaria as a disease become apparent. The clinical symptoms like fever, headache, jaundice, vomiting have been associated with hyperparasitemia and these clinical symptoms coincide with the cyclical release of malaria parasites during schizonts rupture. A severe form of malaria develops as a consequence of capillaric sequestration of parasitized red blood cells (pRBC) and rosetting of pRBC with uninfected red blood cells which obstruct the blood flow to the brain. Activation of complement and coagulation, and increase in vascular permeability further aggravates severity of the disease which can lead to microcirculatory disturbances with comatous death as the ultimate outcome. Rupture of each Plasmodium falciparum infected red blood cell releases 8-32 infective merozoites along with a single digestive vacuole into the blood stream. The released digestive vacuole is an organelle in which hemozoin is surrounded by an intact membrane. We have discovered that the digestive vacuoles have the capacity to dually activate the complement and coagulation systems. Activation of complement and coagulation requires an intact DV membrane. The complement and coagulation activating properties of the DV are inhibited by low molecular weight dextran sulfate. In non-immune serum, DVs are opsonised with complement C3b and rapidly phagocytosed by polymorphonuclear granulocytes (PMN). Upon rupture, DVs lost its functional activities and the extracted malaria pigment from the DV organelle is not engulfed by the PMN. Liberated merozoites are not opsonized in non-immune serum and escape phagocytosis. High titered anti-malarial antibodies from immune patients mediate some uptake of the merozoites, but to an extent that is not sufficient to markedly reduce re-invasion rates. Engulfment of DVs by PMN induces a respiratory burst, but the generated reactive oxygen species (ROS) are unable to suppress the infective capacity of invading merozoites. Finally, ingested DVs drive the PMN into a state of functional exhaustion. Upon challenging of PMN with bacteria after DV ingestion, the ability to phagocytose bacteria prevails, but their capacity to mount a respiratory burst is reduced and microbicidal activity is compromised. We propose that these events might be linked to the development of septicemic episodes in patients with severe malaria in sub-Saharan African countries

A CASE REPORT ON PHENYTOIN INDUCED ATAXIA

ABSTRACTPhenytoin is commonly used anticonvulsant drug which has several adverse effects such as motor ataxia, dizziness, and visual disturbance. Here,we report a case of phenytoin toxicity presenting with behavioral disorder ensuring from underlying primary adverse effects of phenytoin that wereclinically unnoted. A termination of phenytoin resulted in remission of side effects.Keywords: Phenytoin toxicity, Anticonvulsant drug, Behavioral disorder

A Note on One Sided and Two Sided PO-Ternary Ideals in PO-Ternary Semiring

In this paper the term, left(lateral, right and two sided) PO-ternary ideal, maximal left(lateral, right and two sided) PO-ternary ideal, left (lateral, right and two sided) PO-ternary ideal of T generated by a set A, principal left (lateral, right and two sided) PO-ternary ideal generated by an element a left (lateral, right and two sided) simple PO-ternary semiring are introduced. It is proved that (1) the non-empty intersection of any two left (lateral, right and two sided) PO-ternary ideals of a PO-ternary semiring T is a left (lateral, right and two sided) PO-ternary ideal of T. (2) non-empty intersection of any family of left (lateral, right and two sided) PO-ternary ideals of a POternary semiring T is a left(lateral, right and two sided) PO-ternary ideal of T. (3) the union of any left PO-ternary ideals of a PO-ternary semiring T is a left PO-ternary ideal of T. (4) the union of any family of left(lateral, right and two sided) PO-ternary ideals of a PO-ternary semiring T is a left(lateral, right and two sided) PO-ternary ideal of T. (5) The left (lateral, right and two sided) PO-ternary ideal of a PO-ternary semiring T generated by a non-empty subset A is the intersection of all left(lateral, right and two sided) PO-ternary ideals of T containing A. (6) If T is a PO-ternary semiring and a∈T then L(a) =  (Te Tea + na] = (Te Tea U na] (M(a) = (Tea Te + TeTe aTeTe + na] = ( Tea Te U TeTe aTeTe U na], R (a) = (aTe Te + na ] = (aTe Te U na] and T(a) = (Te Tea + aTe Te + TeTe aTeTe +na] = (Te Tea UaTe Te UTeTe aTeTe Una]). (7) A PO-ternary semiring T is a left(lateral, right) simple PO-ternary semiring if and only if (TTa] = T ((TaT U TTaTT] = T, (aTT] = T) for all a∈T

Stashing Scope Afore Encoding For Revocable Data Spanking In Encoded Images

Nowadays, information is rapidly available through the Internet. Companies have the ability to communicate with a worldwide audience through the World Wide Web. The extraction is performed in the reverse order as the embedding process. The side information (peak/zero points) should be additionally transmitted to the receiver for reversible recoveryThe original cover can be losslessly restored after the embedded information is extracted. In some applications, even any degradation of the original cover is not allowed, such as medical imagery, military imagery and law forensics.All early methods embed assemblage by reversibly vacating space from the encrypted reflections, which may be thing to both errors on data extraction and or appearance refurbishment. Data hacking is very challenging problem in today’s internet world. There are number of techniques to secure the data. So, the data hiding in the encrypted reflection comes into the picture, but occurrence of distortion at the time of data extraction is a main problem. In this article, Due to the modification on the pixel differences to hide secret data, the marked differences may be not in the normal range [0, 255] for a 8-bit grayscale image

Case series of clinical study and surgical management of atlanto axial dislocation our institute experience

Background: Atlantoaxial dislocation refers to a loss of stability between the atlas and axis (C1-C2), resulting in loss of normal articulation. Cervical spine C1-C2 motion segment is the most technically challenging.Methods: This is a prospective and retrospective Study which included 34 patients admitted in King George hospital, Andhra medical college, Visakhapatnam over the past two years (January 2014- January 2016) with AAD.Results: The age of the patients ranged from 3 to 60 years with mean age being 37.67 years. Commonest presenting sign is local tenderness at the back of upper cervical region in 91.17%. Most common procedure done was single sitting trans oral odontoid decompression with posterior occipito cervical fusion with occipital plate and C2, C4 polyaxial screws and lateral mass rods in 18 cases out of 34. The next common procedure performed was C1 lateral mass and C2 pars screw fixation 8 out of 34.Conclusions: Trans oral odentoidectomy and posterior ocipito cervical fusion is ideal and still holds good for irreducible AAD with  ventral compressive pathology

Institutional experience of tuberculosis of craniovertebral junction

Background: Craniovertebral junction tuberculosis (CVJ-TB) is a rare entity occurring in only 0.3 to 1% of tuberculous spondylitis. It causes severe instability and neurological deficits. Present study includes 16 cases of CVJ tuberculosis with neck pain and progressive quadriparesis. Radiological evaluation showed wide spread disease around clivus, C1, C2, C3 with extensive bony destruction, cord compression, basilar invagination and atlantoaxial dislocation.Methods: The study included all the cases admitted with cv junction tuberculosis in neurosurgery ward in King George hospital, Visakhapatnam during a period of three years from 2014 to 2016. Four cases were managed conservatively and four cases were treated by only posterior occipitocervical fusion. We performed two stage operation in single sitting i.e. transoral decompression and posterior occipitocervical fusion in 12 cases. The pathological findings confirmed tuberculosis.Results: Postoperatively all the patients had decreased neck pain and two third of the patients (10 of 16 patients) had improvement in motor power.Conclusions: In the available literature, the treatment options offered for cvj-tb have ranged from a purely conservative approach to radical surgery without well-defined guidelines. In this study, we followed a radical approach as the patients included in our study presented with extensive TB cv junction. So, we recommend radical surgery for extensive TB of cv junction

Portal vein embolization versus dual vein embolization for management of the future liver remnant in patients undergoing major hepatectomy: meta-analysis

BACKGROUND: This meta-analysis aimed to compare progression to surgery, extent of liver hypertrophy, and postoperative outcomes in patients planned for major hepatectomy following either portal vein embolization (PVE) or dual vein embolization (DVE) for management of an inadequate future liver remnant (FLR). METHODS: An electronic search was performed of MEDLINE, Embase, and PubMed databases using both medical subject headings (MeSH) and truncated word searches. Articles comparing PVE with DVE up to January 2022 were included. Articles comparing sequential DVE were excluded. ORs, risk ratios, and mean difference (MD) were calculated using fixed and random-effects models for meta-analysis. RESULTS: Eight retrospective studies including 523 patients were included in the study. Baseline characteristics between the groups, specifically, age, sex, BMI, indication for resection, and baseline FLR (ml and per cent) were comparable. The percentage increase in hypertrophy was larger in the DVE group, 66 per cent in the DVE group versus 27 per cent in the PVE group, MD 39.07 (9.09, 69.05) (P = 0.010). Significantly fewer patients failed to progress to surgery in the DVE group than the PVE group, 13 per cent versus 25 per cent respectively OR 0.53 (0.31, 0.90) (P = 0.020). Rates of post-hepatectomy liver failure 13 per cent versus 22 per cent (P = 0.130) and major complications 20 per cent versus 28 per cent (Clavien–Dindo more than IIIa) (P = 0.280) were lower. Perioperative mortality was lower with DVE, 1 per cent versus 10 per cent (P = 0.010). CONCLUSION: DVE seems to produce a greater degree of hypertrophy of the FLR than PVE alone which translates into more patients progressing to surgery. Higher quality studies are needed to confirm these results

Matrix metalloproteinase-9 is elevated and related to interleukin-17 and psychological stress in male infertility: A cross-sectional study

Background: Matrix metalloproteinase-9 (MMP-9), interleukin-17 (IL-17) and psychological stress are known to play a role in the pathogenesis of male infertility. Objective: To assess the association of MMP-9 with IL-17 and psychological stress in infertile men. Materials and Methods: In this cross-sectional study, 39 men with infertility diagnosed based on semen analysis and 39 subjects with normal semen analysis were included in the study. MMP-9 and IL-17 were estimated in both groups by ELISA. Perceived stress scale was used to assess psychological stress in controls and cases. Results: In infertile cases, MMP-9 and IL-17 were significantly increased when compared with controls (p = 0.046, p = 0.041 respectively). A significant association of MMP-9 was observed with IL-17 (r = 0.335, p = 0.037) and perceived stress scale (r = 0.329, p = 0.041). Conclusion: IL-17 and stress increase MMP- 9 levels in infertile men. Key words: Infertility, Interleukins, Peptide hydrolase