A case report of incidentally elevated maternal serum alkaline phosphatase managed in a poor resource setting

The normal serum concentration of alkaline phosphatase (ALP) in adults ranges from 47 to 147 IU/l. Alkaline phosphatase is known to be produced by syncytiotrophoblasts in the placenta during pregnancy. Its levels are normally increased in pregnant women and levels of up to twice the upper limit can be considered normal.  There have been case reports pointing out that an abnormal rise in serum ALP levels could be a marker for placental insufficiency preterm delivery. Here we report a case with delivery of a normal infant and no placental pathology at term. There are very few reports of extreme elevations of ALP in a pregnancy without any co-morbidities and delivery of normal infant with a subsequent decline to normal after delivery. We present the case of a 23-year-old pregnant woman with an incidentally detected 10 fold elevated serum ALP which was managed at a sub district level hospital which is a poor resource setting. She was expectantly managed and delivered a healthy new-born with an unremarkable intrapartum and post-partum period. Her ALP levels were monitored during the peri-partum period and gradually declined. This case is important because it shows that an isolated increase in a biochemical marker can give a good feto-maternal outcome after expectant and vigilant management

Evolution of Sonar Survey Systems for Sea Floor Studies

Approximately 71% of our planet is covered with oceans. It is also known that oceans are the last frontiers for the mankind’s survival and therefore it becomes pertinent that they are studied in great details. It has been found that the exploration of the oceans can be done more precisely using acoustics as one of the methods, as the acoustic waves can propagate over large distances and also using a broad spectrum of frequencies various issues of the ocean studies can be addressed more effectively than many of the other methods, both in terms resolution (using high frequency components) of measuring parameters and over large ranges (using low to very low frequency components). Currently with the technological advancement and improved computing algorithms, we have state of art systems for ocean exploration, which can provide information about the sea floor, sub-surface including ocean floor classification. These could be projected in 2-D and 3-D visualization to a great accuracy. Also available are acoustical methods wherein one can obtain an extremely important information about water column properties (both in terms of bioinformation and physical properties), and has great importance as this water column is the medium for transmission of all kind of energies(acoustic for short, medium and long ranges and some time light source for exploration over a very short distance) that are used for exploration on the oceans. It will therefore be interesting to understand the progress of underwater acoustics from its very primitive stage, where acoustic transmission through water medium was used for first time to the present day highly complex but very advanced acoustic sea-floor surveying systems. It will also be interesting to know, with a very old maritime history of using seas for transportation, as to what were the methods used by early time seafarers to understand depths of the oceans they were sailing. It has taken almost a century in developing an acoustic system to arrive at the present day advancement. An attempt has been made to present a perspective of evolution and advancement in underwater acoustics and related electronic, material and computational advancement, starting from the early attempts to the modern day acoustic equipments

Organic metabolites produced by Vibrio parahaemolyticus strain An3 isolated from Goan mullet inhibit bacterial fish pathogens

Identification and action of several antibacterial metabolites produced by a fish pathogen Vibrio parahaemolyticus strain An3 from marine ecosystem of Goa has been demonstrated. Antibacterial activity of the crude cell extract of the test bacterium has been evaluated against indicator pathogenic bacterial strains such as Acinetobacter sp. An2, Aeromonas hydrophila strain An4, Staphylococcus arlettae strain An1 and Alteromonas aurentia strain SE3 by agar well diffusion method which clearly demonstrated comparatively more significant inhibitory effect on indicator bacteria as compared to several commonly used antibiotics. Gas chromatography mass spectrometry (GC-MS) analysis of crude cell extract of the test organism interestingly revealed presence of indole, phenyl acetic acid, n-(3- methyl-1, 2, 4-oxadiazol-5-yl) - 1- pyrrolidine carboximidamide, pyrrolopyrazines, tetramethyl pyrazine and other important phenolic compounds which may be responsible for antibacterial activity against indicator microorganisms tested. It has been clearly demonstrated that V. parahaemolyticus strain An3 produced several medically important organic metabolites during cultivation suggesting it as a potential candidate for production of several antibacterial metabolites to control pathogenic bacterial strains causing serious fish and human diseases.Key words: Antibacterial, gas chromatography mass spectrometry, metabolites, pathogenic bacteria, welldiffusion

Artery of Percheron infarct - A missed opportunity of stroke thrombolysis

Acute ischemic infarction in the territory of the artery of Percheron (AOP). AOP is a relatively uncommon neurovascular anatomical variant of the posterior circulation. It is a single arterial trunk supplying bilateral paramedian thalami and the rostral midbrain, a crucial structure responsible for regulation of alertness, consciousness, and sleep. The clinical presentation may deviate from the typical sensorimotor deficits seen with classical stroke syndromes. Without a high index of suspicion, AOP infarcts can be missed clinically and radiologically, thereby missing the crucial window of thrombolytic therapy. We discuss a case of a 60-year-old male, who was presented with acute onset altered sensorium due to AOP infarction and missed the opportunity for intravenous thrombolysis due to delayed diagnosis

Rosai dorfman disease of the orbit

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

A new antibacterial imidazole from the marine sponge Iricinia fusca

A new imidazole alkaloid (1) along with two known compounds, variabilin (2) and iricinialactam A (3) have been isolated from the Arabian marine sponge Ircinia fusca. The structure of the new compound was established as 4-((1, 2-dihydroxy-5-(methyl (1-methyl-1H-imidazol-4-yl) amino) pentan-3-yl) oxy)-3, 5-dimethoxy-1-methylpyrrolidin-2-one (1) by 1D and 2D NMR, and high-resolution electrospray ionization mass spectrometry (HRESIMS). Compound 1 exhibited selective growth inhibitory activity against gram-positive bacteria S. aureus at 100 µg/mL

The microbiological profile of lacrimal abscess: two decades of experience from a tertiary eye care center

BACKGROUND: The aim of this study is to exclusively report the microbiological spectrum of lacrimal abscess and the antibiotic sensitivity patterns of the organisms. Retrospective interventional study on 112 eyes of 112 patients who presented to the ophthalmic plastic clinic of a tertiary eye care center over a period of 23 years from January 1990 to February 2013 with lacrimal abscess were reviewed for demographic and microbiological profile. The culture results, organisms isolated, and their antibiotic sensitivity were studied. RESULTS: The mean age at presentation was 37 years. The female to male ratio was 2:1. There was no significant difference in the laterality between the right and left eyes. Gram-positive organisms were the most commonly isolated accounting for 56.3% (63/112), and the commonest species isolated was Staphylococcus aureus in 25% (28/112) of the patients. Hemophilus influenzae was the commonest gram-negative isolate accounting for 30.2% of all the gram-negative isolates. Of the patients, 10.7% (12/112) showed no organisms on smear as well as sterile cultures. Gram-positive organisms were commonly sensitive to penicillins and vancomycin whereas gram-negative organisms were sensitive to quinolones and aminoglycosides. CONCLUSIONS: Gram-positive organisms are quite common as compared to gram-negative ones in cases of lacrimal abscess. The results of this study have significant bearing on the treatment of patients with lacrimal abscess

Extramedullary leukemia in children presenting with proptosis

<p>Abstract</p> <p>Background</p> <p>We highlight the orbital manifestations of acute myeloid leukemia and the role of peripheral blood smear in the diagnosis of these cases. A total of 12 patients who presented with proptosis and were subsequently diagnosed to have acute myeloid leukemia based on incision biopsy or peripheral blood smear were included in the study.</p> <p>Results</p> <p>A retrospective review of all cases of acute myeloid leukemia presenting to the Orbital clinic was performed. The age at presentation, gender, presenting features, duration of symptoms and fundus features were noted. In addition the temporal relationship of the orbital disease to the diagnosis of leukemia, laterality, location of the orbital mass, imaging features and the diagnostic tools used to diagnose leukemia were noted. The median age at presentation was 6 years. The male: female ratio was 0.7:1. None of these patients had been diagnosed earlier as having acute myeloid leukemia. The presenting features included proptosis in all patients, orbital mass in 5 (41.7%), visual symptoms in 2 (16.7%) and subconjunctival hemorrhage in one patient (8.3%). A diagnosis of acute myeloid leukemia was established by incision biopsy in 4 patients, subsequently confirmed by peripheral blood smear testing and bone marrow biopsy in 2 patients which revealed the presence of systemic involvement. Imprint smears of the biopsy identified blasts in 2 of 4 cases. In 8 patients presenting with ocular manifestations, diagnosis was established by peripheral blood smear examination alone which revealed a diagnosis of acute myeloid leukemia.</p> <p>Conclusion</p> <p>A peripheral blood smear should be performed in all cases of sudden onset proptosis or an orbital mass in children and young adults along with an orbital biopsy. It can always be complemented with a bone marrow biopsy especially in cases of aleukemic leukemia or when the blood smear is inconclusive.</p

Hemolysin, Protease, and EPS Producing Pathogenic Aeromonas hydrophila

A pathogenic Aeromonas hydrophila strain An4 was isolated from marine catfish and characterized with reference to its proteolytic and hemolytic activity along with SDS-PAGE profile (sodium dodecyl sulphate-Polyacrylamide gel electrophoresis) of ECPs (extracellular proteins) showing hemolysin (approximately 50 kDa). Agar well diffusion assay using crude cell extract of the bacterial isolate clearly demonstrated antibacterial activity against indicator pathogenic bacteria, Staphylococcus arlettae strain An1, Acinetobacter sp. strain An2, Vibrio parahaemolyticus strain An3, and Alteromonas aurentia SE3 showing inhibitory zone >10 mm well comparable to common antibiotics. Further GC-MS analysis of crude cell extract revealed several metabolites, namely, phenolics, pyrrolo-pyrazines, pyrrolo-pyridine, and butylated hydroxytoluene (well-known antimicrobials). Characterization of EPS using FTIR indicated presence of several protein-related amine and amide groups along with peaks corresponding to carboxylic and phenyl rings which may be attributed to its virulent and antibacterial properties, respectively. Besides hemolysin, EPS, and protease, Aeromonas hydrophila strain An4 also produced several antibacterial metabolites