A mysterious journey of a cardiac pacemaker

A permanent bipolar cardiac pacemaker was inserted in the abdomen of a child with Down's syndrome, due to complete heart block following repair of atrioventricular septal defect. This report describes an unusual and unreported complication of the pacemaker getting extruded through the rectum without dysfunction. Implications for early diagnosis and appropriate management and steps to prevent such episodes in future are discussed.     

Evaluation of Testicular Toxicity Following Short-term Exposure to Cypermethrin in Albino Mice

The present study was undertaken to assess the testicular toxicity following short-term exposure to cypermethrin (α-CP) in albino mice. Cypermethrin was dissolved in arachis oil and administered to two groups of mice (n = 12/group) orally at the dose rate of 250 mg/kg body weight, once a day for 28 days. Fifty percent of the animals in both the groups were sacrificed on day 14 and the remaining on day 28. Plasma samples were subjected to radioimmunoassay to determine testosterone levels. The testes were collected to determine the cholesterol levels and the activity of transaminases (AST and ALT) or epididymal alkaline phosphatase (ALP). Histological study of testicular tissue was also undertaken to examine the α-CP-induced ultrastructural changes using transmission electron microscopy (TEM). α-CP significantly (P<0.05) increased the activities of testicular AST (1.36±0.12 vs. 1.19±0.10), ALT(1.78±0.11 vs. 1.36±0.09), and significantly (P<0.05) decreased the testosterone levels (0.86±0.24 vs. 1.72±0.18). Testicular cholesterol levels were elevated in treated animals as compared to control (1.81±0.16 vs. 1.42±0.08). Epididymal alkaline phosphatase (ALP) activity was also decreased significantly (P<0.05) in treated animals (1.10±0.20 vs. 1.64±0.1). Histological studies on day 28 revealed rupture of spermatogonic cell membrane, shrinkage in the nucleus, stages of apoptosis, condensation of chromatin, and decreased cytoplasmic organelles. The study suggested that short-term exposure to α-CP in albino mice induced toxicopathological lesions in testicular tissue leading to decreased plasma testosterone levels.     

Effect of Plant Extracts Formulated in Different Ointment Bases on MDR Strains

Extracts of Aloe vera whole plant, Eucalyptus globulus leaves, Ficus infectoria bark, Ficus religiosa bark and Piper betel leaves were studied for antibacterial activity on resistant and sensitive strains, isolated from skin and soft tissue infections. A combination of hot alcoholic extracts of Ficus infectoria, Ficus religiosa and Piper betel were found to be more effective against all the isolates. The combined extract was formulated in different ointment bases such as polyethylene glycol, gelatin, sodium alginate, carbopol, cream base and honey. These were then evaluated to find a suitable base for preparation of an ointment. In vitro study of the release of antimicrobials and kill-time studies of the herbal ointments was carried out against multi-drug resistant isolate of Pseudomonas. The ointment showed bactericidal activity within 2 h against the resistant strain of Pseudomonas spp.     

Flucytosine for treatment of Candida albicans in H1N1-positive patient

A 17-year-old H1N1-positive patient was successfully extubated after 25 days of ventilatory support for treatment of viral pneumonia which was complicated by empyema thoracis due to Candida albicans. Hematogenous spread was suspected as simultaneous culture of ascitic fluid identified Candida species sensitive to flucytosine but resistant to amphotericin B and azole group of antifungals. Monotherapy with flucytosine led to clinical and radiological improvement.     

Synthesis and pharmacological investigation of novel 2-substituted-3-carboxamido-4H-pyrimidobenzothiazole derivatives as a new class of H1-antihistaminic agent

With the aim of developing potential H₁-antihistaminic agents, a series of novel 2-substituted-3-carboxamido-4-oxo-4H-pyrimido[2,1-b][1,3]benzothiazole (8a–g) and 2-substituted-3-carboxamido-8-chloro-4-oxo-4H-pyrimido[2,1-b][1,3]benzothiazole (9a–g) were synthesized and evaluated in vitro for H₁-antihistaminic activity on guinea pig ileum preparation. IC₅₀ values of the compounds were found to be in the micromolar range. Chlorpheniramine maleate was used as a standard drug. The active derivatives (8d–8g and 9d–9g) were found to have IC₅₀ values comparable to reference standard chlorpheniramine maleate. The sedative potential of both series (8a–g and 9a–g) is less than the reference drug. Hence, it could serve as prototype molecules for further development as a new class of H₁-antihistaminic agents.     

The synthesis, anti-inflammatory, and anti-microbial activity evaluation of new series of 4-(3-arylureido)phenyl-1,4-dihydropyridine urea derivatives

A new series of 4-(3-arylureido)phenyl-1,4-dihydropyridine urea derivatives were synthesized using simple three component condensation, reduction, and nucleophilic addition sequence in moderate to good yields. All the synthesized compounds 6a–j were evaluated for their anti-inflammatory [against the pro-inflammatory cytokines (tumor necrosis factor-alpha, TNF-α and interleukin-6, IL-6)] and anti-microbial activity (anti-bacterial and anti-fungal). Among all the compound screened, the compound 6b, 6f, and 6j were found to have promising anti-inflammatory activity, 74–83 % TNF-α and 91–96 % IL-6 inhibitory activity, respectively as compared to the standard dexamethasone (71 and 86 % inhibition) but at the MIC of 10 μM/ml. The compounds 6d–e and 6h exhibited relatively lower TNF-α and IL-6 inhibitory activity and found to be moderately potent anti-inflammatory agents. The compounds 6c–e, 6g, and 6i were found to be promising anti-bacterial and anti-fungal agents and remarkably some of the new compounds, viz. 6d and 6i were found be more potent than the standard ciprofloxacin or miconazole. It is to be noted that this is the first report on the anti-inflammatory activity evaluation of novel 1,4-dihydropyridine urea derivatives against the important molecular target, TNF-α, and IL-6.     

Effectiveness of the addition of citicoline to patching in the treatment of amblyopia around visual maturity: A randomized controlled trial

Aim:

To study the effectiveness of the addition of citicoline to patching in the treatment of amblyopia in the age group of 4-13 years.

Materials and Methods:

A randomized controlled trial, which included patients who were randomly divided into two groups. Both the groups received patching therapy till plateau was achieved in phase 1 of the study. Then in phase 2, group I received citicoline plus patching and group II continued to receive only patching.

Outcome Measures:

Outcome was measured by the visual acuity in logMAR every month in phase 1 till plateau was achieved and then for 12 months in phase 2.

Results:

No significant difference was found in the mean visual acuities in these two groups in phase 1 till plateau was reached. In phase 2, for the initial four months, there was no significant difference in the visual acuities in these two groups, at the respective intervals. However, five months onward, up to 12 months, there was a significant difference in the visual acuities in these groups. The result was the same in younger patients (< seven years of age) as well as in older patients (> seven years of age). In phase 2, the mean proportional improvement in group I was significantly more than that in group II, at two months and onward, at the respective intervals.

Conclusion:

The improvement in visual acuity with citicoline plus patching was significantly more than that with patching alone, in one year of treatment.     

Effect of siRNA mediated suppression of signaling lymphocyte activation molecule on replication of peste des petits ruminants virus in vitro

Signaling lymphocyte activation molecule (SLAM) expression was inhibited in B95a cell line using siRNA and the effect of SLAM inhibition on peste des petits ruminants virus (PPRV) replication and infectivity titre was studied. SLAM suppression was assessed using real-time PCR and flow cytometry to confirm suppression at the m-RNA and protein levels, respectively. Three chemically synthesized siRNAs were transfected individually using oligofectamine into B95a cell line. This resulted in SLAM suppression from 48 to 454-folds, in comparison to the untransfected B95a cell line. When the SLAM suppressed B95a cell line was infected with PPRV, replication was reduced by 12-143-folds and virus titre was reduced from log10 1.09 to 2.28. siRNA 3 showed the most potent inhibition of SLAM expression both at m-RNA and protein levels. This also caused the maximum reduction of virus replication and virus titre. A 100-fold reduction in PPRV titres was seen in anti-SLAM antibody neutralized B95a cell line. This further confirms that SLAM is one of the (co) receptors for PPRV. However, the presence of other putative virus receptor(s) is/are not ruled out.