Variant carotid origin of left anterior inferior cerebellar artery mimicking infarct on angiography

A case is presented of a rare anterior inferior cerebellar artery variant, originating from the internal carotid artery. This mimicked a cerebellar infarct on vertebral angiography of a patient who presented with dysmetria and gait imbalance. It is important for the neuroradiologist and neurointerventionist to be aware of common and unusual cerebellar arterial anatomic variants to avoid incorrect diagnoses, as well as understand possible implications for surgery and interventional therapies.     

Gender differences in serum leptin concentrations from umbilical cord blood of newborn infants born to nondiabetic, gestational diabetic and type-2 diabetic mothers

To investigate gender differences, if any, in leptin concentrations from umbilical cord blood of new born infants of mothers with type 2 diabetes mellitus (DM), gestational diabetes mellitus (GDM), and Non diabetic (ND) at delivery. Serum leptin concentrations were measured in 105 newborns (53 males and 52 females in the three groups). Blood was taken from the umbilical cord of the babies at delivery. Maternal anthropometric measurements were recorded within 48 hours after delivery. Pearson correlation coefficient was used to explore the relationship between serum leptin concentrations and anthropometric measures of the fetus and their mother. Both Serum leptin level and serum C-peptide was measured by chemiluminescence based ELISA. The median range of leptin concentration in cord blood was ND group: Male [13.91 (3.22 – 47.63)], Female [16.88 (2 – 43.65)]; GDM group: Male [32 (7 – 76.00)], Female [36.73 (4.80 – 81.20)]; DM group: Male [20.90 (2 –76.00)], Female [32 {2.58 – 80.67)]. Cord serum leptin levels correlated with birth weight(r=0.587, p=0.0001), ponderal index (PI) (r=.319, p=0.024)of the babies and body mass index (BMI) (r=−0.299, p=0.035) of their mothers but did not correlate with gestational age, cord serum C-peptide concentration or placental weight at delivery. Leptin concentrations were higher in the female fetus in comparison to the male fetus. Birth weight of the female fetuses were also higher than that of male fetus. We found that there are very strong associations between cord leptin concentrations at delivery and birth weight, ponderal index of the baby, body mass index of the mothers with Type 2 DM. We also found that high leptin levels could represent an important feedback modulator of substrate supply and subsequently for adipose tissue status during late gestation or adipose tissue is the major determinant of circulating leptin levels.     

The effect of German chamomile (Marticaria recutita L.) extract and tea tree (Melaleuca alternifolia L.) oil used as irrigants on removal of smear layer: a scanning electron microscopy study

AIM: To compare the cleaning effectiveness of chamomile hydroalcoholic extract and tea tree oil to 2.5% sodium hypochlorite (NaOCl) solution as an intracanal irrigant for the removal of the smear layer. METHODOLOGY: Forty extracted, single-rooted, mature, permanent, human teeth were allocated at random into one of three experimental groups of ten teeth and two control groups of five teeth. For each tooth, the pulp chamber was accessed and the canal prepared using K-type files and Gates-Glidden burs, using a step-back technique; the apical stop was prepared to a size 30. Each canal was subsequently irrigated with one of the following solutions: distilled water (as a negative control), 2.5% NaOCl + 17% ethylenediamine tetraacetic acid (EDTA) (as a positive control), chamomile or tea tree oil or 2.5% NaOCl. Each tooth was split longitudinally and prepared for examination by scanning electron microscopy (SEM). The quantity of smear layer remaining on the three levels of each canal (coronal, middle and apical) was examined using magnifications of 2000 and 5000x. The data were analysed using nonparametric Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: The most effective removal of smear layer occurred with the use of NaOCl with a final rinse of 17% EDTA (negative control) followed by the use of a chamomile extract. Chamomile extract was found to be significantly more effective than distilled water and tea tree oil (P < 0.008).The use of a 2.5% NaOCl solution alone, without EDTA and that of tea tree oil, was found to have only minor effects. There was no statistical difference between distilled water, 2.5% NaOCl and tea tree oil. CONCLUSIONS: The efficacy of chamomile to remove smear layer was superior to NaOCl alone but less than NaOCl combined with EDTA.     

Septic shock in the postoperative patient: three important management decisions

The medical consultant should have a high index of suspicion for sepsis. Early goal-directed therapy is recommended and includes early, aggressive fluid resuscitation, antibiotics, and vasoactive agents, if needed. CVO2 may be helpful in guiding therapy, but targeting supranormal levels of oxygen delivery is not necessary. Empiric use of steroids and early use of activated protein C also need to be considered. Vasopressin should be considered if hypotension persists or if the situation requires escalating doses of norepinephrine.     

Docking and CoMFA study on novel human CCR5 receptor antagonists

The CC-chemokine receptor 5 (CCR5), a membrane protein belonging to the G protein-coupled receptor super-family, has been identified as an essential co-receptor for HIV entry into the cells. Small molecules were used to inhibit HIV entry by targeting CCR5. In this study, comparative molecular field analysis (CoMFA) was carried out on 70 novel phenoxybenzyl derivatives as antagonists of CCR5 HIV co receptor. This CoMFA model yielded satisfactory statistical data with the cross-validated q ² of 0.611 and non-cross-validated r ² of 0.903. Mapping this model according to the topology of the active site of CCR5 end to a better understanding of antagonist-CCR5 interactions. Because of lacking crystallography structure of CCR5, the 3D structure from threading assembly refinement (TASSER) method was used. These antagonists were docked into the binding site of the 3D model of CCR5 using ligandfit, and the probable interaction model between CCR5 and the antagonists were obtained. The correlation of predicted binding affinities between antagonists and CCR5 has good statistical quality.     

‘Toy' laser macular burns in children

Purpose

Laser ‘toys'' can be purchased online and imported with relative ease; the variety of such devices is a potential public safety concern. We describe five children with maculopathy following exposure to laser ‘toys''.

Methods

Case series of maculopathy following exposure to laser ‘toys''.

Results

Five children were seen in our Ophthalmic Unit with macular injuries following exposure to laser ‘toys''. Clinically, three children had an acute vitelliform-like maculopathy which resolved to leave sub-foveal retinal pigment epithelium changes with reduced vision. One case was complicated by a choroidal neovascular membrane.

Conclusion

Laser ‘toys'', which resemble laser pointers, are increasingly available over the internet. Such ‘toys'' may not meet safety standards. Retinal injury in childhood following exposure to laser ‘toys'' is a public safety concern.     

Foxp3 promoter polymorphism (rs3761548) in breast cancer progression: a study from India

Breast cancer is the most common female neoplasm that drives the transformation of normal mammary epithelial cells into highly malignant derivatives. Forkhead Box Protein3 (Foxp3), a tumor suppressor/immunomodulatory gene, which controls the function of Treg cells and oncogenes is down regulated in breast cancer. The main aim of the present study is to evaluate the potential influence of Foxp3-3279 C>A polymorphism (rs3761548) and -2383 C>T polymorphism (rs3761549) in 202 breast cancer patients and 130 normal healthy women of Indian origin. The genotypes were determined using ARMS-PCR for rs3761548 and PCR-RFLP method for rs3761549 using specific primers. The results revealed lack of association of these two polymorphisms with breast cancer susceptibility. However, with respect to AA genotype of rs3761548, we found highly significant association with the advanced stage (T3-4) of the tumor (OR?=?3.90; 95 % confidence interval (CI)?=?1.56–9.70; p?=?0.03). Stratified data also revealed an association of homozygous mutant genotype with advanced stage of tumor in premenopausal women (OR?=?4.56; 95 % CI?=?1.07–19.38; p?=?0.04) with disease duration of <6 months (OR?=?6.10; 95 % CI?=?1.80–20.50; p?=?0.002) suggestive of modulating effect of rs3761548 in tumor progression. We conclude that Foxp3 rs37161548 has a potential to be a polymorphic marker for tumor progression in premenopausal breast cancer patients in Indian women.