Attenuation of cytotoxicity induced by tBHP in H9C2 cells by Bacopa monniera and Bacoside A

Cardiovascular diseases are one of the major global health issues leading to morbidity and mortality across the world. In the present study Bacopa monniera and its major bioactive component, Bacoside A (Bac-A) was used to evaluate its cytoprotective property in H9C2 cardiomyocytes against tBHP (150?μM) induced ROS-mediated oxidative stress and apoptosis. Our results implicate that pre-treatment with hydroalcoholic extract of Bacopa monniera (BME) and Bac-A (125?μg/ml and 6?μg/ml respectively) significantly restored oxidative stress by scavenging the free radicals and also elevated phase II antioxidant defensive enzymes such as (SOD, CAT, GR, GPx and GSH). Membrane integrity was estimated by MMP and LDH assays and found 89 and 72% of the protective effect. Further immunoblotting studies confirmed anti-apoptotic effects by regulating protein expression like Bcl2 was up-regulated to 99 and 85% and Bax was down-regulated to 122 and 181%, iNOS by 154.38 and 183.45% compared to tBHP (277.48%) by BME and Bac-A. BME and Bac-A exerts cytoprotective efficacy by attenuation of ROS generated through oxidative stress by an increase in the concentration of antioxidant enzymes and sustain membrane integrity which leads to restoring the damage caused by tBHP.     

Deceived,Disgusted, and Defensive: Motivated Processing of Anti-Tobacco Advertisements

A 2 × 2 experiment was conducted, where participants watched anti-tobacco messages that varied in deception (content portraying tobacco companies as dishonest) and disgust (negative graphic images) content. Psychophysiological measures, self-report, and a recognition test were used to test hypotheses generated from the motivated cognition framework. The results of this study indicate that messages containing both deception and disgust push viewers into a cascade of defensive responses reflected by increased self-reported unpleasantness, reduced resources allocated to encoding, worsened recognition memory, and dampened emotional responses compared to messages depicting one attribute or neither. Findings from this study demonstrate the value of applying a motivated cognition theoretical framework in research on responses to emotional content in health messages and support previous research on defensive processing and message design of anti-tobacco messages.     

Treatment of calcified coronary artery lesions

Heavily calcified coronary plaques represent a complex lesion subset and a challenge to the interventional cardiologist, as they are often resistant to simple plaque modification with conventional balloon angioplasty. Inadequate plaque modification can lead to stent underdeployment, which itself predisposes to in-stent restenosis and stent thrombosis. Over the years, a number of mechanical devices ranging from modified angioplasty balloons to atherectomy devices have become available in order to tackle such lesions. Here we review these devices concentrating on the evidence behind their use.     

Persistent air-leak after transhiatal oesophagectomy: A case report

INTRODUCTIONTranshiatal oesophagectomy is a widely accepted technique for resection of tumours of the lower oesophagus. We present a life-threatening complication associated with the placement of a corrugated neck drain during this procedure.PRESENTATION OF CASEOur patient underwent a transhiatal oesophagectomy for a lower oesophageal tumour. He developed persistent bilateral pneumothoraces despite chest drain insertions. Following removal of the corrugated neck drain, both lungs were successfully re-inflated.DISCUSSIONTo the authors’ knowledge, this serious complication has been described only once before in the medical literature; other surgeons should be made aware of this problem.CONCLUSIONAlternative drainage systems should be considered to help prevent this injury. Exercise caution if positioning corrugated drains in the neck.     

Ileocolic mucormycosis – an unusual cause of a mass in the right iliac fossa

Mucormycosis is a relatively uncommon, aggressive and lethal mycosis. Fungi from the order Mucorales are the etiological agents of mucormycosis. The condition is more common among the immunocompromised, diabetic patients with ketoacidosis and people with iron overload syndromes. Diagnosis of mucormycosis requires a high index of suspicion regarding the possibility of the condition in high-risk individuals. Timely diagnosis is critical to survival and minimization of morbidity. A favourable outcome is possible only if appropriate treatment is initiated as early as possible. The present article reports a case of ileocolic mucormycosis involving a patient with chronic renal failure and familial hyperuricemia.     

Experience with direct acting anti-viral agents for treating hepatitis C virus infection in renal transplant recipients

In recent past, direct-acting anti-viral drugs (DAAs) have become the standard of care for the treatment of hepatitis C virus (HCV) infection. However, the experience with the use of these drugs in Indian renal transplant recipients is limited. We retrospectively reviewed our experience with DAA-based treatment for HCV infection in such patients. Between April 2015 and December 2016, six adults (median age 41 [range 34–52] years, male 5; GT1 2, GT3 3, and GT4 1; including three with prior failed interferon-based treatment) had received genotype-guided, DAA-based anti-HCV treatment 1 to 158 (median 15) months after renal transplantation. Of them, four completed the planned 24-week treatment without any significant adverse event. One of them had increase in serum creatinine after 16 weeks of treatment with sofosbuvir and daclatasvir, with acute interstitial nephritis on kidney biopsy; his renal function improved on stopping the drugs. The other patient had preexisting mild renal dysfunction, which worsened after 8 weeks of sofosbuvir-ledipasvir treatment; this did not reverse on stopping treatment. All the six patients achieved undetectable HCV RNA after 4 weeks of treatment and also achieved sustained virologic response, i.e. lack of detectable HCV RNA in serum 12 weeks after stopping treatment. Overall, DAA-based treatment was effective in treating HCV infection in our renal transplant recipients; however, caution and monitoring of renal function during such treatment is advisable in patients who have additional factors that predispose to renal injury.     

Meta-analysis of self-gripping mesh (Progrip) versus sutured mesh in open inguinal hernia repair

BackgroundThis metaanalysis was designed to systematically analyse all published randomized controlled trials comparing self-gripping mesh (ProGrip) and sutured mesh to analyse early and long term outcomes for open inguinal hernia repair.MethodsA literature search was performed using the Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE, Embase and Science Citation Index Expanded. Randomized trials comparing self-gripping mesh with sutured mesh were included. Statistical analysis was performed using Review Manager Version 5.2 software. The primary outcome measures were hernia recurrence and chronic pain after operation. Secondary outcome measures included surgical time, wound complications and perioperative complications.ResultsFive randomized trials were identified as suitable, including 1170 patients. There was no significant difference between the two types of mesh repairs in perioperative complications, wound haematoma, chronic groin pain and hernia recurrence. Wound infection was lower in self gripping mesh group compared to sutured mesh but this was not statistically significant (risk ratio (RR) 0.57, 95% confidence interval 0.30–1.06, P = 0.08). The duration of operation was significantly shorter with self-gripping mesh compared to sutured mesh with a mean difference of ?5.48 min [?9.31, ?1.64] Z = 2.80 (P = 0.005).ConclusionSelf-gripping mesh was associated with shorter operative time compared to sutured mesh. Both types of mesh repairs have comparable perioperative and long term outcomes.     

Understanding Long-Term Outcomes Following Sepsis: Implications and Challenges

Sepsis is life-threating organ dysfunction due to infection. Incidence of sepsis is increasing and the short-term mortality is improving, generating more sepsis survivors. These sepsis survivors suffer from additional morbidities such as higher risk of readmissions, cardiovascular disease, cognitive impairment and of death, for years following index sepsis episode. In the first year following index sepsis episode, approximately 60 % of sepsis survivors have at least one rehospitalisation episode, which is most often due to infection and one in six sepsis survivors die. Sepsis survivors also have a higher risk of cognitive impairment and cardiovascular disease contributing to the reduced life expectancy seen in this population, when assessed with life table comparisons. For optimal design of interventional trials to reduce these bad outcomes in sepsis survivors, in-depth understanding of major risk factors for these morbid events, their modifiability and a causal relationship to the pathobiology of sepsis is essential. This review highlights the recent advances, clinical and methodological challenges in our understanding of these morbid events in sepsis survivors.