Computed tomography diagnosis of a primary aortoduodenal fistula in a patient with a partially thrombosed abdominal aortic aneurysm

Primary aortoenteric fistula is a rare but fatal cause of gastrointestinal bleeding and requires urgent intervention. A high index of clinical suspicion in conjunction with imaging is required because a favorable outcome relies on prompt diagnosis. The primary forms of aortoduodenal fistulas are nearly always associated with abdominal aortic aneurysm, mostly atherosclerotic. Technological advances in imaging, particularly computed tomography (CT), play a pivotal role in the preoperative detection of these fistulas. We report the case of a 76-year-old man who was diagnosed with a large abdominal aortic aneurysm with associated contained rupture and suggestion of an aortoduodenal fistula on CT. This case demonstrated the effectiveness, ease, and low cost of the preoperative evaluation and documentation of a primary aortoduodenal fistula using CT scans.     

Screening for methylenetetrahydrofolate reductase C677T and A1298C polymorphisms in Indian patients with idiopathic mental retardation

Although genetic, nutritional, and environmental factors have been found to aggravate mental retardation in approximately 1% of individuals, no cause is known till date. In this study, two genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR), C677T (rs#1801133) and A1298C (rs#1801131), have been investigated in idiopathic mental retardation (IMR) subjects. Significantly higher frequency of the C677 allele was observed in IMR (n = 155; chi(2) = 5.5; P = 0.019) and moderate IMR (n = 67; chi(2) = 6.16; P = 0.013) groups as compared to controls (n = 126); for A1298C, no significant difference was noticed. TDT analysis revealed preferential transmission of C677 allele to a small group of mild IMR probands (chi(2) = 5.545; P = 0.018). Higher frequency of CA haplotype was also noticed in IMR cases as compared to controls (chi(2) = 6.28; P = 0.012). We infer from the present investigation that these polymorphisms are not contributing to the aetiology of IMR in this population since both case-control and family-based analysis revealed no significant transmission of the mutated allele.     

Berberine and Curcumin Target Survivin and STAT3 in Gastric Cancer Cells and Synergize Actions of Standard Chemotherapeutic 5-Fluorouracil

Aberrantly expressed survivin and STAT3 signaling have emerged as major determinants of chemoresistance in gastric cancer. We evaluated effects of potent herbal derivatives curcumin, berberine, and quercetin on STAT3 signaling, survivin expression, and response to 5-fluorouracil (5-FU) treatment in gastric cancer cells (AGS). Cytotoxic and inhibitory effects of berberine, curcumin, and quercetin alone or in combination with 5-FU were examined by MTT assay, and their effect on survivin, STAT3, and the phosphorylated active STAT3 (pSTAT3) expression was examined by western blotting. Effect of these herbal derivatives on STAT3 DNA binding activity was measured by electrophoretic mobility shift assay. Curcumin, berberine, and quercetin effectively downregulated pSTAT3 levels, survivin expression, and gastric cancer cells viability in a dose-dependent manner (with corresponding IC₅₀ values of 40.3μM, 29.2μM and 37.5μM, respectively). Berberine was more effective in inhibiting survivin expression as compared to other herbal agents. 5-FU in combination with berberine or curcumin showed a synergistic inhibition of survivin and STAT3 level resulting in enhanced cell death in gastric cancer cells. Overall, our data suggest use of berberine and curcumin as adjunct therapeutics to overcome chemoresistance during treatment of gastric malignancies.     

Preparation of in situ-forming ophthalmic gels of ciprofloxacin hydrochloride for the treatment of bacterial conjunctivitis: in vitro and in vivo studies

Sol-to-gel systems of ciprofloxacin hydrochloride were prepared utilizing the phase transition properties of hydroxy propyl methyl cellulose K 15 M grade (HPMC) and carbopol 934. The sol-to-gel systems were sterilized by gamma radiation and/or filtration. The sol-to-gel systems were evaluated for rheological characteristics, in vitro release behavior, microbial efficacy, in vivo release behavior, and efficacy against induced bacterial conjunctivitis in rabbits' eyes. Concentration in aqueous humor was determined and stability studies were carried out as per the ICH guidelines. The system passed the test for sterility. The sol-to-gel system exhibited a zero-order drug release pattern over 24 h in in vitro release studies. The drug was active against selected microorganisms in microbial efficacy studies. Better improvement in artificially induced bacterial conjunctivitis in rabbits' eyes was observed in animals treated with the sol-to-gel system compared with marketed eye drops. Drug concentration in aqueous humor was greater than the minimum inhibitory concentration (MIC 90) against selected microorganisms. The shelf-life of the product was >2 years.     

Foot index: Is it a tool for sex determination?

Identification of an individual is of paramount importance in forensic investigations. The dimensions of the foot can be used for the determination of sex and stature of an individual in forensic investigations. No systematic studies are available on the determination of sex from foot measurements of North Indians. Therefore, foot index is derived to determine the sex of an individual in a single community of North India. The foot index for both genders is derived by dividing the foot breadth by foot length and multiplying it by hundred. In the present investigation, the foot index is found to be slightly higher in females in the right foot and males in the left foot. The study suggests that although foot length and foot breadth show significant sex differences, sex determination cannot be made conclusively from the foot index.     

Suicidal hanging in Manipal, South India - victim profile and gender differences

Suicide is an important health hazard worldwide. Hanging is one of the preferred means of committing suicide in India. The current research is aimed to describe the victimologic profile and find the gender differences in suicidal hanging in Manipal, South India. A 10-year retrospective review of medicolegal autopsy records was conducted at the Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal. A total of 70 cases of suicidal hanging autopsied during the study period spanning from January 1997 to December 2006 were identified. Data on suicidal hanging was obtained, analysed and compared for males and females using Microsoft Excel and Statistical Package for Social Sciences (SPSS) for Windows, version 10.0. Males were predominantly affected (male:female - 2:1). Maximum victims of suicidal hanging were Hindus in their 3rd decade of life. Mean age for males and females was 40.62 years and 29.96 years respectively. Maximum mortalities were noted during summer months. Identification of target population is the prime issue before the process of prevention and health promotion is initiated. A difference in pattern of suicidal hanging exists among males and females. Thus, psychosocial correlates should be addressed separately for males and females in epidemiological studies for identification of population at risk and strategies for prevention.