Differential growth of the freshwater mussel, Lamellidens marginalis in relation to certain drugs

The survival and growth rate of the Indian freshwater mussel, Lamellidens marginalis, (Lamarck) was ascertained in cultivation by using certain drugs in CIFA, fish farm, BBSR (India) during June 1998 to February 1999.Two sets of experiments were carried out to evaluate the effects of drugs like Betamethasone, Calcium, Azathioprine, Stanazolol, and Folic acid. Chloramphenicol was added with each treatment as prophylaxis to prevent the bacterial growth. In the first set, the inactiveness and mortality of the mussels in different drugs were studied through two different dosages and in subsequent tests the fixation of dosage was employed. The study in the second set was regarding the survival, increment of shell length, its thickness, and wet weight in response to different drugs therapy. The drugs were administered parenterally in "fixed dosage" at a regular interval of 21-23 days. The survival rate was good with Betamethasone and Azathioprine that is 75%, whereas it was 16.66% in Folic acid treatment. But the mussels originating from the control site had the significant survival rate though the growth rate was average. Calcium treatment had shown a marked increment of shell thickness and luster. The culture was lasted for 160 days. The wet weight gain of mussels in all the treatments were significant, p<0.0001 whereas increment of shell thickness was significant only in treatment B (Calcium) and treatment D (Azathioprine), p<0.0001 but with regard to the increment of length of mussel, treatment E (Stanazolol) was not significant, p>0.05. The regression analysis was adopted to find out the coefficient of determination (R(2)=0.90, being the best) from the relationship between length and weight of mussels and to establish the LWR equation with condition factor k=W/L(b).     

Novel molecular targets for antimalarial drug development

Malaria with one million deaths and about 500 million new cases reported annually is a challenge to drug therapy and discovery. As current antimalarial therapeutics become increasingly ineffective because of parasitic resistance, there exists an urgent need to develop and pursue new therapeutic strategies. Antimalarial drug development can follow several strategies, ranging from minor modifications of existing agents to the design of novel agents that act against new targets. Recent advances in our knowledge of parasite biology as well as the availability of the genome sequence provide a wide range of novel targets for drug design. Several promising targets for drug intervention have been revealed in recent years. This review discusses novel molecular targets of the malaria parasite available to the drug discovery scientist.     

Improved Visibility of Metastatic Disease in the Liver During Intra-Arterial Therapy Using Delayed Arterial Phase Cone-Beam CT

Purpose

To compare the visibility of liver metastases on dual-phase cone-beam CT (DP-CBCT) and digital subtraction angiography (DSA), with reference to preinterventional contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.

Methods

This IRB-approved, retrospective study included 28 patients with neuroendocrine (NELM), colorectal (CRCLM), or sarcoma (SLM) liver metastases who underwent DP-CBCT during intra-arterial therapy (IAT) between 01/2010 and 10/2014. DP-CBCT was acquired after a single contrast agent injection in the tumor-feeding arteries at early and delayed arterial phases (EAP and DAP). The visibility of each lesion was graded by two radiologists in consensus on a three-rank scale (complete, partial, none) on DP-CBCT and DSA images using CE-MRI as reference.

Results

47 NELM, 43 CRCLM, and 16 SLM were included. On DSA 85.1, 44.1, and 37.5 % of NELM, CRCLM, and SLM, were at least partially depicted, respectively. EAP-CBCT yielded significantly higher sensitivities of 88.3 and 87.5 % for CRCLM and SLM, respectively (p < 0.01), but not for NELM (89.4 %; p = 1.0). On DAP-CBCT all NELM, CRCLM, and SLM were visible (p < 0.001). Complete depiction was achieved on DSA for 59.6, 16.3, and 18.8 % of NELM, CRCLM, and SLM, respectively. The complete depiction rate on EAP-CBCT was significantly higher for CRCLM (46.5 %; p < 0.001), lower for NELM (40.4 %; p = 0.592), and similar for SLM (25 %, p = 0.399). On DAP-CBCT however, the highest rates of complete depiction were found—NELM (97.8 %; p = 0.008), CRCLM (95.3 %; p = 0.008), and SLM (100 %; p < 0.001).

Conclusion

DAP-CBCT substantially improved the visibility of liver metastases during IAT. Future studies need to evaluate the clinical impact.

     

Compstatin, a peptide inhibitor of C3, prolongs survival of ex vivo perfused pig xenografts

Fiane AE, Mollnes TE, Videm V, Hovig T, Høgåsen K, Mellbye OJ, Spruce L, Moore WT, Sahu A, Lambris JD. Compstatin, a peptide inhibitor of C3, prolongs survival of ex vivo perfused xenografts. Xenotransplantation 1999; 6: 000-000 ©Munksgaard, Copenhagen Compstatin, a newly described C3-binding peptide, inhibits complement activation by blocking C3 convertase-mediated cleavage of C3. As the complement activation is an essential part of the rejection reaction, we evaluated the ability of Compstatin to delay or prevent hyperacute rejection in an ex vivo xenograft model. Porcine kidneys were perfused with fresh human blood containing either Compstatin (n=6) or a control agent (n=6). Graft survival and activation of complement, leukocytes and platelets both in the fluid phase and in the tissue were examined. The survival of the Compstatin-perfused kidneys (median, 380 min) was significantly (P=0.0036) longer than that of the controls (median, 90 min). The classical complement pathway (C1rs-C1inhibitor and C4bc) was significantly and equally activated in both groups during the first 60 min. C3 activation products increased fivefold and terminal complement complex eightfold in the control group, but no increase occurred in the Compstatin group during this period. Immunohistochemistry showed less C3 and fibrin deposition and immuno-electron microscopy showed less terminal SC5b-9 complement complex deposition in the Compstatin group. A significant change in total white cells, neutrophils, myeloperoxidase, and expression of the surface activation markers CD11b (CR3) and CD35 (CR1) and CD62 L ( l -selectin) was observed in both groups. Leukocyte activation was lower in the Compstatin group but the difference was not statistically significant. There were no differences in platelet counts, thrombospondin, soluble P-selectin or β-thromboglobulin between the groups. We conclude that Compstatin prolongs graft survival and suggest that it may be a useful agent for attenuating hyperacute rejection by inhibiting C3 and thus terminal complement pathway activation.     

Pattern of injuries due to wild animal attack among patients presenting to the emergency department: A retrospective observational study

PurposeThe human-wildlife conflicts (HWCs) causing nuisances and injuries are becoming a growing public health concern over recent years worldwide. We aimed to study the demographic profile, mode of injury, pattern of injury, and outcome of wild animal attack victims presented to the emergency department.MethodsThis retrospective cross-sectional study was conducted in the emergency department of a tertiary-care hospital in Eastern India. Data were retrieved from the medical records from May 2017 to May 2021. Patients of all ages and genders attacked by wild animals and secondary injuries were included in this study. Patients with incomplete data, injuries due to the attack of stray and domestic animals and trauma due to other causes were excluded. Demographic profile, mode of injury, the pattern of injury, injury severity score (ISS), radiological pattern, and outcome were recorded. Statistical analysis with R (version 3.6.1.) was conducted.ResultsA total of 411 wild animal attack victims were studied, of which 374 (90.9%) were snakebite injuries and 37 (9.1%) were wild mammalian (WM) attack injuries. The mean age of WM attack victims was 46 years, and the male-to-female ratio was 4:1. Elephant attack injury (40.5%) was the most common WM attack injury reported. Most WM attacks (43.2%) occurred between 4:00 a.m. to 8:00 a.m. The median ISS was 18.5 (13–28), where 54.2% of patients had polytrauma (ISS>15). Elephant attack was associated with a higher ISS, but the difference was not significant compared to other animal types (p = 0.2). Blunt trauma was common pattern of injury in the elephant attack injury cases. Lacerations and soft tissue injuries were common patterns in other animal attacks. Among snakebites, neurotoxic was the most common type (55.4%), and lower extremity was the most common site involved.ConclusionThe young male population is the major victim of HWCs; and elephant is the most common animal involved. There is a need to design scientifically sound preventive strategies for HWCs and to strengthen the preparedness in health establishments to manage victims effectively.     

COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies

COVID-19 emerged initially from Wuhan, Hubei province, China, in late December 2019, and since then, it has spread globally to be declared a pandemic by the World Health Organization. The Caribbean region started reporting COVID-19 cases in early March 2020, triggering new regional public health crises. The initial suspects and confirmed cases across the Caribbean countries were mainly imported cases and from cruise ships. The clinical manifestations varied from fever, cough, and malaise in mild cases to acute respiratory distress syndrome (ARDS) and shock in severe cases. The Caribbean Public Health Agency has provided frequent updates on the preventive strategies and quarantine measures across the Caribbean member states. COVID-19 has had a serious impact on the Caribbean region''s health system, economy, and psychology. This review presents the Caribbean perspective of COVID-19, detailing the epidemiology, clinical manifestations, diagnosis, management, and preventive and surveillance measures. Vaccine hesitancy was found to be a major challenge that needs appropriate health education strategies to address the public. Strong leadership and regional collaboration among the Caribbean member states are necessary to provide optimal real-time data to the public and implement appropriate and effective guidelines in the island states.     

Demographic and Practice Variability Amongst Indian Centres in a Multicentre Prospective Observational Study on Developmental Dysplasia of the Hip

BackgroundSince 2017, five Indian centres have enrolled into the International Hip Dysplasia Registry for prospective collection of data on Developmental Dysplasia of Hip (DDH).AimsTo assess how baseline patient characteristics and initial treatment modalities differ across these five centres.MethodsRegistry data collected over 3 years were analyzed. Children with DDH that had radiograph-based diagnoses were included.ResultsCollectively, there were 234 hips (181 patients), of which 218 had undergone surgery. Overall, median age at presentation was 25.3 months (IQR 16.8–46.0); female/male ratio was 2.6:1 (range 1.46–4.75:1); with 42%, 29%, and 29% unilateral left, bilateral and unilateral right hip dislocations respectively. Most were IHDI grade III and IV dislocations (94%). Closed reduction was performed at all but one centre, at median 15.3 months (IQR 9.6–21.1). Open reduction (OR) as a stand-alone procedure was performed at all centres, at median 20.8 months (IQR 15.4–24.9). Combination of OR with a single osteotomy, femoral (FO) or acetabular (AO), was performed at all centres at median 29.7 months (IQR 22.1–43.5). However, for the same age group, three centres exclusively performed FO, whereas the other two exclusively performed AO. The combination of OR with both FO and AO was used at all centres, at median 53.4 months (IQR 42.1–70.8).ConclusionsThe preliminary findings of this multi-centre study indicate similar patient demographics and diagnoses, but important differences in treatment regimens across the five Indian centres. Comparison of treatment regimens, using the ‘centre’ as a predictive variable, should allow us to identify protocols that give superior outcomes.     

Itch in dermatomyositis: the role of increased skin interleukin‐31

Patients with dermatomyositis often suffer from itching, but the mechanism is unknown. The authors of this study, based in USA, Korea and Italy, aimed to find out how common itch is in patients with dermatomyositis, and whether a cytokine called IL‐31 is increased in affected skin. Cytokines are proteins produced by cells in the immune system and a delicate balance of cytokines is needed to maintain health. In some skin disorders, such as atopic eczema, this balance is disrupted, and too many pro‐inflammatory cytokines (meaning ones which cause inflammation) are produced. 191 patients with the condition were surveyed, and the authors took biopsy samples from skin lesions, compared with four healthy controls (people without dermatomyositis). They found that half of the patients had moderate to severe itch, and itch was linked to the severity of the disease. In skin lesions from patients with itchy dermatomyositis, there was increased gene expression of IL‐31and its receptor (meaning more IL‐31 and the receptor that helps it work were released), and this expression was stronger in patients with more severe itch. A new drug under investigation for dermatomyositis, lenabasum, reduces or ‘downregulates’ the expression of IL‐31, and the authors conclude that it may prove to be of value in the treatment of itch in this condition.