Concentrations of Heavy Metals in Commercially Important Oysters from Goa,Central-West Coast of India

The major beds of oyster along the central-west coast of India are exposed to different anthropogenic activities and are severely exploited for human consumption. In this viewpoint, tissues of oyster Crassostrea madrasensis, C. gryphoides and Saccostrea cucullata were analyzed for Cu, Ni, Cd and Pb concentrations (dry weight) from Chicalim Bay, Nerul Creek and Chapora Bay in pre-monsoon, monsoon and post-monsoon seasons. A higher concentration of Cu (134.4–2167.9 mg kg^?1) and Cd (7.1–88.5 mg kg^?1) was found, which is greater than the recommended limits in all the three species (and sites). Moreover, significant (p?<?0.05) variations were observed for all the metals concentrations among the species, seasons and sites. The high concentrations of Cd and Cu in tissues of edible oyster pose a threat to human health. Therefore, continuous monitoring, people awareness and a stringent government policy should be implemented to mitigate the metal pollution along the studied sites.     

Impact of supplementary royal jelly on in vitro maturation of sheep oocytes: genes involved in apoptosis and embryonic development

Optimizing culture conditions lead to the improvement of oocyte developmental competence and additives with anti-oxidative activity in culture media improved embryonic development. Royal jelly (RJ) is a product from the cephalic glands of nurse bees that has considerable health effects. The aim of this study was to investigate the effect of different concentrations of RJ on the maturation, cleavage, and blastocyst rates and gene expression in the oocyte and cumulus cells during in vitro maturation (IVM) of sheep oocyte. IVM of oocyte was performed in the presence of control (RJ₀), 2.5 (RJ_2.5), 5 (RJ₅), 10 (RJ₁₀), 20 (RJ₂₀), and 40 (RJ₄₀) mg/mL of RJ. Following the maturation period, parthenogenetic activation was carried out in two treatment groups (RJ₀ and RJ₁₀) and embryonic development was examined three and eight days thereafter. Moreover, the relative expression of BCL2 and BAX in oocyte as well as BCL2, BAX, HAS2, PTGS2, and STAR in cumulus cells were assessed. The results indicated that the addition of 10?mg/mL of RJ (90?±?4.51%) to the maturation medium linearly increased the oocyte maturation rate compared to the control group (57?±?2.42%), then it remained constant to the RJ₄₀ (93?±?3.10%) group. The higher RJ concentrations were associated with increased (p?<?0.01) cleavage (53.3?±?1.55% to 82.3?±?2.82%) and blastocyst rate (15.5?±?1.16% to 33.8?±?3.09%) from the RJ₀ to the RJ₁₀ group. The relative mRNA expression of BCL2 and BAX in the oocyte was higher at RJ₁₀. In cumulus cells, the expression of BCL2 was not affected, but that of BAX decreased, and expression of HAS2, PTGS2, and STAR were increased following the addition of RJ to the maturation media. In conclusion, the addition of 10?mg/mL of RJ to maturation medium improved blastocyst formation and decreased the apoptotic incidence in sheep cumulus cells and the oocyte during the in vitro development.     

Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams: a mixed‐methods approach

Defining ‘effectiveness’ in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi‐professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross‐sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20‐item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well‐being, creative problem‐solving, continuous care, inter‐team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.     

Late outcome after repair of mitral valve rupture during balloon atrial septostomy in a neonate

Balloon atrial septostomy is ordinarily a safe palliative procedure for cyanotic congenital heart disease; however, if echocardiographic guidance is unavailable and fluoroscopy is used, distortions in the cardiac anatomy can invalidate the usual landmarks. Herein, we report iatrogenic mitral papillary muscle rupture during balloon atrial septostomy in a 4-day-old male neonate with total anomalous connection of the pulmonary veins. The anomalous connection and severe mitral regurgitation were emergently corrected, and the patient grew and developed normally. At age 24 years, he had only mild residual mitral regurgitation and was in New York Heart Association functional class I.In addition to describing the surgical treatment and positive late outcome of a rare complication, we highlight the importance of accurately evaluating balloon catheter location during atrial septostomy, especially in patients with a small left atrium.     

Outcome and risk factors for late-onset complications 24 months beyond allogeneic hematopoietic stem cell transplantation

Objectives: The aim of this retrospective study was to assess the incidence of late complications occurring ≥2 years after allogeneic hematopoietic stem cell transplantation (HSCT) for malignant diseases using a T‐cell depletion strategy. Methods: Between 1984 and 2004, 142 patients were eligible for the study. Total body irradiation (TBI) was carried out in 85% of the patients and T‐cell depletion in 84%. Results: Non‐relapse mortality (NRM) was 3% (95% CI 0–11) at 10 years, and serious late events affected a substantial number of patients. The cumulative incidence (CI) of chronic graft‐versus‐host disease (cGvHD) was 30% (95% CI 23–40), and that of infectious complications was 17% (95% CI 11–23). Multivariate analysis showed a higher risk for late complications in patients with cGvHD (HR 1.9, 95% CI 1.2–3.2, P = 0.011) and patients receiving methylprednisolone during conditioning (HR 1.9, 95% CI 1.1–3.3, P = 0.019 1), patients with cGvHD also having a higher risk for NRM (HR 13.2, 95% CI 1.2–143, P = 0.03), as well as those receiving steroids for >3 months (HR 40.3, 95% CI 2.3–718, P = 0.02) and those receiving antithymocyte globulin (HR 9.6, 95% CI 0.8–68, P = 0.024). Conclusions: A significant proportion of long‐term survivors of HSCT had late complications. cGvHD remained an important risk factor for late complications despite T‐cell depletion resulting in immunosuppression and infectious complications.     

Patterns of HIV infection among native and refugee Afghans

The current study was conducted to explore the origins of the HIV epidemics among the Afghan refugees in Pakistan and the native Afghans in Afghanistan. Phylogenetic analysis of HIV gag gene from 40 samples showed diverse HIV variants, originating from a number of countries. Intermixing of diverse HIV variants among Afghans may give rise to seeding of infections with rare HIV strains which may pose serious challenges for the treatment and control of infection.     

‘Wrong blood in tube’: solutions for a persistent problem

Background and Objectives This study was performed to determine the incidence of ‘wrong blood in tube’ (WBIT)‐type errors at our institution during the past 5 years, to analyse their root cause and to evaluate the efficacy of preventive measures that have been implemented since 2006. Methods All reports of mislabelled and miscollected specimens detected between January 2005 and December 2009 were reviewed. Of these, WBIT‐type errors were further analysed as they represent a major risk for mistransfusion. Results Between 2005 and 2009, 59 373 type and screens were performed at our institution and a total of 26 major errors (WBIT) were identified. Of the errors, eight were detected by discrepant typing results (in comparison with historic blood type), six were discovered by the clinical service and 12 were identified in the blood bank by other means. Our estimated ‘raw’ WBIT rate (1 in 2283 samples) is comparable to that (1:2262) in the published literature. Since 2006, our nursing policy mandates that ‘all type, screen and cross will have two witnesses to the correct ID of the patient and labeling is done at the bedside at the time of the draw.’ This has reduced (from 11 in 2006 to 5 in 2007), but did not eliminate, our WBIT problem that persisted into 2008 and 2009 (three and seven incidents, respectively). Since 2009, we also require a second, independently drawn sample in previously un‐typed patients who are likely to be transfused. Conclusion We conclude that WBITs continue to represent a leading cause of potential mistransfusions at our institution. Changes in nursing (two witnesses to correct ID) and/or blood bank policy (check‐type with a second specimen) may reduce, but not eliminate, this persistent problem. Clearly, additional safety measures are required to prevent WBIT‐type errors.     

A prospective, randomized, single-blind comparative evaluation of anesthetic efficacy of posterior superior alveolar nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations in patients with irreversible pulpitis

Introduction

The purpose of this study was to evaluate and compare the anesthetic efficacy of posterior superior alveolar (PSA) nerve blocks, buccal infiltrations, and buccal plus palatal infiltrations with 2% lidocaine with 1:200,000 epinephrine in maxillary first molars with irreversible pulpitis.

Methods

Ninety-four adult patients participated in this prospective, randomized, single-blinded study. The patients were divided into 3 treatment groups on a random basis. Twenty-eight patients received a PSA nerve block, 33 patients received buccal infiltrations, and 33 patients received buccal plus palatal infiltrations with 2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated 15 minutes after injection. Pain during treatment was recorded using a Heft-Parker visual analog scale. Success was recorded as “none” or “mild” pain.

Results

Statistical analysis using nonparametric chi-square tests revealed that there was no statistical difference between the anesthetic success of PSA nerve blocks (64%), buccal infiltrations (54%), and buccal plus palatal infiltrations (70%).

Conclusions

None of the tested methods gave 100% anesthetic success rates in maxillary first molars with irreversible pulpitis.