Effect of hydrocortisone on the metabolism of L-ascorbic acid in rats

Adrenalectomy causes a significant decrease in the tissue levels of l-ascorbic acid. The ascorbic acid concentration is raised when adrenalectomized animals receive hydrocortisone. Various enzymes of l-ascorbic acid metabolism have been measured in rats after adrenalectomy and subsequent treatment with hydrocortisone and/or actinomycin D. Hydrocortisone stimulates the activity of liver gulono-oxidase responsible for the synthesis of l-ascorbic acid from l-gulonolactone. A slight increase in the activity of dehydroascorbatase is also observed in the adrenalectomized rats. Little change was observed in uronolactonase, l-gulonate dehydrogenase and l-gulonate decarboxylase activities.     

Inadvertent transvenous left ventricular pacing through an unsuspected atrial septal defect

A 65-year-old male patient with a long standing history of chronic obstructive lung disease had permanent pacemaker implantation for symptomatic atrioventricular nodal blocks. Preoperative echocardiography showed dilated right heart chambers and moderate pulmonary arterial hypertension without any demonstrable intracardiac shunt. Postoperative twelve-lead ECG showed right bundle branch block configuration of paced complexes. This suggested left ventricular pacing which was confirmed by transthoracic echocardiography. Later, transoesophageal echocardiography showed the lead entering into left atrium from right atrium through a sinus venosus type of atrial septal defect. The patient refused any further intervention and continues to remain asymptomatic with stable pacing on aspirin-anticoagulant therapy at end of four years.     

Estimation of relative electrophoretic mutation rates from rare alleles in a sample

The theoretical justifications for using the number of rare alleles observed in a sample and the heterozygosity contributed by such alleles to estimate the relative electrophoretic mutation rate (REMR) are given in this note. It is shown that the estimator using the number of alleles has comparatively less bias. While the total heterozygosity contributed by all alleles at a locus has been previously used to estimate REMR with success, an analogous estimator with only rare alleles has large bias over a wide range of effective population size and sample size.     

Clinical Profile of HLA B-27-Associated Uveitis Patients in a Tertiary Care Eye Hospital in Eastern India

Purpose: To analyse clinical profile of the patients with HLA B 27- associated uveitis in a tertiary care eye hospital in Eastern India Method: Retrospective analysis of 61 eyes of 43 patients with HLA B27- associated uveitis between 2015 and 2016. Result: We observed a male predominance (67%), and more unilateral involvement (58%) in our patients. The mean age of presentation was 44.7 ±11.7 years. Significant vitritis and macular edema were noted in 14 and 7 eyes respectively. In addition to topical therapy, oral steroid was required in 49% patients and 58% patients were treated with methotrexate. Five patients (12%) required biologicals. There was improvement in BCVA at final follow-up (p<0.001). Conclusion: Compared to the existing literature, the current study observed relatively high age of presentation and frequent posterior segment involvement with less systemic association.     

Restoration of impaired free radical generation and proinflammatory cytokines by MCP-1 in mycobacterial pathogenesis

Mycobacterium tuberculosis exerts its pathogenic effects mainly via its cell wall glycolipid called Mannosylated Lipoarabinomannan (Man-LAM), which subverts the cellular inflammatory responses by the suppression of superoxide anion generation in earlier hours, and nitric oxide (NO) generation at later hours of pathogenic invasion. In this paper, we have shown the prophylactic effect of C-C chemokines, both in vitro and in vivo . Exogenous administration of C-C chemokines, particularly monocyte chemoattractant protein (MCP)-1, led to the induction of superoxide anion generation via the restoration of impaired protein kinase C (PKC) signalling in Man-LAM-treated macrophages. Monocyte chemoattractant protein-1 could also potently induce NO generation by upregulation of the proinflammatory cytokines tumour necrosis factor-α and interleukin-12 from Man-LAM-treated macrophages accompanied by inhibition of anti-inflammatory responses. Our in vivo observations clearly exhibited effective restoration of impaired PKC signalling as well as proinflammatory cytokine expression by MCP-1 in Man-LAM treated as well as M. tuberculosis H37Rv-infected C57BL/6 mice. We also observed, as direct evidence, that MCP-1 induced a significant reduction of the number of viable tubercle bacilli in the lungs and spleen of infected mice. Collectively, our findings strongly suggest the effectiveness of MCP-1 as a potent immunoprophylactic tool for controlling the mycobacterial establishment within the host.     

Capsule endoscopy:Present status and future expectation

Video capsule endoscopy(CE)since its introduction 13years back,has revolutionized our approach to small intestinal diseases.Obscure gastrointestinal bleed(OGIB)continues to be the most important indication for CE with a high sensitivity,specificity as well as positive and negative predictive values.It is best performed during ongoing bleed or immediately thereafter.Overt OGIB has a higher diagnostic yield than occult OGIB.However,even in iron deficiency anemia,CE is emerging as important investigation after initial negative work up.In suspected Crohn’s disease(CD),CE has been shown superior to traditional imaging and endoscopic technique and should be considered after a negative ileocolonoscopy.Although CE has also been used for evaluating established CD,a high capsule retention rate precludes its use ahead of cross-sectional imaging.Celiac disease,particularly where gastro-duodenoscopy cannot be performed or is normal,can also be investigated by CE.Small bowel tumor,hereditary polyposis syndrome,and non-steroidal anti-inflammatory drugs induced intestinal damage are other indications for CE.Capsule retention is the only significant adverse outcome of CE and occurs mostly in presence of intestinal obstruction.This can be prevented by use of Patency capsule prior to CE examination.Presence of cardiac pacemaker and intracardiac devices continue to be relative contraindications for CE,though data do not suggest interference of CE with these devices.Major limitations of CE today include failure to control its movement from outside,inability of CE to acquire tissue for diagnosis,and lack of therapeutic help.With ongoing interesting and exciting developments taking place in these areas,these issues would be solved in all probability in near future.CE has the potential to become one of the most important tools in diagnostic and possibly in the therapeutic field of gastrointestinal disorder.     

Antimicrobial susceptibility pattern among methicillin resistant Staphylococcus isolates in Assam

Prevalence of methicillin resistant Staphylococcus aureus from a referral hospital in Assam was studied. Methicillin resistance among the Staphylococcus aureus isolates was 52.9% and 15% among the coagulase negative staphylococci. Resistance to all antibiotics tested among the methicillin resistant and methicillin sensitive staphylococci was found to be 23.2% and 6.6% respectively. Higher resistance to multiple antibiotics in methicillin resistant strains as compared to methicillin sensitive strains was found to be statistically significant. Ciprofloxacin resistance among the strains was still lower in comparison to the findings from other parts of the country.