Isolation of Burkholderia pseudomallei from a case of septicaemia--a case report

Meliodosis, an infectious disease caused by Burkholderia pseudomallei has been recognized as an emerging infectious disease in India. The infection is under diagnosed and underreported, and hence considered a rare disease. Majority of the cases have been documented from the states with heavy rainfall. The present case being reported is a middle-aged woman who had developed a fulminant infection following exposure to stagnant floodwater in the city of Hyderabad. To the best of our knowledge, this is the first case of Melioidosis being reported from this part of the country.     

Transvaginal uterine artery ligation in a woman with uterine leiomyomas. A case report

BACKGROUND: Uterine artery embolization by interventional radiologic techniques is an effective and widely used modality in the management of uterine leiomyomas. Anatomically, uterine arteries can be approached transvaginally with an appropriate surgical technique. In this report, we describe a novel, minimally invasive vaginal technique that also occluded the uterine arteries successfully. CASE: A 45-year-old woman with symptomatic leiomyomas decided to undergo a vaginal hysterectomy. During the procedure, Doppler ultrasonography demonstrated the cessation of blood flow after dissection and ligation of uterine arteries bilaterally without cutting the uterosacral and cardinal ligaments. CONCLUSION: Transvaginal ligation of the uterine arteries is possible. If validated by further clinical investigation, this minimally invasive gynecologic technique could be useful in selected cases of uterine leiomyomas.     

Urinary tract infections in pregnant women with bacterial vaginosis

OBJECTIVE: Our purpose was to investigate the risk of urinary tract infections in pregnant women with bacterial vaginosis. STUDY DESIGN: In a cross-sectional study, 503 pregnant women were examined for bacterial vaginosis and urinary tract infections from July 1999 through April 2000. RESULTS: Nineteen (13.6%) of 140 women who had bacterial vaginosis had urinary tract infections compared with 24 (6.6%) of 363 women without it. Bacterial vaginosis in pregnancy was associated with an increased risk for urinary tract infections (odds ratio 2.21, 95% CI 1.16-4.18). CONCLUSION: Pregnant women with bacterial vaginosis are more likely to have urinary tract infections.     

Histological analysis of cystic tumour like lesions of central nervous system

True cysts of the central nervous system (CNS) are rare lesions. A retrospective study of patients with symptomatic non-neoplastic cystic lesions of CNS operated in the Department of Neurosurgery, G.B. Pant Hospital, New Delhi between Jan 1994 and Feb 2001 was conducted. Parasitic cysts, cystic transformation of hemmorhages, vascular malformations and cystic tumours were excluded from the study. A total of 109 cases were reviewed. There were 34, 27, 17, 16, 8, 3 and 2 cases of epidermoid, arachnoid, dermoid, colloid, neurenteric, Rathke's and ependymal cysts and 1 case each of choroid plexus and glial cysts. The clinical presentations, locations, incidence and pathogenesis of these cysts is discussed.     

Cardiac ischemia during hemolytic uremic syndrome

Increased thrombin generation and impaired fibrinolysis during Escherichia coli O157:H7-associated hemolytic uremic syndrome (HUS) plausibly diminish myocardial blood flow, but the frequency of cardiac ischemia during HUS is unknown. We identified a 9-year-old boy with HUS in whom myocardial diastolic dysfunction was demonstrated by echocardiography, who also had elevated serum troponin-I and creatine kinase MB mass. However, eight additional patients with HUS did not have elevated markers of cardiac injury. When present, elevated troponin-I should be considered to represent myocardial injury, and not attributed simply to renal insufficiency. It is possible that myocardial ischemia and secondary arrhythmias account for some sudden deaths that occur during acute HUS.     

Development and biopharmaceutical evaluation of osmotic pump tablets for controlled delivery of diclofenac sodium

Based on the principles of an elementary osmotic pump (OP), OP tablets were designed and evaluated with the aim to deliver diclofenac sodium (DS) in a controlled manner. In vitro evaluation was done in various release media and kinetics was evaluated using the regression coefficient analysis. Effects of orifice size, coating membrane type, coating thickness, static and stirred conditions and pH variation were studied. In vivo evaluation was performed on six healthy human volunteers and various pharmacokinetic parameters (c(max), t(max), AUC(0-24), MRT) and relative bioavailability were calculated. The results were compared with the performance of two commercial tablets of DS. The drug release from OP tablets was dependent on the type and thickness of the coating membrane, but was independent of the orifice size and static and stirred conditions of the release medium. The OP tablets provided a prolonged and controlled DS release compared to commercial sustained-release and conventional tablets of DS.     

Downregulation of uPA inhibits migration and PI3k/Akt signaling in glioblastoma cells

The ability of glioma cells to migrate great distances from a primary tumor mass is the primary cause of tumor recurrence. The urokinase-type plasminogen activator (uPA) is a serine protease that can initiate proteolytic cascades, which result in remodeling of extracellular matrix and basement membrane, allowing cells to move across and through these barriers. The binding between uPA and its receptor uPAR also mediates several signaling events that seem to contribute to the evolution of a migratory phenotype. In this study, we determined how the downregulation of uPA affects the signaling pathways leading to cell migration. Stably transfecting human glioblastoma cells with antisense uPA decreased the amount of cell-bound uPA and disrupted actin cytoskeleton formation and cell migration. The phosphatidylinositol 3-kinase (PI3k) and Akt signaling pathway has been suggested to mediate migration in various cancer cells. The antisense-uPA clones also had less phosphorylated PI3k and Akt than control cells, a finding associated with decreased cell migration, G2/M-phase arrest, and decreased clonogenic survival. Decreased activation of PI3k and the antiapoptotic factor Akt was not sufficient to induce apoptosis in the antisense-uPA clones, but staurosporine sensitized them to apoptosis to a greater extent than control cells. These results indicate that PI3k/Akt pathway is involved in the signaling cascade required to induce cell migration and that uPA has a direct role in regulating migration.     

Novel cell culture models for prevention of human breast cancer (Review)

Human breast cancer is a multifactorial, multistep disease wherein genetic, endocrine and dietary factors represent crucial regulators of initiation, promotion and progression. Preclinical investigations utilizing human breast carcinoma derived cell lines either in culture, or upon xenotransplantation, have provided valuable leads for molecular pathogenesis of cancer progression and also for novel therapeutic modalities. The mechanistic significance of genetic factors on early events of initiation/promotion, however, is dependent on extrapolation, and is therefore, equivocal. Human tissue derived explant culture/cell culture models utilizing non-involved target tissue at risk for carcinogenic transformation provide a novel approach that minimizes extrapolation for clinical relevance and thereby maximizes the translational impact. This report provides an overview of laboratory investigations focused on: i) development of the model, ii) optimization of mechanistic biomarker assays for carcinogenic transformation, and iii) validation of the model as a high throughput mechanistic screen for preclinical efficacy of natural phytochemicals.     

Hepatic duct confluence injury in blunt abdominal trauma: case report and synopsis on management

Injuries of the extra hepatic biliary tree following blunt trauma to the abdomen are rare. We present here a case of injury to the confluence of the hepatic ducts and a brief synopsis on diagnosis and management of blunt injury to the extrahepatic biliary system.