Collagen scaffolds derived from fresh water fish origin and their biocompatibility

Collagen, a major component of native extracellular matrix, has diverse biomedical applications. However, its application is limited due to lack of cost-effective production and risk of disease transmission from bovine sources currently utilized. This study describes fabrication and characterization of nano/micro fibrous scaffolds utilizing collagen extracted from fresh water fish origin. This is the first time collagen extracted from fresh water fish origin was studied for their biocompatibility and immunogenicity. The nano/micro fibrous collagen scaffolds were fabricated through self-assembly owing to its amphiphilic nature and were subsequently cross-linked. In vitro degradation study revealed higher stability of the cross-linked scaffolds with only ~50% reduction of mass in 30 days, while the uncross-linked one degraded completely in 4 days. Further, minimal inflammatory response was observed when collagen solution was injected in mice with or without adjuvant, without significant dilution of sera. The fish collagen scaffolds exhibited considerable cell viability and were comparable with that of bovine collagen. SEM and fluorescence microscopic analysis revealed significant proliferation rate of cells on the scaffolds and within 5 days the cells were fully confluent. These findings indicated that fish collagen scaffolds derived from fresh water origin were highly biocompatible in nature.     

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.     

Cognitive effects of NSAIDs in cerebral ischemia: A hypothesis exploring mechanical action mediated pharmacotherapy

Insulin resistance is a hallmark of type 2 diabetes (T2D). The mechanisms underpinning β-cell mass expansion and their functionality in insulin-resistant states still remain elusive. It has recently been shown that insulin resistance in skeletal muscles leads to production of myokines that impact negatively on β-cell function. We hypothesize that multiple intramuscular injections (IM) of mesenchymal stromal cells (MSCs) at different sites would aid in countering the insulin resistance in T2D. These IM injections are expected to have dual effects in overcoming muscle insulin resistance. It is likely to modulate the micro environmental niche of insulin-insensitive myocytes under the influence of paracrine secretions from MSCs, in turn changing the myokine secretion pattern to positively regulate β-cell function. Further, it may stimulate the satellite cell population to generate new myocytes, which would be insulin-sensitive. If our hypothesis proves to be right, it might offer a user-friendly approach to control T2D.     

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.     

Trends in medical education: challenges and directions for need-based reforms of medical training in South-East Asia

Most medical schools, especially in South-East Asia, currently are experiencing difficulties in providing the right quality and quantity of educational experiences as the curricula have failed to respond to the needs of the community and country. The pedagogic shift from traditional approach to a need-based approach requires a fundamental change of the roles and commitments of educators, planners and policymakers. Teachers of health professional education in the region are to be well-informed of the trends and innovations and utilize these to increase relevance and quality of education to produce competent human resources for the region. The purpose of this paper is twofold: (i) to discuss innovative strategies and emerging trends, which have been successfully adopted by educators around the world for the reorientation of medical education to overcome existing traditions of educational planning, review and development and (ii) to highlight their implications and importance to initiate need-based reforms of medical training in South-East Asia.     

Teaching of anatomy in a problem-based curriculum at the Arabian Gulf University: the new face of the museum

The College of Medicine and Medical Sciences of the Arabian Gulf University has an undergraduate medical curriculum that uses problem-based learning as the principal teaching strategy. Teaching of anatomy comes at various places in the curriculum, and the anatomy museum serves as an important resource and engages the students in self-directed learning. Although the museum had sufficient resource materials, the emphasis on individualized instruction and self-directed learning in anatomy has resulted in the need for an effective approach and a reorganization of the facilities in the museum. Thus, we recently rearranged the museum to create 42 modules or stations (learning carrels) focusing on specific organ systems for self-study by students. Computer-assisted programs, videocassettes, ultrasound, and structured living anatomy sessions in the clinical professional skills program facilitated such an arrangement. An increased utilization by the students was observed in the reorganized museum. Thus, the museum can play an effective role in the study of anatomy through problem-based integrated learning modules.     

Unusual clinical presentation of nasopharyngeal carcinoma--report of 3 cases

Among head and neck cancers, nasopharyngeal carcinoma has the poorest prognosis because of the primary site's proximity to the base of the skull and multiple vital structures. The presenting symptoms are generally being nasal obstruction, epistaxis, painless cervical lymphadenopathy, etc. Some patients apart from these usual presentations, report with some unusual presentations. Here in this series, 3 patients were presented, one with distant metastasis, one with upper airway obstruction and another with complete visual loss and difficulty in swallowing. They all were treated with combination chemotherapy and external beam radiation.