Correlation between lipid peroxidation-induced TBARS level and disease severity in obsessive–compulsive disorder

Oxidative stress is thought to play an important role in several neuropsychiatric diseases including obsessive–compulsive disorder (OCD). Thiobarbituric acid reacting substances (TBARS) are products formed as a result of free radical induced lipid peroxidation in the human body. Our study investigated the correlation between TBARS and the clinical severity of OCD as indicated by the Yale Brown Obsessive Compulsive Scale (YBOCS). Serum TBARS was estimated in thirty nine newly diagnosed drug free OCD patients and thirty three disease free control subjects. Mean values for serum TBARS were found to be significantly higher (P < 0.001) in cases than in controls (5.85 nmol/ml and 3.90 nmol/ml with an SD of 0.56 and 0.81 respectively). A strong positive correlation (r_s = 0.757, p < 0.01) between the lipid peroxidation marker TBARS and the disease severity indicator YBOCS was found among cases. Significant positive correlation was also found between TBARS and the obsessive and compulsive subscales of YBOCS. These findings were in tune with previous studies, which suggested oxidative stress induced increased free radical generation in the OCD patients. Our findings may help in understanding the development and progress of OCD and the treatment of patients of OCD in future.     

Intragenic deletions and duplications of the LIS1 and DCX genes: a major disease-causing mechanism in lissencephaly and subcortical band heterotopia

Classical lissencephaly, or isolated lissencephaly sequence (ILS), and subcortical band heterotopia (SBH) are neuronal migration disorders associated with severe mental retardation and epilepsy. Abnormalities of the LIS1 and DCX genes are implicated in the majority of patients with these disorders and account for approximately 75% of patients with ILS, whereas mutations of DCX account for 85% of patients with SBH. The molecular basis of disease in patients with ILS and SBH, in whom no abnormalities have been identified, has been questioned. We studied a series of 83 patients with ILS, SBH or pachygyria, in whom no abnormalities of the LIS1 or DCX genes had been identified, for intragenic deletions and duplications by multiplex ligation-dependent probe amplification (MLPA). In 52 patients with ILS, we identified 12 deletions and 6 duplications involving the LIS1 gene (35%), with the majority resulting in grade 3 lissencephaly. Three deletions of the DCX gene were identified in the group of nine female patients with SBH (out of 31 patients with DCX-suggestive brain anomalies), ie 33%. We estimate an overall mutation detection rate of approximately 85% by LIS1 and DCX sequencing and MLPA in ILS, and 90% by DCX sequencing and MLPA in SBH. Our results show that intragenic deletions and duplications of the LIS1 and DCX genes account for a significant number of patients with ILS and SBH, where no molecular defect had previously been identified. Incorporation of deletion/duplication analysis of the LIS1 and DCX genes will be important for the molecular diagnosis of patients with ILS and SBH.     

Caroli's syndrome leading to splenic artery aneurysm: a rare presentation

Splenic artery aneurysm is a rare disorder (0.7%) that arises mainly as a sequlae to portal hypertension. Other causes of splenic artery aneurysm are atherosclerosis, arterial wall injury due to trauma, pancreatitis, and medial dysplasias of the wall. However, though Caroli's disease is known to cause portal hypertension, the rise of vascular pressure leading to aneurysm is not yet reported (extensive Medlar search failed to reveal any publication). Every effort should be made to diagnose this condition as early as possible because 25% of ruptured splenic aneurysms are fatal. A unique case of Caroli's disease giving rise to splenic artery aneurysm and its possible pathogenesis is reported.     

Relook TURBT in superficial bladder cancer: its importance and its correlation with the tumor ploidy

ObjectiveTo evaluate various prognostic factor predictors of residual growth in Relook transurethral resection of bladder tumor (TURBT) in superficial bladder cancer. Also, to evaluate the role of Relook TURBT along with the ploidy for prediction of recurrence and stage progression in these patients.Material and MethodsFifty patients with superficial bladder cancer underwent TURBT after complete evaluation. Ploidy of the tumor specimen was evaluated by flow cytometry. After 4 to 6 weeks of initial TURBT, these patients underwent Relook TURBT. Final treatment was given after the results of the histological evaluation of these specimens. Patients who underwent bladder sparing treatment were followed-up.ResultsOf the patients, 28.5% had residual tumor in Relook TURBT. Growth was found to be at the same site in 66.7% and at a different site 33.3%; 75% had single while 25% had multiple residual growth. Residual malignant tissue had a statistically significant correlation with size of the tumor (>3 cm), appearance (solid tumor), number (>3), grade (high), and multiple previous resections. Overall, the up-migration of stage and grade leads to change in treatment in 41.6%; 5 underwent radical cystectomy and 1 opted for radiotherapy; in 2 patients, intravesical BCG was given. In follow-up of mean 11.5 months, 16.6% had recurrence. Presence of residual growth in Relook TURBT along with number, size, morphology, and multiple previous resections were found to have significant correlation with the recurrence in these patients. Ploidy and grade of the tumor were not found to have correlation.ConclusionsMultiple, more than 3 cm, solid high grade tumor with > 3 previous resections were predictors of presence of residual tumor in Relook TURBT. Presence of residual growth is a significant risk factor for recurrence. Ploidy was not found to be significantly correlated with recurrence.     

Epileptic Spike Recognition in Electroencephalogram Using Deterministic Finite Automata

This Paper presents an automated method of Epileptic Spike detection in Electroencephalogram (EEG) using Deterministic Finite Automata (DFA). It takes pre-recorded single channel EEG data file as input and finds the occurrences of Epileptic Spikes data in it. The EEG signal was recorded at 256 Hz in two minutes separate data files using the Visual Lab-M software (ADLink Technology Inc., Taiwan). It was preprocessed for removal of baseline shift and band pass filtered using an infinite impulse response (IIR) Butterworth filter. A system, whose functionality was modeled with DFA, was designed. The system was tested with 10 EEG signal data files. The recognition rate of Epileptic Spike as on average was 95.68%. This system does not require any human intrusion. Also it does not need any short of training. The result shows that the application of DFA can be useful in detection of different characteristics present in EEG signals. This approach could be extended to a continuous data processing system. Certificate of Originality This is to certify that the article submitted for publication in ‘Journal of Medical Systems’ has not been published, nor is being considered for publication, elsewhere. All experimental procedures on rats were performed in compliance with “Committee for the purpose of control and supervision of experiments on animals (CPCSEA)”, India.     

Diabetes mellitus in India: The modern scourge

India has a high prevalence of diabetes mellitus and the numbers are increasing at an alarming rate. In India alone, diabetes is expected to increase from 40.6 million in 2006 to 79.4 million by 2030. Studies have shown that the prevalence of diabetes in urban Indian adults is about 12.1%, the onset of which is about a decade earlier than their western counterparts and the prevalence of Type 2 diabetes is 4–6 times higher in urban than in rural areas. The risk factors peculiar for developing diabetes among Indians include high familial aggregation, central obesity, insulin resistance and life style changes due to urbanization. Screening for gestational diabetes and impaired glucose tolerance among pregnant women provides a scope for primary prevention of the disease in mothers as well as in their children. The problems of obesity and impaired glucose tolerance (IGT) (important predisposing factors) are not confined to adults alone but children are also increasingly getting affected. Most long standing macro and micro vascular complications are also more common among Indian diabetics as compared to other races and ethnic groups. A strong familial clustering of diabetic nephropathy among Indian Type 2 diabetics has also been noted. Clustering of cardiovascular risk factor like Syndrome X is common among urban Indians. The rising incidence of diabetes and its complications are going to pose a grave health care burden on our country. Timely effective interventions/measures and screening tests for complications at the time of diagnosis becomes imperative not only for early detection, but also to prevent progression to end stage disease. Screening for gestational diabetes among pregnant women would also go a long way in primary prevention of the disease. Life style changes/interventions and drugs like rosiglitazone are the current strategies that can prevent and/or delay the onset of diabetes. Simple interventional strategies like “Eat less, Eat on time and Walk more” can go a long way in preventing these chronic disorders among present as well as in the future generations.     

Migration of intrauterine copper 7 leading to vesical calculus

Intrauterine contraceptive devices have been associated with multitude of complications including uterine perforation and migration into adjacent organs. Here we present a rare case report on 45-year-old lady in whom intrauterine copper 7 (Cu-7) migrated into the urinary bladder leading to calculus formation. The migrated Cu-7 alongwith the calculus were successfully retrieved.     

Utility of measuring serum levels of anti-PGL-I antibody, neopterin and C-reactive protein in monitoring leprosy patients during multi-drug treatment and reactions

Objective To verify the validity of measuring the levels of Mycobacterium leprae‐specific anti‐phenolic glycolipid (PGL)‐I antibody, neopterin, a product of activated macrophages, and C‐reactive protein (CRP), an acute phase protein, in serial serum samples from patients for monitoring the leprosy spectrum and reactions during the course of multi‐drug treatment (MDT). Methods Twenty‐five untreated leprosy patients, 15 multi‐bacillary (MB) and 10 paucibacillary (PB), participated. Eight patients developed reversal reaction and five developed erythema nodosum leprosum (ENL) during follow‐up. The bacterial index (BI) in slit‐skin smears was determined at diagnosis and blood samples collected by venipuncture at diagnosis and after 2, 4, 6 and 12 months of MDT. PGL‐I antibody and neopterin were measured by enzyme‐linked immunosorbent assay, whereas the CRP levels were measured by the latex agglutination method. Results The levels of PGL‐I antibodies and neopterin were higher in the sera of MB than PB patients, which correlated with the patients’ BI. The serum levels of CRP did not differ significantly between the MB and PB patients. The serum levels of PGL‐I and neopterin were no higher in reactional patients than non‐reactional patients prone to such reactions. However, ENL patients had higher serum CRP levels than non‐reactional MB patients. The serum PGL‐I antibody levels declined significantly during MDT, in contrast to neopterin and CRP levels. Conclusion Measuring the serum levels of PGL‐I antibodies and neopterin appeared to be useful in distinguishing MB from PB patients, whereas monitoring the levels of PGL‐I antibodies appeared to be useful in monitoring MB patients on MDT. Measuring serum CRP, although not useful in monitoring the patients, has limited significance in detecting ENL reactional patients.