Infantile-onset diabetes mellitus: a 1-year follow-up study

This study evaluates the clinical profiles and outcomes of children with infantile-onset diabetes mellitus (IODM) (onset at <1 year). Twelve infants with IODM presenting to our hospital from January 2003 to December 2007 are analyzed. All undergo thorough history, clinical examination, and investigations and are managed as per hospital-approved protocol and periodically followed up. Of 12 infants (3 boys and 9 girls), 9 have a family history of DM. The median age at onset is 2.5 months. Six infants have features suggestive of Wolcott-Rallison syndrome (WRS), 4 infants have type 1 DM, and 1 infant each has Fanconi-Bickel syndrome and maturity-onset diabetes of young. None have pancreatic agenesis or calculi. Human leukocyte antigen (HLA) typing shows DQ3 and DR15 alleles predominating. Two children with WRS died; the rest are being followed up. The incidence of IODM is increasing, with multiple syndromic associations rather than a single perspective.     

Thiamine responsive megaloblastic anemia syndrome

Thiamine responsive megaloblastic anemia syndrome (TRMA) is a clinical triad characterized by thiamine-responsive anemia, diabetes mellitus and sensorineural deafness. We report a 4-year-old girl with TRMA whose anemia improved following administration of thiamine and this case report sensitizes the early diagnosis and treatment with thiamine in children presenting with anemia, diabetes and deafness.     

Tuberculous cavernositis of the penis: case report.

The case of an elderly man with tuberculous cavernositis of the penis leading to distortion and sinus tract formation is reported. The condition resembled carcinoma. Histopathology, a positive tuberculin test result, and a good response to treatment aided in making the diagnosis.     

Association between post-transplant donor-specific antibodies and recipient outcomes in simultaneous liver–kidney transplant recipients: single-center,cohort study

There is a dearth of published data regarding the presence of post-transplant donor-specific antibodies (DSA), especially C1q-binding DSA (C1q+DSA), and patient and kidney allograft outcomes in simultaneous liver–kidney transplant (SLKT) recipients. We conducted a retrospective cohort study consisted of 85 consecutive SLKT patients between 2009 and 2018 in our center. Associations between presence of post-transplant DSA, including persistent and/or newly developed DSA and C1q+DSA, and all-cause mortality and the composite outcome of mortality, allograft kidney loss, and antibody-mediated rejection were examined using unadjusted and age and sex-adjusted Cox proportional hazards and time-dependent regression models. The mean age at SLKT was 56 years and 60% of the patients were male. Twelve patients (14%) had post-transplant DSA and seven patients (8%) had C1q+DSA. The presence of post-transplant DSA was significantly associated with increased risk of mortality (unadjusted model: Hazard Ratio (HR) = 2.72, 95% confidence interval (CI): 1.06–6.98 and adjusted model: HR = 3.20, 95% CI: 1.11–9.22) and the composite outcome (unadjusted model: HR = 3.18, 95% CI: 1.31–7.68 and adjusted model: HR = 3.93, 95% CI: 1.39–11.10). There was also higher risk for outcomes in recipients with C1q+DSA compared the ones without C1q+DSA. Post-transplant DSA is significantly associated with worse patient and kidney allograft outcomes in SLKT. Further prospective and large cohort studies are warranted to better assess these associations.     

A phantom study on the effects of target motion in non-gated kV-CBCT imaging

Kilo-voltage cone beam computed tomography (kV-CBCT) integrated with a linac can produce online volumetric and anatomical images for patient set-up and dosimetric analysis in adaptive radiotherapy. However CBCT is prone to motion artifacts. This study investigates the impact of target motion in CBCT imaging. To simulate respiratory movement, a dynamic phantom was moved in three-dimensions with a period of 4 s and two different amplitudes (PA1 and PA2). The targets of well defined geometries were made using wax. A reference image of the static target was achieved with fan beam CT. Using CBCT, the targets in static and dynamic modes were imaged under full-fan beam conditions. The length of average HU spread was reduced in range from 19.35 to 44.44% along the cranio-caudal direction of targets. The percentage volume loss of dynamic targets imaged using CBCT (for Hounsfield Units with window width −500 to 0) ranged from 14.35 to 30.95% for PA1 and 21.29 to 43.80% for PA2 in comparison with static targets imaged with fan beam CT. A significant loss of volumetric information may result for non-gated CBCT imaging of moving targets and may result in a systematic error in re-contouring when CBCT images are used for radiotherapy re-planning.     

Chromatin remodeling protein INO80 has a role in regulation of homeotic gene expression in Drosophila

The homologues of yeast INO80 are identified across phyla from Caenorhabditis elegans to human. In Drosophila it has been shown that dINO80 forms a complex with Pleiohomeotic but does not interact with Hox PRE (polycomb responsive element). As some proteins of the INO80 complex are implicated in homeotic gene regulation, we examined if dINO80 is involved in regulation of homeotic genes. We find that dINO80 null mutants generated by imprecise excision of P‐element are late embryonic lethals and show homeotic transformation. We detect misexpression of homeotic genes like Sex‐comb reduced, Antennapedia, Ultrabithorax and Abdominal‐B in dIno80 mutant embryos by immunostaining which is further substantiated by quantitative PCR. Polycomb phenotype in dIno80‐Pc is enhanced in double mutants. Concurrently, the localization of dINO80 to sequences upstream of misexpressed genes in vivo shows that dINO80 is involved in homeotic gene regulation and probably through its interactions with PcG‐trxG complexes.     

Correlation of renal length with somatic variables in Indian children

Mean kidney length in 230 Indian children without apparent renal disease were examined sonographically and correlated with, age, body weight, length / height, upper thigh (femur) length, head circumference and chest circumference. Mean kidney is length best correlated with height, followed by upper thigh (femur) length and chest circumference.     

Antihyperlipidemic activity of Cassia auriculata flowers in triton WR 1339 induced hyperlipidemic rats

The flower extract of Cassia auriculata, herb has been used traditionally in India for medicinal purposes. The plant has been reported to treat hyperglycemia and associated hyperlipidemia. Hyperlipidemia and oxidative stress are known to accelerate coronary artery disease and progression of atherosclerotic lesions. The present work was undertaken to investigate the possible antihyperlipidemic and antioxidative effect of C. auriculata flower on hyperlipidemic rats. Hyperlipidemia was induced in rats by a single intravenous (iv) injection of Triton WR 1339 (300 mg/kg b.w.) and it showed sustained elevated levels of serum cholesterol and triglyceride. Ethanolic extract of C. auriculata flowers (Et-CAF) (150, 300, 450 mg/kg b.w./day) was administered to normal and hyperlipidemic rats for 14 days. Serum and liver tissue were analysed at three different time intervals for lipid profile, lipid peroxidation products, antioxidants enzymes and the activity were compared to the cholesterol-lowering drug, lovastatin (10 mg/kg/b.w.). Parameters were altered during hyperlipidemia and reverted back to near normal values after Et-CAF treatment or standard drug lovastatin. Lipid peroxidation decreased whereas the activities of superoxide dismutase, glutathione peroxidase and catalase increased in Et-CAF treated rats. Pronounced changes were observed at 450 mg/kg b.w. of Et-CAF for 2 weeks and it was comparable to the standard drug lovastatin. The current study provides a strong evidence that Et-CAF has a beneficial effect in treating hyperlipidemia and ROS without any side effects at the dosage and duration studied.