Adenomatoid odontogenic tumour: An enigma

Adenomatoid odontogenic tumour (AOT) is an uncommon, hamartomatous, benign epitheial lesion of odontogenic origin. The current World Health Organisation (WHO) classification of odontogenic tumors defines AOT as being composed of the odontogenic epithelium in a variety of histoarchitectural patterns, embedded in mature connective tissue stroma, and characterized by slow, but progressive growth. The aim of this paper is to present three rare cases of intraosseous AOTs with varied clinical and radiographic features imposing the fact that AOT should be included in differential diagnosis of routine odontogenic cysts and tumours.     

Correlation of induced sputum eosinophil levels with clinical parameters in mild and moderate persistent asthma in children aged 7–18 years

Background: Treatment decisions in asthma are currently based on clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. Objectives: To measure eosinophil percentage in induced sputum in children with asthma and correlate it with clinical asthma parameters. Methods: A prospective observational study was performed at tertiary care hospital on 91 children aged 7–18 years with newly diagnosed mild or moderate persistent asthma. Theinduced sputum eosinophil percentage was obtained at the time of enrollment and three months after treatment with inhaled budesonide. Patients were specifically evaluated for five clinical parameters of asthma, i.e., days of acute exacerbations, use of salbutamol as rescue medication, emergency visits, nighttime cough and days of school absence. Results: Sputum eosinophil percentage was high (3.1 ± 0.515%) at the time of enrollment which reduced significantly after three months of inhaled budesonide therapy [0.06 ± 0.164% (p < 0.0005)]. Children with moderate persistent asthma had significantly higher values of sputum eosinophil levels than children with mild persistent asthma at the time of enrollment (3.38 ± 0.64% vs. 2.99 ± 0.42%, p = 0.001) but the difference was not significant after three months of inhaled steroid therapy (0.07 ± 0.18 vs. 0.04 ± 0.12, p = 0.5104). A significant negative correlation was found between reduction in sputum eosinophil levels and improvement in FEV1 (r = ?0.400, p = 0.0001). All the clinical asthma parameters also correlated significantly with the reduction in sputum eosinophil levels after three months of inhaled steroid therapy. Conclusion: Eosinophil levels in induced sputum correlate well with clinical asthma parameters and asthma severity in children. It is a simple, noninvasive and cheap method which can be used for the monitoring of asthma in a resource-limited setting.     

Catheter associated mycobacteremia: Opening new fronts in infection control

Mycobacterium fortuitum is a rapidly growing Mycobacterium ubiquitous in nature, known to form biofilms. This property increases its propensity to colonize the in situ central line and makes it a prospective threat for nosocomial infection. We report a case of 48-year-old female with carcinoma cecum who reported to us with clinical illness and neutropenia while on chemotherapy via totally implanted central venous device, postlaparoscopic-assisted right hemicolectomy.     

Pulmonary damage following right ventricular outflow tachycardia ablation in a child: When electroanatomical mapping isn't good enough

A 14‐year‐old female was referred for severe pulmonary valve insufficiency after undergoing radiofrequency ablation for a right ventricular outflow tract tachycardia that originated in the proximal pulmonary artery at 10 years of age. Clinical records indicated that ablation was guided solely by electrograms and electroanatomical mapping. Due to myocardial tissue extensions, mapping failed to identify the level of the pulmonary valve annulus, which resulted in delivery of energy on the valve proper and into the pulmonary artery. She developed severe pulmonary valve insufficiency and moderate proximal pulmonary artery stenosis necessitating intravascular stent placement 4 years later with an associated transcatheter valve. Although the nonfluoroscopic approach during ablation has gained wide acceptance for use in children, this report highlights the benefits of adjunctive imaging to identify the precise location of the pulmonary valve when ablation therapy is contemplated in the right ventricle outflow tract.     

Aquaglyceroporin AQP9: solute permeation and metabolic control of expression in liver

Aquaglyceroporins form the subset of the aquaporin water channel family that is permeable to glycerol and certain small, uncharged solutes. AQP9 has unusually broad solute permeability and is expressed in hepatocyte plasma membranes. Proteoliposomes reconstituted with expressed, purified rat AQP9 protein were compared with simple liposomes for solute permeability. At pH 7.5, AQP9 proteoliposomes exhibited Hg(2+)-inhibitable glycerol and urea permeabilities that were increased 63-fold and 90-fold over background. beta-Hydroxybutyrate permeability was not increased above background, and osmotic water permeability was only minimally elevated. During starvation, the liver takes up glycerol for gluconeogenesis. Expression of AQP9 in liver was induced up to 20-fold in rats fasted for 24-96 h, and the AQP9 level gradually declined after refeeding. No changes in liver AQP9 levels were observed in rats fed ketogenic diets or high-protein diets, but AQP9 levels were elevated in livers of rats made diabetic by streptozotocin injection. When blood glucose levels of the diabetic rats were restored to normal by insulin treatments, the AQP9 levels returned to baseline. Confocal immunofluorescence revealed AQP9 immunostaining on the sinusoidal surfaces of hepatocyte plates throughout the livers of control rats. Denser immunostaining was observed in the same distribution in livers of fasted and streptozotocin-treated rats. We conclude that AQP9 serves as membrane channel in hepatocytes for glycerol and urea at physiological pH, but not for beta-hydroxybutyrate. In addition, levels of AQP9 expression fluctuate depending on the nutritional status of the subject and the circulating insulin levels.     

Developmental gene expression and tissue distribution of the CHIP28 water-channel protein.

The CHIP28 water channel is a major component of red cell and renal tubule membranes; however, its ontogeny and tissue distribution remain undefined. Three patterns of expression were identified when CHIP28 mRNA was surveyed by in situ hybridization histochemistry in rats between embryonic day 14 and maturity. (i) CHIP28 mRNA and protein were very abundant in hematopoietic tissue and kidneys of mature rats, but strong expression did not occur until after birth, when it appeared in renal proximal tubules and descending thin limbs, red pulp of the spleen, and membranes of circulating red cells. (ii) CHIP28 mRNA was abundant in choroid plexus epithelium throughout fetal development and maturity. (iii) CHIP28 mRNA was transiently observed in periosteum, heart, vascular endothelium, and cornea during fetal development. The ontogeny of kidney and red cell CHIP28 expression coincides with the ability of kidneys to concentrate urine, suggesting that CHIP28 promotes water reabsorption in the proximal nephron and provides red cell osmoregulation needed for passage through the hypertonic medulla. Its presence in the choroid plexus suggests that CHIP28-mediated water transport contributes to secretion of cerebrospinal fluid. The functional role of CHIP28 in developing bone, heart, and eye is unclear. These findings further establish the general physiologic role of CHIP28 as a water channel involved in reabsorption, osmoregulation, and secretion. The studies also suggest other possible functions during fetal development and predict that complex mechanisms will be needed for regulation of CHIP28 gene expression in diverse tissues at distinct points in development.     

GIS-based evaluation of groundwater geochemistry and statistical determination of the fate of contaminants in shallow aquifers from different functional areas of Agra city,India: levels and spatial distributions

The quality of groundwater is very important in Agra because groundwater is the main source of water for drinking, domestic, agricultural and industrial uses. A groundwater geochemistry study was conducted in Agra where 28 samples were collected from shallow aquifers in May 2016 from different sites. The aim of this research was to assess the quality of groundwater for drinking purposes in the study area. Arc-GIS has been used to prepare geographic information system-based spatial distribution maps of different major elements. The groundwater quality was analyzed for various physico-chemical parameters, major cations and anions and some trace metals. The observed values were compared with BIS and WHO standards. Statistical parameters such as the mean, median, standard deviation, skewness and kurtosis were used to analyze the hydrogeochemical characteristics of the groundwater. Correlation coefficient analysis and principal component analysis (PCA) were performed to identify the sources of the water constituents. Our results showed that most of the samples exceeded the acceptable limit for drinking water standards. The sequence of abundance of the main cations was generally Na⁺ > Ca²⁺ > Mg²⁺ > K⁺, while the anions in order of abundance were HCO₃⁻ > Cl⁻ > SO₄²⁻ and NO₃⁻ > F⁻. All of the trace metals were within the permissible limit except for iron and manganese. The hazard index value of 5.7 × 10⁻² indicated that there was no potential health risk in the study area. Ca²⁺, Mg²⁺, Cl⁻ and SO₄²⁻ were the dominant hydrogeochemical facies in the majority of the groundwater samples. Most of the parameters such as TDS, Cl⁻, HCO₃⁻, SO₄²⁻, NO₃⁻, Ca²⁺, Mg²⁺, Na⁺, K⁺ and TH showed strong correlations with each other, which were due to natural processes such as weathering, exchangeable ions and reduction/oxidation, as well as anthropogenic activity around the study area. The water quality index indicated that the water quality was poor at 46.43% of the sampling sites, very poor at 28.57% of the sites and unsuitable for drinking purposes at 25% of the sampling sites. Gibbs diagrams suggested rock weathering as a major driving force for controlling the groundwater chemistry in the study area, along with evaporation as a minor influence.

A groundwater geochemistry study was conducted in Agra where 28 samples were collected from shallow aquifers in May 2016 from different sites. The aim of this research was to assess the quality of groundwater for drinking purposes in the study area.