Food poisoning associated methemoglobinemia: Time to wake up

Dear editor,With interest we read the recent article on methemoglobinemia by Chan et al.[1]Through this letter,we would like to add few additional comments regarding methemoglobinemia and its relevance in medicine practice with regards to food poisoning.While Chan et al[1]successfully managed their patient of methemoglobinemia and could pinpoint choy sum as the responsible agent,we wonder if there were any more cases of choy sum related to methemoglobinemia detected at the same time in the community?     

Prevalence of pathology in women attending colposcopy for postcoital bleeding with negative cytology

Objective To determine the frequency of cervical pathology and the incidence of cervical neoplasia in women presenting with PCB at the colposcopy clinic with negative cytology. Design A retrospective study. Setting A district general hospital. Population Eighty-seven women with postcoital bleeding and negative cytology were seen in the colposcopy unit during 1 January 2003 to 31 December 2005. Methods Women were identified from computer records and details were extracted from the case notes. Main outcome measure Histopathological diagnosis. Results Six women (6.9%) had cervical intraepithelial neoplasia. There were no cases of invasive cancer. Thus in our study 6.9% women with postcoital bleeding had abnormal histology even though they had normal smears. Other identifiable causes were cervical polyp (12.5%), ectopy (33.6%) and Chlamydia (2.3%). No pathology was found in 50% of women. Conclusion Women with postcoital bleeding even with normal smears appear to be at much greater risk of cervical neoplasia than the general population. Unfortunately there is no general consensus for management of these patients. Hence further research is needed to standardise the management of women with PCB. Patients should be reassured that in vast majority of cases no serious pathology is detected.     

Evaluation of pregnant women with scarred uterus in a low resource setting

AIM: Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided. METHODS: An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted. RESULTS: A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively). CONCLUSIONS: Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple.     

The Impact of “COVID-19” and “Webinar Pandemic” on Plastic Surgery Practice in Teaching Institutes and Resident Training—A Multicentric Perspective

Introduction  The study was carried out to quantify the changes induced by the pandemic in plastic surgery practice and training and to study the impact of the webinars on plastic surgery education from a residents’ perspective. Methods  In this multicentric study, the number and type of surgeries, cause of injuries, and their regional variation during the coronavirus disease 2019 (COVID-19) period (February–September 2020) were compared with pre–COVID-19 time. An online survey on the impact of webinars was conducted for plastic surgery trainees across the country. Results  There was a significant reduction in total number of surgeries ( p = 0.003). The procedures for hand ( p = 0.156), faciomaxillary injuries ( p = 0.25), and replantations ( p = 0.46) were comparable; there was a significant reduction in combined orthopedic-plastic-surgical procedures ( p = 0.009) during the pandemic. There was a significant reduction in road accidents ( p = 0.007) and suicidal injuries ( p = 0.002) and increase in assault ( p = 0.03) and domestic accidents ( p = 0.01) during the COVID-19 period. A usefulness score of >8 was given for the webinars by 68.7% residents. There was no significant difference in perception of utility when correlated with the academic program at their institutes ( p = 0.109); 92% opined webinars should continue in post-COVID times. Conclusion  There was a drastic reduction in number of elective and emergency procedures during the COVID-19 time, negatively affecting resident training program. Majority of residents felt that webinars could prove a useful adjunct to training in formal training program in post-COVID-19 scenario.     

Nanomaterial catalyzed green synthesis of tetrazoles and its derivatives: a review on recent advancements

Tetrazoles are indispensable nitrogen containing heterocyclic scaffolds that offer a broad spectrum of applications in various domains such as medicinal chemistry, high energy material science, biochemistry, pharmacology etc. Owing to their useful applications, a wide range of catalysts have been explored for green synthesis of tetrazole derivatives. In recent times, nanomaterials have been emerged as extremely efficient catalysts for different organic transformations because of their high surface area-to-volume ratio, easy surface modification, simple fabrications, easy recovery and reusability. In this article, we have presented an overview of utilization of various nano-catalysts, nanocomposites and other solid-supported nanomaterials as an efficient environmental benign catalytic system for green synthesis of tetrazoles and derivatives. This review will provide an exclusive emphasis on boehmite, magnetic, copper, carbon, MCM-41, and composite based nanomaterials that have been developed since the year 2010 for the synthesis of tetrazole derivatives. In addition, we have briefly discussed the fabrication, functionalization and characterization of some novel nanomaterials and their advantages in the synthesis of tetrazole and its derivatives along with the reaction mechanism that involves synthesis of tetrazole derivatives via nanomaterials catalysed reactions.

Tetrazoles are indispensable nitrogen containing heterocyclic scaffolds that offer a broad spectrum of applications in various domains such as medicinal chemistry, high energy material science, biochemistry, pharmacology etc.     

Marcus Gunn Jaw Winking Phenomenon with Cortical Malformation

Indian Journal of Pediatrics -     

Isolation of hypoglycemic phytoconstituent from Swietenia macrophylla seeds

The present study was undertaken to isolate a novel antidiabetic molecule from Swietenia macrophylla seeds. The hydroalcohol extract of Swietenia macrophylla seeds was subjected for bioassay guided isolation employing glucose utilization assay by the isolated rat hemi‐diaphragm method in vitro. One tetranortriterpenoid, swietenine, isolated from the chloroform fraction exhibited significant (p < 0.01) activity and the effect was comparable to that of human insulin (p < 0.01). Copyright © 2009 John Wiley & Sons, Ltd.     

In vivo effects of anti-leprosy drugs on the rat peritoneal macrophages and lymphocyte subpopulations.

The present study describes the in vivo effects of anti-leprosy drugs on rat peritoneal macrophages and T-cell homeostasis. It was observed that BCG-elicited rat peritoneal macrophages produced more H2O2 and expressed more Ia antigen on their cell surfaces compared with resident peritoneal macrophages. Furthermore, elicited macrophages isolated from rats administered multidrug therapy (MDT), consisting of dapsone, clofazimine and rifampicin in high dose (10 x MDT) released more O2-. On the contrary, there was a significant decrease in the Ia antigen expression on these macrophages. Anti-leprosy drug treatment in high dose (10 x MDT) decreased the total number of blood T-helper (W3/25+) cells and increased the total number of blood T-suppressor (OX-8+) cells which resulted in a significant decrease in a W3/25: OX-8 ratio. Electron microscopy of elicited macrophages isolated from 10 x MDT treated rats showed development of many filipodia compared with control macrophages. These data show that 10 x MDT treatment in rats for 1 month alters the homeostasis of blood T-cell subpopulations which perhaps decreases the Ia expression on macrophages. However, the increase in O2- production and the appearance of filipodia on the macrophages is due to a direct effect of drugs on the macrophages. MDT treatment for 1 month in a therapeutic dose has no effect on the above-mentioned parameters.     

Bacterial and fungal co-infection is a major barrier in COVID-19 patients: A specific management and therapeutic strategy is required

Microbial co-infections are another primary concern in patients with coronavirus disease 2019 (COVID-19), yet it is an untouched area among researchers. Preliminary data and systematic reviews only show the type of pathogens responsible for that, but its pathophysiology is still unknown. Studies show that these microbial co-infections are hospital-acquired/nosocomial infections, and patients admitted to intensive care units with invasive mechanical ventilation are highly susceptible to it. Patients with COVID-19 had elevated inflammatory cytokines and a weakened cell-mediated immune response, with lower CD4⁺ T and CD8⁺ T cell counts, indicating vulnerability to various co-infections. Despite this, there are only a few studies that recommend the management of co-infections.