Terson syndrome with bilateral optic nerve sheath hemorrhage.

A 53-year-old man presented with an acute headache and mental status changes due to rupture of an anterior choroidal artery aneurysm. A preoperative CT scan demonstrated subarachnoid hemorrhage, bilateral optic nerve sheath hemorrhage, and bilateral intraocular hemorrhage. Ophthalmoscopy and B-scan ocular ultrasound disclosed vitreous hemorrhages, features consistent with Terson syndrome. This is the first CT report of Terson syndrome showing bilateral optic nerve sheath hemorrhage.     

Argatroban for therapeutic anticoagulation for heparin resistance associated with Covid-19 infection

Journal of Thrombosis and Thrombolysis -     

Major outcomes of patients with tuberculous meningitis on directly observed thrice a week regime

Background:

Revised National Tuberculosis Control Programme (RNTCP) of Government of India provides intermittent thrice-a-week directly observed treatment short course (RNTCP regimen).

Objective:

Assessments of all-cause mortality and nine-month morbidity outcomes of patients with tuberculous meningitis (TBM) on RNTCP regimen.

Materials and Methods:

We prospectively followed up patients registered with RNTCP center, with a diagnosis of TBM from January 1^st, 2010 to December 31^st, 2011. Morbidity was assessed using modified Rankin Scale (mRS).

Results:

We had 43 patients with median duration for follow-up of 396 days and that of survivors of 425 days. Two patients defaulted. Fourteen patients (32.5%) had mRS score of 4 to 6 and 29 had mRS of 0 to 3 after 9-month treatment. Severe disability was not related to any factor on logistic regression. Severe disability was seen in one patient (6.66%) among the 15 patients with stage 1, nine (37.5%) out of 24 patients with stage 2 and three (75%) out of 4 patients with stage 3 disease. Eight patients died (18.6%) of whom 4 died during the intensive phase and 4 during the continuation phase of RNTCP regimen. Mortality was independently related to treatment failure with adjusted Hazard ratio of 8.29 (CI: 1.38-49.78) (P = 0.02). One patient (6.66%) died out of the 15 patients with stage 1 disease, 5 (20.8%) out of 24 patients with stage 2 disease and 2 (50%) out of the 4 with stage 3 disease.

Discussion and Conclusion:

RNTCP regimen was associated with good compliance, comparable mortality and morbidity.     

Epigenetic Modifier Based Enhancement of Piperine Production in Endophytic Diaporthe sp. PF20

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Biodiversity and metabolite richness of endophytic fungi are highly fascinating. Some of them have even been...     

Coriandrum sativum--effect on lipid metabolism in 1,2-dimethyl hydrazine induced colon cancer

The biochemical effect of coriander seeds on lipid parameters in 1,2-dimethyl hydrazine (DMH) induced colon cancer in rats were studied. The study shows that the concentrations of cholesterol and cholesterol to phospholipid ratio decreased while the level of phospholipid increased significantly in the DMH control group compared to the spice administered group. Fecal dry weight, fecal neutral sterols and bile acids showed a sharp increase in the coriander-fed group compared with the DMH administered group. Thus, coriander plays a protective role against the deleterious effects in lipid metabolism in experimental colon cancer.     

Primary syphilis of the eyelid: case report.

Primary syphilis of the palpebral conjunctiva of the lower eyelid is reported because it is rare, which makes its diagnosis difficult but important.     

Chiroptical spectroscopy of natural products: avoiding the aggregation effects of chiral carboxylic acids

Determination of the absolute configurations and predominant conformations of chiral natural products, occurring as carboxylic acids, using chiroptical spectroscopic methods becomes challenging due to the formation of solute aggregates (in the form of dimers, etc.) and/or solute-solvent complexes resulting from intermolecular hydrogen bonding with solvent. A hypothesis that such aggregation effects can be avoided by using corresponding sodium salts or acid anhydrides for chiroptical spectroscopic measurements has been tested. For this purpose, vibrational circular dichroism, electronic circular dichroism, and optical rotatory dispersion spectra for disodium salts of two natural products, hibiscus acid and garcinia acid, and the anhydride of acetylated garcinia acid have been measured. These experimental spectra are analyzed in combination with quantum chemical calculations of corresponding spectra. The spectral analysis for sodium salts and anhydride turned out to be simpler, suggesting that the conversion of carboxylic acids to corresponding salts or anhydride can be advantageous for the application of chiroptical spectroscopy.     

Comparative effect of horse gram and black gram on inflammatory mediators and antioxidant status

A balanced diet is important for the overall wellbeing of an individual. Pulses are an important part of a nutritive diet. Pulses have been consumed for at least 10,000 years and are among the most extensively used foods in the world. They are a rich source of protein and fiber, as well as a significant source of vitamins and minerals, such as iron, zinc, and magnesium. The purpose of this study was to compare the effect of two pulses, horse gram and black gram, on inflammatory mediators and the antioxidant enzymes. Two sets of experiments were conducted in rats which were fed with boiled and unboiled horse gram and black gram, at a dose of 100 mg/100 g body weight, for 21 days and 60 days. The results showed that horse gram supplementation for 21 days and 60 days significantly increased the activities of antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase and showed no significant changes in the activities of the inflammatory mediators such as cyclooxygenase, lipoxygenase, myeloperoxidase, nitric oxide synthase, monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), interleukin-1-beta (IL-1β), etc. However, the black gram (with skin and without skin) supplementation significantly increased activities of the inflammatory mediators and showed a significant decrease in the antioxidant enzymes in both the 21-day and 60-day experiments. Thus, these preliminary results demonstrate the anti-inflammatory and antioxidant potential of horse gram and the proinflammatory effects of black gram in rats. This is in accordance with the dietary regime advised by Ayurveda practitioners, where horse gram is to be included and black gram is to be excluded from the diet for conditions such as rheumatoid arthritis. Further studies are to be conducted to validate the same.     

Hif-1α and Hif-2α synergize to suppress AML development but are dispensable for disease maintenance

Leukemogenesis occurs under hypoxic conditions within the bone marrow (BM). Knockdown of key mediators of cellular responses to hypoxia with shRNA, namely hypoxia-inducible factor-1α (HIF-1α) or HIF-2α, in human acute myeloid leukemia (AML) samples results in their apoptosis and inability to engraft, implicating HIF-1α or HIF-2α as therapeutic targets. However, genetic deletion of Hif-1α has no effect on mouse AML maintenance and may accelerate disease development. Here, we report the impact of conditional genetic deletion of Hif-2α or both Hif-1α and Hif-2α at different stages of leukemogenesis in mice. Deletion of Hif-2α accelerates development of leukemic stem cells (LSCs) and shortens AML latency initiated by Mll-AF9 and its downstream effectors Meis1 and Hoxa9. Notably, the accelerated initiation of AML caused by Hif-2α deletion is further potentiated by Hif-1α codeletion. However, established LSCs lacking Hif-2α or both Hif-1α and Hif-2α propagate AML with the same latency as wild-type LSCs. Furthermore, pharmacological inhibition of the HIF pathway or HIF-2α knockout using the lentiviral CRISPR-Cas9 system in human established leukemic cells with MLL-AF9 translocation have no impact on their functions. We therefore conclude that although Hif-1α and Hif-2α synergize to suppress the development of AML, they are not required for LSC maintenance.Oxygen measurement in the BM indicated that normal and malignant hematopoiesis occur under hypoxic conditions (Spencer et al., 2014). Hif-1 and Hif-2 are key mediators of cellular responses to hypoxia and regulate gene expression to facilitate adaptation to low oxygen tension (Semenza, 2014). Oxygen-regulated α-subunits of Hif-1 and Hif-2, namely Hif-1α and Hif-2α, are paralogs that have common and also distinct functions during responses to hypoxia. Several studies investigated the role of Hif-1α (Wang et al., 2011; Velasco-Hernandez et al., 2014) and Hif-2α (Rouault-Pierre et al., 2013) in acute myeloid leukemia (AML; Gezer et al., 2014; Vyas, 2014). HIF-1α or HIF-2α knockdown in AML patient samples compromised their ability to reconstitute AML upon transplantation into recipient mice (Wang et al., 2011; Rouault-Pierre et al., 2013). Although the subtype and molecular classification of AML samples used in these studies were not specified, the authors implied that HIF-1 and HIF-2 are independently required for the maintenance of AML leukemic stem cells (LSCs), suggesting that HIF-1 and HIF-2 are potential therapeutic targets for AML (Wang et al., 2011; Rouault-Pierre et al., 2013).Considering the caveats of shRNA-mediated gene knockdown approaches, a recent study used a conditional Hif-1α knockout and reported that, surprisingly, conditional Hif-1α deletion does not compromise the development and maintenance of mouse LSCs generated by the MLL-ENL fusion, its downstream effectors Meis1 and Hoxa9, and Aml1-Eto9a (Velasco-Hernandez et al., 2014). In fact, loss of Hif-1α accelerated the development of Meis1/Hoxa9-induced AML or enhanced propagation of disease induced by Aml1-Eto9a (Velasco-Hernandez et al., 2014). This study concluded that Hif-1α can suppress LSC development or propagation and is dispensable for AML LSC maintenance, sparking a debate over the therapeutic benefit of targeting HIF-1 function (Vyas, 2014).To date, the impact of conditional deletion of Hif-2α or loss of both Hif-1α and Hif-2α on leukemic transformation has not been examined. Therefore, in this study, we set out to investigate the requirement for Hif-2α or both Hif-1α and Hif-2α in the development and maintenance of AML LSCs.