Cholesterol granuloma of the peritoneum

Cholesterol granulomas are common in the mastoid region but have rarely been reported in other areas. The authors report the case of a 40-year-old man who had a cholesterol granuloma of the peritoneum. They discuss the morphology of the condition and the difficulties of diagnosis. It is likely that chronic or recurrent inflammation plays a major role in the pathogenesis and that, when dealing with such lesions preoperatively or intraoperatively, a radical approach may not be necessary.     

New photodegradation products of chlorpyrifos and their detection on glass,soil, and leaf surfaces

The organophosphate insecticide chlorpyrifos was irradiated under different photochemical conditions and the products characterized by gas chromatography, mass spectrometry, and NMR spectroscopy. Irradiation of chlorpyrifos in hexane yielded dechlorinated photoproducts and cleavage products. In methanol, besides these products, chlorpyrifos gave oxons. Several new photoproducts, the formation of which apparently occurs by the displacement of 5-chloro by a methoxy substituent in the pyridyl moiety. The possibility of formation of such products on glass, soil, and leaf surfaces under the influence of UV and solar simulated light have also been explored and many new products presumably formed due to simultaneous photo-dechlorination, oxidation and hydrolytic processes were detected. Photodegradation of chlorpyrifos was rapid on a soil surface but comparatively slow on glass and leaf surfaces.Contribution No. 344     

A Management of Early CRPS I Caused by Ankle Sprain: A Case Report

Abstract:   We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat.     

A multicenter evaluation of safety of early extubation in liver transplant recipients.

Small single-institutional studies performed prior to the introduction of organ allocation using the Model for End-Stage Liver Disease (MELD) suggest that early airway extubation of liver transplant recipients is a safe practice. We designed a multicenter study to examine adverse events associated with early extubation in patients selected for liver transplantation using MELD score. A total of 7 institutions extubated all patients meeting study criteria and reported adverse events that occurred within 72 hours following surgery. Adverse events were uncommon: occurring in only 7.7% of 391 patients studied. Most adverse events were pulmonary or surgically related. Pulmonary complications were usually minor, requiring only an increase in ambient oxygen concentration. The majority of surgical adverse events required additional surgery. Analysis of a limited set of perioperative variables suggest that blood transfusions and technical factors were associated with an increased risk of adverse events. In conclusion, while early extubation appears to be safe under specified circumstances, there are performance differences between institutions that remain to be explained.     

Association of HLA antigens with differential responsiveness toMycobacterium w vaccine in multibacillary leprosy patients

Leprosy patients undergoing phase II trials in two hospitals of New Delhi, India, were HLA typed to see the association of HLA with differential responsiveness toMycobacterium w vaccine. The vaccine comprises an atypical, nonpathogenic mycobacterium,Mycobacterium w, which has cross-reactive antigens withM. leprae. Multibacillary patients who are lepromin negative are vaccinated at an interval of 3 months. Considerable improvement is evident in the patients in terms of a decline in bacterial indices and histopathological and immunological upgrading. But all the patients do not respond to the vaccine in the same manner; some are slow responders, while others are good responders. HLA-A28 and DQw3 (DQw8+9) were found to be associated with slow responsiveness, while DQw1 and DQw7 were found to be associated with a more rapid responsiveness to theM. w vaccine. However, these associations were not significant afterP correction for the number of antigens tested for each locus except for HLA-DQw3 (DQw8 and DQw9) and DQw7. DQw7, a new defined split of HLA-DQw3, seems to be associated with the responsiveness toM. w vaccine.     

Abdominal tuberculosis

Forty-two cases of abdominal tuberculosis seen between June 1984 and June 1988 at Amiri Hospital in Kuwait were reviewed retrospectively. The clinical diagnosis was correct in only 35%. Nine patients presented as an emergency, but in none was a diagnosis of tuberculosis considered. Abdominal pain and tenderness were the commonest clinical findings; "doughy abdomen" and a mass in right iliac fossa were uncommon. Thus, symptoms were vague, signs nonspecific and investigations nonpathognomonic. In spite of this, abdominal tuberculosis should be considered in any patient who has obscure abdominal symptoms, weight loss and lethargy. Laparoscopy and colonoscopy with biopsy for histologic and bacteriologic study led to a definitive diagnosis in 66% of cases, obviating the need for exploratory laparotomy in many. Histologic examination was the surest way to establish the diagnosis.     

Accuracy of glycated haemoglobin in screening for pre‐diabetes in Asian Indians—a community survey: the Chandigarh Urban Diabetes Study (CUDS)

Aim To compare American Diabetes Association and International Expert Committee recommended cut‐off values of HbA_1c for detecting the presence of pre‐diabetes against plasma glucose values obtained from oral glucose tolerance tests in Asian Indians. Methods A cross‐sectional randomly sampled population survey involving 2368 adults, aged ≥ 20 years. HbA_1c was measured on a Bio‐Rad 10 system in 1972 subjects. Results Of the 1972 subjects studied, 329 were detected to have pre‐diabetes based on isolated impaired fasting glucose in 125 subjects (6.3%), isolated impaired glucose tolerance in 141 subjects (7.1%) and the presence of both in 63 subjects (3.2%). The HbA_1c cut‐off of 34 mmol/mol (5.7%), as recommended by the American Diabetes Association for detecting the presence of pre‐diabetes, showed sensitivity of 62%, specificity 77%, with a positive predictive value of 34.7%, a negative predictive value of 89.5% and accuracy of 67.8%; whereas the HbA_1c cut‐off recommended by the International Expert Committee of 42 mmol/mol (6%) had a sensitivity of 36%, specificity of 90%, positive predictive value of 42.7%, negative predictive of 85.4% and an accuracy of 77%. However, both these HbA_1c cut‐offs underdiagnosed the presence of pre‐diabetes in 38 and 64% of these subjects, respectively. Conclusions The American Diabetes Association and the International Expert Committee recommended HbA_1c cut‐off values and oral glucose tolerance tests identify different pre‐diabetes cohorts. Long‐term prospective studies are required to define the usefulness of one over the other.     

Synthesis of 1,2,3-triazole tethered bifunctional hybrids by click chemistry and their cytotoxic studies

In view of the drug resistance with most of the currently used anticancer drugs, molecular hybrids of pyrazolyl chalcones and p-nitro benzyl functionalities tethered by triazole ring have been synthesised and evaluated for cytotoxic studies against three human cancer cell lines (THP, COLO-205, A-549). The results of the preliminary investigation exhibited marked dependence of the cytotoxic activity on the electronic factors. Placement of naphthyl (JGPT-11) and trimethoxy phenyl ring (JGPT-6) as ring A proved to be extremely beneficial in enhancing the cytotoxic potential. Thus we herein report the synthesis and cytotoxic studies of a new class of molecular hybrids. Detailed investigation on the biological mechanistic insights of JGPT-11 and 6 is under progress.     

Purification and identification of a polysaccharide from medicinal mushroom Amauroderma rude with immunomodulatory activity and inhibitory effect on tumor growth

Medicinal mushrooms in recent years have been the subject of many experiments searching for anticancer properties. We previously screened thirteen mushrooms for their potential in inhibiting tumor growth, and found that the water extract of Amauroderma rude exerted the highest activity. Previous studies have shown that the polysaccharides contained in the water extract were responsible for the anticancer properties. This study was designed to explore the potential effects of the polysaccharides on immune regulation and tumor growth. Using the crude Amauroderma rude extract, in vitro experiments showed that the capacities of spleen lymphocytes, macrophages, and natural killer cells were all increased. In vivo experiments showed that the extract increased macrophage metabolism, lymphocyte proliferation, and antibody production. In addition, the partially purified product stimulated the secretion of cytokines in vitro, and in vivo. Overall, the extract decreased tumor growth rates. Lastly, the active compound was purified and identified as polysaccharide F212. Most importantly, the purified polysaccharide had the highest activity in increasing lymphocyte proliferation. In summary, this molecule may serve as a lead compound for drug development.