Unearthing Earth's secrets: Exploring the environmental legacy of contaminants in soil, water, and sediments.

The Earth's history is documented in human civilizations, soil layers, river movement, and quiet sediments throughout millennia. This investigation explores the significant legacy of environmental toxins in these key planet components. Understanding how ancient activity shaped the terrain is crucial as mankind faces environmental issues. This interdisciplinary study uses environmental science, archaeology, and geology to uncover Earth's mysteries. It illuminates the dynamic processes that have built our globe by studying pollutants and soil, water, and sediments. This research follows human actions, both intentional and unintentional, from ancient civilizations through contemporary industrialization and their far-reaching effects. Environmental destiny examines how contaminants affect ecosystems and human health. This study of past contamination helps solve modern problems including pollution cleanup, sustainable land management, and water conservation. This review studies reminds us that our previous activities still affect the ecosystem in a society facing rapid urbanisation and industrialization. It emphasises the importance of environmental stewardship and provides a framework for making educated choices to reduce toxins in soil, water, and sediments. Discovery of Earth's secrets is not only a historical curiosity; it's a necessary step towards a sustainable and peaceful cohabitation with our home planet.

Respectful Maternity Care Practices During Normal Delivery at the Public Health Facilities in Tamil Nadu, Southern India: A Descriptive Study.

INTRODUCTION: The quality of maternity care in Tamil Nadu has significantly improved in the past few years and various public health initiatives have helped to reduce crucial indicators like Maternal Mortality Ratio and Infant Mortality Rate. The improvement in quality of interface between the mothers and service providers in term of language, behaviour and attitude for ensuring 'Respectful Maternity Care' would support further enhancement of maternal and new born outcomes. Delivery of appropriate and respectful care to each pregnant woman would not only go a long way in reducing mortality and morbidity for the woman and new-born but also help in improved cognitive development of the baby. OBJECTIVE: To assess the quality of delivery care practices provided during normal delivery among women accessing public health facilities in Tamil Nadu. METHODS: A descriptive evaluation study was conducted from May to December 2018 in 16 facilities across 14 districts in Tamil Nadu. The health facilities were stratified according to the level of services, Government Medical College hospitals (MC), District headquarter hospitals (DHQ), Sub-district hospitals (SDH), and PHCs, 4 facilities in each category were selected. Data was collected by direct observation using a facility observation check list in an Android-based tablet application. Informed consent was obtained from all participants. RESULTS: A total of 1006 pregnant women out of 2242 women who had normal delivery were assessed and included in the study. More than 50% of deliveries were conducted by nurses and midwives and the perinatal and maternal outcomes were found to be good. The parameters for the respectful maternity care were recorded. Routine care monitoring parameters helped to reduce mortality rate and improved delivery care. CONCLUSION: The state though has achieved substantial success in promoting institutional delivery practices, still needs certain crucial improvements in the quality of respectful maternal care during the delivery.

The overall pooled prevalence of disrespectful maternity care in India was 71.31% (95% CI 39.84­102.78) where every individual study prevalence ranged from 20.9 to 100%. Institutional delivery is 100 percent in Puducherry and Tamil Nadu (NFHS V) and hence it is important to assess the quality of maternity care provided in public healthcare facilities in the state. The improvement in the quality of the interface between the women and service providers in terms of language, behavior, and attitude for ensuring 'Respectful Maternity Care' would thus contribute to positive outcomes for women and their newborns, and also to ensure the cognitive development of children later in life.

Synthesis of green marine algal-based biochar for remediation of arsenic(V) from contaminated waters in batch and column mode of operation.

The sorption behavior of biochar derived from green seaweed (Ulva reticulata) toward arsenic(V) ions was explored in both batch and continuous modes. The pH edge experiments indicated optimum arsenic(V) sorption observed at pH 4, with maximum sorptional capacity of 7.67 mg/g through isotherm experiments. The kinetic experimental trials indicated that arsenic(V) sorption onto biochar was a fast electrostatic attraction process, with maximum removal occurred within 30 min. The sorption isotherms were modeled using the Toth, Redlich-Peterson, Langmuir and Freundlich isotherm models while the adsorption kinetics was modeled using the pseudo-first- and pseudo-second-order kinetic equations. The three-parameter models (Redlich-Peterson and Toth) better described the isotherm data, whereas pseudo-first-order model represented kinetic data well with low error and high correlation coefficient values. Among the different alkaline and acidic elutants investigated, the solution of 0.01 M NaOH effectively desorbed arsenic(V) from spent biochar. The feasibility of the biochar in continuous remediation of arsenic(V) from contaminated waters was explored in an up-flow fixed column. The biochar exhibited arsenic(V) removal efficiency and sorptional uptake of 59.5% and 8.12 mg/g, respectively. The biochar-loaded column was effectively desorbed using NaOH (0.01 M), with desorption efficiency of 99.5%.

Thermally Reduced Graphene Oxide as a Counter Electrode Material for Dye-Sensitized Solar Cells.

In this present study, a highly conductive thermally reduced graphene oxide (TRGO) was synthesized by a low temperature thermal reduction method using RF heating, under an argon-hydrogen atmosphere. The crystallinity and morphology were examined by X-ray diffraction, Raman spectroscopy and TEM analysis. The chemical structure including the functional groups present on TRGO was studied using X-ray photoelectron spectroscopy and FTIR analysis. The studies reveal that thermal reduction of graphene oxide was successful under the experimental conditions and that the TRGO had high crystallinity. Further, the performance of the as-prepared TRGO was tested as a counter electrode (CE) in a dye-sensitized solar cell (DSSC). The maximum power conversion efficiency (PCE) obtained was 4.86% for TRGO under one sun illumination, which is comparable to that of a platinum CE-based DSSC (5.24%). The electrocatalytic activity and electron transfer kinetics were examined by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and Tafel measurements. The series resistance (Rs) and charge transfer resistance (Rct) values were found to be 35.4 Ωcm-2 and 56.40 Ωcm-2 for TRGO. The results reveal that the TRGO had an electrocatalytic performance similar to that of Pt, making TRGO-CEs promising alternatives to the conventional Pt-CEs in DSSCs.

One-Step RF-CVD Method for the Synthesis of Graphene Decorated with Metal and Metal Oxide Nanoparticles.

Bilayer and few layer-graphene (Gr) with noble metal (Ag and Au) and TiO2 nanoparticles were synthesized using atmospheric pressure radio frequency chemical vapor deposition (APRF-CVD). The precursors for the formation of the respective nanoparticles were dissolved in ethanol and injected into the APRF-CVD containing a Cu foil catalyst at 1000 °C. The graphene obtained had a blistered morphology similar to bubble-wrap. The bubble-like protrusions on the graphene sheet were caused by large nanoparticle clusters (~220 nm) formed below the graphene sheets. Smaller nanoparticles (10-80 nm) were also observed on top of the graphene sheets. Encapsulation of the nanoparticles with graphene, to yield core-shell particles was observed. Similarly, secondary growth of carbon nanotubes (CNTs) from the Au nanoparticles was observed. The average full width half maxima (FWHM) of 2D bands in the Raman spectra indicate that the graphene formed was predominantly bilayer graphene for Gr-TiO2 (55 ± 1.72 cm-1), and few-layer graphene for Gr-Ag (76 ± 22 cm-1) and Gr-Au (88 ± 4.7 cm-1). Raman spectroscopy also showed evidence for the doping of graphene and surface-enhanced Raman sensitivity (SERS) in the materials. These electronic properties of graphene with nanoparticles are relevant to various applications such as optoelectronics, catalysis, chemical and biological sensing.

Noninvasive ventilation: Are we overdoing it?

BACKGROUND: Use of noninvasive ventilation (NIV) outside guideline recommendations is common. We audited use of NIV in our tertiary care critical care unit (CCU) to evaluate appropriateness of use and patient outcomes when used outside level I recommendations. MATERIALS AND METHODS: Prospective observational study of all patients requiring NIV. Clinical parameters and arterial blood gases were recorded at initiation of NIV and 2 h later (or earlier if clinically warranted). NIV titration and decision to intubate were left to the discretion of treating intensivist. Patients were categorized into two groups: Group 1: Those with level I indications for use of NIV and group 2: All other levels of indications. Patients were followed until hospital discharge. RESULTS: From January 2010 to June 2010, 1120 patients were admitted to the CCU. Of these 106 patients required NIV support with 40.6% (n = 43/106) being in group 1 and 59.4% (n = 63/106) in group 2. Of these 35.8% patients (38/106) failed NIV and required endotracheal intubation. NIV failure rates (41.27% vs. 27.91%; P = 0.02) and mortality (30.6% vs. 18.6%; P = 0.03) were significantly higher in group 2 patients. In a logistic regression analysis Acute Physiology and Chronic Health Evaluation (APACHE) II score (P = 0.02), time on NIV before intubation (P = 0.001) and baseline PaCO2 levels (P = 0.01) were strongly associated with mortality. CONCLUSION: Noninvasive ventilation failure and mortality rates were significantly higher when used outside level I recommendations. APACHE II score, baseline PaCO2 and duration on NIV prior to intubation were predictors of increased mortality.

Epigenetic profile of the euchromatic region of human Y chromosome.

The genome of a multi-cellular organism acquires various functional capabilities in different cell types by means of distinct chromatin modifications and packaging states. Acquired during early development, the cell type-specific epigenotype is maintained by cellular memory mechanisms that involve epigenetic modifications. Here we present the epigenetic status of the euchromatic region of the human Y chromosome that has mostly been ignored in earlier whole genome epigenetic mapping studies. Using ChIP-on-chip approach, we mapped H3K9ac, H3K9me3, H3K27me3 modifications and CTCF binding sites while DNA methylation analysis of selected CpG islands was done using bisulfite sequencing. The global pattern of histone modifications observed on the Y chromosome reflects the functional state and evolutionary history of the sequences that constitute it. The combination of histone and DNA modifications, along with CTCF association in some cases, reveals the transcriptional potential of all protein coding genes including the sex-determining gene SRY and the oncogene TSPY. We also observe preferential association of histone marks with different tandem repeats, suggesting their importance in genome organization and gene regulation. Our results present the first large scale epigenetic analysis of the human Y chromosome and link a number of cis-elements to epigenetic regulatory mechanisms, enabling an understanding of such mechanisms in Y chromosome linked disorders.

Beta 1,3-1,6 Glucans Produced by Two Novel Strains of Aureobasidium Pullulans Exert Immune and Metabolic Beneficial Effects in Healthy Middle-aged Japanese Men: Results of an Exploratory Randomized Control Study.

Objectives: In this pilot study, we have evaluated the specific metabolic and immune-related benefits of the AFO-202 strain and N-163 strain of black yeast Aureobasidium pullulans-produced beta 1,3-1,6 glucan in healthy human subjects. Methods: Sixteen healthy Japanese male volunteers (aged 40 to 60 years) took part in this clinical trial. They were divided into four groups (n = 4 each): Group I consumed AFO-202 beta-glucan (2 sachets of 1 g each per day), IA for 35 days and IB for 21 days; Group II consumed a combination of AFO-202 beta-glucan (2 sachets of 1 g each) and N-163 beta-glucan (1 sachet of 15 g gel each per day), IIA for 35 days and IIB for 21 days. Results: Decrease in HbA1C and glycated albumin (GA), significant increase of eosinophils and monocytes and marginal decrease in D-dimer levels, decrease in neutrophil-to-lymphocyte ratio (NLR), with an increase in the lymphocyte-to-CRP ratio (LCR) and leukocyte-to-CRP ratio (LeCR) was observed in Group I between pre- and post-treatment. Decrease in total and LDL cholesterol, a decrease of CD11b, serum ferritin, galectin-3 and fibrinogen were profound in Group II between pre- and post-treatment. However, there was no statistically significant difference between day 21 and day 35 among the groups. Conclusion: This outcome warrants larger clinical trials to explore the potentials of these safe food supplements in the prevention and prophylaxis of diseases due to dysregulated metabolism, such as fatty liver disease, and infections such as COVID-19 in which balanced immunomodulation are of utmost importance, besides their administration as an adjunct to existing therapeutic approaches of both communicable and non-communicable diseases.

Assessment of the scale, coverage and outcomes of the Avahan HIV prevention program for female sex workers in Tamil Nadu, India: is there evidence of an effect?

BACKGROUND: Avahan, the India AIDS Initiative, a large-scale HIV prevention program, using peer-mediated approaches and STI services, was implemented for high-risk groups for HIV in six states in India. This paper describes the assessment of the program among female sex workers (FSWs) in the southern state of Tamil Nadu. METHODS: An analytical framework based on the Avahan impact evaluation design was used. Routine program monitoring data, two rounds of cross-sectional biological and behavioural surveys among FSWs in 2006 (Round 1) and 2009 (Round 2) and quality assessments of clinical services for sexually transmitted infections (STIs) were used to assess trends in coverage, condom use and prevalence of STIs, HIV and their association with program exposure. Logistic regression analysis was used to examine trends in intermediate outcomes and their associations with intervention exposure. RESULTS: The Avahan program in Tamil Nadu was scaled up and achieved monthly reported coverage of 79% within four years of implementation. The cross-sectional survey data showed an increasing proportion of FSWs being reached by Avahan, 54% in Round 1 and 86% in Round 2 [AOR=4.7;p=0.001]. Quality assessments of STI clinical services showed consistent improvement in quality scores (3.0 in 2005 to 4.5 in 2008). Condom distribution by the program rose to cover all estimated commercial sex acts. Reported consistent condom use increased between Round 1 and Round 2 with occasional (72% to 93%; AOR=5.5; p=0.001) and regular clients (68% to 89%; AOR=4.3; p=0.001) while reactive syphilis serology declined significantly (9.7% to 2.2% AOR=0.2; p=0.001). HIV prevalence remained stable at 6.1% between rounds. There was a strong association between Avahan exposure and consistent condom use with commercial clients; however no association was seen with declines in STIs. CONCLUSIONS: The Avahan program in Tamil Nadu achieved high coverage of FSWs, resulting in outcomes of improved condom use, declining syphilis and stabilizing HIV prevalence. These expected outcomes following the program logic model and declining HIV prevalence among general population groups suggest potential impact of high risk group interventions on HIV epidemic in Tamil Nadu.

Serum cystatin C unmasks renal dysfunction in cirrhosis and performs better in estimation of glomerular filtration rate.

In this study, we aimed to measure glomerular filtration rate (mGFR) using 99Tc DTPA in patients with Child-Pugh C cirrhosis and normal serum creatinine levels; and to compare the performance of creatinine and cystatin C-based equations [estimated GFRs (eGFRs)] to 99TcDTPA GFR in the same group. We selected a group of 65 consecutive patients with advanced liver cirrhosis and apparently normal renal function by serum creatinine alone. Patients with confounding and reversible factors were excluded. Demographic data, blood, urine, and imaging tests along with simultaneous measurement of serum creatinine and cystatin C were analyzed. The GFR was measured by 99Tc DTPAscintigraphy (mGFR) in 41 patients. We compared the performance of chronic kidney disease epidemiology collaboration (CKD-EPI-creatinine, CKD-EPI-cystatinC, CKD-EPI-creatinine-cystatinC) and Modification of Diet in Renal Disease equation equations for bias (mean difference), precision (root mean square error), and accuracy (P10 and P30). Bland-Altman plots were used to show the agreement of eGFR and mGFR. Twenty-five out of 41 patients (61%) had significant renal dysfunction (GFR ≤60 mL/min/ 1.73m2) by 99TcDTPA in our study and three patients were already in Stage 4 CKD. Unlike serum creatinine, serum cystatin C values were deranged in these patients. Among all GFR estimating formulae, CKD-EPI-creatinine-cystatinC combined equation had the least bias (-2.3), superior precision (7.1), highest P30 accuracy (78%), good sensitivity (87.5%), and best specificity (96%) in our study. Two-thirds of patients with cirrhosis had significant renal impairment despite having normal serum creatinine. Isolated serum creatinine values are misleading in cirrhosis. Cystatin C unmasks renal dysfunction in these patients. CKD-EPI-creatinine-cystatinC equation showed the best correlation and accuracy with 99TcDTPA GFR in our study. Creatinine based GFR estimation is fallacious in cirrhosis. Cystatin C and equations based on it may be worthwhile in liver disease.

A rare cause of nephrotic syndrome.

Classical Alport syndrome is a rare X-linked disease of males (85%) presenting early with hematuria, ocular, and hearing defects. Proteinuria and renal failure are less common in the early stages. Here, we report the case of a young female with nephrotic range proteinuria, microscopic hematuria, and renal failure. A keen observation of abundant interstitial foam cells with suspicious glomerular basement membrane changes on kidney biopsy hinted the possibility of Alport syndrome. Further directed testing of the index patient and her family members including genetic analysis revealed a rare pathogenic variant of COL4A homozygous autosomal recessive Alport syndrome. Pedigree analysis showed that the peculiar inheritance could be due to maternal gonadal mosaicism or uniparental isodisomy of paternal genes alone.

Alterations in beta-islets of Langerhans in alloxan-induced diabetic rats by marine Spirulina platensis.

Marine Spirulina platensis may potentially influence the metabolic process in animal cells, and the effect of marine Spirulina platensis in normal and alloxan-induced diabetic rats was therefore investigated. Normal and diabetic rats (albino Wistar strain) were orally administered marine Spirulina platensis for 30 days and their blood levels of glucose and insulin and body weight changes were determined. Pancreatic histopathology was also noted. Treatment with marine Spirulina platensis caused significant alterations in the content of these indicators and therefore in the antidiabetic capacity of the treated animals compared to control rats.

Detection and characterization of Streptococcus downei, a rare bacterial species of mutans streptococci from caries-active patients.

BACKGROUND: The oral bacteria, mutans streptococci (MS), are an etiological agent of dental caries. Of MS, Streptococcus downei are rarely isolated bacteria. AIM: The aim of this study was to isolate and characterize S. downei from caries-active subjects. MATERIALS AND METHODS: In all, 65 dental plaque samples were collected from dental caries-active subjects. All the isolates were further identified and characterized using 16S rDNA sequencing, biochemical tests, antibiogram, and minimum inhibitory concentration (MIC). RESULTS: Five isolates have been identified as S. downei using 16S rDNA sequencing. Phylogenetic analysis showed that S. downei was closely related to S. sobrinus. The biotype traits of these five isolates were IV (n = 3), V (n = 1), and variants (n = 2). The study proposed one new biotype, classified as biotype VIII for the variant strain. The antibiogram tests revealed that all the strains of S. downei were susceptible to all the antibiotics used in the study with higher sensitivity to penicillin and ampicillin. The MIC of ampicillin and erythromycin against S. downei was 0.047 and 0.39 µg/mL, respectively. CONCLUSION: The study reports the prevalence of S. downei in caries-active subjects and recommends further investigations to determine its role in the disease.

Green alga-mediated treatment process for removal of zinc from synthetic solution and industrial effluent.

The present work explored biosorption of Zn(II) ions from aqueous and zinc-bearing factory effluent using marine seaweed Ulva lactuca. The batch pH edge experiments using aqueous zinc solution indicated that Zn(II) uptake by U. lactuca was found to be maximum at pH 4.5 and the batch isotherm trials performed at pH 4.5 resulted in maximum uptake capacity of 128.0 mg Zn(II)/g. With 0.1 M CaCl2 (pH 3.5, HCl) as elutant, the elution of Zn(II) ions from Zn(II)-laden U. lactuca biosorbent was effective with possible regeneration and reuse for three cycles. The zinc industrial effluent was found to comprise of 87.8 mg/L of zinc ions along with excess co-ions and high total dissolved solids (838.1 mg/L). Owing to this, Zn(II) uptake from electroplating effluent by U. lactuca was suppressed due to competition from other ions. Continuous-flow sorption trials were conducted at flow rate of 5 mL/min in an up-flow fixed column. The existence of surplus competing ions in zinc wastewater influenced the Zn(II) biosorption by U. lactuca. U. lactuca-loaded packed column exhibited uptakes of 78.3 and 70.8 mg Zn(II)/g for aqueous solution and effluent, respectively. The results of three continuous sorption-desorption cycles demonstrated that reuse of U. lactuca biosorbent in remediation of zinc-containing wastewaters was practical and economical.

Laparoscopic transhiatal approach for benign supra-diaphragmatic lesions of the esophagus: a replacement for thoracoscopy?

Benign esophageal lesions are rare conditions and tumors account for about 10% of all esophageal neoplasms. Epiphrenic diverticula occur in the distal esophagus (the lower 10 cm). Currently, thoracotomy/thoracoscopy is the most popular approach for these conditions. We present our experience of 13 patients (1994-2006) with benign supra-diaphragmatic esophageal lesions that we treated with a laparoscopic transhiatal approach. The lesions included in the series were lower esophageal tumors (n = 8) and epiphrenic diverticula (n = 5). Laparoscopic transhiatal stapler excisions of diverticulum and enucleation of tumors were performed for all patients. Intra-operative endoscopy was used in all the procedures. All patients had an uneventful recovery except one with posterior diverticulum, who had an anastomotic leak. He had a prolonged hospital stay and recovered eventually. There was no mortality. Benign lesions of the lower third of the esophagus can be adequately treated through the transhiatal route. This is probably superior to the traditional approaches of thoracotomy/thoracoscopy as it does away with increased morbidity while maintaining adequate access. An endoscopy is of great value in localizing the lesion and assessing the esophageal lumen size during the application of staples. A laparoscopic transhiatal excision is technically feasible for all benign supra-diaphragmatic lesions and epiphrenic diverticula and is the approach of choice.

Studies on phytoplankton diversity in response to abiotic factors in Veeranam lake in the Cuddalore district of Tamil Nadu.

The phytoplankton samples were collected from the Veeranam lake for a period of one year from March-2005 to February-2006. The physico-chemical parameters of water such as air-temperature, water temperature, pH, salinity, dissolved oxygen, electrical conductivity and total dissolved solids were observed and their ranges were: 30.1-36.5 degrees C, 29.0-34.4 degrees C, 7.9-8.4, 1.2-2.5 mgl(-1), 7.6-9.2 microS and 2.5-5.2 mgl(-1). Totally 160 species of phytoplankton belonging to different taxonomic groups were identified. Among these 74 species to belong to Bacillariophyceae, 43 species to Chlorophyceae, 38 species to Cyanophyceae and 5 species to Euglenophyceae. The phytoplankton density was high (1705 cells l(-1)) during the summer season and low (760 cells l(-1)) during the winter season. Bacillariophyceae formed the dominant group. Species diversity index (H'), species richness (SR) and species evenness (J') were calculated.

Modulatory influence of dietary resveratrol during different phases of 1,2-dimethylhydrazine induced mucosal lipid-peroxidation, antioxidant status and aberrant crypt foci development in rat colon carcinogenesis.

To shed light on the association of lipid peroxidation and antioxidant status with the development of aberrant crypt foci (ACF), we studied the modulatory influence of resveratrol, supplemented in three dietary regimens (initiation, post-initiation and entire period) on 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis. Rats were administered DMH (20 mg/kg body weight, s.c.) for 15 weeks and were supplemented with resveratrol (8 mg/kg body weight, p.o. everyday) in three dietary regimens. Intestines and colons were analyzed for the levels of diene conjugates (DC), lipid hydroperoxides (LOOHs) and thiobarbituric acid reactive substances (TBARS). Enzymic antioxidants (superoxide dismutase, SOD; catalase, CAT; glutathione peroxidase, GPX; glutathione S-transferase, GST; and glutathione reductase, GR) and non-enzymic reserve (reduced glutathione, GSH; ascorbate; and alpha-tocopherol) were also assessed in the intestine and colon. Unsupplemented DMH exposed rats showed significantly decreased levels/activities of tissue DC, LOOHs, TBARS, SOD, CAT, GSH, GR and significantly elevated (P<0.05) GPX, GST, alpha-tocopherol and ascorbate as compared to control rats. Resveratrol supplementation during the entire period of the study resulted in significant (P<0.01) modulation of lipid peroxidation markers and antioxidants status, which were paralleled with ACF suppression, as compared to DMH-alone treated rats. These results indicate that resveratrol effectively inhibits DMH-induced ACF and colonic tumor development.

Laparoscopic esophagogastrectomy without thoracic or cervical access for adenocarcinoma of the gastroesophageal junction: an Indian experience from a tertiary center.

BACKGROUND: The phenomenal progress of minimally invasive surgery has imparted its influence on conventional esophagectomy. Currently, more esophagectomies are being performed by laparoscopic and/or thoracoscopic methods. Esophagogastrectomy for the adenocarcinoma of the gastroesophageal (GE) junction has been a conventional treatment. The literature is limited regarding the laparoscopic approach to esophagogastrectomy. The aim of this study was to evaluate the outcome of laparoscopic esophagogastrectomy in the management of adenocarcinoma of the GE junction. METHODS: From January 1997 to February 2005, laparoscopic esophagogastrectomy was performed in 32 patients. Indication for operation was adenocarcinoma of the GE junction in all patients. Neo-adjuvant therapy was used in two patients (6.88%) only. Initially, our approach to intrathoracic anastomosis without thoracic and cervical access was to introduce the anvil of circular stapler through minilaparotomy incision (n = 22), but later we switched to trans-oral placement of anvil into the distal end of the esophagus (n = 10). RESULTS: There were 22 men and 10 women. Median age was 61.8 years (range, 39-72). There was no conversion. The laparoscopic esophagogastrectomy was completed in all patients. The pyloromyotomy and feeding jejunostomy were performed in all cases. The median intensive care unit stay was 1 day (range, 1-28); hospital stay was 7 days (range, 5-42). Mean estimated blood loss and mean operative time were 150 ml and 200 min, respectively. At mean follow-up of 14 months (range, 2-40), stage-specific survival was similar to that of other series. CONCLUSION: In selected cases of adenocarcinoma of the GE junction, laparoscopic esophagogastrectomy offers as good as or better results than open operation in our institution with extensive advance endoscopic and open experience. This study shows that laparoscopic esophagogastrectomy has potential to meet oncologic criteria of clearance and provide the benefits of minimally invasive surgery as well.

Isolation and Typing of Streptococcus mutans and Streptococcus sobrinus from Caries-active Subjects.

BACKGROUND: Streptococcus mutans and Streptococcus sobrinus are main etiological agents of dental caries. AIM: The aim of the study was to isolate, identify, characterize, and determine the minimum inhibitory concentration (MIC) of S. mutans and S. sobrinus from caries-active subjects. MATERIALS AND METHODS: Sixty-five plaque samples were collected from caries-active subjects aged between 35 and 44 years, processed and cultured on mitis salivarius bacitracin agar. All the bacterial isolates were subjected to morphotyping and the suspected colonies were identified by 16S rDNA sequencing. The S. mutans and S. sobrinus strains were characterized by biotyping and phylogenetic analysis. The MIC of ampicillin and erythromycin was determined by microtiter plate method. RESULTS: Of the study population, 41 isolates displayed typical colony morphologies of S. mutans and S. sobrinus. The 16S rDNA sequencing results revealed that 36 isolates were S. mutans and 5 isolates were S. sobrinus. The biotyping of these isolates demonstrated three biotypes, namely, biotype I (n = 35), biotype III (n = 1), and biotype IV (n = 2). However, 3 isolates exhibited variant biotypes. The phylogenetic analysis revealed that the clinical strains of S. mutans and S. sobrinus clustered independently along with respective reference strains. The average MIC of ampicillin and erythromycin against S. mutans and S. sobrinus was 0.047 µg/ml and 0.39 µg/ml, respectively. CONCLUSION: The 16S rDNA sequencing was an impeccable method for S. mutans and S. sobrinus identification when compared with morphotyping and biotyping methods. The study also suggested that nonspecific bacteria might be involved in caries formation.

Synthesis, characterization and antibacterial activity of hybrid chitosan-cerium oxide nanoparticles: As a bionanomaterials.

The hybrid chitosan cerium oxide nanoparticles were prepared for the first time by green chemistry approach using plant leaf extract. The intense peak observed around 292nm in the UV-vis spectrum indicate the formation of cerium oxide nanoparticles. The XRD pattern revealed that the hybrid chitosan-cerium oxide nanoparticles have a polycrystalline structure with cubic fluorite phase. The FTIR spectrum of prepared samples showed the formation of Ce-O bonds and chitosan main chains COC and CO. The FESEM image of hybrid chitosan cerium oxide nanoparticles revealed that the particles are spherical in shape with grains size varying from 23.12nm to 89.91nm. EDAX analysis confirmed the presence of Ce, O, C and N elements in the prepared sample. TEM images showed that the prepared hybrid chitosan-cerium oxide nanoparticles are predominantly uniform in size and most of the particles are spherical in shape with less agglomeration and the particles size varies from 3.61nm to 24.40nm. The prepared chitosan cerium oxide nanoparticles of 50µL concentration showed good antibacterial properties against test pathogens, which was confirmed by the FESEM analysis. The prepared small particle size facilitate that these hybrid ChiCO2 NPs could effectively be used in biomedical applications.