18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and 68Ga-prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Imaging in the Evaluation of Rare Entity Adult Embryonal Rhabdomyosarcoma of Prostate.

A 21-year-old male with embryonal rhabdomyosarcoma of the prostate was referred for 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 68Ga-prostate-specific membrane antigen (PSMA) PET/CT for initial disease staging. The PET scans revealed hypermetabolic and PSMA expressing lobulated mass involving both lobes of the prostate and weakly metabolic and PSMA expressing few bilateral pararectal and external iliac nodes, multiple bilateral lung nodules scattered over the lung parenchyma and multiple bone marrow lesions in both axial and appendicular skeleton. Magnetic resonance imaging prostate showed gross prostatomegaly with large lobulated T2 hyperintense heterogeneously enhancing mass lesion showing restricted diffusion, involving both lobes of the prostate with extraprostatic spread along anterior, posterior, and left lateral margins with evidence of lymph nodal and osseous metastases. The demonstration of increased uptake of 18F-FDG and 68Ga-PSMA in the primary as well as bilateral pararectal and external iliac nodes, multiple bilateral lung nodules, and multiple bone marrow lesions in both axial and appendicular skeleton indicates a potential role of 18F-FDG PET/CT and 68Ga-PSMA PET/CT in disease staging in this rare aggressive tumor of the prostate.

Speckle tracking echocardiography-derived left ventricular global longitudinal strain in ex-thalassaemics.

AIMS: Long term survivors of haematopoietic stem cell transplantation (HSCT) for ß-thalassemia major are designated "ex-thalassaemics". Whether ex-thalassaemics continue to harbour residual myocardial dysfunction and thereby stand the risk of heart failure-related morbidity and mortality is unknown. The aim of this study was to assess the prevalence and predictors of subclinical left ventricular (LV) dysfunction in an apparently normal ex-thalassaemic population. METHODS: We conducted a single centre cross-sectional study among 62 ex-thalassaemic patients, who had undergone HSCT for ß-thalassaemia major at our centre. The primary outcome variable was LV systolic dysfunction, as assessed by 1) LV global longitudinal strain (GLS) derived by 2D speckle tracking echocardiography and 2) LV ejection fraction (EF) derived by 2D Simpsons Biplane method. RESULTS: Among the 62 patients included in the study, 7 [11.3%] were found to have LV systolic dysfunction, all of which were subclinical. Of these, 4 [6.5%] had abnormal GLS and LVEF, 2 [3.2%] had abnormal GLS with normal LVEF, and 1 [1.6%] had abnormal LVEF with low normal mean GLS. There were no statistically significant predictors of LV dysfunction in this cohort. CONCLUSION: There was a high prevalence of subclinical myocardial dysfunction in the ex-thalassaemic population reiterating the need for close follow up of these patients. 2D Speckle tracking echocardiography-derived LV global longitudinal strain is an effective tool in detecting subclinical myocardial dysfunction in this cohort.

Production and characterization of a bioactive extracellular homopolysaccharide produced by Haloferax sp. BKW301.

The production of extracellular polysaccharides (EPS) by haloarchaeal members, with novel and unusual physicochemical properties, is of special importance and has the potential for extensive biotechnological exploitation. An extremely halophilic archaeon, Haloferax sp. BKW301 (GenBank Accession No. KT240044) isolated from a solar saltern of Baksal, West Bengal, India has been optimized for the production of EPS under batch culture. It produced a considerable amount (5.95 g/L) of EPS in the medium for halophiles with 15% NaCl, 3% glucose, 0.5% yeast extract, and 6% inoculum under shake flask culture at 120 rpm. The purified EPS, a homopolymer of galactose as revealed by chromatographic methods and Fourier-transform infrared spectroscopy, is noncrystalline (CIxrd , 0.82), amorphous, and could emulsify hydrocarbons like kerosene, petrol, xylene, and so forth. Moreover, the polymer is highly thermostable (up to 420°C) and displayed pseudoplastic rheology. Biologically, the EPS was able to scavenge DPPH (2,2-diphenyl-1-picrylhydrazyl) radical efficiently and inhibit the proliferation of the Huh-7 cell line at an IC50 value of 6.25 µg/ml with a Hill coefficient of 0.844. Large-scale production of this thermostable, pseudoplastic homopolysaccharide, therefore, could find suitable applications in industry and biotechnology.

Congenital methaemoglobinaemia diagnosed in an adolescent boy.

A 14-year-old boy of Asian origin presented with a history of bluish discolouration of the finger and toenail bed with associated mild fatiguability on exertion since early childhood. Clinical examination revealed bilaterally symmetric uniform central cyanosis with no associated clubbing. Cardiovascular and respiratory system examination was normal. Pulse oximetry revealed an oxygen saturation of 87% in all four limbs. Transthoracic and transoesophageal echocardiography showed no evidence of shunt lesions. In view of the past diagnosis of pulmonary arteriovenous fistulae made at 4 years of age, a repeat cardiac catheterisation study was done, which revealed no shunt at any level. Interestingly, arterial oxygen tension of the chocolate-brown blood was normal in all the samples, suggesting the possibility of methaemoglobinaemia. Co-oximetry revealed methaemoglobin levels of 36%, confirming the diagnosis. Secondary causes were ruled out. The family was counselled about the hereditary nature of the condition.

Cardiac involvement in beta-thalassaemia: current treatment strategies.

Despite the advances in the management of thalassemia major, heart disease remains the leading cause of mortality in patients afflicted with this disorder. Cardiac involvement in thalassemia encompasses a spectrum of disorders including myocardial dysfunction, arrhythmias, pulmonary hypertension, and peripheral vascular disease. Although cardiac siderosis (accumulation of iron in cardiac myocytes) as a consequence of repeated blood transfusions is deemed to be the main etiologic factor for myocardial dysfunction in transfusion-dependent patients, the significance of other pathophysiologic mechanisms is being increasingly recognized especially in non-transfusion dependent patients. Management of cardiac complications in thalassemia major hinges on the treatment of the underlying pathophysiology, which often is unmitigated iron overload. The prevalence and predictors of cardiac complications in 'ex-thalassaemics' [thalassaemic patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) is unknown at present. In this review, we look at the pathogenesis of cardiac involvement in patients with beta-thalassemia major, the advances in the management of these patients and the future prospects.

Hexavalent chromium reduction by immobilized cells of Bacillus sphaericus AND 303

Bacillus sphaericus AND 303, a Cr(VI)-resistant and reducing bacterium reported from serpentine outcrops of Andaman was evaluated for Cr(VI) reduction using immobilized cells under batch culture. Screening of inert matrices for entrapment of whole cells indicated that polyvinyl alchohol-alginate was the most effective one reducing 87.5% of 20 µM Cr(VI) in 24 h. The rate of chromate reduction was dependent on initial Cr(VI) and biomass concentrations. The PVA cell beads were recycled three times without cell leakage and disintegration. The reduction efficiency was improved in the presence of glucose and glycerol as electron donors leading to complete reduction. However, the presence of additional metal ions was inhibitory to Cr(VI) reduction. It could be emphasized that PVA-alginate immobilized cells of B. sphaericus AND 303 could be used as a continuous bioprocess in treating Cr(VI) contaminated effluents.