Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Angiosarcoma of the scalp in a 79-year-old male: A case report

Introduction@#Angiosarcoma is a rare head and neck sarcoma of vascular endothelial cell origin. We report a case of angiosar- coma in an elderly male, and the multidisciplinary approach employed in his treatment.@*Case report@#A 79-year-old male presented with a 4-month history of a rapidly enlarging black, soft, immovable tumor surround- ed by bruise-like patches over the right temporoparietal scalp. There was associated pruritus and bleeding when scratched. Dermoscopy showed bluish black crusts over the tumor, and surrounding violaceous patches. Wedge biopsy revealed a dermis with irregular vascular spaces infiltrating dermis, lined by atypical endothelial cells. Immunohistochemistry of the atypical in- filtrative cells was positive for CD31. These findings were consistent with angiosarcoma. The patient underwent wide excision with a rotational flap and split thickness skin graft. Postoperatively, the patient was referred to Oncology for adjuvant radiation therapy.@*Conclusion@#Even with treatment, the prognosis of angiosarcoma remains poor due to its aggressive nature, with a 5-year sur- vival rate ranging from 10-54%. However, early detection of the disease may increase patient survival rates. This rare case shows the importance of maintaining a high level of suspicion for lesions that have an atypical presentation to prevent delays in man- agement and improve patient outcomes.

A partnership model for capacity-building of primary care physicians in evidence-based management of diabetic retinopathy in India

In India, more than 72 million people have diabetes. Diabetic retinopathy (DR), a vision-threatening complication of people with diabetes, is an important cause of avoidable blindness. The delay in the detection of DR is due to lack of awareness and shortage of ophthalmologists trained in the management of DR. With this background, in 2015, we initiated a capacity-building program “Certificate Course in Evidence Based Management of Diabetic Retinopathy (CCDR)” with an objective to build the skills and core competencies of the physicians across India in the management of diabetes and DR. The program has completed four cycles and 578 physicians have been trained. The course elicited an excellent response, which reflects the much-felt need for skill improvement in DR diagnosis and management for physicians in India. This model demonstrates an innovative modality to address DR-related avoidable blindness in a resource-restraint country like India.

External morphology of the immature stages of Neotropical heliconians: IX. Dione glycera (C. Felder & R. Felder) (Lepidoptera, Nymphalidae, Heliconiinae)

External morphology of the immature stages of Neotropical heliconians: IX. Dione glycera (C. Felder & R. Felder) (Lepidoptera, Nymphalidae, Heliconiinae). The biology of the Andean silverspot butterfly Dione glycera (C. Felder & R. Felder, 1861) is still poorly known. This species is restricted to high elevations in the Andes, where the immature stages are found in close association with species of Passiflora belonging to the section Tacsonia (Juss.) Harms, especially P. tripartida var. mollissima (Kunth), which is grown for subsistence by villagers. Herein we describe and illustrate the external features of the egg, larva and pupa of D. glycera, based on light and scanning electron microscopy.

External morphology of the immature stages of Neotropical heliconians: VIII. Philaethria wernickei (Röber) (Lepidoptera, Nymphalidae, Heliconiinae) / Morfologia externa dos estágios imaturos de heliconíneos neotropicais: VIII. Philaethria wernickei (Röber) (Lepidoptera, Nymphalidae, Heliconiinae)

The external features of egg, larva, and pupa of Philaethria wernickei (Röber, 1906) are described and illustrated, based upon light and scanning electron microscopy.

As estruturas externas do ovo, larva e pupa de Philaethria wernickei (Röber, 1906) são descritas e ilustradas, baseadas em microscopia ótica e eletrônica de varredura.

Detecção de cáries oclusais in vitro / In vitro detection occlusal cavities

O objetivo deste estudo foi determinar a confiabilidade e a validade de dois métodos de fluorescência DIAGNOdent (KaVo) e QLF/clin (QLF-Inspektor Research Systems) e exame visual(V) 1 para detectar cáries oclusais incipientes em pré-molares. Noventa e nove pré- molares foram selecionados e examinados através dos três métodos. Dois examinadores realizaram V e a interpretação do DIAGNodent, enquanto apenas o primeiro autor examinou os dentes com QLF. O segundo autor treinou o primeiro autor a usar o critério visual, enquanto o primeiro autor treinou o segundo a usar o DIAGNOdent. O primeiro autor era bem treinado em usar o QLF. Como padrão (gold standard), usou-se um critério histológico com cinco categorias representando a profundidade das lesões em cortes histológicos(H). A intraconfibilalidade de V e do DIAGNOde), enquanto a interconfibialidade foi substancial. A intraconfibialidade do QLF foi menor (ICC=0,51). A validade para os três métodos foi moderada quando o método H foi usado. As lesões avaliadas por V e DIAGNOdent eram histologicamente mais profundas do que o esperado, enquanto as lesões avaliadas por QLF eram menos profundas do que o esperado. Tanto o DIAGNOdent quanto o QLF foram métodos muito pobres para expressar o tamanho da área da lesão na seção correspondente. Conclui-se que a confiabiblidade do critério visual (V) e DIAGNOdent foi quase perfeita, mas a precisão foi pobre. Isto indica que novos sistemas histológicos devem ser desenvolvidos.

Macular ischaemia as a marker for nephropathy in diabetic retinopathy.

PURPOSE: To determine whether diabetic macular ischaemia is associated with ischaemic heart disease (IHD), hyperlipidaemia, hypertension (HTN) and nephropathy. METHODS: Prospective case-control study from January to December 2001, involving 102 type 2 diabetic patients (aged 40-80 years), 59 with unilateral / bilateral macular ischaemia and 43 concurrent controls. Diabetic retinopathy was graded and macular ischaemia assessed by fundus examination, central fundus photography and fluorescein angiography. Systemic examination and laboratory investigations were done to evaluate systemic diseases. The associations were analysed by Chi-square test and Student's t-test. The significance of the variables as independent risk factors was tested by logistic regression analysis. RESULTS: Macular ischaemia was not associated with IHD (P=1.00); HTN (P=1.00) and hyperlipidaemia (P=0.30). Nephropathy was significantly associated with macular ischaemia (P=0.025; odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.16-5.9). The association remained significant after controlling for age, gender, duration of diabetes, severity of retinopathy, HTN, IHD and hyperlipidaemia. Further, the association with nephropathy was not affected by the presence of macular isachaemia in one or both the eyes (P=0.39). CONCLUSION: Macular ischaemia may serve as a marker for nephropathy in type 2 diabetes mellitus irrespective of the severity of retinopathy.

Management of age-related macular degeneration.

With the increase in life expectancy across the world, the magnitude of blindness due to age-related macular degeneration (AMD) is expected to rise. Exudative form is the major cause of visual loss from AMD. Several treatment options are available for this form of the disease. However, all treatment strategies aim at preservation of residual vision rather than regaining the lost vision. Two well-proven strategies are laser photocoagulation and photodynamic therapy. Other viable options are submacular surgery, transpupillary thermotherapy and pharmacological modalities like angiostatic-steroids. Oral anti-oxidants and zinc appear to be beneficial in preventing disease progression in early cases. Further research is on to explore more efficient treatments and to prove the safety and efficacy of large number of emerging newer treatment options.

Congenital retinal arterial loops and spontaneous vitreous haemorrhage: a case report.

This report describes a case of unilateral spontaneous vitreous haemorrhage associated with congenital retinal arterial loops.