Effect of intrapartum fetal stress associated with obstetrical interventions on viability and survivability of canine neonates.

AIM: This study was conducted with the objective of identifying and evaluating intrapartum fetal stress in connection with the type of delivery in bitches. MATERIALS AND METHODS: A total of 26 bitches between 1 and 5 years, belonging to 10 different breeds were evaluated. Bitches were subjected to detailed clinico-gynecological examination based on history. Neonatal stress associated with spontaneous whelping (SW), assisted whelping (AW), and emergency cesarean section (EC) was evaluated using umbilical vein lactate (UL) estimation by collecting the blood from umbilical vein. RESULTS: A high umbilical vein lactate value was associated with fetal distress. The mean umbilical lactate value was highest in EC (12.54±0.8 mmol/L) followed by AW (8.86±0.9 mmol/L) and the lowest value was found in SW (7.56±0.58 mmol/L). A significant increase (p<0.05) in umbilical lactate level was observed in EC group of canine neonates compared with AW and SW groups. Overall mean umbilical lactate values of neonates which died within 24 h (13.31±1.08 mmol/L) and the neonates which survived beyond 24 h (8.87±0.55 mmol/L) differed significantly at 5% level. CONCLUSION: Immediate identification of neonatal distress by use of umbilical vein lactate estimation is helpful for the clinician to undertake resuscitation or medical therapy to ensure better neonatal survivability.

Shape tailored green synthesis and catalytic properties of gold nanocrystals.

The use of environmentally benign procedures is highly desirable for the synthesis of nanoparticles. Here we report a simple, versatile, economic, ecofriendly and reproducible green method for the size-tunable synthesis of stable and crystalline gold nanoparticles of varied shape using aqueous extract of Garcinia Combogia fruit. The predominant anisotropic nature in the morphology of synthesized particles at lower quantities of extract gradually shifted to spherical particles with larger quantity of extract and increase of temperature. The onset of reduction, the time-evolution of the Surface Plasmon Resonance (SPR) and the catalytic activity are studied using UV-Visible spectroscopy. The Selected Area Diffraction (SAED) pattern, the lattice fringes in the High Resolution Transmission Electron Microscopic (HRTEM) image and the X-ray Diffraction (XRD) pattern clearly show the pure crystalline nature of the synthesized gold nanoparticles. The role of carboxyl group present in Garcinia Combogia fruit extract in the reduction of chloroaurate ions is established using Fourier Transform Infrared (FTIR) spectra. The size dependent catalytic activity of the green synthesized gold nanoparticles on the reduction of 4-Nitrophenol to 4-Aminophenol using sodium borohydride is studied and reported for the first time. The first order kinetics is fitted and rate constants are calculated. Catalytically active green synthesized gold nanoparticles with controllable size and shape presents an advanced step in future biomedical and chemical applications.

Are elderly end-stage renal disease patients more susceptible for drug resistant organisms in their sputum?

End stage renal disease (ESRD) patients are at risk for pneumonia in view of their impaired immune status. Similar empiric antibiotic regimens are used in elderly as well as young ESRD patients with respiratory tract infections. We conducted an observational, cross sectional study between June 2007 and June 2008 in 100 ESRD patients half being > 65 yrs. All patients had positive sputum culture and chest X-ray findings of pneumonia Streptococcus pneumoniae was the commonest in younger while Klebsiella pneumoniae in > 65 yrs old patients. Elderly patients had significant resistance to common antibiotics. Ceftrioxone was the most suitable antibiotic in the younger patients while a combination of piperacillin with gentamycin was the best choice in the geriatric age group. In conclusion, organisms cultured from sputum in ESRD patients with pneumonia were different in the ESRD patients of more than and less than 65 years of age as well as the drug susceptibility. We should probably redefine the management of pneumonia according to the sensitivities in our local populations to better treat these patients.

Can retinal changes predict coronary artery disease in elderly hypertensive patients presenting with angina?

BACKGROUND: The prevalence of coronary artery disease (CAD) has been increasing in India, and so is the population of elderly patients with hypertension. In the predominantly resource-poor setting prevailing in India, this study is an effort to analyze the accuracy of retinal changes in predicting CAD among a cohort of elderly patients with hypertension presenting to the emergency department with angina. METHODS: A total of 72 elderly patients with hypertension older than 65 years presenting to the emergency department with acute angina were studied. Optic fundi were assessed for retinopathy after pupillary dilatation, which were photographed. All patients underwent coronary angiogram, and the presence or absence of CAD was determined. RESULTS: Mean +/- SD age of the participants was 72.95 +/- 6.51 years, and there were 39 men (54.2%) and 33 women (45.8%). Prevalence of CAD and retinopathy was 40.8% and 30.6%, respectively. Coronary artery disease showed a strong association with retinopathy (P < .0001). Male sex (P = .035), microalbuminuria (P = .025), and increased high-sensitivity C-reactive protein (P = .001) were identified as risk factors for CAD. Tests of accuracy for retinopathy as a predictor of CAD showed a likelihood ratio of a positive test and likelihood ratio of a negative test of 3.92 and 0.52, respectively. Area under the receiver operating characteristics curve was 70.6%. CONCLUSION: Prevalence of CAD (40.8%) and retinopathy (30.6%) was quite high in our cohort of elderly patients with hypertension. Retinal changes of any grade have a moderate accuracy in predicting CAD and, hence, may be used as an early screening tool in a resource poor setting.

Virilizing ovarian steroid cell tumor in a 40 year old South Indian female: a case report.

Virilism is the masculinization and enhancement of male secondary sexual characteristics in females. The etiology is usually of adrenal or ovarian origin. Here we report a case of virilizing Leydig cell type, steroid cell tumor of the left ovary, in a 40 year old female who presented with clinical signs and symptoms of virilization: deepening of voice, hirsutism (Ferriman-Gallwey score 26), clitoromegaly, and androgenic alopecia. On further evaluation, laboratory investigations revealed hyperandrogenism in the male range. Basal testosterone values were elevated. Folicle Stimulating Hormone and Luteinising Hormone levels were within normal limits. Dexamethasone suppression test did not alter cortisol or testosterone levels. An ovarian mass was confirmed radiologically. Following a total abdominal hysterectomy with bilateral salpingoophorectomy, histopathological studies confirmed a left sided steroid-cell ovarian tumor, Leydig cell type (stage T(1)N(0)M(0)), which proved to the etiology of virilization in this patient. Post-operatively her serum testosterone levels declined with near-complete reversal of symptoms over time.