Management of the Hand Tumors.

Tumors in the hand are relatively uncommon but 95% are benign. Tumors occurring in the hand, forearm and arm often have unique growth patterns and potential for metastasis that may be different from those seen elsewhere in the body. Secondary metastatic tumors in the hand are very rare (0.1%). Diagnosis is mainly clinical, but X-ray, USG and MRI help as a diagnostic aid. The aim of the study was to early diagnosis, see the pattern and proper management of the hand tumor and ensure good hand function. This prospective study was done from January 2004 to July 2019. We found 220 hand tumors in the hand unit, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Bangladesh. Among 220 patients, male were 114(51.81%) and female were 106 (48.19%). Out of 220 patients we found 190(86.36%) benign tumor and tumor like lesions and 30(13.64%) was malignant hand tumors. Out of 190 benign lesions, benign tumor was 158(83.15%) and 32(16.85%) was tumor like lesions. Among 158 benign tumor, bone tumors were 40(25.31%) and soft tissue tumours were 138(74.69%). Out of soft tissue tumor, peripheral nerve tumor was 20(12.66%). Enchondroma and Giant cell tumors are the most common among the benign bone tumors, on the other hand giant cell tumors of tendon sheath, Glomus tumor, haemangioma, neurofibroma, schwanoma are the common soft tissue tumors. Compound palmar ganglion, fibromatosis and tuberculosis of phalanx are the most common tumor like lesions. Synovial sarcoma 10(33.33%), osteosarcoma 03(10%), chondrosarcoma 03(10%), ewings sarcoma 02(6.66%), fibrosarcoma 04 (13.33%), Malignant fibrous histocytoma 01(3.33%), soft tissue sarcoma 01(3.33%), Merkel cell tumor 01(3.33%), pleomorphic Rabdomyosarcoma 01(3.33%), malignant melanoma 01(3.33%), clear cell sarcoma of tendon and aponeurosis 01(3.33%), undifferentiated carcinoma 01(3.33%) and extra skeletal chondro sarcoma 01(3.33%) were the malignant tumors. Most of the benign lesions recovered fully after excision except neurofibroma and malignant tumors were treated with excision (including amputation) and chemo-radiotherapy successfully, but 4 patients were refereed to higher center due to recurrence and deteriation of hand function and one patient died due to metastasis. Malignant hand tumor management is very difficult even after amputation with multidisciplinary approach. Hand tumor is uncommon and malignant tumors are rare but any abnormal lump or bump in the hand or wrist is considered as tumor. Early detection and intervention are essential for better prognosis and survival for malignant tumors of hands and upper limbs.

Reducing pain through distraction therapy in small acute paediatric burns.

INTRODUCTION: The majority of patients who sustained small (low % total body surface area [TBSA]) burns are assessed in an outpatient setting. This can be a traumatic experience, particularly, for paediatric patients. During the initial assessment pharmacological and non-pharmacological adjuncts, such as distraction therapy, can be employed to provide an environment that may reduce and minimise distress. In this study, we investigated whether distraction therapy reduces objective pain scores during the outpatient assessment of small acute burns in children. METHODS: Two cohorts of patients were formed. In the first group (group A), the children received analgesia and routine nursing care. In the second group (group B), the children received specialist distraction therapy in addition to the same analgesia and nursing care. We recorded patient demographics, TBSA, anatomical sites and mechanism of burn. The Wong Baker™ visual analogue scale (VAS) was used to convert perceived pain, as reported by the patient or parent, into a numerical value at three set intervals during the consultation. RESULTS: 50 patients were recruited with 32 patients in group A and 18 in group B. A larger TBSA positively correlated with higher pain scores (p < 0.05). At the start of the consultation the mean pain score without distraction therapy was 1.55 and with specialist distraction therapy was 0.33 (p < 0.05). The mean peak pain score during dressing change without distraction therapy was 6.80 and with specialist distraction was 4.47 (p < 0.05). At the end of the procedure, the mean pain score was 2.12 without distraction therapy and with specialist distraction 1.75. CONCLUSION: This study of pain scores in small acute paediatric burns has shown that distraction therapy provided by a qualified play specialist can reduce maximal pain by over 2 points on the Wong-Baker™ VAS. Consideration should be given to ensure that distraction therapy is available at all times during initial consultations for children who have sustained small burns.

De-colourization of textile effluent using immobilized Geotrichum candidum: an insight into mycoremediation.

Textile effluent is generally complicated to manage because of its extremely noxious and recalcitrant coloured compositions. Mycoremediation is an extensively used strategy for the competent degradation of hazardous pollutants present in textile effluent. Fungus could be immobilized in synthetic or natural matrices. The current study shows the decolourization of the textile effluent by 85·5 and 98·5% within 6 h using suspended and immobilized fungus, Geotrichum candidum with optimized parameters like inoculum size (5%), pH (4·5), and temperature (30°C). To maintain a high biomass of fungal population and enhance the retention of fungal strain in the contaminated sites, the fungi need to be immobilized. Hence, the fungus was immobilized naturally onto the selected inert support that is, coconut fibres by the means of adsorption, where they grew as active films on the fibres after being grown in the culture broth. The optimized process parameters of inoculum size, fibre quantity and agitation speed for immobilized G. candidum were 5%, 2·2 g l-1 of effluent and 100 rev min-1 respectively. High level of laccase (22 and 25 U l-1 in suspended and immobilized fungal cells treatment respectively) was observed during the process of decolourization and it was found that decolourization was directly proportional to the laccase activity. The UV-vis, FTIR, 1 H NMR and GC-MS analyses of treated textile industrial wastewater revealed the degradation of toxic pollutants in the textile effluent and formation of lower molecular weight intermediates. The study revealed a higher efficacy of immobilized G. candidum in comparison to suspended fungal culture, employing ligninolytic enzyme laccase, which catalyzes the degradation/transformation of aromatic dyes in the textile effluent thus decolourizing it.

Elucidation of fungal dye-decolourizing peroxidase (DyP) and ligninolytic enzyme activities in decolourization and mineralization of azo dyes.

AIM: The aim of the study is to investigate the efficiency of Geotrichum candidum in the decolourization and mineralization of synthetic azo dyes. METHODS AND RESULTS: It includes screening of enzymes from G. candidum and its optimization, followed by decolourization and mineralization studies. Decolourization was observed to be maximum in methyl orange (94·6%) followed by Congo red (85%), trypan blue (70·4%) and Eriochrome Black T (55·6%) in 48 h, suggesting the plausible degradation of the azo dyes by G. candidum. The enzyme activity study showed that DyP-type peroxidase has highest activity of 900 mU ml-1 compared to that of laccase (405 mU ml-1 ) and lignin peroxidase (LiP) (324 mU ml-1 ) at optimized pH (6) and temperature (35°C). Moreover, the rate of decolourization was found to be directly proportional to the production of laccase and LiP, unlike DyP-type peroxidase. Furthermore, mineralization study demonstrated reduction in aromatic amines, showing 20% mineralization of methyl orange. CONCLUSION: Geotrichum candidum with its enzyme system is able to efficiently decolourize and mineralize the experimental azo dyes. SIGNIFICANCE AND IMPACT OF THE STUDY: The efficient decolourization and mineralization of azo dyes makes G. candidum a promising alternative in the treatment of textile effluent contaminated with azo dyes.

Assessing the Rehabilitation of Achilles Tendon Ruptures using Modified Teuffer and Lindholm Technique.

The aim of this study is to assess the optimum rehabilitation and the functional outcome of open repaired Achilles tendon ruptures. This study was conducted for the 18 consecutive patients of complete ruptures at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 2012 to 2013. Two groups were considered during 6 to 18 months post-operative observation and each group consist 9 patients. In the Group I, modified Teuffer's and in Group II, Lindholm operative methods were employed for the open repair of Achille tendon. The post operative outcomes were assessed for both of the groups through the modified Thermann's scores. In this study the patients median age was seen 39 years with 72.2% male and 27.8% female. The Thompson test was found positive in pre-operative and negative in post-operative outcome. The results shown that Achilles tendon ruptures occurred in 4 to 6cm rupture site, where the rupture side was 61.1% left and 38.9% right. The subjective overall assessment of total Thermann's scores were found very good (91 to 96) in 4 cases and (90 to 98) in 3 cases for Group I and Group II, respectively. Both of the operative techniques were found accountable results for rehabilitation. Therefore, based on the further statistical evidence of higher correlations and errors it may be concluded that Achilles tendon ruptures can be treated by modified Teuffer's or Lindholm technique.

Analysis of Ly49 gene transcripts in mature NK cells supports a role for the Pro1 element in gene activation, not gene expression.

The variegated expression of murine Ly49 loci has been associated with the probabilistic behavior of an upstream promoter active in immature cells, the Pro1 element. However, recent data suggest that Pro1 may be active in mature natural killer (NK) cells and function as an enhancer element. To assess directly if Pro1 transcripts are present in mature Ly49-expressing NK cells, RNA-sequencing of the total transcript pool was performed on freshly isolated splenic NK cells sorted for expression of either Ly49G or Ly49I. No Pro1 transcripts were detected from the Ly49a, Ly49c or Ly49i genes in mature Ly49(+) NK cells that contained high levels of Pro2 transcripts. Low levels of Ly49g Pro1 transcripts were found in both Ly49G(+) and Ly49G(-) populations, consistent with the presence of a small population of mature NK cells undergoing Ly49g gene activation, as previously demonstrated by culture of splenic NK cells in interleukin-2. Ly49 gene reporter constructs containing Pro1 failed to show any enhancer activity of Pro1 on Pro2 in a mature Ly49-expressing cell line. Taken together, the results are consistent with Pro1 transcription having a role in gene activation in developing NK, and argue against a role for Pro1 in Ly49 gene transcription by mature NK cells.

The free instep flap for palmar and digital resurfacing.

The palmar and digital volar skin is unique because of its glabrous nature, texture and light colour in all races. Any defect on the palmar surface not suitable for a homodigital or thenar flap remains a challenge for reconstructive surgeons. Various skin flaps have been described in the literature for palmar resurfacing. They all provide wound cover and may even match the contour satisfactorily, however, the colour and texture mismatch compromises the aesthetics of reconstruction. In our experience, the free instep flap is a more appropriate choice for palmar and volar digital resurfacing. It provides glabrous, potentially sensate, hairless skin with a better colour and texture match compared to conventional pedicled or free flaps in all cases. This paper describes our refined flap raising technique, the possibility of a neurotisation and discusses the role of the free instep flap for idealised digital and palmar resurfacing. It can provide a truly cosmetic microsurgical reconstructive option.

Chromosome-specific physical localisation of expressed sequence tag loci in Corchorus olitorius L.

Jute (Corchorus spp.), as a natural fibre-producing species, ranks next only to cotton. Inadequate understanding of its genetic architecture is a major lacuna for genetic improvement of this crop in terms of yield and quality. Establishment of a physical map provides a genomic tool that helps in positional cloning of valuable genes. In this report, an attempt was initiated to study association and localisation of single copy expressed sequence tag (EST) loci in the genome of Corchorus olitorius. The chromosome-specific association of EST was determined based on the appearance of an extra signal for a single copy cDNA probe in mitotic interphase nuclei of specific trisomic(s) for fluorescence in situ hybridisation, and validated using a cDNA fragment of the 26S rRNA gene (600 bp) as molecular probe. The probe exhibited three signals in meiotic interphase nuclei of trisomic 5, instead of two as observed in diploids and other trisomics, indicating its association with chromosome 5. Subsequent hybridisation of the same probe on the pachytene chromosomes of diploids confirmed that 26S rRNA occupies the terminal end of the short arm of chromosome 5 in C. olitorius. Subsequently, chromosome-specific association of 63 single copy EST and their physical localisation were determined on chromosomes 2, 4, 5 and 7. The study describes chromosome-specific physical localisation of genes in jute. The approach used here could be a step towards construction of genome-wide physical maps for any recalcitrant plant species like jute.

RNA-sequencing of the brain transcriptome implicates dysregulation of neuroplasticity, circadian rhythms and GTPase binding in bipolar disorder.

RNA-sequencing (RNA-seq) is a powerful technique to investigate the complexity of gene expression in the human brain. We used RNA-seq to survey the brain transcriptome in high-quality postmortem dorsolateral prefrontal cortex from 11 individuals diagnosed with bipolar disorder (BD) and from 11 age- and gender-matched controls. Deep sequencing was performed, with over 350 million reads per specimen. At a false discovery rate of <5%, we detected five differentially expressed (DE) genes and 12 DE transcripts, most of which have not been previously implicated in BD. Among these, Prominin 1/CD133 and ATP-binding cassette-sub-family G-member2 (ABCG2) have important roles in neuroplasticity. We also show for the first time differential expression of long noncoding RNAs (lncRNAs) in BD. DE transcripts include those of serine/arginine-rich splicing factor 5 (SRSF5) and regulatory factor X4 (RFX4), which along with lncRNAs have a role in mammalian circadian rhythms. The DE genes were significantly enriched for several Gene Ontology categories. Of these, genes involved with GTPase binding were also enriched for BD-associated SNPs from previous genome-wide association studies, suggesting that differential expression of these genes is not simply a consequence of BD or its treatment. Many of these findings were replicated by microarray in an independent sample of 60 cases and controls. These results highlight common pathways for inherited and non-inherited influences on disease risk that may constitute good targets for novel therapies.

Role of pro-/anti-inflammatory cytokines and their correlation with established risk factors in South Indians with coronary artery disease.

Cytokines are responsible for the modulation of immunological and inflammatory processes and play a significant role in the pathogenesis of coronary artery disease. We estimated the levels of pro-/anti-inflammatory cytokines in South Indian patients with coronary artery disease. The study population comprised of groups 1-3: 100 patients each with acute myocardial infarction, unstable angina, and stable angina, respectively, and group 4 (100 healthy controls). Cytokine levels (interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-alpha) were estimated by enzyme-linked immunosorbent assay (ELISA). Interleukin-6, interleukin-8, and tumor necrosis factor-alpha levels were significantly higher in patients from groups 1 and 2, than in group 3 and controls. Acute myocardial infarction patients exhibited higher serum levels of interleukin-10 compared with other groups and control subjects. Patients with unstable angina had significantly lower interleukin-10 concentrations than those with stable angina. The ratios of pro-/anti-inflammatory cytokines in all the study groups increased significantly when patients with unstable angina were compared to other groups. In patients with acute myocardial infarction, interleukin-10 and tumor necrosis factor-alpha levels showed significant correlation with established risk factors such as body mass index, blood pressure, and lipid levels. Acute myocardial infarction patients show elevation in proinflammatory and anti-inflammatory cytokines, while unstable angina is associated with low levels of serum interleukin-10. Higher levels of anti-inflammatory cytokine interleukin-10 may be needed to provide protection in unstable angina. These cytokines are markers of coronary artery disease and may be used for the identification of high-risk patients with unstable angina/acute myocardial infarction.

Thyroid disorders in women of Puducherry.

Thyroid stimulating hormone (TSH), Free Thyroxine (FT(4)) and Free Triiodothyronine (FT(3)) were assayed in 505 women of this region. 60 women had previous history of thyroid disease. The remaining 445 women formed the "Disease free group". A "Reference group" was obtained by excluding women with previous and present history of thyroid dysfunction. Of the total 505 women examined 15.8% had thyroid dysfunction and 84.2% were euthyroid. 11.5% were hypothyroid (9.5% sub-clinical) and 1.8% hyperthyroid (1.2% clinical). The geometric mean TSH for the total population was 2.65 µIU/ml. It was significantly (p=0.025) lower in the reference population 2.17 µIU/ml. There was no significant difference in the FT(3) and FT(4) values between groups. 19% of women over 60 years had elevated TSH above 4.5 µIU/ml. The 2.5 and 97.5 percentiles of the reference population was 1.1-5.2 µIU/ml. 6.1% of women in the reference group had TSH levels above the reference intervals. Hypothyroidism particularly sub-clinical hypothyroidism is predominantly present amongst women in this iodine sufficient region. Evaluation of thyroid status could help in early detection and treatment.

Plasma Homocysteine, Folate and Vitamin B(12) levels in senile cataract.

Elevated plasma Homocysteine level is an independent risk factor for age related (senile) cataract. Certain nutritional deficiencies, in particular Folate, Vitamin B(12), Vitamin B(6) relate inversely with Homocysteine level. This study was undertaken to evaluate the plasma level of Vitamin B(12), Folate, and Homocysteine of cataract patients and to study the interplay between them. Serum Homocysteine level is significantly increased in cataract patients when compared with control (p< 0.001). There was a significant decrease in the level of Folate as compared with control (p<0.001). There was a negative correlation between Homocysteine vs. Vitamin B(12) (p<0.01) and Folate (p<0.01) in the Cataract patients. Our findings suggest that increased plasma Homocysteine level is associated with decreased plasma levels of Folate and VitaminB(12) in Cataract patients, which might have a possible role in the root cause of cataract pathogenesis.

Interacting resonances in the F+H2 reaction revisited: complex terms, Riemann surfaces, and angular distributions.

We study the effect of overlapping resonances on the angular distributions of the reaction F+H2(v=0,j=0)-->HF(v=2,j=0)+H in the collision energy range from 5 to 65 meV, i.e., under the reaction barrier. Reactive scattering calculations were performed using the hyperquantization algorithm on the potential energy surface of Stark and Werner [J. Chem. Phys. 104, 6515 (1996)]. The positions of the Regge and complex energy poles are obtained by Pade reconstruction of the scattering matrix element. The Sturmian theory is invoked to relate the Regge and complex energy terms. For two interacting resonances, a two-sheet Riemann surface is contracted and inverted. The semiclassical complex angular momentum analysis is used to decompose the scattering amplitude into the direct and resonance contributions.

Ferulic acid esterase production by Streptomyces sp.

Studies were carried out on ferulic acid esterase production using a culture of Streptomyces S10. In optimized condition, enzyme yield was 2.0 mU/ml in MBS medium, containing 1.5% de-starched wheat bran at 30 degrees C and initial pH 6.5 under agitated submerged culture.

Cloning and functional expression of an acyl-ACP thioesterase FatB type from Diploknema (Madhuca) butyracea seeds in Escherichia coli.

A cDNA of fatty acyl-acyl carrier protein (ACP) thioesterase (Fat) from developing seed of Madhuca butyracea has been cloned. The deduced amino acid sequence of the cDNA corresponding to the mature polypeptide showed 30-40% and 60-75% identity to the reported FatA and FatB class of plant thioesterases, respectively. This gene, MbFatB, is present as a single copy in M. butyracea genome and the MbFatB protein was detected clearly in seed tissues of this plant but not in that of Indian mustard (Brassica juncea). Heterologous expression of the MbFatB gene driven by different promoters in E. coli wild type and fatty acid beta-oxidation mutant (fadD88) strains resulted production of the recombinant protein with various fusion tags either as biologically inactive (insoluble) or functionally active forms. Expression of functionally active recombinant MbFatB in E. coli affected bacterial growth and cell morphology as well as changed the fatty acid profiles of the membrane lipid and the culture supernatant. Alteration of the fatty acid composition was directed predominantly towards palmitate and to a lesser extent myristate and oleate due to acyl chain termination activity of plant thioesterase in bacteria. Thus, this new MbFatB gene isolated from a non-traditional oil-seed tree can be used in future for transgenic development of oil-seed Brassica, a widely cultivated crop that expresses predominantly oleoyl-ACP thioesterase (FatA) in its seed tissue and has high amount of unwanted erucic acid in edible oil in order to alter the fatty acid profile in a desirable way.

Purification, characterization, and antifungal activity of chitinase from Streptomyces venezuelae P10.

Streptomyces venezuelae P(10) could produce extracellular chitinase in a medium containing 0.6% colloidal chitin that was fermented for 96 hours at 30 degrees C. The enzyme was purified to apparent homogeneity with 80% saturation of ammonium sulfate as shown by chitin affinity chromatography and DEAE-cellulose anion-exchange chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of the enzyme showed a molecular weight of 66 kDa. The chitinase was characterized, and antifungal activity was observed against phytopathogens. Also, the first 15 N-terminal amino-acid residues of the chitinase were determined. The chitin hydrolysed products were N-acetylglucosamine and N, N'-diacetylchitobiose.

Hyperinsulinemia and dyslipidemia in non-diabetic benign prostatic hyperplasia.

BACKGROUND: BPH is a multifactorial disease. Several studies have elucidated the role of hormones and growth factors in its etiology. Insulin is a growth-stimulating hormone. Previous studies have reported the association between hyperinsulinemia, dyslipidemia and BPH in patients with metabolic disorders like diabetes. We evaluated insulin and lipid profile parameters in non-diabetic BPH cases and correlated it with prostate size. METHODS: 50 symptomatic BPH cases and 38 controls were included in this study. Fasting serum insulin concentrations were measured by radioimmunoassay. Insulin resistance was assessed by HOMA. Fasting glucose, total cholesterol and triglycerides were quantified by enzymatic methods. HDL-cholesterol was quantified by phosphotungstate magnesium chloride method. LDL-cholesterol was calculated by Friedwald's formula. RESULTS: Fasting serum insulin, HOMA, total cholesterol, and LDL-cholesterol were significantly higher and HDL-cholesterol was significantly lower in cases as compared to controls. Insulin was significantly associated with prostate size, cholesterol, triglycerides, VLDL-cholesterol and LDL-cholesterol in BPH cases. Stepwise regression analysis showed insulin as an independent risk factor in the development of BPH. CONCLUSIONS: Hyperinsulinemia associated with insulin resistance is an independent risk factor in the development of BPH.

Dibutyl phthalate, the bioactive compound produced by Streptomyces albidoflavus 321.2.

It was found that the bioactive compound, dibutyl phthalate, was produced by a new soil isolate Streptomyces albidoflavus 321.2. Once this active compound was recovered by ethyl acetate from the fermented broth, being possible to isolate 13.4 mg/l, it was purified by paper, silica gel column, thin layer and gas chromatography. Structure was determined by analysing UV, IR and GC-MS spectra. During analysis, such active compound showed strong activity against gram-positive and gram-negative bacteria, as well as unicellular and filamentous fungi. The antimicrobial activity of the compound was reversed by the amino acid proline. No acute toxicity was observed.