Export of particulate organic carbon and nitrogen to the northern Indian Ocean by the monsoonal rivers of India.

This study analyses particulate organic carbon (POC) and particulate nitrogen (PN) export from Indian monsoonal rivers to the north Indian Ocean. Indian monsoonal rivers export approximately 1.2 Tg yr-1 (1Tg = 1012 g) of POC and 0.14 Tg yr-1 of PN, with about two-thirds entering the Bay of Bengal (0.8 and 0.1 Tg yr-1, respectively) and the remaining reaches to the Arabian Sea (0.4 and 0.04 Tg yr-1, respectively). Remarkably, just four rivers from northwest India's black soil-dominated regions contribute about half of the total POC and PN exports (0.64 and 0.06 Tg yr-1, respectively). This is due to substantial erosion in these catchments, resulting in suspended matter concentrations averaging 596 ± 252 mg L-1, significantly higher than catchments dominated by red sandy, red loamy and alluvial soils (54 ± 56 mg l-1). In contrast, rivers originating from catchments with heavy precipitation, a tropical wet climate, red loamy soils (with peaty and marshy characteristics), rich tropical wet evergreen and moist deciduous forests, and higher soil organic carbon content yield more POC and PN (1704 ± 383 kgC km-2 yr-1 and 261 ± 56 kgN km-2 yr-1, respectively) than the other rivers of India (951 ± 508 kgC km-2 yr-1 and 120 ± 57 kgN km-2 yr-1, respectively). These findings stress that the export flux and yield of POC and PN from the Indian monsoonal rivers are primarily influenced by the interplay of hydrological, lithological, environmental, and climatic conditions within the catchment, rather than river size. Moreover, this study highlights the significant impact of incorporating POC data from medium-sized rivers worldwide, as it reveals that yield is independent of river size. This calls for a re-evaluation of global POC export fluxes, taking into account hydrological, lithological, environmental, and climatic factors.

Trans-rectal ultrasound-guided hybrid intra-cavitary and interstitial brachytherapy in carcinoma cervix: A feasibility study from a tertiary cancer center in India.

Purpose: To report the feasibility of performing hybrid intra-cavitary and interstitial (IC/IS) brachytherapy in patients with carcinoma cervix under trans-rectal ultrasound (TRUS) guidance. Material and methods: All patients who received an external beam radiotherapy (EBRT) dose of 50 Gy in 25 fractions with weekly chemotherapy, followed by a brachytherapy boost (21 Gy in 3 fractions) were prospectively included for analysis. IC/IS brachytherapy was performed using Fletcher style tandem and ovoid applicator with interstitial component under TRUS guidance. Parameters of implant quality analyzed included ability to insert tandem, ratio of needles loaded to the number of needles inserted, and incidence of uterine or organ at risk (OARs) perforation. Dosimetric parameters evaluated were dose to point A*, TRAK, D90 high-risk clinical target volume (HR-CTV), and D2cc to OARs (bladder, rectum, and sigmoid). Width and thickness of the target was compared between TRUS (TRUSw and TRUSt) and MRI (MRIw and MRIt). Results: Twenty carcinoma cervix patients treated with IC/IS brachytherapy were included for analysis. The mean HR-CTV volume was 36 cc. The median number of needles used were 6 (range, 2-10 needles). None of the patients had uterine perforation. Two patients had bowel and bladder perforation. The mean D90 HR-CTV and D98 HR-CTV were 87.3 Gy and 82 Gy EQD2, respectively. The mean D2cc to the bladder, rectum, and sigmoid were 80 Gy, 70 Gy, and 64 Gy EQD2, respectively. The mean dose to point A* was 70.4 Gy EQD2. The mean TRAK was 0.40. The mean TRUSw (±SD) and MRIw (±SD) were 4.58 cm (±0.44) and 4.49 cm (±0.50), respectively. The mean TRUSt (±SD) and MRIt (±SD) were 2.7 cm (±0.59) and 2.62 cm (±0.59), respectively. On statistical analysis, there was a significant correlation between TRUSw and MRIw (r = 0.93), and TRUSt and MRIt (r = 0.98). Conclusions: TRUS-guided IC/IS brachytherapy is feasible and provides adequate coverage of the target, with acceptable doses to OARs.

Hardware Removal in Maxillofacial Trauma: A Retrospective Study.

BACKGROUND: Miniplates are commonly used for the fixation of maxillofacial fracture segments. Removal of the hardware is controversial. A retrospective study of medical records was performed to observe the reasons for plate removal. MATERIALS AND METHODS: A 10-year retrospective study of medical records was performed. Demographics, type of fracture, location, type of miniplate used, the time gap between the insertion and removal, and causes of hardware removal were assessed. RESULTS: About 1472 patients had undergone internal fixation for the facial fractures. Stainless steel miniplate was used in 489 patients, and titanium was used in 983 patients. Out of the 42 cases, 22 cases involved the removal of titanium hardware and 20 patients involved the removal of stainless steel hardware. Infection/osteomyelitis was the main cause of hardware removal. The maximum amount of hardware failure was in the mandible. 78.6% of hardware removal was performed in males. CONCLUSION: Based on our study, routine removal of titanium miniplates can be performed in children to avoid growth disturbances, not indicated in adult patients unless symptomatic.

Temporalis space infection secondary to an undiagnosed intra-oral foreign object - a case report.

The penetration of foreign objects is one of the leading causes of maxillofacial infection following trauma. Failure to detect such objects at initial stages can lead to complications like abscess formation, cellulitis, or space infections. Detection is even more complicated if the patient presents to the maxillofacial center after a delay of days or weeks following trauma. Sole reliance on radiographs or CT can be inconclusive as most of these objects are radiolucent and can be difficult to detect even by the experienced radiologists. We report the case of a patient who had an unwitnessed trauma and presented to our center 7 days after the incident, with signs of buccal space infection. Failure to detect the embedded intra-oral wooden object at an earlier stage led to the propagation of infection to superficial temporal space. The management strategy and pitfalls associated with conventional imaging in detecting wooden object are discussed.

Frequency and amplitude modulation of a cw-dye laser for measuring hyperfine frequency separations in optogalvanic spectra of 139La I.

This paper describes frequency modulation of a cw-dye laser to generate a frequency-discriminant dispersive signal by phase-sensitive detection of the optogalvanic signal in a lanthanum hollow cathode lamp. The frequencies of the six major hyperfine components in 5d26s4F9/2 (4121.572cm-1)----→579.13nm⁡5d26p4F9/2(21384.0cm-1) transition in 139La I were measured with an accuracy of 50 MHz, using a calibrated wavemeter after locking the cw-dye laser frequency to the dispersive error signal of the constituent hyperfine component. The measured hyperfine separations are found to be consistent with separations measured using the standard amplitude modulation technique and also with earlier reported results. The relative ease of the optical setup for locking of the cw-dye laser to optogalvanic spectra can be adapted to atomic physics applications for stabilization of laser frequency in the visible region.

Total body irradiation of bone marrow transplant using helical TomoTherapy with a focus on the quality of dose contribution at junction target volumes.

PURPOSE: Total body irradiation (TBI) can be safely delivered on TomoTherapy (Accuray, Sunnyvale, CA, USA) in both pediatric and adult patients with proper imaging and planning despite the length constraint of 135 cm. To overcome this limitation, two CT (Computed Tomography) scans (CT1& CT2) are taken in patients above 135 cm in height. Adequate junction dose coverage is important in TBI. Presently, there is no clinical report with a focus on the quality of dose distribution at the CT junction in view of the guidelines on quality of coverage from the RTOG. Hence, our main objectives were to evaluate the dose distribution and quality of coverage at the junction in 16 patients who received TBI using TomoTherapy. METHODS: PTV(upper) and PTV(lower) along with a junction were created on CT1 and CT2, respectively. Subsequently, the 10 cm junction in the thigh region was divided into five target volumes of 2 cm thickness with dose prescription ranging from 10 to 90% to deliver a total dose equal to 100% when fused. RESULTS: The D50 was equal to the prescribed dose in most of the cases ranging from 99.5 to 104% for PTV(upper), 100-103% for PTV(lower), and 99.5-108% for junctional PTVs (1PTV, 2PTV, 3PTV, 4PTV, and 5PTV). The average D95 doses from PTV(upper) and PTV(lower) were 97 ± 1.4% and 96.7 ± 1.08%, respectively. The average D95 doses for 1PTV, 2PTV, 3PTV, 4PTV, and 5PTV were 96.1 ± 1.88%, 91.6 ± 1.82%, 87.3 ± 1.5%, 91.6 ± 1.4%, and 96.2 ± 1.5% respectively. QRTOG values ranged between 0.85 and 1.05 and were in concordance with RTOG guidelines. CONCLUSION: Since junction-based planning was required for most TBI patients, it is essential to evaluate the quality of dose coverage in the junction for better TBI plans.

"Orofacial Dystonia-A Silent Killer": Mandibular Fractures with Orofacial Dystonia, A Report of a Case and Review.

Mandibular parasymphysis fracture is very commonly observed especially in old age when there is resorptions of the alveolar ridges. In cervical dystonia, there is centrally mediated disease in which there is uncontrolled and spasmodic contraction of the facial and the masticatory muscles. Due to the application of this sudden and uncontrolled force, there is a tendency of the bone to unfavourably remodel and weaken. The case presented here is of a geriatric patient who presented to us with a fracture at the right parasymphysis and left dentoalveolar region of the mandible and was suffering from cervical dystonia. Management of this case posed a challenge in every step, and it needed a resurgery where the fracture was managed by the placement of reconstruction plate. Not many cases in the literature have been reported where dystonic movements have resulted in the fracture of the mandible.

A linguoverted impacted tooth with orocutaneous fistula - a rare case report.

The orocutaneous fistulous tract of odontogenic origin is often a diagnostic challenge, due to its rare manifestation and absence of dental signs and symptoms. The odontogenic cutaneous fistula is often misdiagnosed as a superficial skin lesion of non-odontogenic origin delaying the treatment. The diagnosis and treatment must be precise and swift to improve the clinical outcome and minimize the complications. This article presents a rare case of odontogenic keratocyst involving a linguoverted impacted third molar presenting as orocutaneous fistula. The patient was initially treated with empirical antibiotic therapy with no resolution of the cutaneous fistula and thickening of the skin around the sinus opening resulting in cosmetic deformity. Once the fistula was attributed to the underlying odontogenic cyst, treatment was done by cyst enucleation along with the extraction of tooth and fistula excision. The purpose of the paper is to emphasize the importance of early and accurate diagnosis and prompt management of the orocutaneous fistula due to the odontogenic origin.

Hydrolysis of Letrozole catalyzed by macrocyclic Rhodium (I) Schiff-base complexes.

Ten mononuclear Rhodium (I) complexes were synthesized by macrocyclic ligands having N4 and N2O2 donor sites. Square planar geometry is assigned based on the analytical and spectral properties for all complexes. Rh(I) complexes were investigated as catalysts in hydrolysis of Nitrile group containing pharmaceutical drug Letrozole. A comparative study showed that all the complexes are efficient in the catalysis. The percent yields of all the catalytic reaction products viz. drug impurities were determined by spectrophotometric procedures and characterized by spectral studies.

Ludwig's Angina in Post Partum Patient.

Ludwig's Angina is a rapid progressive cellulitis of the submandibular spaces, with potential for significant upper airway obstruction. Most reported cases follow an odontogenic infection. We present a case of 22-year-old female patient in her 2 weeks post partum period developing a life threatening infection. Immediate intubation, surgical decompression and antibiotic therapy successfully resolved the episode.

Comparative evaluation of decalcified freeze dried bone allograft with and without local doxycycline in non-contained human periodontal infrabony defects.

BACKGROUND: Doxycycline has been advocated as useful adjuncts in periodontal therapy not only due to their antimicrobial actions, but also to their recently recognized anti-collagenolytic, anti-inflammatory, osteoclast inhibitory and fibroblast stimulating property. The purpose of the present cohort study was to evaluate the regenerative outcomes of bone graft with or without local doxycycline in non-contained infrabony periodontal defects. MATERIALS AND METHODS: 16 one or two wall infrabony defects, in 11 patients suffering from moderate to severe chronic periodontitis, aged 35-60 years, were randomly divided for bone graft, alone (control) and with doxycycline (test) for the study. At baseline, after 3 months and after 6 months of post-operative period, pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF) and alveolar height reduction were recorded. Analysis of variance and Newman-Keuls post-hoc test were used or statistical analysis. A two-tailed probability (P) value P < 0.05 was considered to be statistically significant. RESULTS: For the control group PPD reduction 2.00 ± 0.18 mm, CAL gain 1.38 ± 0.17 mm, RBF 0.63 ± 0.27 mm (18.0%) was observed while in the test group PPD reduction 2.00 ± 0.38 mm, CAL gain 1.25 ± 0.31 mm, RBF 0.75 ± 0.31 mm (20.7%) was evaluated. While alveolar height reduction for the control group and test group was 13% and 12.5% respectively. CONCLUSION: The study confirmed no added benefits of local doxycycline, as compared with bone graft alone, for regeneration of non-contained human periodontal infrabony defects.

Clinical evaluation of intrabony defects in localized aggressive periodontitis patients with and without bioglass- an in-vivo study.

BACKGROUND: Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as rapid attachment loss, bone destruction and familial aggregation. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. OBJECTIVE: The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. METHODS: Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth = 2 mm, preoperative probing depths = 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. RESULTS: After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P < 0.001) and a gain in clinical attachment level of 4.42+0358mm (P < 0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P <0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P < 0.001) in the test group and by 0.1792 + 0.031mm (P < 0.001) in the control group. Changes in gingival recession showed no significant differences. . CONCLUSION: Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material.

Transumbilical laparoendoscopic single-site donor nephrectomy: Without the use of a single port access device.

INTRODUCTION: Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a procedure in evolution. Currently described techniques utilize single port access devices and articulating, flexible, and bent working instruments. We describe a modified technique of transumbilical LESS-DN with conventional laparoscopic instruments in five kidney donors. MATERIALS AND METHODS: Three standard laparoscopic ports (10 mm × 1, 5 mm × 2) were placed through a 4.5 cm vertical transumbilical incision. A 10 mm 45°, long bariatric lens (Karl Storz) was used. Renal mobilization was performed using conventional rigid laparoscopy instruments. A port closure needle loaded with a blunt plastic needle cap was used for traction. After hilar clamping, an incision was made connecting the three ports, and the kidney was extracted using a preplaced suture over the lower pole fat. All data were prospectively recorded. RESULTS: LESS-DN was performed successfully in all five patients. The mean operative time was 157.2 minutes (range, 134-184) and the mean warm ischemia time was 3.2 minutes (range, 3-4). All donors were discharged on postoperative day 3 and were able to resume normal physical activity by 2 weeks after the procedure. All donors had an excellent cosmetic outcome. The mean serum creatinine (recipient) at discharge was 1.14 mg% (range, 0.9-1.4). CONCLUSIONS: Transumbilical LESS-DN can be cost-effectively performed using conventional laparoscopy instruments and without the need for a single port access device. Warm ischemia times with this technique are comparable with that during conventional multiport laparoscopic donor nephrectomy.

Single-incision laparoscopic splenectomy with innovative gastric traction suture.

Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP) undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL) splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up.

Primary hepatic (extranodal) lymphoma: utility of [(18)F]fluorodeoxyglucose-PET/CT.

Primary hepatic lymphoma is extremely rare. Although the utility of fluorodeoxyglucose (FDG)-positron emission tomography (PET) for imaging extranodal lymphoma has been reported, there is very little literature describing its use in primary hepatic lymphoma. This case report demonstrates the effect of FDG-PET/computed tomography (CT) in a case of unifocal primary hepatic lymphoma and its usefulness in the assessment of treatment response.

Task-dependent compensation after pyramidal tract and dorsolateral spinal lesions in rats.

The purpose of this research was to investigate whether pathways in the dorsal part of the lateral spinal funiculus (DLF) can compensate for loss of corticospinal input (CST) to the spinal cord. The CST is known to control skilled limb movements in rats. The DLF contains several different pathways, including the rubrospinal tract (RST) which is also thought to influence limb movements. After lesions of either the corticospinal or the rubrospinal system, it is unclear how much of the remaining forelimb function is due to the presence of the alternate pathway. To begin to address this issue, the present study investigates the compensatory role of pathways in the DLF, including the rubrospinal tract, after bilateral lesions of the pyramidal tract (PT). We initially performed bilateral PT lesions in rats, which effectively removed the CST input to the spinal cord. We tested these rats during overground locomotion, skilled locomotion and skilled forelimb usage. After a 6 week recovery period, we then performed bilateral DLF lesions and compared the behavioural abilities of these rats to those of animals which underwent simultaneous PT and DLF lesions. If DLF pathways do compensate for PT lesions, then animals with PT lesions would rely more on DLF pathways than animals without PT lesions. Thus we hypothesized that animals with DLF lesions which were performed 6 weeks after PT lesions would exhibit more deficits on several behavioural tasks compared to animals which received PT and DLF lesions simultaneously. Our hypothesis was supported only for skilled pellet retrieval. Hence some DLF pathways, including the RST, were able to compensate for loss of CST input during skilled reaching but not during overground or skilled locomotion in PT-lesioned rats. These differential responses suggest that behavioural tasks vary in their reliance on specific pathways after injury, and, furthermore, that compensation for loss of specific connections can arise from numerous sources.

Establishment of a rat model of myocardial infarction with a high survival rate: A suitable model for evaluation of efficacy of stem cell therapy.

The most common rat model of myocardial infarction (MI) is by ligation of left anterior descending (LAD) coronary artery but it is associated with high mortality and large variations in the infarct size. We evolved certain innovations/modifications in the existing technique including immobilization of the heart without exteriorization, identification of the LAD by pressing it proximal to the site of ligation by an ear-bud, and subsequently its ligation 8 mm from its origin, no touch technique of the lungs during surgery, removal of air from the chest cavity prior to its closure using an in-house tubing, and deflation of the lungs before extubation. We induced MI in 24 Sprague- Dawley (SD) rats using these modifications and carried out post-MI evaluation of hemodynamic parameters, serum cardiac enzymes and histological studies upto 90 days using 13 sham operated and 3 healthy SD rats as controls. Three of the 24 rats (13%) died <24 hours of MI, but thereafter no mortality was observed till the follow-up period of 90 days. The infarct size was consistent in all the rats (21±4% of left ventricular area). This model with low early and no long-term mortality may be suitable for studying efficacy of stem cell therapy in MI, where a follow-up of at least 13 weeks is required to assess myocardial regeneration.

Effects of combined dorsolateral and dorsal funicular lesions on sensorimotor behaviour in rats.

The purpose of this research was to investigate the compensatory role of undamaged spinal pathways after partial spinal injury in rats. We have previously shown that bilateral lesions of the dorsal funiculus (DF) at the cervical level caused changes in overground and skilled locomotion that affected the forelimbs more than the hindlimbs. The same lesions also caused fore-paw deficits during a skilled pellet retrieval task (Kanagal and Muir, 2007). In contrast, bilateral cervical lesions of the dorsolateral funiculus (DLF) caused alterations in overground and skilled locomotion that were most marked in the hindlimbs rather than the forelimbs, but also caused fore-paw deficits during skilled pellet retrieval (Muir et al., 2007). We hypothesized that the relative lack of forelimb deficits during locomotion after DLF lesions was due to compensatory input arising from intact pathways in the DF. We tested this hypothesis in the present study by performing bilateral DF lesions in animals in which both DLFs had been transected 6 weeks previously. These secondary DF lesions involved either only ascending sensory pathways (DLF+ASP group) in the DF, i.e. sparing the corticospinal tract (CST), or involved both the ASP and the CST (DLF+DF group). All animals were assessed during overground locomotion, while crossing a horizontal ladder and during a pellet retrieval task. During overground locomotion, both groups moved with slightly altered forces and timing in both forelimbs and hindlimbs. During both ladder crossing and reaching, secondary lesions to DF (with or without CST) exacerbated the deficits seen after initial DLF lesions and additionally caused changes in the manner in which the rats used their forelimbs during reaching. Nevertheless, the relative magnitude of the deficits indicates that DF pathways in rats likely do not compensate for loss of DLF pathways during the execution of locomotor tasks, though there is indirect evidence that DLF-lesioned rats might rely more on ascending sensory pathways in the DF during skilled forelimb movements. The plastic changes mediating recovery are therefore necessarily occurring in other regions of the CNS, and, importantly, need time to develop, because animals with DLF+DF lesions performed simultaneously displayed marked functional deficits and were unable to use their forelimbs for skilled locomotion or reaching.

Analysis of effect of divergence of laser beam on prism-based inscription of fiber Bragg gratings over a wide wavelength range.

In this report, we present analysis of an inscription method for fiber Bragg gratings (FBGs) that uses diverging laser beam and a biprism. We analyze the effect of divergence on inscription characteristics of FBGs. We show that the method allows inscription of a number of FBGs, each with a different Bragg wavelength in a section of optical fiber by using a single biprism. We discuss how such tuning affects other crucial parameters of the FBGs, such as bandwidth, reflectivity, and chirp. We show that the current method allows one to control the tuning range, and tuning sensitivity, by a mere change in the divergence of the laser beam during inscription. We also show that the method can be optimized to inscribe highly chirped tilted FBGs.