Judicious use of DXA-BMD in assessing fracture risk by using clinical risk factors in the Indian population.

FRAX scores were significantly higher in patients admitted with fragility fractures than controls and can be useful in choosing the right patients for bone density testing, thus using of an expensive test judiciously. PURPOSE: This study was planned to compare the FRAX scores for the risk for major osteoporotic fracture (FRAX-MOF) and hip fracture (FRAX-HF) in patients with fragility fractures (cases) and those admitted for other indications (controls) in the orthopedic ward in our institute. METHODS: Historical and anthropometric data were prospectively recorded from 500 consecutive patients admitted in the orthopedic ward in in Medanta, the Medicity, Gurgaon, India. The receiver operating characteristic (ROC) curves were constructed for FRAX-MOF and FRAX-HF and the area under the curve (AUC) was calculated between cases and controls. RESULTS: The FRAX-MOF was significantly high in cases as compared to controls (7.34 ± 4.41 versus 5.64 ± 4.3; p = 0.001). The FRAX-HF was also significantly high in cases as compared to controls (2.95 ± 3.13 versus 1.67 ± 2.21; p < 0.001). The areas under the curves were 0.627 for FRAX-MOF and 0.654 for FRAX-HF. For FRAX-MOF, a cutoff of 2 has a 90% sensitivity, but only 15% specificity; whereas a cutoff of 10.5 had a specificity of 90% to differentiate those with and without fractures, but only 23% sensitivity. For FRAX-HF, a cutoff 0.3 had about 90% sensitivity and 20% specificity, whereas a cutoff of 3.5 had 90% specificity and 25% specificity to differentiate cases and controls. CONCLUSIONS: This study compared the FRAX-MOF and FRAX-HF in patients with and without fragility fractures and derived cutoffs for practical clinical use of FRAX-MOF and FRAX-HF to optimize the use of DXA-BMD.

Chemosensors for biogenic amines and biothiols.

There is burgeoning interest among supramolecular chemists to develop novel molecular systems to detect biogenic amines and bio-thiols in aqueous and non-aqueous media due to their potential role in biological processes. Biogenic amines are biologically important targets because of their involvement in the energy metabolism of human biological systems and their requirement is met through food and nutrition. However, the increasing instances of serious health problems due to food toxicity have raised the quality of food nowadays. Biogenic amines have been frequently considered as the markers or primary quality parameters of foods like antioxidant properties, freshness and spoilage. For instance, these amines such as spermine, spermidine, cadavarine, etc. may originate during microbial decarboxylation of amino acids of fermented foods/beverages. These amines may also react with nitrite available in certain meat products and concomitantly produce carcinogenic nitrosamine compounds. On the other hand, it is also well established that biothiols, particularly, thiol amino acids, provide the basic characteristics to food including flavor, color and texture that determine its acceptability. For instance, the reduction of thiol groups produces hydrogen sulfide which reduces flavour as in rotten eggs and spoiled fish, and the presence of hydrogen sulfide in fish is indicative of spoilage. Thus, biogenic amines and bio-thiols have attracted the profound interest of researchers as analytical tools for their quantification. Much scientific and technological information is issued every year, where the establishment of precise interactions of biogenic amines and bio-thiols with other molecules is sought in aqueous and non-aqueous media. This review summarizes the optical chemosensors developed for the selective detection of biogenic amines and bio-thiols.

Fe(III) conjugated fluorescent organic nanoparticles for ratiometric detection of tyramine in aqueous medium: A novel method to determine food quality.

A tetrapodal receptor was synthesized and was processed into fluorescent organic nanoparticles (FONs) for determination of important analytes in aqueous medium. The receptor was fully characterized using characterization techniques. Recognition behavior of FONs towards different metal ions was investigated with fluorescence spectroscopy, amongst them Fe3+ ions showed quenching behavior in the emission spectra. The Fe3+ ion complex of FONs based sensor was further tested with different biogenic amines and ratiometric response was obtained for tyramine. Fluorescence emission profile of FONs. Fe3+ ion complex showed no change in the pH in wide range; thereby increasing their utility in biological and environmental samples. Tyramine detection was linearly proportional in response with the detection limit of 377 nM.

Ultrasensitive and Selective Sensing of Selenium Using Nitrogen-Rich Ligand Interfaced Carbon Quantum Dots.

This work reports a label-free, ultrasensitive, and selective optical chemosensory system for trace level detection of selenite (SeO32-), the most toxic form of selenium, in water. The probe, i.e., carbon quantum dots (CQDs), is designed from citric acid by means of pyrolysis and is interfaced with a newly synthesized nitrogen-rich ligand to create a selective sensor platform (functionalized CQDs, fCQDs) for selenite in a water matrix. Spectral (NMR, UV-vis, photoluminescence, Raman, and Fourier transform infrared analyses) and structural (high-resolution transmission electron microscopy) characteristics of the designed new probe were investigated. The developed sensor exhibits high sensitivity (limit of detection = 0.1 ppb), a wide detection range (0.1-1000 ppb range, relative standard deviation: 3.2%), and high selectivity even in the presence of commonly interfering ions reported to date, including Cl-, NO3-, NO2-, Br-, F-, As(V), As(III), Cu2+, Pb2+, Cd2+, Zn2+, Sr2+, Rb2+, Na+, Ca2+, Cs+, K+, Mg2+, Li+, NH4+, Co2+, etc. The observed selectivity is due to designed ligand characteristics in terms of strong Se-N chemistry. Ultrafast spectroscopic analysis of the fCQDs in the absence and presence of selenite was studied to understand the sensing mechanism. The sensor was successfully exemplified for real water samples and exhibits comparative performance to conventional ion channel chromatography as well as flame atomic absorption spectroscopy for selenite analysis. The promising results pave ways for realization of a field deployable device based upon a developed probe for selenite quantification in water.

Calix[4]arene based dipodal receptor nanohybrids for selective determination of chloride ions in aqueous media.

A chemical sensor based on p-tert butyl calix[4]arene has been synthesized and characterized using an assortment of spectroscopic techniques such as (1)H NMR, (13)C NMR, and elemental analysis. For sensor application, organic nanoparticles (N1) of 1 have been primed by implementing re-precipitation technique, which were further employed for preparing organic-inorganic hybrid (H1) by decorating N1 with gold nanoparticles. Both N1 and H1 were characterized using UV-visible, fluorescence, and DLS studies. Photo-physical changes due to anion binding with H1 were scrutinized using UV-visible absorption spectrometer and found it to promptly and selectively recognize Cl(-) ions in aqueous media. Thus, H1 can be effectively used for recognition of Cl(-) ions in aqueous media over a wide pH range, in samples of real time importance with a detection limit of 2.84×10(-9) M with a linear detection range up to 50 µM.

Effect of octreotide on endometriosis in acromegaly: Case report with review of literature.

OBJECTIVE: To study the effect of octreotide therapy on endometriotic lesions in a patient with coexisting endometriosis and acromegaly. INTERVENTION PATIENT: A 34-year-old female was diagnosed with acromegaly and coexisting endometriosis. Post-surgical resection of the tumor, patient was initiated on octreotide therapy. RESULTS: There was improvement in menstrual bleeding as IGF1 levels decreased with Octreotide therapy. Resolution of the endometriotic lesions was observed during follow up. CONCLUSION: In this unusual case, the treatment of acromegaly concurred with regression in the endometriotic lesions. Causal or incidental association cannot be inferred from the present case.

Persistence of histoplasma in adrenals 7 years after antifungal therapy.

Adrenal histoplasmosis is an uncommon cause for adrenal insufficiency. The duration of treatment for adrenal histoplasmosis is not clear. Existing treatment regimens advocate antifungals given for periods ranging from 6 months to 2 years. We report here a rare case who showed persistence of histoplasma in adrenal biopsy 7 years after being initially treated with itraconazole for 9 months. This calls for a prolonged therapy with regular review of adrenal morphology and histology in these patients.

Incidence of gall stone formation in acromegalic patients on octreotide therapy.

OBJECTIVE: Octreotide, a long-acting synthetic somatostatin analog, has been widely used for ac-romegalic patients. Gastrointestinal (GI) side effects and gall stones are predominant side effects. We report incidence of gall stones in our cohort of acromegalic patients treated with octreotide therapy. DESIGN: Retrospective case observational study. SETTING: Endocrinology Unit, Dr. Ram Manohar Lohia, Hospital, New Delhi. MATERIALS AND METHODS: Patients of acromegaly on primary or secondary octreotide therapy. INTERVENTION: Patients were enquired regarding complaints related to the GI system and their medical records were reviewed. Ultrasound films at various intervals while on octerotide therapy were evaluated by the radiologist for presence of sludge and development of gall stones. RESULTS: Of seven patients, five developed gallstones and sludge was seen in three patients at intervals ranging from 11 to 36 months postoctreotide initiation. CONCLUSION: A high incidence of gall stone formation in the present study as compared to the West was noted, the reasons for which are not clear.