134Cs transfer factors to green gram and soybean as influenced by waste mica.

Greenhouse pot culture experiment was carried out to study the (134)Cs transfer factors from soils to green gram and soybean as influenced by waste mica application (@ 0, 10, 20, 40 g mica kg(-1) soil) and compared with muriate of potash (MOP) application (0.17 g kg(-1) soil). For the study, the soils were contaminated with (134)Cs radionuclide @ 37 kBq kg(-1) soil. The shoot biomass and K uptake by crops were significantly improved with waste mica application (@ 40 g kg(-1) soil). Compared to control, waste mica and MOP application significantly improved the yield, K content in plant and its uptake. Amongst the soils, crops grown in vertisol recorded higher shoot biomass compared to inceptisol and ultisol. Irrespective of the treatments, higher (134)Cs transfer factors were seen in ultisol (0.30) as compared to inceptisol (0.16) and vertisol (0.13). It was observed that higher the K concentration in soil and plant, lowered (134)Cs transfer to green gram and soybean. The study recommended that waste mica @ 20 g kg(-1) would be useful for checking the (134)Cs transfer factors from soils to green gram and soybean.

Percutaneous transluminal coronary angioplasty following Kawasaki Disease.

Kawasaki disease (KD) can result in coronary artery disease in the form of ectasia, aneurysm and stenosis. The final complication can be myocardial infarction. We report a child who presented with severe left ventricular dysfunction following KD and was detected on angiography to have total left anterior descending artery occlusion. Angioplasty was done which resulted in improvement in the flow. Follow up angiography a year later showed recurrence of total occlusion.

Effect of nitrogen, potassium and humic acid on ( 134 )Cs transfer factors to wheat from tropical soils in Neubauer growth units.

A Neubauer plantlet experiment was carried out using Inceptisol (Typic Haplustept) and Vertisol (Typic Chromustert) soils contaminated with 134Cs at 74 kBq kg(-1) soil to study the transfer factor to wheat crop (Triticum aestivum) as influenced by four levels of humic acid (100, 200, 300, 400 mg HA kg(-1) soil), potassium and NH4-N (36.4, 54.5, 72.7 and 90.9 mg K or NH4 kg(-1) soil) under tropical climate. The biomass yield and K uptake by wheat were significantly improved in Vertisol with NH4-N and K application. The potassium application significantly increased the potassium concentration in wheat plants. The increase in the levels of each of the treatments dramatically improved the yield, K content and K uptake parameters, irrespective of the soils. The 134Cs transfer factors, irrespective of the treatments were observed to be higher in Vertisols as compared to Inceptisols. Among the treatments, the effect of HA was significantly greater than that of K and NH4-N application in Inceptisol, however, in Vertisols both HA and NH4-N were observed to be superior as compared to K application. With each increment in the levels of the treatments, a significantly lowered TF value was found, higher in Inceptisols (56.3%) than Vertisols (48.5%). Comparison of treatments indicates that in general higher potassium concentration in plant drastically lowered radiocesium transfer to wheat. Neubauer plant culture study, a rapid laboratory experimental model based on simple soil-plant system was quite clearly brought out the potential effectiveness of N, K and HA on soil-to-wheat transfer of radiocesium. Such screening technique needs to be extended to cover wider crop species, different climatic conditions and factors governing/modifying the mobility of radiocesium in soil and its absorption by crop plants.

Coccidioidomycosis masked by symptoms of end-stage liver disease in transplant candidates.

Coccidioidomycosis is a common fungal infection in the southwestern United States. Two liver transplant candidates contracted coccidioidomycosis while awaiting transplantation in an endemic area, one of whom had successful transplantation despite unrecognized active mycosis. Symptoms and signs mistakenly attributed to terminal liver disease may actually be caused by coccidioidomycosis.

Right ventricular diastolic function after repair of tetralogy of Fallot.

The objective of this study was quantitate diastolic dysfunction in the postoperative phase of tetralogy of Fallot (TOF) and to correlate it with the type of surgical procedure and clinical parameters. Fifty consecutive patients (mean age, 5.0 years; mean weight, 13.5 kg), operated for TOF during the period November 2004 to May 2005, were prospectively studied [infundibular resection, 23; infundibular resection and transannular patch (TAP), 19; right ventricle --> pulmonary artery conduit, 8). Detailed echocardiography was done on postoperative days 3 and 9 with a focus on Doppler indices of right ventricular (RV) function, Antegrade late diastolic flow in the right ventricular outflow tract (RVOT) was taken as the marker of restrictive RV physiology. The previous parameters were correlated to the type of surgery and clinical indices of RV dysfunction. There was no mortality. Twenty-four patients showed restrictive RV physiology. This finding correlated with lower values of E/A ratio (0.98 +/- 0.17 vs 1.33 +/- 0.49, p < 0.002), tricuspid valve E-wave deceleration time (86.9 +/- 21.7 vs 151.4 +/- 152 msec, p < 0.05), index of myocardial performance (0.15 +/- 0.06 vs 0.26 +/- 0.09, p < 0.001), isovolumic relaxation time (19.4 +/- 17 vs 39+/-30 msec, p < 0.009), and a higher central venous pressure (15.1 +/- 1.5 vs 12.7 +/- 1.9, p < 0.001). Restrictive RV physiology correlated with prolonged intensive case unit (ICU) stay (5.1 +/- 3.7 vs 2.8 +/- 2 days, p < 0.015), longer duration of inotropic support (108.3 +/- 56.2 vs 55.5 +/- 28.3 hours, p < 0.02), and higher dosage of diuretics. RV diastolic dysfunction is demonstrable by Doppler echocardiography in the first week following surgery for TOF and tends to be worse with TAP. Restrictive physiology demonstrated by RVOT pulse Doppler predicts longer duration of inotropic support, prolonged ICU stay, and higher dosage of diuretics.

Profile of amblyopia in a hospital referral practice.

OBJECTIVE: Evaluation of the clinical profile and distribution of different sub-types of amblyopia in a referral eye hospital in India. METHODS: This was a prospective hospital-based observational study, evaluating the clinical profile of patients with amblyopia presenting to a referral strabismology practice. The examination included assessment of the visual acuity, the refractive status, the fixation pattern, the grade of binocularity, and evaluation of the associated strabismus, if any before treatment was started. RESULTS: The average age of the patients at presentation was 7.97?6.18 years with 81 out of 683 patients (11.8%) presenting above the age of 20 years. The best-corrected visual acuity (BCVA) was less than 6/60 in the amblyopic eye in 121 out of 733 eyes (16.5%). Strabismic amblyopia was the most common sub-type of amblyopia seen (274/733 eyes, 37.38%). Though patients with anisometropic amblyopia presented at a later age (average of 10.03+/-6.92 years), they had better visual acuity, binocular functions, and centricity of fixation at all ages, relative to other sub-types of amblyopia. The BCVA did not show any co-relation with the age of presentation [co-relation co-efficient (CF) of 0.074], refractive status of the amblyopic eye (CF of 0.078), the type of amblyopia (CF of 0.196), or the type of strabismus present (CF of 0.079). However, a very significant co-relation was seen between the BCVA and the fixation pattern of the amblyopic eye (CF of 0.817). CONCLUSIONS: Lack of knowledge and awareness about amblyopia and its appropriate timely management has been the main cause for the late presentations and significant visual impairment associated with the condition.

Epidural mass due to aspergillus flavus causing spinal cord compression--a case report and brief update.

Aspergillus infection of the central nervous system (CNS) is an uncommon disease. Most of the reported cases are of sinocranial spread and cases with contiguous spread to spinal cord from lung and other organs are uncommon. A case of pulmonary aspergillosis with extension to thoracic vertebrae forming a paraspinal mass resulting in neurological deficit due to Aspergillus flavus, is reported. The 43 year old patient did not have any obvious predisposing condition. He presented with loss of motor function and succumbed to the infection despite operative intervention and antifungal therapy. A brief update on CNS aspergillosis is presented along with detailed clinical, radiological and laboratory work up of the patient.

Major histocompatibility complex class I polymorphism in Asiatic lions.

Asiatic lions (Panthera leo persica), whose only natural habitat in the world is the Gir forest sanctuary of Gujarat State in India, are highly endangered and are considered to be highly inbred with narrow genetic diversity. An objective assessment of genetic diversity in their immune loci will help in assessing their survivability and may provide vital clues in designing strategies for their scientific management and conservation. We analyzed the comparative sequence polymorphism at exon 2 and exon 3 of major histocompatibility complex (MHC) class I in three groups of lions, i.e. wild Asiatic (from Gir forest), captive-bred Asiatic (from zoological parks in India), and Afro-Asiatic hybrid groups (from zoological parks in India) through polymorphism chain reaction-assisted sequence-based typing. The two exons were amplified, cloned, sequenced, and analyzed for polymorphism at nucleotide and putative translated product level. The analysis revealed extensive sequence polymorphism not only between clones derived from different lions but also the clones derived from a single lion. Furthermore, the wild Asiatic lions of Gir forest exhibited abundant sequence polymorphism at MHC class I comparable with that of Afro-Asiatic hybrid lions and significantly higher than that of captive-bred Asiatic lions. We hypothesize that Asiatic lions of Gir forest are not highly inbred as thought earlier and they possess abundant sequence polymorphism at MHC class I loci. During this study, 52 new sequences of the multigene MHC class I family were also identified among Asiatic lions.

Evaluation of potentiating effect of a drop of lignocaine on tropicamide-induced mydriasis.

PURPOSE: To analyze whether preinstillation of lignocaine potentiates mydriasis by tropicamide in dark eyes and to determine possible mechanisms for this effect. METHODS: This investigation was conducted in two phases, the first being a double-masked, placebo-controlled, randomized clinical trial, enrolling 60 healthy dark brown eyes in 30 subjects aged 7 to 58 years. The control eye received a drop of (nonlignocaine) placebo before tropicamide 1%, and the contralateral study eye received a 4% lignocaine drop 3-minutes before the 1 drop of tropicamide was administered. A ruled pupillometer recorded pupil diameters every 10 minutes for 50 minutes. In phase II, to elucidate pathomechanisms after lignocaine, corneal and tear parameters were compared with baseline records in a further 60 such eyes. RESULTS: Pupillary diameters in the study eyes increased by 3.62 +/- 0.75 mm, significantly more than in the placebo (control) group (P = 0.000). Ninety percent of study eyes attained the clinically significant 6-mm size with preinstillation of lignocaine-many more than the 67% of control eyes (P = 0.016). The median time to achieve this critical 6-mm size was significantly faster in the study group (P = 0.005). In phase II, the 1 drop 4% lignocaine did not show corneal changes with slit lamp or fluorescein staining and did not reduce media clarity or induce a significant change in tear pH. It markedly decreased Schirmer values (P = 0.000), reduced tear break-up time (P = 0.003), and increased corneal thickness measured by optical pachymetry (P = 0.010). CONCLUSIONS: The phase II findings indicate corneal microepithelial damage and reduced tearing. Both may enhance intraocular penetration and hence potentiation of tropicamide. This remarkable phenomenon could find use with many other important topical medications.

Dermatologic surgery: pulsed erbium:YAG laser-assisted autologous epidermal punch grafting in vitiligo.

BACKGROUND: A pilot study was conducted to evaluate the efficacy and safety of pulsed erbium:YAG laser ablation of autologous minipunch grafted sites for the treatment of refractory or stable vitiligo. METHODS: Thirteen patients, seven men and six women, aged between 19 and 58 years, with Fitzpatrick skin types ranging from type IV to VI, were grafted. The pulsed erbium: YAG laser was used to create recipient graft sites. RESULTS: Repigmentation was observed in 12 out of 13 patients. Failure of grafts to repigment ranged from 3% to 100%. No untoward side-effects of surgery were noted. CONCLUSIONS: Using an erbium:YAG laser to create graft recipient sites permits the survival of punch harvested grafts and the spread of pigmentation to the surrounding skin.

Inhibition of glutathione synthesis as a chemotherapeutic strategy for leishmaniasis.

This study focuses on the use of buthionine sulphoximine (BSO), a gamma-glutamylcysteine synthetase inhibitor, on Leishmania donovani growth. The effect of BSO on amastigote multiplication within macrophages showed that 5 mM BSO decreased infectivity by about 50% and the mean number of amastigotes per 100 infected macrophages by 21%. The mechanism may be that BSO resulted in enhanced nitric oxide (NO) levels within macrophages, probably due to inhibition of GSH content since GSH (10 mm) given after BSO treatment led to a decrease in NO compared to macrophages treated with BSO alone which were preexposed to the Leishmania surface molecule lipophosphoglycan.

Suction blister grafting for stable vitiligo using pulsed erbium:YAG laser ablation for recipient site.

BACKGROUND: Suction blister grafting was performed via a modified simple technique using a 20-mL syringe to create the donor graft and pulsed erbium:YAG laser ablation of the recipient site. METHODS: Two patients with stable vitiligo and one with postinflammatory depigmentation were studied. RESULTS: The grafts took well in all three patients and pigmentation was retained at 20 weeks. No complications occurred. CONCLUSIONS: The erbium:YAG laser is an ideal tool for creating graft recipient sites, given its precision in terms of width and depth of ablation. A 20-mL syringe can be used to create a blister of adequate size.

Focal cortical-subcortical calcifications (FCSCs) and epilepsy in the Indian subcontinent.

PURPOSE: A focal cortical-subcortical calcification (FCSC) is a common finding on computed tomography (CT) in individuals with focal or generalized seizures in the Indian subcontinent. We sought to determine the relation of FCSCs to epilepsy by comparing the lobe of seizure origin by electroclinical and CT evaluations and to study the nature and severity of epilepsy associated with FCSCs. METHODS: The relation of these FCSCs to epilepsy/seizures was studied in 40 patients, seen for the first time to the neurology outpatient department of a tertiary care hospital. An attempt was made to classify seizures and determine their lobe of origin based on clinical-electroencephalographic (EEG) criteria of the International League Against Epilepsy (ILAE). The clinical lobe of origin was compared with the location of the FCSC on CT scan. In addition, records of the CT unit of the same hospital were reviewed retrospecitvely, to identify cases with an FCSC and their referral diagnoses. RESULTS: Thirty-one (77.5%) patients with FCSCs were considered to have localization-related epilepsy (frontal lobe epilepsy, 20; temporal lobe epilepsy, three; parietal lobe epilepsy, one; occipital lobe epilepsy, three; and definitely localization related but having ambiguous localization features, four) based on ictal semiology and EEG studies. Other ILAE categories in the cohort included epilepsy without unequivocal focal or generalized features (four patients; 10%), isolated seizures (one patient; 2.5%), juvenile absence epilepsy (one patient; 2.5%), and insufficient data to classify epilepsy (three patients; 7.5%). Radiologic sites for FCSCs included frontal (20; 50%), temporal (six; 15%), parietal (seven; 17.5%), and occipital (seven; 17.5%). Electroclinical and radiologic data were congruent in localizing and lateralizing seizures in 22 (55%) patients. The FCSC was truly incidental in one patient with juvenile absence epilepsy. Discordance between the clinical and radiologic localizations was noted in five (12.5%) instances. Magnetic resonance imaging (MRI) did not reveal additional lesions corresponding to lobes of origin as determined by electroclinical analysis. Discordance was surmised to be a result of seizure spread from a silent region to symptomatic cortex. In 12 (30%) patients, electroclinical and radiologic congruence could not be ascertained because ictal descriptions were either inadequate or ambiguous, and EEG findings were noncontributory. Review of 4,452 CT scans of brain performed in the CT unit revealed 29 (0.65%) cases with FCSCs in individuals with nonseizure disorders, that could be labeled as incidental. CONCLUSIONS: An FCSC is an important radiologic finding in localization-related epilepsy in the Indian subcontinent. The severity of epilepsy ranges from asymptomatic cases to daily seizures.

Evaluation of topical 0.03% flurbiprofen drops in the treatment of herpetic stromal keratitis.

PURPOSE: The management protocol for herpetic stromal keratitis (HSK) is still controversial. We have attempted to compare the relative efficacy of topical dexamethasone 0.01% and flurbiprofen 0.03% in combination with topical acyclovir 3% in HSK. METHODS: In this institutional, prospective, randomized, controlled, double-blind study, 45 clinically diagnosed cases of HSK were randomly distributed into three coded treatment groups--topical placebo, dexamethasone 0.01%, and flurbiprofen 0.03% each in tapering frequency and in combination with acyclovir 3% ointment five times per day for four weeks. Therapeutic response was assessed every third day for four weeks. Decoding of the treatment groups was done at the conclusion of the study and data analysed. RESULTS: Four-week success rate was 93.3% (14 of 15) in the dexamethasone-acyclovir treatment group, 66.7% (10 of 15) in the flurbiprofen-acyclovir treatment group and 20% (3 of 15) in the placebo-acyclovir treatment group. CONCLUSION: While dexamethasone in combination with acyclovir gives the best results in HSK with minimal side-effects, the role of topical flurbiprofen seems promising.

Postoperative intraocular pressure changes with use of different viscoelastics.

Sixty eyes with age-related cataract underwent extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC-IOL) implantation under similar conditions using hydroxypropyl methylcellulose (HPMC) (Oculose) (n = 20), sodium hyaluronate (Healon) (n = 20), or hyaluronic acid (IAL) (n = 20) as the viscoelastic (VE). Postoperative evaluation was performed for intraocular pressure (IOP), corneal thickness, and anterior chamber reaction at 6, 24, 48, 72 hours, and 10 days. Statistically-significant rises in IOP with IAL and Healon were observed at 6 and 24 hours; no such rises were observed with Oculose (P < .05). Seven eyes in the IAL group and six in the Healon group had IOPs greater than 22 mm Hg at 6 hours (range: 22 to 38 mm Hg and 22 to 28 mm Hg, respectively). A significant increase in average corneal thickness was observed in all of the 60 patients at 6 hours (18.5%). The average thickness decreased to 6.8% by day 10, with no intergroup variations. There were significantly fewer anterior chamber cells at 6 hours in the Healon group. We conclude that all three viscoelastics are equally useful for routine ECCE with PC-IOL implantation. However, IAL and Healon do cause an early postoperative IOP increase, which, though transient, should be treated.

Hyperplastic pupillary membrane and laser therapy.

The eyes in two cases of extensive hyperplastic pupillary membranes with significant reduction of visual acuity and clarity were subjected to sectioning of the membranes in the superior 270 degrees of the pupil using a Q-switched Nd:YAG laser. The complications of microhemorrhages, pigment dispersal, and elevation of intraocular pressure were insignificant, while the objective and subjective improvement in vision was remarkable.

Comparative efficacy of diclofenac and flurbiprofen for maintenance of pupillary dilatation during cataract surgery.

A double-blind, prospective, randomized clinical study was undertaken to evaluate the relative efficacy of flurbiprofen 0.03% and diclofenac 0.1% eye drops, in combination with routinely used mydriatics, in maintaining pupillary dilatation during extracapsular cataract surgery with intraocular lens implantation. The effectiveness of administering systemic flurbiprofen along with the topical drugs in enhancing maintenance of pupillary dilatation also was assessed. Pupillary diameter, as measured at various surgical stages, was significantly greater in the patients receiving diclofenac or flurbiprofen eye drops as compared with those in a control group who did not (P < .001). While the maintenance of pupillary dilatation was consistently better with diclofenac than with flurbiprofen, the difference was not statistically significant. Furthermore, though maintenance of pupillary dilatation was better in cases in which systemic flurbiprofen was added to the preoperative drug regime, again, the difference was not significant.