Periarticular calcifications.

Periarticular calcification and ossification is a frequent finding on imaging and may sometimes pose a diagnostic challenge. The differential diagnoses for this radiological finding are wide and can be classified into broad groups such as idiopathic, developmental, trauma, burns, infection, tumor, connective tissue disease, crystalline, metabolic, vascular, and foreign bodies. With careful consideration of the clinical and imaging findings as well as awareness of mimickers of periarticular mineralization, the list of differential diagnoses can be narrowed down. This article aims to review the clinical-radiologic findings of periarticular calcified or ossified lesions with relevant imaging illustrations.

Investigating potential roles of extruded flaxseed and α-tocopherol acetate supplementation for production of healthier broiler meat.

The present study was conducted to evaluate the role of extruded flaxseed (EFS) and α-tocopherol acetate (ATA) for the enhancement of polyunsaturated fatty acids ratio (PUFA) over saturated fatty acids (SFA) in broiler meat as a source of healthier meat. A total of 96 one-d-old Cobb 550 broilers were randomly divided into 8 treatments with three replicates having 4 birds in each. EFS (extruded at 155°C) at 100, 150 and 200 g/kg alone and in combination with ATA at 200 mg/kg were supplemented through normal feed from the third week onward. During the 6-week growth period, body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR) and mortality were recorded. At slaughter, weight of liver, heart and kidney and fat content in breast and leg meat were measured. Fatty acid profiles in breast and leg meat were developed to estimate the PUFA to SFA ratio. The results revealed that FI and FCR changed significantly in all groups and BWG increased in all the supplemented groups. The weight of liver, kidney and heart increased more in the supplemented group containing the maximum level of EFS with ATA compared with single supplementation of EFS. The fat content in breast and leg meat decreased as the inclusion level of EFS increased. The level was low in leg meat compared with breast meat. Mortality decreased in all supplemented groups. The PUFA to SFA ratio was significantly higher in leg meat (3.23) compared with breast meat (1.81) and the study therefore indicates that ATA and EFS supplementation could be used to improve the PUFA to SFA ratio in broiler meat.

A novel photosynthesis of carboxymethyl starch-stabilized silver nanoparticles.

The water soluble photoinitiator (PI) 4-(trimethyl ammonium methyl) benzophenone chloride is used for the first time in the synthesis of silver nanoparticles (AgNPs). A new green synthesis method involves using PI/UV system, carboxymethyl starch (CMS), silver nitrate, and water. A mechanism of the reduction of silver ions to AgNPs by PI/UV system as well as by the newly born aldehydic groups was proposed. The synthesis process was assessed by UV-vis spectra and TEM of AgNPs colloidal solution. The highest absorbance was obtained using CMS, PI and AgNO3 concentrations of 10 g/L, 1 g/L, and 1 g/L, respectively; 40 °C; 60 min; pH 7; and a material : liquor ratio 1 : 20. AgNPs so-obtained were stable in aqueous solution over a period of three weeks at room temperature (~25 °C) and have round shape morphology. The sizes of synthesized AgNPs were in the range of 1-21 nm and the highest counts % of these particles were for particles of 6-10 and 1-3 nm, respectively.

Population-based survey of the prevalence and types of glaucoma in Bangladesh.

BACKGROUND: To delineate the epidemiological landscape of glaucoma using a population-based sample representative of Bangladesh. METHODS: Using multistage stratified cluster random sampling, households were selected to identify individuals ≥35 years across all 8 divisions of Bangladesh. Sampling frames were derived from the 2011 national census. Fifty-eight study examination sites were set up for comprehensive eye evaluations, including intraocular pressure, gonioscopy and visual field testing when indicated. International Society for Geographic and Epidemiological Ophthalmology definitions were used to define glaucoma and glaucoma suspect cases. RESULTS: One hundred forty clusters (89 rural and 51 urban) were randomly selected, and 13 791 residential households were visited. We invited 17 002 individuals ≥35 years for on-site examination, of which 12 000 (71%) complied, with a male-to-female ratio of 1:1. The prevalence of glaucoma was 3.2% (95% CI 2.79% to 3.64%), and glaucoma suspect was 10.1% (95% CI 9.05% to 11.12%). The majority (78%) had primary open-angle glaucoma (POAG), while angle closure was seen in 16%. Of the POAG, 83% (n=251) were normal-tension glaucoma. Multivariable logistic regression showed increasing age (OR=1.01 for every 5-year increment, 95% CI 1 to 1.01) and male gender (OR=1.43, 95% CI 1.15 to 1.77) to be associated with an increased risk of glaucoma. CONCLUSIONS: The prevalence of glaucoma in Bangladesh is 3.2% in ≥35-year-old individuals with older men most at risk. Extrapolating the results, we estimate about 2 million patients with glaucoma. Though normal-tension variety was the most common type, caution should be exercised in generalising these results to other populations.

Hepatitis B surface antigen carrier rate in unvaccinated and vaccinated children with thalassaemia major at Bahawal Victoria Hospital, Bahawalpur, Pakistan.

Screening of blood reduces but does not eliminate the risk of hepatitis B virus (HBV) infection in multi-transfused thalassaemia patients. This study was done to evaluate efficacy of HBV vaccination on hepatitis B virus surface antigen (HBsAg) carrier rate in children with thalassaemia major receiving multiple blood transfusions. In a cohort study conducted at a hospital in Bahawalpur, Pakistan, during 2009-10, children with thalassaemia major aged < 60 months who received more than 24 blood transfusions and were HBsAg negative at the time of first blood transfusion were included. Of 196 unvaccinated children, the seropositive rate was 12.2%; while among 218 children vaccinated during the first year of life via the Pakistan Expanded Programme on Immunization, the seropositive rate was only 0.9%. The HBV vaccine was highly effective in reducing the HBsAg carrier rate in hildren with thalassaemia aged < 5 years.

SSR and RAPD analysis of genetic diversity in walnut (Juglans regia L.) genotypes from Jammu and Kashmir, India.

In this study, the genetic relatedness of 82 walnut genotypes adapted to the North Western Himalayan region of Jammu and Kashmir, India was analyzed by combination of 13 SSR and 20 RAPD primers. A high level of genetic diversity was observed within populations with the number of alleles per locus ranging from one to five in case of SSR primers and two to six in case of RAPD primers, the proportion of polymorphic loci was 100 %, and similarity ranged from 12 % to 79 % with an average of 49 %. Dendrogram showed that all the accessions formed four main clusters with various degree of sub-clustering within the clusters. These results have implications for walnut breeding and conservation.

Development of a wearable belt with integrated sensors for measuring multiple physiological parameters related to heart failure.

Heart failure is a chronic disease, the symptoms of which occur due to a lack of cardiac output. It can be better managed with continuous and real time monitoring. Some efforts have been made in the past for the management of heart failure. Most of these efforts were based on a single parameter for example thoracic impedance or heart rate alone. Herein, we report a wearable device that can provide monitoring of multiple physiological parameters related to heart failure. It is based on the sensing of multiple parameters simultaneously including thoracic impedance, heart rate, electrocardiogram and motion activity. These parameters are measured using different sensors which are embedded in a wearable belt for their continuous and real time monitoring. The healthcare wearable device has been tested in different conditions including sitting, standing, laying, and walking. Results demonstrate that the reported wearable device keeps track of the aforementioned parameters in all conditions.

Outcome of trabeculectomy versus Ahmed glaucoma valve implantation in the surgical management of glaucoma in patients with Sturge-Weber syndrome.

AIMS: To compare the surgical outcomes of trabeculectomy versus Ahmed glaucoma valve (AGV) implantation in the surgical management of glaucoma in patients with Sturge-Weber syndrome (SWS). METHODS: A retrospective chart review was performed on 40 eyes of secondary glaucoma in patients with SWS separated into two groups: AGV (N=20) and trabeculectomy with mitomycin C (N=20). Demographic data, intraocular pressure (IOP), visual acuity and the number anti-glaucoma medications (AGM) needed were evaluated prior to and following surgery. Surgical success was defined as an IOP of ≤21 mm Hg, with or without the use of topical AGM. Complete success was achieved when IOP values were obtained without AGM. RESULTS: Mean follow-up duration was 23.15±2.36 months and 22.95±2.87 months in the AGV and trabeculectomy groups, respectively (p=0.811). Both the AGV (34.50±4.65 mm Hg at baseline to 15.20±3.31 mm Hg at last visit) and trabeculectomy (32.10±5.86 mm Hg to 16.10±3.02 mm Hg) groups achieved a statistically significant fall in IOP following surgery (p=0.000). Kaplan-Meier survival of complete success after 24 months was 80% and 70% after AGV implant and trabeculectomy, respectively, but the difference between two groups was not statistically significant (p=0.442). CONCLUSIONS: Both AGV implant and trabeculectomy appear to be safe and efficacious in controlling glaucoma secondary to SWS, although the potential for serious complications such as choroidal detachment must be anticipated when planning surgeries in patient with SWS, and the authors recommend the maintenance of a stable IOP during and following the surgery to avoid such complications.

Tubewell water quality and predictors of contamination in three flood-prone areas in Bangladesh.

AIMS: To measure enteric bacterial contamination of tubewells in three flood prone areas in Bangladesh and the relationship of bacteriological contamination with tubewell sanitary inspection scores. METHODS AND RESULTS: Microbiologists selected 207 tubewells in three flood prone districts, assessed physical characteristics of the tubewells and collected a single water sample from each tubewell. Tubewell water samples were contaminated with total coliforms (41%, n = 85), thermotolerant coliforms (29%, n = 60) and Escherichia coli (13%, n = 27). Among contaminated wells, the median CFU of contamination per 100 ml was 8 (interquartile range, 2-30) total coliforms, 5 (interquartile range, 2-23) thermotolerant coliforms and 6 (interquartile range, 1-30) E. coli. There was no significant association between tubewell contamination with E. coli, thermotolerant coliforms or total coliforms and a poor sanitary inspection score, though a history of inundation was associated with contamination with both E. coli and thermotolerant coliforms. CONCLUSIONS: Tubewells in flood-prone regions of Bangladesh were commonly contaminated with low levels of faecal organisms, contamination that could not be predicted by examining the tubewell's external characteristics. SIGNIFICANCE AND IMPACT OF THE STUDY: The forms currently used for sanitary inspection do not identify the most important causes of drinking water contamination in these communities.

Usefulness of the hydrogen sulfide test for assessment of water quality in Bangladesh.

AIM: To evaluate the usefulness of the hydrogen sulfide (H(2)S) test for assessing water quality in Bangladesh. METHODS AND RESULTS: We tested 382 water samples from a variety of sources using locally produced H(2)S test kits and laboratory-based membrane filtration for the detection of Escherichia coli. Compared with membrane filtration, H(2)S tests, when incubated for 24 h, had both a sensitivity and positive predictive value (PPV) of <40% when analysis was restricted to water samples with E. coli levels below 100 colony forming units (CFU) per 100 ml. In contrast, for E. coli levels from 1000 to 9999 CFU per 100 ml, sensitivity was 94% and PPV 88%; specificity was 97% and negative predictive value was 99%. CONCLUSIONS: The hydrogen sulfide test, when incubated at 24 h, is a promising alternative for assessing water quality where E. coli levels may be high. An improved understanding of the incremental impact of contamination level on health is needed to better determine its usefulness. SIGNIFICANCE AND IMPACT OF THE STUDY: The hydrogen sulfide test is inexpensive, easy to use and portable. Its use may allow rapid assessment of water quality in situations where cost or logistics prevent use of other testing methods, such as in remote areas or during flood and other natural disasters.

Health of people working/living in the vicinity of an oil-polluted beach near Karachi, Pakistan.

A short-term study was conducted after the oil spillage from the tanker Tasman Spirit to analyse seawater and sand samples taken from Karachi beach for hydrocarbon/organic contents. Blood samples were collected from people who were working or living in the vicinity of the beach. Lymphocyte and eosinophil levels were slightly increased. About 11 people had raised serum glutamic pyruvic transaminase, but this was not significant. Such steps are vital to ensure that there are no long-term hazardous effects of oil on human health.

Gene silencing and homology-dependent gene silencing in Arabidopsis: genetic modifiers and DNA methylation.

Transgenes inserted into the plant genome can become inactive (gene silencing) or result in silencing of homologous cellular genes [homology-dependent gene silencing (HDG silencing)]. In an earlier study we reported HDG silencing of chalcone synthase (CHS) in Arabidopsis. This study concerns genetic revertants of one of the CHS HDG-silencing transgenic homozygotes. Two monogenic recessive trans-acting mutations (hog1 and ddm1) that impair gene silencing and HDG silencing were identified. These mutations reduce genomic DNA methylation and affect the quantity and size of CHS mRNA. These results imply that DNA methylation is necessary for both gene silencing and HDG silencing. Two further monogenic, trans-acting, recessive mutations (sil1 and sil2) reduce gene silencing but not HDG silencing. The existence of this mutant class shows that gene silencing involves genes that are not necessary for HDG silencing. A further mutant (Catt) was isolated and has an attenuated HDG-silencing T-DNA.

Synthesis, characterization, release kinetics and toxicity profile of drug-loaded starch nanoparticles.

The current research work focuses on the medical application of the cost-effective cross-linked starch nanoparticles, for the transdermal delivery using Diclofenac sodium (DS) as a model drug. The prepared DS-cross-linked starch nanoparticles were synthesized using nanoprecipitation technique at different concentrations of sodium tripolyphosphate (STPP) in the presence of Tween 80 as a surfactant. The resultant cross-linked starch nanoparticles loaded with DS were characterized using world-class facilities such as TEM, DLS, FT-IR, XRD, and DSc. The efficiency of DS loading was also evaluated via entrapment efficiency as well as in vitro release and histopathological study on rat skin. The optimum nanoparticles formulation selected by the JMP(®) software was the formula that composed of 5% maize starch, 57.7mg DS and 0.5% STPP and 0.4% Tween 80, with particle diameter of about 21.04nm, polydispersity index of 0.2 and zeta potential of -35.3mV. It is also worth noting that this selected formula shows an average entrapment efficiency of 95.01 and sustained DS release up to 6h. The histophathological studies using the best formula on rat skin advocate the use of designed transdermal DS loaded cross-linked starch nanoparticles as it is safe and non-irritant to rat skin. The overall results indicate that, the starch nanoparticles could be considered as a good carrier for DS drug regarding the enhancement in its controlled release and successful permeation, thus, offering a promising nanoparticulate system for the transdermal delivery non-steroidal anti-inflammatory drug (NSAID).

Study of potassium citrate treatment of crystalluric nephrolithiasis.

Patients with crystalluric nephrolithiasis were treated orally with aqueous potassium citrate solution three times a day with a large quantity of water. After administration of potassium citrate, citric acid (P < 0.001) and potassium (P < 0.001) excretion was significantly increased. Increase in protein (P < 0.05) and uric acid (P < 0.05) excretion in urine revealed their association with the crystallization process. Crystals were absent in 12 (71%) out of 17 patients. Calcium excretion in urine was significantly decreased (P < 0.05). A decrease of calcium ions availability to oxalate ions to form calcium oxalate crystals may result in the prevention of calcium oxalate stone formation.

Pharmacokinetics of gentamicin in rabbits pretreated with nonsteroidal anti-inflammatory drugs: an interaction study.

Interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and other drugs occurs relatively frequently because of the wide use of NSAIDs. Such interactions with drugs of narrow therapeutic index used in serious disease states may lead to toxicity. Gentamicin toxicity is based on its concentration in serum, and any alteration in pharmacokinetic parameters may lead to gentamicin accumulation in the body and subsequently to severe nephrotoxicity and ototoxicity. To test this hypothesis, the effect of pretreatment with NSAIDs on gentamicin pharmacokinetics was examined in rabbit. Gentamicin sulfate (5 mg/kg) was administered to rabbits pretreated with aspirin (300 mg/kg), ketorolac tromethamine (3 mg/kg), ibuprofen (20 mg/kg), and piroxicam (2 mg/kg) twice a day for 1 week. The pretreatment with NSAIDs had significant effects on the body clearance and maximum concentration. Aspirin, piroxicam and ketorolac tromethamine pretreatment had significant effects on the area under the curve of gentamicin versus time. Aspirin and ketorolac tromethamine pretreatment had significant effects on the half-life of gentamicin. Aspirin had a significant effect on the volume of distribution of gentamicin. These results suggest that pretreatment with NSAIDs alters the pharmacokinetics of gentamicin and leads to accumulation inside the body, which could result in toxicity.

Hypercoagulable syndromes: evaluation and management strategies for acute limb ischemia.

Acute limb ischemia secondary to peripheral arterial thrombosis is a relatively uncommon but ominous form of vascular accident. Select inherited and acquired hypercoagulable states appear to contribute to an initial arterial thrombosis and, more importantly, recurrent thrombotic events. Mounting interest in hypercoagulability, the increased availability of hypercoagulable state "profiles," and enhanced ability to identify an abnormality in tested patients have promoted widespread testing. Unfortunately, widespread testing has had a limited beneficial impact on the management of acute limb ischemia. Ideally, costly and specialized testing should be limited to situations in which the results will have a tangible impact on patient care. Clear goals of testing should be determined before testing is performed. This article addresses a practical approach to hypercoagulable state testing in patients with acute limb ischemia with a focus on abnormalities that impact patient management.

A modified enzyme-linked immunosorbent assay for the detection of avian pneumovirus antibodies.

Avian pneumovirus (APV) infection of turkeys in Minnesota was first confirmed in March 1997. Serum samples (n = 5,194) from 539 submissions to Minnesota Veterinary Diagnostic Laboratory were tested by a modified enzyme-linked immunosorbent assay (ELISA). Of these, 2,528 (48.7%) samples from 269 submissions were positive and 2,666 (51.3%) samples from 270 submissions were negative for APV antibodies. Most positive samples were from Kandiyohi, Stearns, Morrison, and Meeker counties in Minnesota. In addition, 10 samples from South Dakota were positive. The sensitivity and specificity of the ELISA test with anti-chicken and anti-turkey conjugates were compared by testing field and experimental sera. The ELISA test with anti-turkey conjugate was more sensitive than that with anti-chicken conjugate. The ELISA tests with antigens prepared with APV strains isolated from Colorado and Minnesota were also compared. No difference was detectable. Currently, the Minnesota Veterinary Diagnostic Laboratory uses an antigen prepared from the Colorado isolate of APV and a goat anti-turkey conjugate in the ELISA test.

Congenital H-type anourethral fistula with severe urethral hypoplasia: case report and review of the literature.

Congenital H-type anourethral fistula with severe urethral hypoplasia and normal anus is an extremely rare variant of anorectal malformations among boys. The authors report a case of a 5-year-old boy who underwent successful management of severe urethral hypoplasia with progressive augmentation by dilating urethra anterior gently and achieving a functionally normal urethra with minimal morbidity. H-type anourethral fistula was excised subsequently through anterior perianal approach.

Treatment of chronic hepatitis C genotype 4 with alpha-interferon in Saudi Arabia: a multicenter study.

BACKGROUND/AIM: Several studies have indicated that there are certain predictive factors (gender, duration of infection with HCV, cirrhosis and genotype of HCV) of a better response with alpha-interferon treatment in patients with chronic hepatitis C. The aim of this study was to evaluate these factors in Saudis and other Arab nationals with chronic hepatitis C-genotype 4-undergoing alpha-interferon treatment. METHODOLOGY: A multicenter study was conducted between 1992 and 1994 on 80 consecutive patients who were prospectively recruited and randomized in treatment and control groups. RESULTS: The results of this multicenter study indicated a low response rate to alpha-interferon with an overall response rate of 43%, of which 28% was complete. The sustained response was only 16%. Among the reasons for this low response in our study are the high percentage of patients with cirrhosis and the long infection interval, as about 80% of our HCV cases were community-acquired. CONCLUSION: Liver cirrhosis was found to be the main predetermining factor for response to interferon treatment. Genotype 4 was not a contributing factor to the difference in response rate.

Reproductive hormone profiles in regularly menstruating Sudanese women.

Venous blood samples were taken daily from 21 regularly menstruating Sudanese women throughout one complete menstrual cycle. FSH, LH, estradiol-17 beta and progesterone were assayed in all plasma samples and normal reference ranges were thus established. Fifteen subjects had a luteal phase of more than 12 days whilst in 3 subjects it was shorter. Two subjects were found to be hyperprolactinemic and one had an anovulatory cycle with an elevated LH. The plasma concentrations of estradiol-17 beta in the follicular phase and progesterone in the luteal phase were significantly lower in subjects with short luteal phase than in those with a luteal phase of more than 12 days. The hormonal profile of FSH, LH, estradiol-17 beta and progesterone throughout a normal menstrual cycle in regularly menstruating Sudanese women was similar to what has been reported in the literature for other ethnic groups.