Alzheimer disease (AD) is the most common cause of dementia worldwide. Its clinical manifestations include a progressive loss of memory and other cognitive domains, as well as brain atrophy. An elevated homocysteine level (>15 µmol/L), known as hyperhomocysteinemia, is also an attributing risk factor for AD, vascular pathologies, and brain atrophy. Neuroimaging studies including T2-weighted magnetic resonance imaging scans revealed white matter hyperintensities in the periventricular and deep white matter, enlarged ventricles, widened sulci, and decreased white matter mass, which are features of aging, as well as cerebrovascular changes. This case series investigated changes in biochemical marker levels including serum homocysteine, folate, and vitamin B12, and the degree of atrophic variations in cortical-subcortical white matter in AD. The present study hypothesized that serum homocysteine levels might be used as a surrogate marker to screen for AD at an earlier stage.

Aims: The increased importance of biosurfactant in the recent past is mainly due to their applications in various industries ranging from petroleum to pharmaceuticals. Their biodegradability and environmental compatibility with low toxicity makes it even more interesting. Microbial production of biosurfactant is found to be a viable option as they are diverse, eco-friendly, facilitate large scale production, able to perform under extreme conditions etc. One class of microbes that is endophytes are known to show great potential in producing different varieties of medically and industrially significant biological compounds. The present study focuses on the screening and production of biosurfactant from endophytic bacteria. Methodology and results: Of all the isolates tested, one endophyte identified as Bacillus cereus HM998898 was found to produce maximum biosurfactant. Statistical method Plackett burman was used to optimize the media for the maximum production and the ideal composition was found to be KNO3 (1 g/L), Gingley oil (2 mL), K2HPO4 (2.5 g/L), KH2PO4 (0.75 g/L), MgSO4·5H2O (0.5 g/L), FeSO4.7H2O (0.005 g/L) and NaCl (0.025 g/L). The extracted biosurfactant was characterized and was identified to be glycolipid. This was further tested for biocompatibility against Fibroblast (3T3) cells and was evaluated for their anti tumor activity against Hep2 cells. Conclusion, significance and impact of study The biosurfactant produced was found to induce toxicity to cancer cells at appreciable levels while they remained non-toxic to normal cells supporting the possible applications of biosurfactant in medical field.

This is the first Indian case report of a biopsy proven temporal arteritis that presented as acute ischemic stroke. The 60 year old woman presented with an isolated pure motor flaccid fractional weakness of the left distal hand, as a rare stroke chameleon due to isolated infarction of the ‘hand motor cortex’ area. The hand motor cortex infarction masquerades as ‘pseudoperipheral palsy’.

OBJECTIVE: A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS: We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS: Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION: Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.
Biological Psychiatry* ; Curriculum* ; Evidence-Based Practice* ; Learning* ; Neurobiology* ; Patient Care ; Problem-Based Learning ; Psychiatry ; Psychopharmacology* ; Teaching

Tissue fibrosis, characterized by excessive accumulation of aberrant extracellular matrix (ECM) produced by myofibroblasts, is a growing cause of mortality worldwide. Understanding the factors that induce myofibroblastic differentiation is paramount to prevent or reverse the fibrogenic process. Integrin-mediated interaction between the ECM and cytoskeleton promotes myofibroblast differentiation. In the present study, we explored the significance of integrin alpha 11 (ITGA11), the integrin alpha subunit that selectively binds to type I collagen during tissue fibrosis in the liver, lungs and kidneys. We showed that ITGA11 was co-localized with α-smooth muscle actin-positive myofibroblasts and was correlatively induced with increasing fibrogenesis in mouse models and human fibrotic organs. Furthermore, transcriptome and protein expression analysis revealed that ITGA11 knockdown in hepatic stellate cells (liver-specific myofibroblasts) markedly reduced transforming growth factor β-induced differentiation and fibrotic parameters. Moreover, ITGA11 knockdown dramatically altered the myofibroblast phenotype, as indicated by the loss of protrusions, attenuated adhesion and migration, and impaired contractility of collagen I matrices. Furthermore, we demonstrated that ITGA11 was regulated by the hedgehog signaling pathway, and inhibition of the hedgehog pathway reduced ITGA11 expression and fibrotic parameters in human hepatic stellate cells in vitro, in liver fibrosis mouse model in vivo and in human liver slices ex vivo. Therefore, we speculated that ITGA11 might be involved in fibrogenic signaling and might act downstream of the hedgehog signaling pathway. These findings highlight the significance of the ITGA11 receptor as a highly promising therapeutic target in organ fibrosis.
Animals ; Collagen ; Collagen Type I ; Cytoskeleton ; Extracellular Matrix ; Fibrosis ; Hedgehogs ; Hepatic Stellate Cells ; Humans ; In Vitro Techniques ; Kidney ; Liver ; Liver Cirrhosis ; Lung ; Mice ; Mortality ; Myofibroblasts* ; Phenotype* ; Transcriptome ; Transforming Growth Factors

Mosquitoes are the vectors of several life threatening diseases like dengue, malaria, Japanese encephalitis and lymphatic filariasis, which are widely present in the north-eastern states of India. Investigations on five local plants of north-east India, selected on the basis of their use by indigenous communities as fish poison, were carried out to study their mosquito larvicidal potential against Anopheles stephensi (malaria vector), Stegomyia aegypti (dengue vector) and Culex quinquefasciatus (lymphatic filariasis vector) mosquitoes. Crude Petroleum ether extracts of the roots of three plants viz. Derris elliptica, Linostoma decandrum and Croton tiglium were found to have remarkable larvicidal activity; D. elliptica extract was the most effective and with LC50 value of 0.307 μg/ml its activity was superior to propoxur, the standard synthetic larvicide. Half-life of larvicidal activity of D. elliptica and L. decandrum extracts ranged from 2-4 days.

We report a case of Ewing's sarcoma of the sacroiliac joint in a 21-year-old male mimicking tubercular sacroiliitis, a rare entity not reported in literature. He presented with pain in the lower back radiating to the right lower limb along with constitutional symptoms of 3 months duration. On examination, the right sacroiliac joint was tender. The laboratory investigations showed anaemia, leukocytosis and raised erythrocyte sedimentation rate. On X-ray, features of right sacroiliitis were seen. This was further investigated with magnetic resonance imaging (MRI), which showed features consistent with tubercular sacroiliitis. Patient was then started on antitubercular treatment, but the improvement was not consistent. So, a contrast MRI was done, which indicated features of primary sarcoma. It was then further confirmed by a computed tomography-guided biopsy, which showed features consistent with Ewing's sarcoma of the sacroiliac joint.
Biopsy ; Blood Sedimentation ; Humans ; Leukocytosis ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Sacroiliac Joint* ; Sacroiliitis* ; Sarcoma ; Sarcoma, Ewing* ; Young Adult

Urachal carcinoma is an uncommon neoplasm. Benign urachal tumours are extremely rare. All urachal mucinous tumours, regardless of tumour type, have the potential to behave in an aggressive clinical manner that includes the development of pseudomyxoma peritonei. We report a 58-year-old man who presented with lower abdominal pain. Ultrasound and CT imaging defined a large lobulated cystic mass superior to the urinary bladder. At laparotomy, the multiloculated cystic mass, 10 x 8 x 6 cm, could be completely separated from the bladder and was excised. It was smooth-walled and filled with thick mucinous fluid. Histology revealed a complex mucinous cystadenoma of undetermined malignant potential of the urachus. The cystic spaces were lined by mucin-secreting columnar epithelium that showed focal areas of mild atypia. The epithelium lacked architectural features of villous adenoma. There was no stromal invasion to support an invasive neoplastic process. No pseudomyxoma peritonei was present. The patient was well, with no tumour recurrence, at 6 months follow-up.

STUDY DESIGN: We performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days. PURPOSE: To assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles. OVERVIEW OF LITERATURE: No head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done. METHODS: The assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score. RESULTS: The improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001). CONCLUSIONS: Tolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.
Colchicine ; Head ; Humans ; Low Back Pain ; Muscle Spasticity ; Muscle, Skeletal ; Muscles ; Spasm ; Spine ; Tolperisone

<p>INTRODUCTIONKnowledge of anatomical variations of the great vessels of the abdomen, including the coeliac trunk, is important for clinicians planning surgical intervention and radiological imaging. The present study aimed to record the prevalence of variations in the vascular pattern of branches of the coeliac trunk in cadavers.p><p>METHODSA total of 50 properly embalmed and formalin-fixed cadavers from the Indian population were selected for the study. Dissection included surgical incision, followed by mobilisation of the anatomical viscera, to observe and record the branching pattern of the coeliac trunk.p><p>RESULTSThe left gastric, common hepatic and splenic arteries were found to arise from the coeliac trunk in 86% of cadavers. In 76% of cadavers, the origin of the gastric artery was proximal to the bifurcation of the coeliac trunk into the common hepatic and splenic arteries. In one case, all three branches arose directly from the abdominal aorta, and the origin of the splenic artery was 1 cm distal to the origin of the left gastric and common hepatic arteries. In another case, the common hepatic and left gastric arteries arose from the coeliac trunk, and the origin of the splenic artery was 1.5 cm distal to the abdominal aorta.p><p>CONCLUSIONVessel ligation and anastomosis are important in surgical procedures like liver transplantation, and background knowledge of the different vascular patterns of branches of the coeliac trunk is vital. The findings of our study could help to minimise complications related to abdominal surgery, including bleeding and necrosis, and facilitate better and more accurate radiological interpretations.p>
Adult ; Aged ; Anastomosis, Surgical ; Aorta, Abdominal ; anatomy & histology ; surgery ; Cadaver ; Celiac Artery ; anatomy & histology ; surgery ; Female ; Hepatic Artery ; anatomy & histology ; surgery ; Humans ; Liver ; blood supply ; surgery ; Liver Transplantation ; methods ; Male ; Middle Aged ; Splenic Artery ; anatomy & histology ; surgery ; Vascular Surgical Procedures ; methods ; Young Adult