Humans ; Pharmaceutical Preparations ; Singapore

Blastocystis sp. subtype 3 (ST3) has been implicated previously to be phenotypically heterogeneous between isolates from symptomatic and asymptomatic persons in previous studies. The aim of this study is to identify the immunogenic and antigenic heterogeneity among three different isolates of Blastocystis sp. ST3 isolated from asymptomatic and symptomatic individuals. Immunogenic and antigenic profile of ST3 isolates was assessed through splenocyte proliferation, cytokine assessment and antibody measurements. The total IgG antibody responses in mice immunised with symptomatic (0.736±0.033) and asymptomatic (0.426±0.025) of ST3 Blastocystis sp. were significantly higher compared to the controls respectively. High secretions of IgG antibody mixture of IgG1/IgG2a antibodies were detected in sera of mice immunised with symptomatic and asymptomatic solubilised Blastocystis sp. Antigen (Blastocystis-Ag). Predominant IgG1 production was detected higher in mice injected with Blastocystis sp. ST 3 from asymptomatic individuals (0.148±0.016) (P<0.05) whereas predominant IgG2a production was detected higher in mice injected with the same subtype but from the symptomatic individuals (0.355±0.021). This data was supported by the production of significantly higher Th1 (IFNγ and IL-2) response (393.56±49.21) and (628.89±31.06) respectively in symptomatic isolates compared to Th2 (IL-4 and IL-10) response (93±7.85) and (103.22±11.33) in asymptomatic isolates after in-vitro stimulations. Splenocyte stimulation index (SI) was detected higher in symptomatic Blastocystis-Ag group. This study is the first to demonstrate antigenic and immunogenic heterogeneity among ST3 symptomatic and asymptomatic Blastocystis-Ag with symptomatic isolates being highly immunogenic and antigenic. No significant variations among the three isolates of asymptomatic and symptomatic groups. The study supports the suggestion from previous study that surface variations between symptomatic and asymptomatic isolates as well their distinct phenotypic variation despite being the same subtype may have caused the differences in the distinct immune responses.

Umbilical cord ulceration is a rare condition presenting with sudden fetal bradycardia due to fetal hemorrhage and in most cases leading to intrauterine death. A strong association with intestinal atresia has been reported. Most cases present after 30 weeks of gestation, with preterm labor or rupture of membranes followed by sudden fetal bradycardia. We report two such cases of umbilical cord ulceration and review the available literature. One of the cases interestingly presented at 26 weeks, much earlier than what is reported in the world literature. In view of high perinatal mortality and morbidity, awareness of this condition is mandatory for timely and appropriate management to improve the fetal outcome.
Bradycardia ; Female ; Hemorrhage ; Intestinal Atresia ; Membranes ; Obstetric Labor, Premature ; Perinatal Mortality ; Pregnancy ; Rupture ; Ulcer* ; Umbilical Cord*

Umbilical cord ulceration is a rare condition presenting with sudden fetal bradycardia due to fetal hemorrhage and in most cases leading to intrauterine death. A strong association with intestinal atresia has been reported. Most cases present after 30 weeks of gestation, with preterm labor or rupture of membranes followed by sudden fetal bradycardia. We report two such cases of umbilical cord ulceration and review the available literature. One of the cases interestingly presented at 26 weeks, much earlier than what is reported in the world literature. In view of high perinatal mortality and morbidity, awareness of this condition is mandatory for timely and appropriate management to improve the fetal outcome.
Bradycardia ; Female ; Hemorrhage ; Intestinal Atresia ; Membranes ; Obstetric Labor, Premature ; Perinatal Mortality ; Pregnancy ; Rupture ; Ulcer* ; Umbilical Cord*

BACKGROUND: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. METHODS: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. RESULTS: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. CONCLUSIONS: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.
Arthroplasty ; Humans ; Injections, Epidural* ; Lower Extremity ; Radiculopathy ; Sacroiliac Joint ; Treatment Failure ; Zygapophyseal Joint

Additional heads of the biceps brachii muscle of arm have the clinical importance, because they mislead the surgeon in arm surgical procedures. Existence of such variation is one of the reasons for neurovascular compression in the arm region. The present study was conducted to find out the incidence of third head of biceps brachii among 80 samples in South Indian population. The third head of biceps brachii was found in right side in one case which was 13.7 cm in length and arising from antero medial wall of lower part of shaft of humerus. Incidence of the study is 1.25% in South Indians. Occurrence of supernumerary third head of biceps is rare in Indian population.

Fifty three fungi isolated from soils of different microhabitats of eastern Himalayan range (3,400~3,600 msl) were screened for mycosynthesis of silver nanaoparticles (AgNPs) and their efficacy as antimicrobials were assessed in combination with commonly used antibiotics. Three isolates Aspergillus terreus SP5, Paecilomyces lilacinus SF1 and Fusarium sp. MP5 identified based on morphological and 18S rRNA gene sequences were found to synthesize AgNPs. These nanoparticles were characterized by visual observation followed by UV-visible spectrophotometric analysis. The AgNPs synthesized by Aspergillus terreus SP5, Paecilomyces lilacinus SF1 and Fusarium sp. MP5 showed absorbance maxima at 412, 419, and 421 nm respectively in the visible region. Transmission electron microscopy micrograph showed formation of spherical AgNPs of 5~50 nm size. The antimicrobial activity of the mycosynthesized nanoparticles were investigated alone and in combination with commonly used antibiotics for analysis of growth inhibition zone against test organisms, namely, Staphylococcus aureus MTCC96, Streptococcus pyogenes MTCC1925, Salmonella enterica MTCC735 and Enterococcus faecalis MTCC2729. The mycosynthesized nanoparticles showed potent antibacterial activity and interestingly their syngergistic effect with erythromycin, methicillin, chloramphenicol and ciprofloxacin was significantly higher as compared to inhibitions by AgNPs alone. The present study indicates that silver nanoparticles synthesized using soil borne indigenous fungus of high altitudes show considerable antimicrobial activity, deserving further investigation for potential applications.
Altitude ; Anti-Bacterial Agents ; Aspergillus ; Chloramphenicol ; Ciprofloxacin ; Enterococcus faecalis ; Erythromycin ; Fungi ; Fusarium ; Genes, rRNA ; Methicillin ; Microscopy, Electron, Transmission ; Nanoparticles ; Paecilomyces ; Salmonella enterica ; Silver ; Soil ; Staphylococcus aureus ; Streptococcus pyogenes

Very few studies have addressed the phylogenetic diversity of fungi from Northeast India under the Eastern Himalayan range. In the present study, an attempt has been made to study the phylogenetic diversity of culturable soil fungi along the altitudinal gradients of eastern Himalayas. Soil samples from 24 m above sea level to 2,000 m above sea level altitudes of North-East India were collected to investigate soil micro-fungal community structure and diversity. Molecular characterization of the isolates was done by PCR amplification of 18S rDNA using universal primers. Phylogenetic analysis using BLAST revealed variation in the distribution and richness of different fungal biodiversity over a wide range of altitudes. A total of 107 isolates were characterized belonging to the phyla Ascomycota and Zygomycota, corresponding to seven orders (Eurotiales, Hypocreales, Calosphaeriales, Capnodiales, Pleosporales, Mucorales, and Mortierellales) and Incertae sedis. The characterized isolates were analysed for richness, evenness and diversity indices. Fungal diversity had significant correlation with soil physico-chemical parameters and the altitude. Eurotiales and Hypocreales were most diverse and abundant group of fungi along the entire altitudinal stretch. Species of Penicillium (D = 1.44) and Aspergillus (D = 1.288) were found to have highest diversity index followed by Talaromyces (D = 1.26) and Fusarium (D = 1.26). Fungal distribution showed negative correlation with altitude and soil moisture content. Soil temperature, pH, humidity and ambient temperature showed positive correlation with fungal distribution.
Altitude ; Ascomycota ; Aspergillus ; Biodiversity ; Collodion ; DNA, Ribosomal ; Eurotiales ; Fungi ; Fusarium ; Humidity ; Hydrogen-Ion Concentration ; Hypocreales ; India ; Mucorales ; Penicillium ; Polymerase Chain Reaction ; Soil ; Talaromyces

Objectives To determine the socio-demographic profile, clinical characteristics and quality of life of adult psoriasis patients as well as the association between the first two variables with the latter. Methods A cross-sectional study of 30 adult psoriasis patients was conducted in the Dermatology Clinic, Serdang Hospital from 9th to 23rd May 2011. A questionnaire regarding clinical data containing multilingual Dermatology Life Quality Index (DLQI) was used in a face-to-face interview. Results Male-to-female ratio was 1:1.5. Psoriasis was more common in Malays (76.7%) compared to Chinese (10%) and Indians (10%), however this ethnic distribution was proportionate to that of the clinic attendance. The onset of psoriasis was during the second to third decade of life in most patients (53.3%) with a mean of 31 years (range 7 - 62). Nine (30%) patients had positive family history of psoriasis. The main aggravating factors were stress and sunlight. Hyperlipidemia was the commonest associated co-morbidity. Plaque psoriasis was the commonest clinical type (66.7%) and majority (66.7%) had <10% body surface area affected. Nail changes were present in 15 (50%) patients and psoriatic arthropathy occurred in 11 (36.7%), with mono/oligoarticular type being as common as symmetrical polyarthropathy. All patients were treated with topical therapy, six were on systemic medication and only one underwent phototherapy. The mean DLQI score was 10.77 ± 6.22. The duration of disease and the age group were negatively correlated with the DLQI scores (r= -0.45 and -0.42 respectively, p < 0.05). Conclusion The clinical findings are similar to previous local studies and are valuable to improve patient care.

This workshop was held on July 31-August 1, 2010 and was organized to promote the academic environment and to enhance the communication among Asian countries prior to the 2nd biennial meeting of Australian Society of Gynaecologic Oncologists (ASGO), which will be held on November 3-5, 2011. We summarized the whole contents presented at the workshop. Regarding cervical cancer screening in Asia, particularly in low resource settings, and an update on human papillomavirus (HPV) vaccination was described for prevention and radical surgery overview, fertility sparing and less radical surgery, nerve sparing radical surgery and primary chemoradiotherapy in locally advanced cervical cancer, were discussed for management. As to surgical techniques, nerve sparing radical hysterectomy, optimal staging in early ovarian cancer, laparoscopic radical hysterectomy, one-port surgery and robotic surgery were introduced. After three topics of endometrial cancer, laparoscopic surgery versus open surgery, role of lymphadenectomy and fertility sparing treatment, there was a special additional time for clinical trials in Asia. Finally, chemotherapy including neo-adjuvant chemotherapy, optimal surgical management, and the basis of targeted therapy in ovarian cancer were presented.
Asia ; Asian Continental Ancestry Group ; Chemoradiotherapy ; Endometrial Neoplasms ; Female ; Fertility ; Humans ; Hysterectomy ; Laparoscopy ; Lymph Node Excision ; Mass Screening ; Ovarian Neoplasms ; Uterine Cervical Neoplasms ; Vaccination