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Ali M Hassan,1 Chad W Donley,2 Praveen Venkatachalam3 1Department of Emergency Medicine, St. Elizabeth Hospital, Boardman, OH, USA; 2Department of Emergency Medicine, St. Elizabeth Hospital, Youngstown, OH, USA; 3Department of Interventional Neuro-Radiology, St. Elizabeth Hospital, Youngstown, OH, USACorrespondence: Ali M Hassan, Email alihassan.kh@hotmail.comBackground: Epistaxis is a frequent presenting complaint in the Emergency Department (ED). Roughly 60% of the population will suffer from epistaxis in their lifetime. The most common causes of epistaxis include nose picking, facial trauma, foreign bodies, and coagulopathies. There are other causes that are much less common, such as intracranial pseudoaneurysms. There are multiple causes that precipitate intracranial pseudoaneurysm formation, with head trauma accounting for less than 1% of inciting events.Case Report: A 24-year-old female with history of traumatic brain injury with associated skull fractures due to a gunshot wound to the head 6 months prior presented to the ED in hemorrhagic shock secondary to epistaxis. After stabilization with the administration of blood products, Computed Tomography with Angiography (CTA) imaging of the head and neck was obtained and revealed a 3.1 × 2.2 × 2.5 cm pseudoaneurysm of the cavernous portion of the right internal carotid artery penetrating through the base of the skull into the ethmoidal sinus. The patient was taken for formal angiography by interventional radiology-and a partially thrombosed daughter sac of the initial aneurysm was identified and believed to be the source of the hemorrhage. The aneurysm was successfully coiled and occluded using ONYX embolization. Postoperatively, the patient returned to her baseline mental status without any acute complaints. The patient was discharged back to her nursing home 2 days later with a 3-week follow-up CTA revealing persistent occlusion of the aneurysm and a patent internal carotid artery.Conclusion: Awareness and consideration of intracranial vascular etiology for common complaints in the emergency room, such as Epistaxis, especially in patients with any history of head injury/trauma, known intracranial aneurysms or prosthetic devices from prior surgery may help guide decision-making in managing critically ill patients.Keywords: epistaxis, hemorrhagic shock, ONYX embolization, pseudoaneurysm

Cadmium (Cd) and Lead (Pb) heavy metal pollution induced toxicity severely affects the plant growth and yield of various agriculutral crops worldwide. The present study discuss the prime role of phycomolecules coated zinc oxide nanoparticles (ZnONPs) application on development of heavy metal tolerance mechanism in cotton (Gossypium hirsutum L.) seedlings better than exposed to Cd and Pb treatments alone. Co-exposure of ZnONPs along with heavy metal treatments significantly promoted the shoot, and root growth as well as biomass compared to control, while it was down-regulated in Cd and Pb exposed seedlings. The intervention of ZnONPs had up-regulated the level of chlorophyll a, b and carotenoid contents in leaves grown under Cd and Pb treatments than the untreated control. Similarly, the level of total soluble protein and malondialdehyde (MDA-lipid peroxidation) contents was significantly increased in the co-presence of ZnONPs along with Cd and Pb treatments over their respective control. Accumulation of antioxidant defense enzymes viz., superoxide dismutase (SOD), catalase (CAT), peroxidase (POX) and ascorbate peroxidase (APX) was up-regulated significantly in seedlings upon co-exposure of ZnONPs with Cd and Pb treatments. Random amplified polymorphic DNA (RAPD) fingerprinting analysis exhibited no genomic changes/alterations in seedlings by co-existence of ZnONPs with heavy metals. Overall, the present results indicate that the addition of ZnONPs with Cd and Pb ion exposure protects cotton seedlings by alleviating heavy metal induced phytotoxicity and promoted physiochemical characteristics via differential regulation of photosynthetic machinery as well as antioxidative defense mechanisms in cotton seedlings. Results strongly suggest that phycomolecule coated ZnO nanoparticles could be effectively used as nanofertilizer to cultivate agronomically important crops in heavy metal polluted soil in the future.

Effect of feeding strategy on levan production was studied in a shake flask and a 5 L lab scale fermenter. In a shake flask, levan specific substrate yield (YP/S) increased from 0.35 g levan/g sucrose to 0.48 g levan/g sucrose with repeated batch feeding. In a 3 L reactor, levan productivity of 7.18 g/L h was obtained with the fed-batch mode of fermentation. The gel permeation chromatography results indicate that higher initial sucrose concentration under the fed-batch mode operation resulted in the formation of low molecular weight fractions (4 and 10 kDa). Thus, fed-batch fermentation favors levan production resulting in higher yield and productivity and also affects the molecular weight distribution of the biopolymer.

Annual public exposure from background radiation is about 2.8 mSv which comes from both natural and manmade sources. The medical applications of ionizing radiation contribute around 98% of the manmade sources of background radiation. The annual per caput dose rose from 0.35 to 0.62 mSv by the worldwide usage of radiation diagnostic examinations. Based on the published reports, the diagnostic examinations – computed tomography (CT) scan and cerebral angiography are high (7.4 mSv and 9.3 mSv, respectively) in the average effective dose. In our study, we measured the entrance surface dose at different anatomical locations using thermoluminescence dosimeter in patients who underwent CT examinations and neurointerventional radiology procedures. The measured dose values range between 0.70 and 518.12 mGy for CT and 0.99 and 777.31 mGy for interventional procedures. Thus, X-radiation based procedures delivered a considerable amount of radiation dose to the patients. To minimize the risks of developing any health effects, safety measures should be taken to reduce the dose without compromising the image quality.

Deviation from the orchestra of regulated cell division into unregulated and then result into the formation of tumor is known as carcinogenesis. While causes and hallmarks of many cancer types are well established, newer concepts on tumor cell response to treatment, challenges established therapeutic regime and drives into alternative toward the better management. The phenomena of therapeutics induced bystander response, and genomic instability on late effects of cancer therapy is emerging as a newer challenge. Bystander response is defined as the manifestation of radiation/chemotherapy drug signatures on the unexposed cells which are in the closer vicinity of the directly exposed; on the other hand, genomic instability is defined as the expression of radiation/chemotherapy drug signatures in the progeny of exposed cells. Unequivocally, existence of those phenomena has been demonstrated with many cell types (both in vitro and in vivo) followed by radiation and widely used chemotherapeutic drugs. Nevertheless, it is also revealed that the effects are variable and depend on dose, type of radiation/chemicals agents, experimental model, type of donor and recipient cells, and biomarkers adopted; moreover, to observe those effects, reactive oxygen species has been reported as leading mediators of those responses when compared to other molecules such as interleukins, cytokines, and inflammatory markers. Available data on those phenomena and our findings suggest that a role of therapeutic drugs induced bystander effects, and genomic instability on the development of secondary malignancy cannot be ruled out completely.

Conventionally, many biomarkers are being in use as a measure to genotoxicity in occupational exposure to chemicals, pesticides, radiation, and drug screening. Of which, the micronucleus assay is a preferred choice for many of those applications owing to its simplicity and rapidity. The assay methodology has evolved in cell preparations, staining, and scoring methods: from quantifying the DNA damage in mononucleated cells and binucleated cells; solid (Giemsa) and fluorescence staining (propidium iodide/DAPI); and manual and automated microscopy scoring and flow cytometry. Despite the advantages, preparation of cells with good morphology to interpret DNA damage from a different type of cells remains a challenge in particular for laboratory being the processes of developing the assay. Therefore, the aim of the present report was to explain the micronuclei (MN) assay and means to overcome the troubleshoot for reliable outcome measure using cytokinesis-arrested micronucleus (CBMN) assay from suspension and adherent cultures.

Introduction: Chemotherapy is an important treatment option which is used for all cancer types. The basic mechanism of action of chemotherapy is that the drugs cause damage to the cancer cells by breaking down DNA, interfere with replication, or enhance the cell killing. Emerging studies have shown that despite tremendous improvements on the therapeutic options, benefit derived from the therapy is not desirable. It is because, interindividual variations among the patient′s response to therapy as well as complex signaling molecules and mechanism involved, determining the final outcome of the therapy. Therapeutic efficacy can be improved by predicting a patient response to that agent, adopting a suitable marker. Materials and Methods: This study involves analysis of the frequencies of chromosomal aberrations and micronucleus, expression profile of p53 ser15 and BAX in healthy subjects and cancer patients, to identify a novel marker to predict their response to chemotherapy agents. For this, peripheral blood sample (4 ml) from cancer patients (solid tumors) was obtained before and after chemotherapy (n = 20). The change in those marker in cancer patients were compared with age- and sex-matched healthy subjects (n = 20). Results: The present study results indicated substantial increase in all four biomarkers for postchemotherapy compared to that obtained before therapy; however, the increase was not significant (P > 0.05), whereas a significant increase (P < 0.05) was observed in all markers from cancer patients compared to that of healthy volunteers relate the genetic instability to the disease status. Furthermore, on comparison, the levels of all those changes are increased in samples obtained posttherapy, despite the magnitude of BAX expression is considerably higher when compared to other markers. Conclusion: Therefore, the study results implied that BAX can be used as a better marker to predict the patient response to chemotherapy.

Introduction: In modern dentistry, as the patient’s demand for aesthetic dentistry increases, the use of tooth-coloured restorative material increase correspondingly. One among them is the use of Porcelain Fused to Metal (PFM) restorations. However, fracture of PFM crown is a common problem in restorative dentistry. Various methods have been advocated to repair fractured porcelain. Aim: The aim of present study was to evaluate the efficiency of the two different bonding systems in reference to three different surface treatments on Nickel Chromium (Ni-Cr) alloys by evaluating the shear bond strength at metal and resin interface. Materials and Methods: A total of 80 Ni-Cr alloys measuring 1x1 cm square blocks were cast using lost wax technique. After casting, the specimens were grouped into four groups based on the surface treatments planned. The four groups were further subdivided into two subgroups based on the bonding technique. The subgroup A samples was treated with Single Bond Universal (SBU) and subgroup B samples was treated with Alloy Primer (AP) and SBU. After surface treatment of the sample, a clear plastic tube measuring 4 mm diameter and 4 mm length was placed and composite resin was packed and cured. Shear bond testing of all the groups was performed on Universal testing machine. Results: The means and standard deviations of Shear Bond Strength (SBS) values in MPa were calculated for each group, and the results were statistically analysed with one-way ANOVA and Tukey HSD tests. All statistical analyses were performed using the SPSS software version 10.0. Conclusion: Within the limitations of this in vitro study, Erbiumdoped Yttrium Aluminium Garnet (Er-YAG) Laser treated alloy surfaces bonded along with AP displayed highest shear bond strength and subgroup B samples bond strength was significantly higher.