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Objective: This study was to evaluate echocardiographic findings and its usefulness in clinical management of patients with scorpion sting envenomation., Material and Methods: A total of 84 consecutive patients were prospectively studied. The data included demographics, at the time of presentation to the hospital, the clinical features, echocardiographic findings, admission to intensive care unit, use of inotropic medication, time to discharge, and mortality., Results: Out of 84 patients studied 60 patients (71.4%) had echocardiographic evidence of myocarditis (LVEF <50%). Majority of patients had LVEF <40% (50 patients, 83.3%). Severe LV dysfunction (LVEF <30%) was noted in 20 patients (33.3%). No patient had significant valvular regurgitation. RV dysfunction was noted in half of the patients who had LV dysfunction. RV dysfunction was not seen in isolation. Twenty four patients without evidence of myocarditis on echocardiography were observed in general wards and were discharged in 24 to 48 hours of admission. Ten patients with mild LV dysfunction (LVEF 50-40%) and 20 patients with moderate LV dysfunction were observed in high dependency units with regular monitoring for 24 to 48 hours. Only 3 patients were put on inotropics support and others could be discharged in 72 to 96 hours. All the patients with severe LV dysfunction and moderate LV dysfunction with significant RV dysfunction were admitted in intensive care unit irrespective of symptoms (Total 30 patients). These patients were put on inotropics support. Among severe LV dysfunction group, 4 patients required ventilator support and 2 (2.3%) patients died with refractory shock and multi-organ failure. Tachycardia, muffled and or gallop heart sounds and hypertension didn't predict presence of LV dysfunction. Persistent hypotension requiring inotropics support was a marker of severe LV dysfunction., Conclusion: Echocardiography is a useful tool in emergency to assess LV function in patients with scorpion sting envenomation. It can guide therapy by identifying patients with severe LV dysfunction.

Gastrointestinal stromal tumour (GIST) is a soft tissue sarcomas arising from interstitial cell of Cajal of the gastrointestinal tract. Since its description in 1983, its management has seen sea change - from surgery to drug therapy, for CD 117 positive patients. Though it has an indolent course compared to adenocarcinoma, over the decades it has surprised surgeons with its varied presentation. We report a series of 12 cases of GIST. These were evaluated with respect to their age, gender, clinical presentation, histopathology grade, treatment offered & final outcome. There were 7 gastric, 1duodenal, 1 sigmoid, 1 rectal & 2 retroperitoneal GISTs. Resection was carried out for 8 GISTs, 1 was enucleated, 2 are on imatinib therapy & one is under observation. All operated patients had an uneventful post-operative recovery.

Large retroperitoneal liposarcomas represent a unique situation and require a more aggressive surgical approach, including multiple resections for recurrences. We report a series of 5 cases of large retroperitoneal liposarcoma managed aggressively with surgical resection. All cases presented with lump and abdominal pain and diagnosis was established by Ultrasonography and CT scan. Post-operative course was uneventful and a median follow up of 3 years, all patients were free from recurrence.

Objective: This study was to evaluate the levels of NT-proBNP in patients with myocarditis which occurred after a scorpion sting envenomation., Material and Methods: A total of 30 patients with scorpion sting envenomation and 21 patients with heart failure which was caused by cardiomyopathy, were prospectively studied. The data included the patient demographics, clinical features, echocardiography and the NT-proBNP levels., Results: An echocardiographic evidence of myocarditis with a left ventricular ejection fraction of less than 50%, was found in 22 patients. In all the 22 patients, NT-proBNP was significantly elevated. The NT-proBNP levels were very high in the patients with severe LV dysfunction. However, it was in the normal range in the patients without an evidence of myocarditis. The elevated NT-proBNP levels were correlated with the LV dysfunction and myocarditis. When they were compared with the patients with heart failure which was caused by cardiomyopathy, the NTproBNP levels were found to be significantly more elevated in scorpion sting myocarditis., Conclusions: The NT-proBNP levels were significantly elevated in myocarditis which occurred after a scorpion sting envenomation.

Four 220 MWe pressurised heavy water reactors are under operation at Kaiga in the state of Karnataka in India. Environmental radiological survey of the surrounding areas of the Kaiga site is carried out by Bhabha Atomic Research Centre, Mumbai. The estimated dose to the members of the public due to ingestion of radioactive isotope of potassium, a natural radionuclide, in the surroundings of the Kaiga site is 136 μSv (13.6 mrem) per year. The value indicates that the dose to the public due to operation of the nuclear reactors in Kaiga is insignificant in comparison with the dose due to unavoidable natural radioactivity.

Objective: This study was to evaluate the predictive value of the cardiac troponins in scorpion sting myocarditis at a tertiary care hospital in Raichur, (Karnataka state) India., Methods: A total of 84 consecutive patients were prospectively studied. The data included the demographics, the time of presentation to the hospital, the clinical features, the cardiac troponin levels and the echocardiographic findings., Results: 12 patients with only local symptoms had troponin levels of less than 0.01μg/L. 12 patients with local and systemic symptoms without an echocardiac evidence of myocarditis had troponin values of 0.01 to 0.11 μg/L. 60 patients with an echocardiographic evidence of myocarditis had troponin levels of above 0.11 μg/L. 6 patients with severe myocarditis who required ventilator support or which led to death had troponin values which were higher than 10 μg/L., Conclusions: High cardiac troponin levels predict myocarditis in scorpion sting envenomation and they can be a useful tool in guiding the therapy early.

Recent national reports have stressed the importance of teacher knowledge in teaching reading. However, in the past, teachers' knowledge of language and literacy constructs has typically been assessed with instruments that are not fully tested for validity. In the present study, an instrument was developed; and its reliability, item difficulty, and item discrimination were computed and examined to identify model fit by applying exploratory factor analysis. Such analyses showed that the instrument demonstrated adequate estimates of reliability in assessing teachers' knowledge of language constructs. The implications for professional development of in-service teachers as well as preservice teacher education are also discussed.

The three current models of identifying learning disabilities: discrepancy model, RtI, and Componential Model of reading are discussed in terms of their utility.

Whether the simple view of reading (SVR) as incorporated in the componential model of reading (CMR) is applicable to other orthographies than English was explored in this study. Spanish, with transparent orthography and Chinese, with opaque orthography were selected because of their diverse characteristics. The first part reports a study of students from grades 2 and 3, whose home language and medium of instruction was Spanish, and were administered tests of decoding, listening, and reading comprehension. A comparison group of 49 children from Grade 2, 54 children from Grade 3, and 55 children from Grade 4, whose home language and instruction was English, were also administered tests of decoding, listening, and reading comprehension. Multiple regression analysis showed that approximately 60% of the variance in reading comprehension of Spanish participants and 50% of the variance in reading comprehension of English participants were explained by decoding and listening comprehension. Furthermore, the performance of third grade Spanish participants resembled that of fourth grade English-speaking participants. In the second study, 102 Chinese students from Grade 2 and 106 students from Grade 4 were administered tasks of Chinese character recognition, reading fluency, listening, and reading comprehension. Multiple regression analyses showed character recognition and listening comprehension accounted for 25% and 42% of the variance in Chinese reading comprehension at Grades 2 and 4 respectively. These results indicate that the simple view of reading is applicable to writing systems other than that of English.

In the transport model for the prediction of the concentration of (137)Cs in milk, the transfer coefficient from feed to milk, F(m), is an important parameter. Site-specific transfer coefficient from feed to cow's milk, for (137)Cs in the Kaiga environment, a nuclear power station site in India, determined over a period of 10 y is presented in this paper. The value is determined from (137)Cs concentration in milk and grass samples of the Kaiga region and the result ranged from 6.43E-03 to 1.09E-02 d l(-1) with a geometric mean value of 8.0E-03 d l(-1). The result is compared with that for (40)K, determined concurrently at the same region and ranged from 3.06E-03 to 3.48E-03 d l(-1) with a geometric mean value of 3.26E-03 d l(-1). This parameter is quite useful in decision-making for implementing countermeasures during a large area contamination with (137)Cs in tropical areas like Kaiga.

Transfer factors are the most important parameters required for mathematical modeling used for environmental impact assessment of radioactive contamination in the environment. In this paper soil to leaf transfer factor for the radionuclides ⁴⁰K, ²²⁶Ra, ¹³⁷Cs and ⁹⁰Sr is estimated for Kaiga region in Karnataka state, India. Among the plants in which study is carried out, ²²⁶Ra, ⁴⁰K, ¹³⁷Cs and ⁹⁰Sr activity in leaves of herbaceous plants is higher than that of tree leaves. Soil to leaf transfer factor for ²²⁶Ra, ⁴⁰K, ¹³⁷Cs and ⁹⁰Sr was found to be in the range of 0.03-0.65, 0.32-8.04, 0.05-3.03 and 0.42-2.67 respectively., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Head injury is the major cause of death in a neurosurgical patient., Objective: To find the outcome, and treatment modality affecting the outcome in patients with head injury., Methods: Nine hundred eighty seven patients presenting to National Institute of Neurological and Allied Sciences, Kathmandu, with head injury from September 2009 to October 2010 were included in the study. Patients were categorized according to post resuscitation Glasgow Coma Score. Outcome was assessed at discharge using Glasgow Outcome Score and analyzed for any correlation with modality of treatment and severity of injury., Results: Among 987 patients with head injury,152 (15.4%) had severe, 126 (12.8%) had moderate and 709 (71.8%) had mild head injuries. Three hundred twelve (31.6%) patients required definitive and supportive surgical intervention. One hundred eighty two required cranial surgical intervention. Overall mortality was 10% (99), 137 patients (13.9%) had unfavorable outcome and 850 (86.1%) had favorable Glasgow Outcome Score of 4 and 5. Mortality was 53.2%, 9.5% and 0.8% in severe, moderate and mild head injury group respectively. Mortality rate was significantly higher (64.6%) in severe head injury group managed conservatively than those in same group treated with supportive and definite surgical intervention (44.8%) (p=0.016)., Conclusion: Mortality in head injury patients depend upon severity of injury. Mortality in severe head injury group can be reduced by supportive and definite surgical intervention.

We previously demonstrated that inhaling nitric oxide (NO) increases the oxygen affinity of sickle red blood cells (RBCs) in patients with sickle cell disease (SCD). Our recent studies found that NO lowered the P(50) values of sickle hemoglobin (HbS) hemolysates but did not increase methemoglobin (metHb) levels, supporting the role of NO, but not metHb, in the oxygen affinity of HbS. Here we examine the mechanism by which NO increases HbS oxygen affinity. Because anti-sickling agents increase sickle RBC oxygen affinity, we first determined whether NO exhibits anti-sickling properties. The viscosity of HbS hemolysates, measured by falling ball assays, increased upon deoxygenation; NO treatment reduced the increment. Multiphoton microscopic analyses showed smaller HbS polymers in deoxygenated sickle RBCs and HbS hemolysates exposed to NO. These results suggest that NO inhibits HbS polymer formation and has anti-sickling properties. Furthermore, we found that HbS treated with NO exhibits an isoelectric point similar to that of HbA, suggesting that NO alters the electric charge of HbS. NO-HbS adducts had the same elution time as HbA upon high performance liquid chromatography analysis. This study demonstrates that NO may disrupt HbS polymers by abolishing the excess positive charge of HbS, resulting in increased oxygen affinity., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Reading disabilities such as dyslexia, a specific learning disability that affects an individual's ability to process written language, are estimated to affect 15-20% of the general population. Consequently, elementary school teachers encounter students who struggle with inaccurate or slow reading, poor spelling, poor writing, and other language processing difficulties. However, recent evidence may suggest that teacher preparation programs are not providing preservice teachers with information about basic language constructs and other components related to scientifically based reading instruction. As a consequence preservice teachers have not exhibited explicit knowledge of such concepts in previous studies. Few studies have sought to assess preservice teachers' knowledge about dyslexia in conjunction with knowledge of basic language concepts. The purpose of the present study was to examine elementary school preservice teachers' knowledge of basic language constructs and their perceptions and knowledge about dyslexia. Findings from the present study suggest that preservice teachers, on average, are able to display implicit skills related to certain basic language constructs (i.e., syllable counting), but fail to demonstrate explicit knowledge of others (i.e., phonics principles). Also, preservice teachers seem to hold the common misconception that dyslexia is a visual perception deficit rather than a problem with phonological processing. Implications for future research as well as teacher preparation are discussed.

Roughly one-fifth of the US population displays one or more symptoms of dyslexia: a specific learning disability that affects an individual's ability to process written language. Consequently, elementary school teachers are teaching students who struggle with inaccurate or slow reading, poor spelling, poor writing, and other language processing difficulties. Findings from studies have indicated that teachers lack essential knowledge needed to teach struggling readers, particularly children with dyslexia. However, few studies have sought to assess teachers' knowledge and perceptions about dyslexia in conjunction with knowledge of basic language concepts related to reading instruction. Thus, the purpose of the present study was to examine elementary school teachers' knowledge of basic language concepts and their knowledge and perceptions about dyslexia. Findings from the present study indicated that teachers, on average, were able to display implicit skills related to certain basic language concepts (i.e. syllable counting), but failed to demonstrate explicit knowledge of others (i.e. phonics principles). Also, teachers seemed to hold the common misconception that dyslexia is a visual processing deficit rather than phonological processing deficit., (Copyright © 2011 John Wiley & Sons, Ltd.)

Site-specific wet, dry deposition velocities and mass interception factors at Kaiga site, where three PHWR type power plants are operational, using 7Be as a tracer are presented. Mean wet and dry deposition velocities for Kaiga site were found to be 7.4 x 10(-2) m s(-1) and 3.0 x 10(-4) m s(-1), respectively. Mass interception factors for vegetation were found to be 0.7-5.6 m(2) kg(-1) dry weight with a mean of 2.4 m(2) kg(-1) dry weight. The site-specific data were used for the prediction of radionuclide distribution pattern in soil and vegetation in the case of a hypothetical air contamination.

Context: Splenic involvement in neuroendocrine pancreatic tumors is well known but rarely presents as a primary splenic mass., Case Report: A rare case of a neuroendocrine tumor involving the tail of the pancreas, splenic hilum and splenic flexure of the colon, forming a conglomerate mass and presenting as isolated gastric varices is described. A 75-year-old male presented with hematemesis and melena. Esophagogastroduodenoscopy revealed isolated gastric varices. A CT scan revealed a mass predominantly involving the spleen and a small part of the pancreas., Conclusion: A splenic mass with isolated gastric varices should be kept in mind as one of the presentations of a pancreatic neuroendocrine tumor.

This study explores the nature of reading difficulties of two bilinguals in Kannada and English, which vary in their orthographic depth and script layout. VN and MS manifest two different types of reading disabilities, dyslexia and hyperlexia, respectively. The performance of VN was below average on Kannada and English tests of phonemic awareness, spelling, and pseudoword naming. Despite his poor decoding skills, the listening comprehension skill both at the word level and at the sentence level of VN was within the normal range. VN, therefore, can be described to have developmental dyslexia. MS, in contrast, showed good decoding ability in both Kannada and English, but his listening and reading comprehension were poor in both languages. MS, therefore, displays a pattern of reading disability akin to that of hyperlexia. The deficits of both VN and MS, although dissimilar from each other, cut across the linguistic boundaries and affect their performance in both Kannada and English., (Copyright 2010 John Wiley & Sons, Ltd.)

When multiple treatment options are available, debate invariably persists regarding the optimal option. Confusion and controversy must then be resolved based on scientific evidence, but one needs to be practical because options depend on the available expertise. We aimed to evaluate the efficacy of endotherapy vis-à-vis surgery in patients with choledocholithiasis. The records of 349 patients with stone disease from February 2005 to January 2010 were analyzed. A total of 349 patients were analyzed: 279 patients with gallstones alone, 56 with choledocholithiasis, 3 with stones with stricture, 5 with common bile duct (CBD) and pancreatic duct (PD) stones, and 6 with combined choledocholithiasis and hepatolithiasis. In the 56 patients with choledocholithiasis alone, preoperative endoscopic retrograde cholangio pancreatography (ERCP) and endotherapy were followed by cholecystectomy within 48 hours. Endotherapy was successful in 15 patients, whereas surgery was required in the remaining 41 patients. Surgery is an efficacious option and can be carried out safely with acceptable morbidity and no mortality, even in difficult situations.

Background: We report a case of bacteremia caused by Streptobacillus moniliformis., Case Presentation and Intervention: A 2 years and 3 months female Kuwaiti child presented with febrile convulsions, mild cough and vomiting. The patient's history, clinical findings and radiological investigations were reviewed. There was no history of rat/animal bite, but the child had been camping in the desert prior to the illness and may have been exposed to rodent excreta. On two occasions, blood culture specimens yielded pure growth of the organism which was identified by standard diagnostic criteria. The patient was successfully treated with cefotaxime and clarithromicin., Conclusion: S. moniliformis may be a cause of bacteremia even in the absence of rat/animal bites., (Copyright 2010 S. Karger AG, Basel.)

Several national reports have suggested the usefulness of systematic, explicit, synthetic phonics instruction based on English word structure along with wide reading of quality literature for supporting development in early reading instruction. Other studies have indicated, however, that many in-service teachers are not knowledgeable in the basic concepts of the English language. They may be well versed in children's literature but not know how to address the basic building blocks of language and reading. The authors hypothesized that one of the reasons for this situation is that many instructors responsible for training future elementary teachers are not familiar with the concepts of the linguistic features of English language. This hypothesis was tested by administering a survey of language concepts to 78 instructors. The results showed that even though teacher educators were familiar with syllabic knowledge, they performed poorly on concepts relating to morphemes and phonemes. In a second study, 40 instructors were interviewed about best practices in teaching components and subskills of reading. Eighty percent of instructors defined phonological awareness as letter-sound correspondence. They also did not mention synthetic phonics as a desirable method to use for beginning reading instruction, particularly for students at risk for reading difficulties. In conclusion, providing professional development experiences related to language concepts to instructors could provide them the necessary knowledge of language concepts related to early literacy instruction, which they could then integrate into their preservice reading courses.

Background: Lumbar disc surgery has come a long way since its fi rst description by Dandy in 1929. Evolving through the transdural approach and a laminectomy for the removal of a disc, it now surpasses the primal technique with essentially a minimally invasive procedure, an extradural approach without laminectomy., Objective: The objective of this study is to ascertain the effectiveness of Minimally Invasive Open Lumbar Discectomy in the treatment of lumbar disc prolapse., Materials and Methods: It is a descriptive study entailing the patients with paramedian or central disc prolapse at single or two consecutive lumbosacral levels undergoing surgery at the National Institute of Neurological and Allied Sciences, Bansbari, Nepal, over a period of one and a half years. Patients who underwent either laminectomy or bilateral fenestration were excluded. Results of surgery were measured prospectively in terms of primary outcome measure (outcome at six months follow up as measured with Prolo Functional and Economic Scale) and secondary outcome measures (radicular pain relief, mobilisation, complication, and residual disc)., Results: In the series of 137 consecutive patients, 120 fulfilled the criteria. 98.33 % of patients had an improvement in the radicular pain and ambulation was commenced from the fi rst post-operative day. There were three instances of inadvertent dural tear without fascicle injury, and one instance of residual disc requiring reoperation. At 6 months, 97.5 % had good to excellent (grade 4, or 5) results reaching the premorbid states in the Prolo Functional and Economic Scale., Conclusion: The results of Minimally Invasive Open Lumbar Discectomy compare favourably with those of a microlumbar discectomy, and could therefore be an alternative to the latter in resource deprived circumstances.

In the present work, statistical experimental methodology was used to enhance the production of amidase from Rhodococcus erythropolis MTCC 1526. R. erythropolis MTCC 1526 was selected through screening of seven strains of Rhodococcus species. The Placket-Burman screening experiments suggested that sorbitol as carbon source, yeast extract and meat peptone as nitrogen sources, and acetamide as amidase inducer are the most influential media components. The concentrations of these four media components were optimised using a face-centred design of response surface methodology (RSM). The optimum medium composition for amidase production was found to contain sorbitol (5 g/L), yeast extract (4 g/L), meat peptone (2.5 g/L), and acetamide (12.25 mM). Amidase activities before and after optimisation were 157.85 units/g dry cells and 1,086.57 units/g dry cells, respectively. Thus, use of RSM increased production of amidase from R. erythropolis MTCC 1526 by 6.88-fold.

This paper entails a comprehensive study on production of a biosurfactant from Rhodococcus erythropolis MTCC 2794. Two optimization techniques--(1) artificial neural network (ANN) coupled with genetic algorithm (GA) and (2) response surface methodology (RSM)--were used for media optimization in order to enhance the biosurfactant yield by Rhodococcus erythropolis MTCC 2794. ANN and RSM models were developed, incorporating the quantity of four medium components (sucrose, yeast extract, meat peptone, and toluene) as independent input variables and biosurfactant yield [calculated in terms of percent emulsification index (% EI(24))] as output variable. ANN-GA and RSM were compared for their predictive and generalization ability using a separate data set of 16 experiments, for which the average quadratic errors were approximately 3 and approximately 6%, respectively. ANN-GA was found to be more accurate and consistent in predicting optimized conditions and maximum yield than RSM. For the ANN-GA model, the values of correlation coefficient and average quadratic error were approximately 0.99 and approximately 3%, respectively. It was also shown that ANN-based models could be used accurately for sensitivity analysis. ANN-GA-optimized media gave about a 3.5-fold enhancement in biosurfactant yield.

The production of biosurfactant from Rhodococcus spp. MTCC 2574 was effectively enhanced by response surface methodology (RSM). Rhodococcus spp. MTCC 2574 was selected through screening of seven different Rhodococcus strains. The preliminary screening experiments (one-factor at a time) suggested that carbon source: mannitol, nitrogen source: yeast extract and meat peptone and inducer: n-hexadecane are the critical medium components. The concentrations of these four media components were optimized by using central composite rotatable design (CCRD) of RSM. The adequately high R2 value (0.947) and F score 19.11 indicated the statistical significance of the model. The optimum medium composition for biosurfactant production was found to contain mannitol (1.6 g/L), yeast extract (6.92 g/L), meat peptone (19.65 g/L), n-hexadecane (63.8 g/L). The crude biosurfactant was obtained from methyl tert-butyl ether extraction. The yield of biosurfactant before and after optimization was 3.2 g/L of and 10.9 g/L, respectively. Thus, RSM has increased the yield of biosurfactant to 3.4-fold. The crude biosurfactant decreased the surface tension of water from 72 mN/m to 30.8 mN/m (at 120 mg L(-1)) and achieved a critical micelle concentration (CMC) value of 120 mg L(-1).

Biliary complications occur because of causes such as obscure or variant anatomy, predisposing conditions such as fibrosis or severe inflammation, equipment failure, and surgeon factors. The aim of this study was to review the optimal surgical treatment. Analysis of 81 patients with bile duct injuries treated in a single referral unit over an 8.5-year period was done. Time of detection of biliary injury and its presentation were ascertained as well as the level of injury (Strasburg's). In 8 patients, injury was detected intraoperatively, and 41 were detected in the early postoperative period with bile leak (n = 25) or obstructive jaundice (n = 10). Those diagnosed in the delayed postoperative period (n = 32) presented with recurrent cholangitis (n = 9), obstructive jaundice (n = 16), and a cholestatic enzymatic profile (n = 1). Roux-en-Y hepatico-jejunostomy was the preferred option (n = 64). One patient died because of biliary peritonitis. Improper treatment is associated with disastrous results, but early recognition and correct management can lead to a successful outcome and good prognosis.

Solid pseudopapillary tumor of the pancreas is considered to be a rare pancreatic tumor. These tumors are typically present in women in their third decade of life. The tumors have a low malignant potential. We report a case of 22-year-old female who presented with intermittent abdominal pain of 3 years duration. Distal pancreatectomy with splenectomy was done as a definitive treatment. The importance of accurate diagnosis and treatment is emphasized.

Antenatal steroids like dexamethasone (DEX) are used to augment fetal lung maturity and there is a major concern that they impair fetal growth. If delivery is delayed after using antenatal DEX, placental function and hence fetal growth may be compromised even further. To investigate the effects of DEX on placental function, we treated 9 pregnant C57/BL6 mice with DEX and 9 pregnant mice were injected with saline to serve as controls. Placental gene expression was studied using microarrays in 3 pairs and other 6 pairs were used to confirm microarray results by semi-quantitative RT-PCR, real-time PCR, in situ hybridization, western blot analysis and Oligo ApopTaq assay. DEX-treated placentas were hydropic, friable, pale, and weighed less (80.0+/-15.1mg compared to 85.6.8+/-7.6mg, p=0.05) (n=62 placentas). Fetal weight was significantly reduced after DEX use (940+/-32mg compared to 1162+/-79mg, p=0.001) (n=62 fetuses). There was >99% similarity within and between the three gene chip data sets. DEX led to down-regulation of 1212 genes and up-regulation of 1382 genes. RT-PCR studies showed that DEX caused a decrease in expression of genes involved in cell division such as cyclins A2, B1, D2, cdk 2, cdk 4 and M-phase protein kinase along with growth-promoting genes such as EGF-R, BMP4 and IGFBP3. Oligo ApopTaq assay and western blot studies showed that DEX-treatment increased apoptosis of trophoblast cells. DEX-treatment led to up-regulation of aquaporin 5 and tryptophan hydroxylase genes as confirmed by real-time PCR, and in situ hybridization studies. Thus antenatal DEX treatment led to a reduction in placental and fetal weight, and this effect was associated with a decreased expression of several growth-promoting genes and increased apoptosis of trophoblast cells.

Objective: To report an incident of bacteremia caused by Ochrobactrum anthropi., Case Presentation and Intervention: The case of a female child aged 2 years and 10 months with a known history of long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency who developed O. anthropi bacteremia during hospital stay is presented. Patient's history, clinical findings, laboratory and radiological investigations were thoroughly reviewed. The cultured organism was identified using MicroScan WalkAway 96 SI (Dade Behring) as well as by conventional techniques. Imipenem resistance was confirmed by the conventional Kirby-Bauer disk diffusion technique on Muller-Hinton agar with no zone of inhibition around a 10-mug imipenem disk (Hi Media) using the 0.5 McFarland standard., Conclusion: This report shows O. anthropi as a rare nosocomial pathogen that affected a patient who was immunocompromised. The O. anthropi showed multidrug resistance., (Copyright 2007 S. Karger AG, Basel.)

The temperature-dependent secondary-structural changes in the two known helical model peptides Boc-Val-deltaPhe-Ala-Leu-Gly-OMe (1; alpha-helical) and Boc-Leu-Phe-Ala-deltaPhe-Leu-OMe (2; 3(10)-helical), which both comprise a single dehydrophenylalanine (deltaPhe) residue, were investigated by means of FT-IR spectroscopy (peptide film on KBr). Both the first-order and the better-resolved second-order derivative IR spectra of 1 and 2 were analyzed. The nu(NH) (3240-3340 cm(-1)), the Amide-I (1600-1700 cm(-1)), and the Amide-II (1510-1580 cm(-1)) regions of 1 and 2 showed significant differences in thermal-denaturation experiments (22 degrees --> 144 degrees), with the 3(10)-helical peptide (2) being considerably more stable. This observation was rationalized by different patterns and strengths of intramolecular H-bonds, and was qualitatively related to the different geometries of the peptides. Also, a fair degree of residual secondary-structural elements were found even in the 'denatured' states above 104 degrees (1) or 134 degrees (2).

Although there has been widespread dissemination of knowledge about hypertension, it remains poorly treated in most populations. Systemic hypertension is associated with increased risk for coronary artery disease, stroke, nephrosclerosis, peripheral vascular disease, etc. The treatment of hypertension includes non-pharmacological measures and the specific drug therapy. Losartan potassium is an orally active, non-peptide angiotensin II receptor antagonist. It is the first of this new class of drugs introduced for clinical use in hypertension. Data was obtained of 347 patients from 140 general physicians. The study revealed that losartan potassium is used in the treatment of mild to moderate hypertension with excellent to good response in 98.8% of the cases. Mild adverse reactions were reported in 5.8% of the cases. None of the adverse reactions were severe enough which required discontinuation of therapy or needed hospitalisation. Thus, the present postmarketing surveillance study confirms the safety and efficacy of losartan potassium in Indian population.

Background: Concern about the emergence of antibiotic-resistant strains and about morbidity and/or mortality related to rheumatic fever and rheumatic heart disease has been a continuous impetus for the development of a safe, effective vaccine against group A Streptococcus (GAS). To date, >120 GAS M types are known, as identified by serological typing. In general, serum immunoglobulin G directed to the hypervariable NH2 terminal portion of M protein leads to complement fixation and opsonophagocytosis of the homologous streptococcal serotype by polymorphonuclear leukocytes, and the protection is type specific. The sequence variation at the N terminus ultimately affects the binding of opsonic antibodies. Because of hypervariability in these opsonic sequences from different M types, it was relevant to use epitopes derived from these multiple sequences in a "multivalent vaccine" design for evaluation of protection against these M types of GAS. Thus, any attempts to design vaccines for a given community will require information on N terminal-sequence typing and variation., Methods: In the present study, we performed molecular characterization of isolates recovered from patients in northern India--to our knowledge, for the first time--in an attempt to study the circulating M types and their N terminal sequence variability., Results: We report tremendous diversity in GAS strains recovered from symptomatic patients, with implications on the design of appropriate vaccines. Fifty-nine isolates represented 33 different sequence types. Very few novel types and no predominant clones were found., Conclusions: The high diversity of emm types encountered in a single year suggests that any M protein-based multivalent vaccine would have to be specifically tailored for this region.

Poor performance on tests of reading comprehension could be the result of weak word-recognition skills, inconsistent attention (ADD), or a combination of the two. Identifying the source of the reading disability (RD) reliably has been difficult because inconsistent attention interferes with reading and weak word recognition skill makes attention wander. The situation is further complicated by the fact that there are no objective diagnostic tests for ADD (Breggin, 1998; Diller, 1998). We proposed a new model of differential diagnosis of ADHD-I/RD and field-tested its utility in two studies. The new diagnostic procedure utilizes intra-individual differences seen in the performance of at-risk learners on tasks related to reading that vary in the degree of sustained attention required for successful performance. The hypothesis is that children whose attention is inconsistent would perform more poorly on tests such as listening comprehension, which require sustained attention, than on tests such as reading comprehension, which are more tolerant of inattention. Such differences will not be seen in the test scores of children who have only a reading disability because their performance on reading tests is determined more by the difficulty level of the tests than by the sensitivity of the tests to attention. The validity of this new model was evaluated by determining the relationship between differences seen in the scores of tests that differ in their attention requirement and the degree of inconsistency in sustained attention as measured by Conners' CPT. The results of the two studies indicate this to be a viable approach. The results of the second study are presented in this report.

Major blood stage antimalarial drugs like chloroquine and artemisinin target the heme detoxification process of the malaria parasite. Hemozoin formation reactions in vitro using the Plasmodium falciparum histidine-rich protein-2 (Pfhrp-2), lipids, and auto-catalysis are slow and could not explain the speed of detoxification needed for parasite survival. Here, we show that malarial hemozoin formation is a coordinated two component process involving both lipids and histidine-rich proteins. Hemozoin formation efficiency in vitro is 1-2% with Pfhrp-2 and 0.25-0.5% with lipids. We added lipids after 9h in a 12h Pfhrp-2 mediated reaction that resulted in sixfold increase in hemozoin formation. However, a lipid mediated reaction in which Pfhrp-2 was added after 9h produced only twofold increase in hemozoin production compared to the reaction with Pfhrp-2 alone. Synthetic peptides corresponding to the Pfhrp-2 heme binding sequences, based on repeats of AHHAAD, neither alone nor in combination with lipids were able to generate hemozoin in vitro. These results indicate that hemozoin formation in malaria parasite involves both the lipids and the scaffolding proteins. Histidine-rich proteins might facilitate hemozoin formation by binding with a large number of heme molecules, and facilitating the dimer formation involving iron-carboxylate bond between two heme molecules, and lipids may then subsequently assist the mechanism of long chain formation, held together by hydrogen bonds or through extensive networking of hydrogen bonds.

Purpose: To use DNA microarray to analyze the expression patterns of genes in the uninoculated eye following uniocular anterior chamber inoculation of HSV-1., Methods: On Day 9 following inoculation of 2 x 10( 4) PFU of HSV-1 (KOS strain) or an equivalent volume of tissue culture medium into one anterior chamber of BALB/c mice, the uninoculated eyes were enucleated, pooled, and total RNA was isolated. cDNA was synthesized from the total RNA. The gene expression patterns were inferred based on the hybridization intensities of the probes on the cDNA array. The hybridization signals were globally normalized and filtered. The data were analyzed using hierarchical and gene tree clustering algorithms. Additional uninoculated eyes collected on Day 9 p.i. were stained for F4/80 and CD19., Results: Compared with the uninoculated eye of control mice, 3800 genes were upregulated at least twofold in the contralateral eye of HSV-1-infected mice. Among the 10 most upregulated genes, T cell-specific protein, MHC II antigen A, and MHC II k region locus 2 were upregulated 179-, 164-, and 162-fold, respectively. Ten T-cell receptor-related genes, 61 cytokine and chemokine genes, and 16 MHC genes were upregulated. Furthermore, 11 immunoglobulin and B cell genes and 11 macrophage-related genes were also upregulated. F4/80+ and CD19+ cells were observed on Day 9 p.i., Conclusions: The DNA microarray results support the idea that T cells and immunomodulatory factors (cytokines, chemokines) are likely to be involved in HSV-1 retinitis. These results also suggest that B cells and/or macrophages play a role in the pathogenesis of HSV-1 retinitis.

Although Listeria monocytogenes infection occurs in sporadic and epidemic forms throughout the world, there are certain countries (especially Asian countries) that have reported only a few cases or failed to report even a single case. During her third visit at 17(+5) weeks of gestation, a 22-year-old primigravida presented with the complaint of an acute painful abdomen, leaking per vaginum and low-grade fever for the 2 preceding days. On ultrasonography, a single live fetus with no amniotic fluid was seen and the pregnancy was therefore terminated. L. monocytogenes was isolated from a high vaginal swab.

Deoxyribonucleic acid (DNA) microarrays provide a means to assess genome-wide expression patterns after exposure of an organism to different xenobiotics. Potential uses for this technology include identification of unknown toxicants, assessment of toxicity of new compounds, and characterization of the cellular mechanisms of toxicant action. Here we describe another use of DNA microarrays in toxicant-specific gene discovery. Combining results from two DNA microarray experiments, we have identified genes from the model plant Arabidopsis thaliana that are induced in response to one but not other heavy metals. The promoters of these genes should be useful in developing metal-specific transgenic biomonitors. To test this idea, we have fused the promoter of one of the newly identified Ni-inducible genes (AHB1) to the beta-glucuronidase (GUS) reporter gene. Arabidopsis plants containing the AHBI::GUS transgene show reporter gene activity when they are grown on media containing Ni but not when grown on media containing Cd, Cu, Zn, or without added metals. Thus, this approach has resulted in the creation of a transgenic strain of Arabidopsis that can report on the presence and concentration of Ni in plant growth media. Such transgenic models can serve as cheap and efficient biomonitors of bioavailable heavy metal contamination in soils and sediments.

The association of tylosis with esophageal cancer has been extensively reported but association with gastric cancer is rare. We report a 55-year-old man with familial tylosis and carcinoma of the stomach for which radical gastrectomy was done. Repeat endoscopy 3 years later is normal.

Conventional methods of differentiating reading disability (RD) caused by deficits in decoding skills or comprehension from poor reading performance caused by inconsistent attention associated with attention-deficit/hyperactivity disorder (ADHD) have produced equivocal results. This study presents a model of differential diagnosis of attentional problems and RD that differs from these conventional approaches. The new diagnostic procedure uses intraindividual differences seen in the performance of at-risk learners on tasks related to reading that vary in their sensitivity to the sustained attention required for successful performance. The hypothesis is that children with inconsistent attention would perform more poorly on tests that require sustained attention, such as listening comprehension, than on tests that are more tolerant of inattention, such as reading comprehension. Such differences would not be seen in the test scores of children who have only RD, because their performance is determined more by the difficulty level of the reading tests than by the degree of sensitivity of the task to attention. The validity of this new model was evaluated by determining the capability of the differences seen in the scores of tests that differ in their sensitivity to sustained attention to predict the degree of inconsistency in sustained attention as measured by a continuous performance test. The data obtained from 39 children who are at risk for RD suggest that this is a viable model.

Leiomyoma of the stomach, a type of gastrointestinal stromal tumor, is uncommon. We report a 51-year-old woman with an extraserosal pedunculated leiomyoma of the stomach.