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Reactive arthritis (ReA) is an immune mediated disease, clinically associated with oligoarthritis of the lower limbs and sometimes with urethritis and conjunctivitis. In our case, a 24-year-old male presented with severe mutilating arthritis involving both upper and lower extremities in contrast to conventional Reiter's syndrome which presents with asymmetric oligoarthritis. He had multiple well-defined, irregular, erythematous, hyperkeratotic, scaly and itchy plaques, not easily distinguishable from pustular psoriasis. The patient also gave history of circinate balanitis and urethritis. He was started on methotrexate (7.5 mg/week, later escalated to 15 mg/week with 15 mg/day folinic acid supplementation) to which he responded. But when he stopped it on his own, the symptoms recurred. Hence, methotrexate was restarted, but still the patient suffers from fixed flexion deformities in affected joints. Histopathological examination of skin lesions is also suggestive of ReA. Thus, this case report suggests that diagnosis of Reiter's should be considered in symmetrical, mutilating polyarthritis patients with typical skin lesions.

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A computer lithium battery cell was impacted in the cricopharynx of a 1 year and 9 month-old child. The battery cell was safely removed with the pediatric flexible oesophagoscope under anesthesia without trauma to the surrounding structures. The lithium battery cell is potentially dangerous due to its ability to cause chemical damage to the mucosa and cause early inflammation and edema leading to dysphagia and respiratory obstruction. Hence, it should be promptly extracted without delay to prevent catastrophe. The toddler recovered uneventfully in the immediate post-operative period and was followed-up for the last 1 year without any complication. To the horizon of our knowledge, no previous case was reported with computer battery cell in the cricopharynx of a toddler in Eastern India. In conclusion, parent education is important in the early detection of foreign bodies and their interventions.

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Malignant osteopetrosis is a rare autosomal recessive bone disease usually present with short stature, severe anemia, thrombocytopenia, hepatosplenomegaly, and macrocephaly. Here we report a rare case of malignant osteopetrosis presented with evidence of short stature, anemia, thrombocytopenia, hepatosplenomegaly, rickets, aqueductal stenosis, and hydrocephalus with resultant optic atrophy.

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A talon cusp is a supernumerary structure projecting from the dento-enamel junction to a variable distance towards the incisal edge of an anterior tooth. It consists of enamel, dentine and a variable amount of pulp tissue. Hyperactivity of the enamel organ during morpho-differentiation has been attributed to its formation. It has esthetic and functional concerns. Reports of a mandibular talon cusp are rare in the literature. To the best of our knowledge, only 14 cases have been reported, of which only 2 cases in mandibular left central incisors. We report the second instance of a talon cusp in the lingual aspect of the mandibular left central incisor and the first such report in a patient of Libyan origin. A talon cusp is an odontogenic anomaly, which can cause occlusal interferences, displacement of the affected tooth and speech difficulties. Early diagnosis of a talon cusp helps in selecting the appropriate treatment procedure and to avoid future complications.

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Juvenile systemic lupus erythematosus is an autoimmune disorder characterized by inflammatory damage to joints, kidney, central nervous system, and hematopoietic system in the form of fever, cutaneous lesion including skin rash, arthritis, anemia, and fatigue. We report a case in which the patient had features mimicking idiopathic thrombocytopenic purpura and juvenile dermatomyositis, but on a detailed Hematological investigation and kidney biopsy patient was diagnosed as juvenile SLE.

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Nowadays, data acquisition software and sensors are being widely used in introductory physics laboratories. This allows the student to spend more time exploring the data that is collected by the computer hence focusing more on the physical concept. Very often, a faculty is faced with the challenge of updating or introducing a microcomputer-based laboratory (MBL) at his or her institution. This article will provide a list of experiments and equipment needed to convert about half of the traditional labs on a 1-year introductory physics lab into MBLs.

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Objective: A computational model for predicting oral bioavailability is very important both in the early stage of drug discovery to select the promising compounds for further optimizations and in later stage to identify candidates for clinical trials. In present study, we propose a support vector machine (SVM)-based kernel learning approach carried out at a set of 511 chemically diverse compounds with known oral bioavailability values. Material and Methods: For each drug, 12 descriptors were calculated. The selection of optimal hyper-plane parameters was performed with 384 training set data and the prediction efficiency of proposed classifier was tested on 127 test set data. Results: The overall prediction efficiency for the test set came out to be 96.85%. Youden's index and Matthew correlation index were found to be 0.929 and 0.909, respectively. The area under receiver operating curve (ROC) was found to be 0.943 with standard error 0.0253. Conclusion: The prediction model suggests that while considering chemoinformatics approaches into account, SVM-based prediction of oral bioavailability can be a significantly important tool for drug development and discovery at a preliminary level.

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Background: Menstruation is a phenomenon unique to females and nearly universal experience in women's lives and is poorly understood. This study has been done to assess menstrual pattern and associated factors. Materials and Methods: A total of 194 girl students aged 18 to 27 years were selected and asked to complete a questionnaire anonymously. Data regarding demographic features, menarche age, menstrual pattern, severity of dysmenorrhea and associated symptoms, and impact of menstrual pain on working ability were obtained. Source for information about menarche and menstruation the participants depend was also elicited. Results: Mean age of the subjects at menarche was 13.36 ± 1.25 years with a range being 10 to 17 years. Mean duration of menstrual flow was 4.77 ± 1.06 days. The most prevalent menstrual symptoms were tiredness (47.9%), backache (38.3%), and anger (34.5%). Prevalence of menstrual irregularity and dysmenorrhea was 11.9 and 78.2%. 6.7% of the participants had severe dysmenorrhea. 76.6% of the dysmenorrheic girls reported that their working ability was affected. 60.4% of the girls were aware of menstruation prior to menarche. Mothers and friends were the main sources of information (47.8%). Conclusion: In conclusion, it can be mentioned that prevalence of dysmenorrhea and menstrual irregularity among young females is high. Working ability is reported to be affected by menstrual pain. It could be possible to improve menstrual discomforts management by including awareness programs.

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Aim: The present study was undertaken out of a commercial need for the synthesis of Linezolid with impurity limits within the specification. Materials and Methods: ( R)-Glycidyl butyrate (RGB) is raw material for the synthesis of Linezolid drug substance. This RGB contains (S)-(+)-Glycidyl butyrate (SGB) and SGB appears in same concentration in the final Active Pharmaceutical Ingredient. So, a normal phase high-performance liquid chromatography (HPLC) method has been developed to determine the SGB level in the raw material. RGB and SGB were separated using an HPLC system equipped with quaternary gradient pumps on a Daicel chiralpak AD-H (250 × 4.6 mm) column with a mobile phase consisting 2.0 ml of ethanol in 1 000 ml of n-hexane. A 0.5 ml/minute flow rate and a 10 μl injection volume was used and the compounds were detected at 215 nm. Results: Method validation parameters demonstrated the same to be reliable, reproducible, and accurate one. Conclusion: Thus, the present study may be used for regular quality control of RGB to improve commercial feasibility for the synthesis of Linezolid.

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Background: In India, screening of blood for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) is mandatory before issue, but the donors are often not informed of their positive status. ¹ The positive donors are always kept in dark. Is it essential to inform the positive donor? It is a debate still. Materials and Methods: Sri Ramachandra Blood Bank, Chennai, took the challenge of posttest counseling of blood donors from June 2008. Blood collected from donors were screened for HIV, HBsAg, and HCV. The donors of the blood, which are positive by two different enzyme-linked immunosorbent assay for any of the above tests, were sent a letter of calling respecting their rights and maintaining confidentiality. Responded donors were given counseling and offered information about confirmation, evaluation, consultation, early treatment, follow-up, contact testing, and transmission prevention. The results were analyzed for a period of 2 years from June 2008 to May 2010. Results: Among the 22,573 donors, 355 (1.7%) were found to be positive in the screening tests. Letters of calling were sent to 310 (87.04%) donors. In all, 218 (70.3%) donors with 7 (87.5%) HIV, 199 (68.85%) HBsAg, and 12 (92.31%) HCV positivity responded. None of the responded donors knew their status earlier. In all, 82 (35%) of them were repeat donors with 201 earlier donations at various blood banks. Conclusion: Posttest counseling of positive donors is essential for the health of the donor and his family, prevention of diseases, improving blood bank economy, and reducing exposure to healthcare workers.

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Aim: Abnormalities in water balance are manifested as hyponatremia and hypernatremia and the present investigation shows the effect of water deprivation in hot and humid climatic condition of north eastern part of India. Methods: Twenty four BALB/c mice of either sex (weight 30-40 g) were used for a 13-week experiment to determine the effects of water deprivation on behavioral and physiological changes. Mice were divided into control group (I) (n = 8), given water ad libitum, water-deprivation male group (15 ml/day) (Group II, n=8) and water-deprivation female group (15 ml/day) (Group III, n=8). Results: The water deprivation mice shows significantly (P<0.05) deteriorated of reflex, progressive visual placement, emotional whereas body weight, grip strength and rectal temperature were significantly (P<0.05) increased as compared to the control group. This information is useful to those living or deployed in crisis situations where the water supply limited in a hot-humid climate.

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Hemolytic disease of the newborn is the clinical condition in which Rh blood group antigens in couples are incompatible with each other and mother is negative for the antigen, whereas father is positive. Although RHD antigen encoded by RHD gene that is localized on chromosome 1 determines person's Rh genotyping, this incompatibility can lead to delivery as anemia, jaundiced, or dead in mother's uterus. In recent years, improvements have occurred in the prenatal diagnosis of Rh incompatibility. Quantitative real-time polymerase chain reaction (Real-time PCR) has been improved and determining rapidly, reliably, and sensitively has been possible. In this study, the determination of RHD genotyping was investigated using fetal DNA obtained from amniotic fluid and SYBR Green I and TaqMan probe methods were compared, and reliability in prenatal diagnosis of these methods was determined. We studied 35 pregnant women in the second trimester of pregnancy. "SYBR Green I" and "TaqMan" probes results for RHD gene of genomic DNA extracted from total 35 different amniotic fluid samples acquired from 10 RHD (-) and 25 pregnant women randomly were analyzed. DNA extracted from amniotic fluid was analyzed for RHD gene with real-time PCR and the results were then compared with the RHD fetal genotype determined on RHD phenotype of the red blood cells of the infants at birth. The results of RHD TaqMan probes PCR analysis of amniotic fluid DNA were completely concordant with the fetal blood group analysis after birth. Real-time PCR using the TaqMan probes has proven to be more sensitive, accurate, and specific for RHD gene than SYBR Green I method.

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Background: To investigate the anti-cobra venom effect of alcoholic extract of Andrographis paniculata. Materials and Methods: After calculating the LD ₉₉ of snake venom, the venom-neutralizing ability of plant extract at the dose 1 g/kg and 2 g/kg was determined using in vitro and in vivo methods. The alleviation in the mean survival time of the animals were used to infer the antivenom property of the drug after challenging with LD ₉₉ of snake venom. Results: The ethanolic extract of plant A. paniculata significantly increases mean survival time and the protection fold, but could not protect animals from death when used alone. The higher dose, i.e., 2 g/kg was found better than that of the lower. ASV was found more effective than the plant extract. When ASV was given along with plant extract, it potentiates its effect. Conclusion: The observation demonstrates the anti-cobra venom activity of ethanolic extract of A. paniculata which is comparable with ASV.

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Background: The central nervous system tumors are a rare neoplasm with little knowledge with Human Leukocyte Antigen (HLA) involvement. Primary brain tumors are cancers that originate in brain classified according to their appearance under a microscope as low grade (grade I and II) with diffuse astrocytomas, pliocytic astrocytomas, oligodendrogliomas, gangliogliomas, and mixed gliomas as common subtypes and high grade (grade III and IV). Materials and Methods: HLA associations in common glioma are reported from other parts of the world. The normal cancer treatment is surgery, followed by radiotherapy, and chemotherapy; nowadays immunotherapy is advised. HLA distribution in a Glioma patient was done based on serology and molecular techniques. The immune response gene studies have implicated the HLA allele association in most of the common diseases from India. Considerable variations are noted in HLA association with cancers; hence, we have summarized the HLA involvement in Glioma with respect to the literature. Results: HLA A*030101, A*310102, B*350101, B*4406, Cw*040101, Cw*070101, DRB1*070101, and DRB1*1001. Conclusion: Ethnic diversity and HLA polymorphism precipitate differential immune response genes involved in variable disease manifestations. Therefore, caste-specific HLA allelic specificity needs to be identified, which may help in early identification of the associated HLA allele and establishing clinical practices among glioma patients.

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Background: Basically, (pro)renin acts via a specifi c receptor, (pro)renin receptor (PRR) binding between renin and prorenin, its inactive proenzyme form. The study on the molecular level of PRR can give useful knowledge to help understand many renal disorders. Method: Here, the author focuses on the stability of the PRR molecule. The mutation prone positions within the PRR molecule was assessed using standard reference technique. Result: The study showed there is no identifi ed mutation prone position within the PRR molecule. Conclusion: This imply the high stability of PRR. This means that PRR rarely undergoes mutation. The reported mutation in PRR should be a very rare episode and the study on the specifi c cause is warranted.

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Objective: In childhood Guillain-Barré syndrome (GBS), the clinical profiles using intravenous immunoglobulin (IVIg) in addition to supportive care were studied. Materials and Methods: This was a retrospective analysis of 139 children with severe GBS admitted to our respiratory care unit managed with the IVIg as an adjunct intervention to conventional supportive and respiratory care. Results: In our case series of 139 cases, motor weakness was the most common presenting feature. Antecedent illness was found in 66.7% of cases in the preceding two weeks, which included nonspecific illness, acute respiratory infection, diarrhea, and chickenpox. At onset, sensory symptoms (pain and paresthesia) were noted in 59% of the cases and limb weakness in 77%. On admission, a majority (61.54%) were in Hughes neurological disability grading stage V; all had limb weakness at the peak deficit, autonomic disturbance was seen in 35.8%, and bulbar palsy in 52%. Duration of illness was less than three weeks in 67% of cases. The mean duration of ventilation was 21.5 days (range, 5-60 days). Conclusions: Male preponderance and motor weakness was the most common presenting illness and a majority achieved full recovery in our series. Although IVIg may be useful in the treatment of GBS, the key issue is excellent intensive care unit management.

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Despite the liver being proliferatively quiescent, it maintains balance between cell gain and cell loss, invokes a rapid regenerative response following hepatocyte loss, and restores liver mass. Human liver has immense regenerative capacity. Liver comprises many cell types with specialized functions. Of these cell types, hepatocytes play several key roles, but are most vulnerable to damage. Recent studies suggest that the extrahepatic stem cell pool contributes to liver regeneration. Stem cell therapies have the potential to enhance hepatic regeneration. Both embryonic and induced pluripotent stem cells could be a suitable source to regenerate hepatocytes. In the present review, we discuss the therapeutic potential of stem cells in hepatic repair and focus on the clinical applications of stem cells.

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From the onset of the human immunodeficiency virus (HIV) epidemic over 20 years ago (since the appearance of the first cases of contamination by the HIV virus in the 1980s), more than 60 million people have become infected and more than 20 million people have died. An estimated 15,000 new infections occur each day, with more than 95% of these in developing countries. The distinctive characteristic in the pathogenesis of HIV/acquired immunodeficiency syndrome is that the primary target cell for HIV is immune cells bearing the CD4 marker at their surface, and the CD4 cell count and viral load have been used lately as the most important laboratory parameters to evaluate the evolution of the disease. Oral lesions are common (30-80%) in patients infected by the HIV virus and may indicate an impairment in the patient's general health status and, consequently, a poor prognosis. Oral manifestations can suggest decreased cluster-differentiated (CD4+) T cell count and increased viral load, which might also aid in diagnosis, progression, and prognosis of the disease. At the tertiary level of oral care, a dentist should be available to make definitive diagnoses of oral lesions and provide professional oral services such as prophylaxis, restorations, biopsies, and the prescription of appropriate medication.

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The oral cavity appears as an open ecosystem, with a dynamic balance between the entrance of microorganisms, colonization modalities, and host defenses aimed to their removal: To avoid elimination, bacteria need to adhere to either hard dental surfaces or epithelial surfaces. The oral biofilm formation and development, and the inside selection of specific microorganisms have been correlated with the most common oral pathologies, such as dental caries, periodontal disease, and peri-implantitis. The mechanical removal of the biofilm and adjunctive use of antibiotic disinfectants or various antibiotics have been the conventional methods for periodontal therapy. Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms, and its application in medicine and dentistry has been indicated for the treatment of 260 different pathologies. The ozone therapy has been more beneficial than present conventional therapeutic modalities that follow a minimally invasive and conservative application to dental treatment. The exposition of molecular mechanisms of ozone further benefits practical function in dentistry.

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Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been rampantly used to recompense for the bone loss, but the procedure is coupled with severe adverse effects. Hence, there is a boost in the production of newer synthetic products to ward off the effects of menopause-related osteoporosis. As of today, there are several prescription products available for the treatment of postmenopause osteoporosis; most of these are estrogenic agents and combination products. Nevertheless, in view of the lack of effect and/or toxicity of these products, majority of the postmenopausal women are now fascinated by highly publicized natural products. This is an offshoot of the generalized consensus that these products are more effective and free from any adverse effects. Recently, certain plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes, flavonoids) and many more novel estrogen-like compounds in plants have been immensely used to prevent menopause-related depletion in bone mineral density (BMD). Although, a number of papers are published on menopause-related general symptoms, sexual dysfunction, cardiovascular diseases, Alzheimer's disease, diabetes, colon, and breast cancers, there is paucity of literature on the accompanying osteoporosis and its treatment. In view of the controversies on synthetic hormones and drugs and drift of a major population of patients toward natural drugs, it was found worthwhile to investigate if these drugs are suitable to be used in the treatment of postmenopausal osteoporosis. Preparation of this paper is an attempt to review the (a) epidemiology of postmenopausal osteoporosis, (b) treatment modalities of postmenopausal osteoporosis by hormones and synthetic drugs and the associated drawbacks and adverse effects, and (c) prevention and treatment of postmenopausal osteoporosis by phytoestrogens, their drawbacks and toxicity. It is apparent that both the categories of treatment are useful and both have adverse effects, but the plant products are nonscientific and hence are not advised to be used till more studies are undertaken to ensure that the benefits clearly outweigh the risk, in addition to recognition by Food and Drug Administration.

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