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Effect of Surface Modified Fullerene C70 on the ROS Production and Cellular Integrity Using Chinese Hamster Ovarian Cells
No full textFullerene, a distinct buckyball structured carbon allotrope, has immense popularity among various scientific disciplines. Comparing various fullerene allotropes, recent attention is focused on C70 fullerene owing to it potent applications in various interdisciplinary arenas including optoelectronics, photovoltaics as well as in biomedical technology. Although C70 suggests as a tunable material in biomedicine, con-vincing results about its toxic effects are still under controversy, which recommends the necessity for proper toxicity evaluation. Dextran polysaccharide was effectively coated on C70 to overcome the poor dispersion in water and for achieving proper stabilization. The as-prepared material was further characterized using various sophisticated techniques such as DLS, TEM, FTIR and zeta potential. Chinese Hamster Ovarian cell lines (CHO) served as the subject for major experiments. Various cytotoxicity assays and DCFH-DA probe ROS scavenging analysis were done. Morphological examinations of major sub-cellular organelles were carried out with the aid of fluorescent microscopy for nuclear condensation, mitochondrial membrane potential, lysosomal integrity, cytoskeletal integrity, etc. Flow cytometric FACS analysis for possible apoptosis-necrosis mediated cell death assessment and DNA ladder experiment for genotoxicity was done. Cell viability assays show up to 80% live CHO cells after dextran-coated C70 treatment for 24 h. The fluorescent staining results that confirm intact or-ganelles further prove the non-toxic nature of dextran-coated C70. DNA laddering assay results ex-clude chances for genotoxic potential of dextran-coated C70. Experimental results of the present study indicate that dextran stabilized C70 fullerene is a potent candidate material for futuristic healthcare ap-plications
Impact of left renal vein division during abdominal aortic aneurysm surgery on immediate and long-term renal function
No full textOpen surgical repair is the gold standard in the treatment of abdominal aortic
aneurysms. The surgical technique has improved so vastly over the years, that even
high risk patients can undergo the procedure with acceptable morbidity. Juxtarenal
aortic aneurysms and the aneurysms with difficult or hostile neck anatomy like large
aneurysm hindering clamp space or crossing of left renal vein (LRV) pose serious
technical challenge to the operating surgeon. There are different techniques to tackle
this and one such important method is division of left renal vein. Although described
by many authors, there are contradicting reports in the literature regarding the safety
of the same and need for routine reconstruction of vein. This study intends to look into
the immediate post-operative and long term renal function of all patients who
underwent left renal vein division during elective abdominal aortic aneurysm surgery.
Left renal vein division was employed more commonly than other methods in
juxtarenal aortic aneurysms and infrarenal aortic aneurysms with difficult neck
anatomy. Renal function in the LRV division group was further analysed based on
aortic clamp placement (suprarenal, inter-renal or infrarenal). Blood urea, serum
creatinine and estimated glomerular filtration rate (eGFR) were measured
preoperatively, in the post-operative period and during follow up
Disability adjusted life years as measure of burden of epilepsy in persons who undergo seizure monitoring
No full textndia and other developing countries are undergoing a phase of epidemiological
transition where in the burden of non-communicable diseases (NCD) is increasing. This
transition is probably due to transformation of scenario with improving health care services
in preventive and promotive domains. Among various NCDs, Neurological disorders
contribute to significant proportion of global burden. (1)
Two principal documents which have been published by World Health
Organization (WHO) and World federation of Neurology bring attention to the public
health challenges posed in management of Neurological disorders, especially in the
developing countries with limited resources.(2) In this context, it is of prime importance to
determine the magnitude and pattern of Neurological disorders in India through
neuroepidemiological approach to facilitate planning and prioritizing health needs at local,
regional and national levels of health care delivery system.
Epilepsy is a chronic non-communicable disease of the brain that affects people of
all ages. The cardinal manifestations of epilepsy are epileptic seizures: that is, recurrent
paroxysmal events characterized by stereotyped behavioral alterations reflecting the neural
mechanisms involved in the epileptic process. Around 70 million people worldwide have
epilepsy, making it one of the most common neurological diseases globally. (3) Nearly 80%
of people with epilepsy live in low- and middle-income countries. It is estimated that up to
70% of people living with epilepsy could live seizure- free if properly diagnosed and
treated. The risk of premature death in people with epilepsy is up to three times higher than
for the general population. Three quarters of people with epilepsy living in low-income
countries do not get the treatment they need. In many parts of the world, people with
epilepsy and their families suffer from stigma and discrimination. (3
Prognostic indicators in guillain barre syndrome with special reference to serum albumin
No full textGuillain Barre syndrome (GBS) is a common cause of neuromuscular paralysis, the
annual incidence of which is reported to be 0.81–1.89 per 100,000 person–years.1
It is
characterised by the combination of rapidly progressive symmetrical weakness in the
limbs with or without sensory disturbances, hypoflexia or areflexia, with or without
involvement of respiratory muscles or cranial nerve-innervated muscles, with or
without autonomic dysfunction, in the absence of a CSF cellular reaction. 2 According
to the clinical criteria, maximum weakness is reached within 4 weeks, but most
patients usually reach their maximum weakness within 2 weeks.34
Patients then have a
plateau phase of varying duration, ranging from 2 days to 6 months (median duration
7 days), followed by a usually much slower recovery phase. 4,5. In patients with GBS
who have inability to walk (severely affected patients), about 25% eventually need
artificial ventilation because of weakness of the respiratory muscles. Despite
treatment with IVIg or Plasma exchange, about 20% of severely affected patients
remain unable to walk after 6 months. 6 Hence, the prognosis of GBS is tough to
predict because of the considerable variation in outcome. In the past few decades, the
GBS Disability Scale by Hughes et al has been used as an outcome scale in the
majority of clinical trials in GBS. 7 Nevertheless, it is essential to foresee the outcome
of GBS, as those likely to have a severe disease may require more aggressive therapy.
Certain indicators postulated to be of prognostic significance are - higher age (>40 or >50 years), preceding diarrhoea, severe weakness with consequent low MRC score on
admission and high early GBS disability grade. Electrophysiologically, the most
consistently described finding predictive of poor outcome has been low mean or
summated CMAPs. 7,8 The Erasmus GBS outcome score has been used to predict
inability to walk independently after 6 months, and consists of—the GBS disability
score at 2 weeks after admission, age and presence of preceding diarrhea. 9
Hence, the current prognostic models are based predominantly on clinical features,
but there is a lack of a serologic biomarker to enhance these models. At present no
biomarkers are available to assess the extent of peripheral nerve damage or to predict
outcomes in immune-mediated neuropathies. Serum albumin has already been
established as a prognostic marker in various pathological conditions like
amyotrophic lateral sclerosis, cancer,in geriatric long-term care facility
residents,individuals undergoing surgical interventions,patients with kidney disorders,
and predicts failure of IVIG therapy in Kawasaki disease. It is unclear whether in
these conditions albumin levels are a marker of patients’ nutritional status or chronic
inflammatory state, which decreases the hepatic synthesis of albumin through the
production of proinflammatory cytokines 10
.
In this study, we aim to ascertain if serum albumin levels can serve as a prognostic
biomarker in patients with GBS. This would help in anticipating treatment outcomes,
and in deciding which patients need early and more aggressive therapy in clinical
practic
Identification and characterization of endogenous human glycoconjugates recognised by plasma anti-carbohydrate antibodies
No full textLuminescent Gold Nanorod to enhance the NIR emission of Photosensitizer for Targeted Cancer Imaging and Dual therapy: Experimental and Theoretical Approach.
No full textThe strong plasmon absorption in the near‐infrared (NIR) region render gold nano rods (GNR) amenable for biomedical applications, particularly for photo‐thermal therapy. However, these nanostructures have not been explored for their imaging potential because of their weak emission profile. In this study, the weak fluorescence emission of GNR is tuned to match with the absorption of a photosensitizer molecule (PS), and the energy transfer from GNR to PS enhances emission profile of GNR‐PS combination. GNR complexes generally quench the fluorescence emission of nearby chromophores. However, in the present study, through a competition of energy transfer, the complex retains or rather enhances the fluorescence. The excitation dependent energy transfer has been explained experimentally and theoretically using DFT calculations and CIE chromaticity diagram and power spectrum. The final GNR‐PS complex modified for tumor specificity serves as an excellent organ specific theranostic probe for bioimaging and dual modal therapy, both in vitro and in vivo. Principal component analysis designates photodynamic therapy as a better candidate than the photothermal therapy for long term efficacy, in vivo
Reinforcement of amniotic membrane with fibrin coated poly- [Lactide-co-Glycolide-co-Caprolactone] terpolymer containing silver nanoparticles for potential wound healing applications
No full textHuman amniotic membrane (AM) is reported to possess remarkable therapeutic potential for wound healing due to its inherent bioactive and biocompatible properties. However, poor handling characteristics have limited its clinical use on wounds to a great extent. Reinforcement of AM with a biodegradable polymer is therefore expected to provide adequate mechanical and handling nature. Poly-[Lactide-co-Glycolide-co-Caprolactone] terpolymer incorporated with silver nanoparticles and coated with fibrin is used in this study to reinforce the membrane which delivers bioactive molecules to the wound site without wound contraction. This combination scaffold exhibited desirable properties with excellent biocompatibility for potential use in wound healing applications
Gender specific response to cardiac resynchronization therapy
No full textSystolic heart failure is an important cause of morbidity and mortality all over the
globe. Despite excellent pharmacological treatment, many patients remain highly
symptomatic and at risk of premature death. Over the last decade, cardiac resynchronization
therapy has emerged as a valuable treatment, substantially reducing morbidity and mortality
in selected patients(1). Of the several mechanisms by which Cardiac resynchronization
therapy exerts its effect, the main mechanism is improving the co-ordination of left
ventricular contraction in patients who have dyssynchrony.
Dyssynchrony was first recognized in patients with cardiomyopathy and bundle
branch block, who were noted to have a delay in the contraction of the posterior wall relative
to the septum on M-mode echocardiography in 1994 (2). The presence of bundle branch
block identified electrical delay in conduction results in mechanical delay in contraction. The
presence of a left bundle branch block is associated with higher mortality in patients with
heart failure. (3)
Furthermore, prolongation of the QRS is associated with adverse left ventricular
hemodynamic performance. An inverse relationship between QRS duration and left
ventricular end-diastolic pressure has been found (4). Furthermore, prolonged QRS has been
shown to have other adverse consequences, resulting in diastolic mitral regurgitation, and
reduced cardiac output.
A 10% reduction of LV end-systolic volume (LVESV) after CRT
for 3 to 6 months is found to be associated with a significantly lower all-cause mortality and
heart failure events (5). MIRACLE study reported a reduction of LV mass from 3 to 6
months after CRT. Effects range from individuals normalizing left ventricular (LV) function
to others who do not respond (or worsen) (6). Around 30% of patients do not respond to
CRT, in terms of improvement in symptoms, reverse LV remodelling, freedom from3
hospitalization or indeed death (7). Intriguingly, there may be sex differences. Reasons may
include frequency of underlying nonischemic pathology and/or incidence of “true” left
bundle branch block (LBBB) (i.e., QRS notching/ slurring in leads I, AVL, V5, or V6). (8)
QRS duration (QRSd) itself may have different implications in women versus men. For
example, women with LBBB and QRSd <150 ms tend to benefit, whereas males in this
category do not. (9) When QRSd is treated as a continuous function, sex-specific differences
are even more pronounced. (10) Women accounted for less than 30% of high-voltage
implants and fewer than half of low-voltage implants in a large, nationwide cohort. Survival
for women and men receiving implantable cardioverter defibrillators and PMs was similar but
dramatically greater for women receiving both defibrillators- and PM-based CRT. (11) This
has prompted calls for different guideline recommendaions for males and females. The
reasons why any single QRSd in LBBB predicates different probabilities of response between
men and women are unclear. Sex differences in the prevalence of ischemic pathology and
“false LBBB,” and effects of body and/or heart size have been proposed as underlying
factors, but not examined. (12) The premise of CRT is that pre-exciting late-activated LV
regions, due to LV depolarization delays caused by LBBB, restores synchronized LV
contraction. QRSd indexes extent of conduction delay: wider QRSd specifies an electrical
substrate more likely to be responsive to CRT. However, this concept does not account for
modulation of the QRSd by LV size, itself affected by body size and/or remodeling in heart
failure (typically producing LV dilatation). Thus, in the presence of LBBB, prolongation of
QRSd may occur from reduced myocardial conduction velocity and/or extension of the travel
distance (conduction “path length”) of the wavefront across the LV. (13). Reversal of delayed
LV activation due to LBBB is the aim of CRT, but on the other hand, LV dilation limits CRT
response. This raises the interesting notion that, because women generally have smaller4
hearts, any single QRSd may represent greater retardation of myocardial conduction
compared with men, and account for better CRT response. (14)
This study was planned with the aim of assessing the response rates between males and
females who have undergone CRT implantation in our institut
Self-Controlled Hyperthermia & MRI Contrast Enhancement via Iron Oxide Embedded Hydroxyapatite Superparamagnetic particles for Theranostic Application
No full textIncreasing effectiveness of cancer therapeutics requires a multipronged approach. Delivery of controlled hyperthermia in the ranges of 43 to 45 °C on site aided by superparamagnetic particles ensures cell death via the apoptosis pathway.We demonstrated the use of iron-oxide embedded hydroxyapatite (HAIO) superparamagnetic particles for delivery of controlled hyperthermia and contrast enhancement in MRI. To determine optimal hyperthermia delivery, we used 5 and 10 mg/mL concentrations of HAIO on various magnetic fields in alternating magnetic field (AMF) study. Time–temperature profile and specific loss power (SLP) data revealed that HAIO delivered precisely controlled temperature in contrast to superparamagnetic iron oxide nanoparticles (SPIONs). Earlier studies had demonstrated that HAIO concentrations of 0.5 to 3 mg/mL are cytocompatible. Exposure of HeLa cells to HAIO at a concentration of 2 mg/mL and applied field of 33.8 mT for a period of 30 min resulted in apoptosis induction in 75% of population. Significant cellular disruption was affirmed via FACS, ESEM and cLSM techniques. An aqueous phantom study and in vitro cell culture study evaluation indicated relaxivity of 50.92 mM–1 s–1 and good pixel intensity variation in MRI. The current study assesses the potential of HAIO to deliver controlled hyperthermia and act as a negative MRI contrast agent. Repeated experiments have confirmed enhanced utility of the technique in the burgeoning field of theranostics
Ultrasound guided paravertebral versus caudal epidural block in pediatric patients with acyanotic heart diseases undergoing cardiac surgery
No full textCardiac surgery with cardiopulmonary bypass elicits intense inflammatory and stress
response which persists into the immediate postoperative period. This subsequently
contributes to the development of postoperative complications such as myocardial
dysfunction, respiratory insufficiency and postoperative organ dysfunction and injury.1, 2
Pain following cardiac surgery may be related to the sternotomy incision, intraoperative
tissue dissection, vascular cannulation, chest tube insertion.1 The stress response to
surgery is characterized by neurohumoral, immunologic, metabolic and endocrine
derangements leading to increased secretion of catabolic hormones like cortisol and
catecholamines.1 All these can cause adverse effects such as tachycardia, hypertension,
increased oxygen consumption, catabolism, and impaired immune function.2
An appropriate anaesthetic technique can alleviate perioperative stress. This may
positively impact the overall surgical outcome. One of the most intriguing aspects of
regional anaesthesia is its ability to attenuate the stress response to surgery.3 Pre-emptive
thoracic paravertebral block has become an increasingly popular alternative to thoracic
epidural as an adjuvant to general anaesthesia.4,5
Ultrasound guided thoracic paravertebral block is superior to landmark technique as the
needle can easily be visualized and the drugs can be deposited in the correct space. Thus,
there is less incidence of pneumothorax and failed block.6Although few studies have
evaluated the role of unilateral thoracic paravertebral block in children undergoing non
cardiac surgery under thoracotomy,7,8 there is very limited evidence supporting the efficacy of bilateral thoracic paravertebral block in children undergoing cardiac surgery
through a median sternotomy.9
There are no large scale prospective studies done on caudal epidural block in pediatric
cardiac surgery. Most of the studies which we reviewed were retrospective in nature and
were inconclusive about the efficacy of caudal analgesia. 10,11 Levyi et al found a higher
early extubation rate in tetralogy of Fallot patients who received caudal epidural block.11
One prospective study done on the effect of caudal bupivacaine and sufentanil on stress
response found it to be beneficial and demonstrated a significant reduction of serum
cortisol levels in pediatric cardiac surgical patients who received the block.12 There are
no studies done on the effectiveness of ultrasound guided caudal block and comparing it
with ultrasound guided bilateral thoracic paravertebral block in pediatric cardiac surgical
patients.
Hence, we propose to assess the efficacy of ultrasound guided bilateral thoracic
paravertebral block and caudal epidural block in attenuating the intraoperative
hemodynamic and stress response in children undergoing open heart surgery through a
median sternotomy approac