Unearthing Earth's secrets: Exploring the environmental legacy of contaminants in soil, water, and sediments

The Earth's history is documented in human civilizations, soil layers, river movement, and quiet sediments throughout millennia. This investigation explores the significant legacy of environmental toxins in these key planet components. Understanding how ancient activity shaped the terrain is crucial as mankind faces environmental issues. This interdisciplinary study uses environmental science, archaeology, and geology to uncover Earth's mysteries. It illuminates the dynamic processes that have built our globe by studying pollutants and soil, water, and sediments. This research follows human actions, both intentional and unintentional, from ancient civilizations through contemporary industrialization and their far-reaching effects. Environmental destiny examines how contaminants affect ecosystems and human health. This study of past contamination helps solve modern problems including pollution cleanup, sustainable land management, and water conservation. This review studies reminds us that our previous activities still affect the ecosystem in a society facing rapid urbanisation and industrialization. It emphasises the importance of environmental stewardship and provides a framework for making educated choices to reduce toxins in soil, water, and sediments. Discovery of Earth's secrets is not only a historical curiosity; it's a necessary step towards a sustainable and peaceful cohabitation with our home planet.

Respectful Maternity Care Practices During Normal Delivery at the Public Health Facilities in Tamil Nadu, Southern India: A Descriptive Study

INTRODUCTION

The quality of maternity care in Tamil Nadu has significantly improved in the past few years and various public health initiatives have helped to reduce crucial indicators like Maternal Mortality Ratio and Infant Mortality Rate. The improvement in quality of interface between the mothers and service providers in term of language, behaviour and attitude for ensuring 'Respectful Maternity Care' would support further enhancement of maternal and new born outcomes. Delivery of appropriate and respectful care to each pregnant woman would not only go a long way in reducing mortality and morbidity for the woman and new-born but also help in improved cognitive development of the baby.

OBJECTIVE

To assess the quality of delivery care practices provided during normal delivery among women accessing public health facilities in Tamil Nadu.

METHODS

A descriptive evaluation study was conducted from May to December 2018 in 16 facilities across 14 districts in Tamil Nadu. The health facilities were stratified according to the level of services, Government Medical College hospitals (MC), District headquarter hospitals (DHQ), Sub-district hospitals (SDH), and PHCs, 4 facilities in each category were selected. Data was collected by direct observation using a facility observation check list in an Android-based tablet application. Informed consent was obtained from all participants.

RESULTS

A total of 1006 pregnant women out of 2242 women who had normal delivery were assessed and included in the study. More than 50% of deliveries were conducted by nurses and midwives and the perinatal and maternal outcomes were found to be good. The parameters for the respectful maternity care were recorded. Routine care monitoring parameters helped to reduce mortality rate and improved delivery care.

CONCLUSION

The state though has achieved substantial success in promoting institutional delivery practices, still needs certain crucial improvements in the quality of respectful maternal care during the delivery.

Beta 1,3-1,6 Glucans Produced by Two Novel Strains of Aureobasidium Pullulans Exert Immune and Metabolic Beneficial Effects in Healthy Middle-aged Japanese Men: Results of an Exploratory Randomized Control Study

Objectives

In this pilot study, we have evaluated the specific metabolic and immune-related benefits of the AFO-202 strain and N-163 strain of black yeast Aureobasidium pullulans-produced beta 1,3-1,6 glucan in healthy human subjects.

Methods

Sixteen healthy Japanese male volunteers (aged 40 to 60 years) took part in this clinical trial. They were divided into four groups (n = 4 each): Group I consumed AFO-202 beta-glucan (2 sachets of 1 g each per day), IA for 35 days and IB for 21 days; Group II consumed a combination of AFO-202 beta-glucan (2 sachets of 1 g each) and N-163 beta-glucan (1 sachet of 15 g gel each per day), IIA for 35 days and IIB for 21 days.

Results

Decrease in HbA1C and glycated albumin (GA), significant increase of eosinophils and monocytes and marginal decrease in D-dimer levels, decrease in neutrophil-to-lymphocyte ratio (NLR), with an increase in the lymphocyte-to-CRP ratio (LCR) and leukocyte-to-CRP ratio (LeCR) was observed in Group I between pre- and post-treatment. Decrease in total and LDL cholesterol, a decrease of CD11b, serum ferritin, galectin-3 and fibrinogen were profound in Group II between pre- and post-treatment. However, there was no statistically significant difference between day 21 and day 35 among the groups.

Conclusion

This outcome warrants larger clinical trials to explore the potentials of these safe food supplements in the prevention and prophylaxis of diseases due to dysregulated metabolism, such as fatty liver disease, and infections such as COVID-19 in which balanced immunomodulation are of utmost importance, besides their administration as an adjunct to existing therapeutic approaches of both communicable and non-communicable diseases.

Study on personal profile of members in biodiversity management committees of Kerala

This is a study of the personal profile of members in Biodiversity Management Committees (BMCs), functioning under selected local self-governments of Kerala. BMCs constitute the grass root level institutional machinery for decentralized biodiversity governance. Five BMCs each from six districts, two each from the northern, central, and southern zones were selected purposively based on key informant technique. The selection of districts was based on criteria viz. indigenous cattle population, documentary evidence on native livestock of conservation value and expert guidance by subject matter specialists. Data regarding personal attributes of two hundred and forty members, eight each from thirty selected BMCs, procured through e-surveys and telephonic interviews were analyzed statistically. Results indicated dismal representation of women (37.08 per cent) as well as youth (21.25 per cent) in the committees. Another significant finding was the prevalence of political/ social workers among BMC members (61.66 per cent).The representation of stakeholder communities including those of farming, livestock and fisheries was minimal (17.08 per cent), whereas there was absolute absence of traditional knowledge holders and practitioners of indigenous medicine. Graduates and postgraduates together constituted nearly half of the respondents. All the members reported a working experience of five years in BMCs. The findings regarding training exposure in biodiversity management among BMC members revealed that a vast majority received not more than one training (79.58 per cent). Only a few had attended two or three training programmes (16.25 per cent).The Awards/recognitions received by individual members in biodiversity management was minimal (0.42 per cent), whereas at organizational level, 43.33 per cent of BMCs received only one and 3.33 per cent received more than one awards.

A scale to measure the perception of veterinarians towards antimicrobial use and resistance

Veterinarians are the primary sourceof knowledge for farmers on how to use antibiotics responsibly in farm animals and how to decrease the risk of antibiotic resistance.Antimicrobial use and resistance is a multidimensional construct that lacks a specific measurement scale. This paper looks into the development of a scale to assess veterinarian perception about antimicrobial use and resistance. Following a thorough literature review, focus group interviews were conducted with selected key informant veterinarians to identify statements.An initial list of 80 statements reflecting positive and negative perception towards antimicrobial use and resistance was prepared. After editing, a final list of 70 statements were arrivedat. Descriptives of antimicrobial use and resistance, consensus regarding antimicrobial use and resistance indicators were arrived at through relevancy rating by a panel of 40 judges in the field of veterinary science based on which 35 statements were selected for item analysis. These 35 statements were subjected to item analysis among 60 veterinarians selected from a non-sample area. Out of the 60 veterinarians to whom the items were administered for item analysis, 15 veterinarians each with the lowest and highest scores were used as the two criterion groups to evaluate individual items. Individual items were selected based on‘t’ value whereinitems that had a t-value of more than 1.75 were selected and incorporated into the final schedule. Based on the calculated‘t’ values, 14 items were finally selected and includedin the final scale. Reliabilityof the scale was tested using Cronbach’s alpha coefficient of reliability test for which a Cronbachalpha of 0.852 was obtained indicating the internal consistancy of the scale.

A scale to measure knowledge level of dairy farmers affected by Kerala flood 2018 on disaster response

Kerala was worst affected by flood disaster in August 2018.The most effective strategy to mitigate the adverse effects of flood disaster is providing the general public with basic knowledge of how to respond to disasters. The present study was contemplated to develop and standardise a scale for measuring dairy farmers’ knowledge on disaster response. Based on thinking and differentiation of well knowledgeable dairy farmers from poorly knowledgeable dairy farmers 27 items comprehensively covering each aspect of disaster response was constructed. Based on relevancy test, 16 items were selected. These selected knowledge items were subjected to item analysis comprising of difficulty index, discrimination index and point biserial co- relation. A total of 9 items were selected for the final scale. The reliability of the knowledge test was measured by Cronbach alpha. Cronbach’s alpha was found to be excellent .811, which is very high and indicates strong internal consistency among the 09 items. The developed knowledge test was found to be highly stable and dependable measurement. Keywords: Disaster, response, knowledge scale, reliability, validity

Genotypic Variations of Mutans Streptococci Isolated from Dental Caries by REP-PCR

Mutans streptococci (MS) are a group of oral bacteria considered as the main cariogenic organisms. MS consists of several species of genus Streptococcus which are sharing similar phenotypes and genotypes. The aim of this study is to determine the genetic diversity of the core species of clinical strains of Streptococcus mutans, Streptococcus sobrinus and Streptococcus downei by using repitative extragenic palindromic (REP) primer. The DNA of the clinical strains of S. mutans (n=10), S. sobrinus (n=05) and S. downei (n=04) have been employed in the present study, which have been previously isolated from caries active subjects. The DNA of the clinical and reference strains was subjected to PCR amplification using REP primer. The phylogenetic dendrogram is constructed from the REP PCR banding profile by neighbour-joining method using PyElph 1.4 software. The size of the DNA amplicons generated by using REP primer were S. mutans (1500 bp to 250 bp), S. sobrinus (6000 bp to 250 bp) and S. downei (5000 bp to 400 bp). The results present common band at 480 bp in all the clinical strains of S. sobrinus. The current study is the first to demonstrate the genetic variety of S. sobrinus and S. downei by using REP primer. REP-PCR have been found to be a powerful method to study the molecular diversity of S. mutans, S. sobrinus and S. downei. Additionally, further studies are suggested to analyze the species specific bands and also to find the possibility to produce a new specific primer for S. sobrinus.

Detection and characterization of Streptococcus downei, a rare bacterial species of mutans streptococci from caries-active patients

Background

The oral bacteria, mutans streptococci (MS), are an etiological agent of dental caries. Of MS, Streptococcus downei are rarely isolated bacteria.

Aim

The aim of this study was to isolate and characterize S. downei from caries-active subjects.

Materials and Methods

In all, 65 dental plaque samples were collected from dental caries-active subjects. All the isolates were further identified and characterized using 16S rDNA sequencing, biochemical tests, antibiogram, and minimum inhibitory concentration (MIC).

Results

Five isolates have been identified as S. downei using 16S rDNA sequencing. Phylogenetic analysis showed that S. downei was closely related to S. sobrinus. The biotype traits of these five isolates were IV (n = 3), V (n = 1), and variants (n = 2). The study proposed one new biotype, classified as biotype VIII for the variant strain. The antibiogram tests revealed that all the strains of S. downei were susceptible to all the antibiotics used in the study with higher sensitivity to penicillin and ampicillin. The MIC of ampicillin and erythromycin against S. downei was 0.047 and 0.39 μg/mL, respectively.

Conclusion

The study reports the prevalence of S. downei in caries-active subjects and recommends further investigations to determine its role in the disease.

Synthesis of green marine algal-based biochar for remediation of arsenic(V) from contaminated waters in batch and column mode of operation

The sorption behavior of biochar derived from green seaweed (Ulva reticulata) toward arsenic(V) ions was explored in both batch and continuous modes. The pH edge experiments indicated optimum arsenic(V) sorption observed at pH 4, with maximum sorptional capacity of 7.67 mg/g through isotherm experiments. The kinetic experimental trials indicated that arsenic(V) sorption onto biochar was a fast electrostatic attraction process, with maximum removal occurred within 30 min. The sorption isotherms were modeled using the Toth, Redlich-Peterson, Langmuir and Freundlich isotherm models while the adsorption kinetics was modeled using the pseudo-first- and pseudo-second-order kinetic equations. The three-parameter models (Redlich-Peterson and Toth) better described the isotherm data, whereas pseudo-first-order model represented kinetic data well with low error and high correlation coefficient values. Among the different alkaline and acidic elutants investigated, the solution of 0.01 M NaOH effectively desorbed arsenic(V) from spent biochar. The feasibility of the biochar in continuous remediation of arsenic(V) from contaminated waters was explored in an up-flow fixed column. The biochar exhibited arsenic(V) removal efficiency and sorptional uptake of 59.5% and 8.12 mg/g, respectively. The biochar-loaded column was effectively desorbed using NaOH (0.01 M), with desorption efficiency of 99.5%.

Thermally Reduced Graphene Oxide as a Counter Electrode Material for Dye-Sensitized Solar Cells

In this present study, a highly conductive thermally reduced graphene oxide (TRGO) was synthesized by a low temperature thermal reduction method using RF heating, under an argon-hydrogen atmosphere. The crystallinity and morphology were examined by X-ray diffraction, Raman spectroscopy and TEM analysis. The chemical structure including the functional groups present on TRGO was studied using X-ray photoelectron spectroscopy and FTIR analysis. The studies reveal that thermal reduction of graphene oxide was successful under the experimental conditions and that the TRGO had high crystallinity. Further, the performance of the as-prepared TRGO was tested as a counter electrode (CE) in a dye-sensitized solar cell (DSSC). The maximum power conversion efficiency (PCE) obtained was 4.86% for TRGO under one sun illumination, which is comparable to that of a platinum CE-based DSSC (5.24%). The electrocatalytic activity and electron transfer kinetics were examined by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and Tafel measurements. The series resistance (R_s) and charge transfer resistance (R_ct) values were found to be 35.4 Ωcm^-2 and 56.40 Ωcm^-2 for TRGO. The results reveal that the TRGO had an electrocatalytic performance similar to that of Pt, making TRGO-CEs promising alternatives to the conventional Pt-CEs in DSSCs.

Green alga-mediated treatment process for removal of zinc from synthetic solution and industrial effluent

The present work explored biosorption of Zn(II) ions from aqueous and zinc-bearing factory effluent using marine seaweed Ulva lactuca. The batch pH edge experiments using aqueous zinc solution indicated that Zn(II) uptake by U. lactuca was found to be maximum at pH 4.5 and the batch isotherm trials performed at pH 4.5 resulted in maximum uptake capacity of 128.0 mg Zn(II)/g. With 0.1 M CaCl₂ (pH 3.5, HCl) as elutant, the elution of Zn(II) ions from Zn(II)-laden U. lactuca biosorbent was effective with possible regeneration and reuse for three cycles. The zinc industrial effluent was found to comprise of 87.8 mg/L of zinc ions along with excess co-ions and high total dissolved solids (838.1 mg/L). Owing to this, Zn(II) uptake from electroplating effluent by U. lactuca was suppressed due to competition from other ions. Continuous-flow sorption trials were conducted at flow rate of 5 mL/min in an up-flow fixed column. The existence of surplus competing ions in zinc wastewater influenced the Zn(II) biosorption by U. lactuca. U. lactuca-loaded packed column exhibited uptakes of 78.3 and 70.8 mg Zn(II)/g for aqueous solution and effluent, respectively. The results of three continuous sorption-desorption cycles demonstrated that reuse of U. lactuca biosorbent in remediation of zinc-containing wastewaters was practical and economical.

One-Step RF-CVD Method for the Synthesis of Graphene Decorated with Metal and Metal Oxide Nanoparticles

Bilayer and few layer-graphene (Gr) with noble metal (Ag and Au) and TiO2 nanoparticles were synthesized using atmospheric pressure radio frequency chemical vapor deposition (APRF-CVD). The precursors for the formation of the respective nanoparticles were dissolved in ethanol and injected into the APRF-CVD containing a Cu foil catalyst at 1000 °C. The graphene obtained had a blistered morphology similar to bubble-wrap. The bubble-like protrusions on the graphene sheet were caused by large nanoparticle clusters (~220 nm) formed below the graphene sheets. Smaller nanoparticles (10-80 nm) were also observed on top of the graphene sheets. Encapsulation of the nanoparticles with graphene, to yield core-shell particles was observed. Similarly, secondary growth of carbon nanotubes (CNTs) from the Au nanoparticles was observed. The average full width half maxima (FWHM) of 2D bands in the Raman spectra indicate that the graphene formed was predominantly bilayer graphene for Gr-TiO2 (55 ± 1.72 cm-1), and few-layer graphene for Gr-Ag (76 ± 22 cm-1) and Gr-Au (88 ± 4.7 cm-1). Raman spectroscopy also showed evidence for the doping of graphene and surface-enhanced Raman sensitivity (SERS) in the materials. These electronic properties of graphene with nanoparticles are relevant to various applications such as optoelectronics, catalysis, chemical and biological sensing.

Isolation and Typing of Streptococcus mutans and Streptococcus sobrinus from Caries-active Subjects

Background

Streptococcus mutans and Streptococcus sobrinus are main etiological agents of dental caries.

Aim

The aim of the study was to isolate, identify, characterize, and determine the minimum inhibitory concentration (MIC) of S. mutans and S. sobrinus from caries-active subjects.

Materials and Methods

Sixty-five plaque samples were collected from caries-active subjects aged between 35 and 44 years, processed and cultured on mitis salivarius bacitracin agar. All the bacterial isolates were subjected to morphotyping and the suspected colonies were identified by 16S rDNA sequencing. The S. mutans and S. sobrinus strains were characterized by biotyping and phylogenetic analysis. The MIC of ampicillin and erythromycin was determined by microtiter plate method.

Results

Of the study population, 41 isolates displayed typical colony morphologies of S. mutans and S. sobrinus. The 16S rDNA sequencing results revealed that 36 isolates were S. mutans and 5 isolates were S. sobrinus. The biotyping of these isolates demonstrated three biotypes, namely, biotype I (n = 35), biotype III (n = 1), and biotype IV (n = 2). However, 3 isolates exhibited variant biotypes. The phylogenetic analysis revealed that the clinical strains of S. mutans and S. sobrinus clustered independently along with respective reference strains. The average MIC of ampicillin and erythromycin against S. mutans and S. sobrinus was 0.047 μg/ml and 0.39 μg/ml, respectively.

Conclusion

The 16S rDNA sequencing was an impeccable method for S. mutans and S. sobrinus identification when compared with morphotyping and biotyping methods. The study also suggested that nonspecific bacteria might be involved in caries formation.

The spectroscopic (FT-IR, FT-Raman), MESP, first order hyperpolarizability, NBO analysis, HOMO and LUMO analysis of 1,5-dimethyl napthalene by density functional method

The Fourier-transform infrared and FT-Raman spectra of 1,5-Dimethyl Napthalene (15DMN) was recorded in the region 4000-400cm(-1) and 3500-50cm(-1) respectively. Quantum chemical calculations of energies, geometrical structure and vibrational wavenumbers of 6M2C were carried out by density functional theory (DFT/B3LYP) method with 6-311++G(d,p) basis set. The difference between the observed and scaled wavenumber values of most of the fundamentals is very small. The values of the total dipole moment (μ) and the first order hyperpolarizability (β) of the investigated compound were computed using B3LYP/6-311++G(d,p) calculations. The calculated results also show that 15DMN might have microscopic non-linear optical, MESP, NBO analysis with non-zero values. A detailed interpretation of infrared and Raman spectra of 15DMN is also reported. The calculated HOMO7-LUMO energy gap shows that charge transfer occur within the molecule. The molecular electrostatic potential map shows that the negative potential sites are on the electronegative atoms as well as the positive potential sites are around the hydrogen atoms.

Noninvasive ventilation: Are we overdoing it?

BACKGROUND

Use of noninvasive ventilation (NIV) outside guideline recommendations is common. We audited use of NIV in our tertiary care critical care unit (CCU) to evaluate appropriateness of use and patient outcomes when used outside level I recommendations.

MATERIALS AND METHODS

Prospective observational study of all patients requiring NIV. Clinical parameters and arterial blood gases were recorded at initiation of NIV and 2 h later (or earlier if clinically warranted). NIV titration and decision to intubate were left to the discretion of treating intensivist. Patients were categorized into two groups: Group 1: Those with level I indications for use of NIV and group 2: All other levels of indications. Patients were followed until hospital discharge.

RESULTS

From January 2010 to June 2010, 1120 patients were admitted to the CCU. Of these 106 patients required NIV support with 40.6% (n = 43/106) being in group 1 and 59.4% (n = 63/106) in group 2. Of these 35.8% patients (38/106) failed NIV and required endotracheal intubation. NIV failure rates (41.27% vs. 27.91%; P = 0.02) and mortality (30.6% vs. 18.6%; P = 0.03) were significantly higher in group 2 patients. In a logistic regression analysis Acute Physiology and Chronic Health Evaluation (APACHE) II score (P = 0.02), time on NIV before intubation (P = 0.001) and baseline PaCO2 levels (P = 0.01) were strongly associated with mortality.

CONCLUSION

Noninvasive ventilation failure and mortality rates were significantly higher when used outside level I recommendations. APACHE II score, baseline PaCO2 and duration on NIV prior to intubation were predictors of increased mortality.

Malignant thyroglossal duct cyst with synchronous occult thyroid gland papillary carcinoma

A 52-year-old male was referred to our department with complaints of a painless midline neck swelling. Clinico-radiological evaluation suggested a 6 × 5 cm thyroglossal cyst with non-palpable nodules in isthmus and right lobe of thyroid gland. FNAC of the thyroglossal cyst was suggestive of papillary carcinoma. He underwent Sistrunk's operation, total thyroidectomy, and central compartment neck dissection. Co-existence of papillary carcinoma of thyroid gland and thyroglossal cyst is a rare presentation and in this report, we describe our management and propose an evidence-based algorithm to assist decision-making in the management of these patients in future.

In vitro antitumor assessments of peptide nanocomplexes on Dalton's lymphoma ascites tumor model

This research work reports the in vitro antitumor personality of few novel peptide nanocomplexes synthesized via a phase-assisted, modified Brust-Schiffrin methodology. Here, a series of metallo(copper, cobalt, nickel and zinc) nanocomplexes engineered with a pre-prepared peptide [N,N'-(1,2-ethylene)-bis-hippuricamide] have been synthesized for damaging the Dalton's lymphoma ascites tumor model. All the peptide nanocomplexes are spectrally, thermally and morphologically examined. The peptide bound zinc and cobalt nanocomplexes deliver excellent antitumor behavior against both the animal and human cancer cell lines, which has been pre-documented by their efficient DNA damaging skills under physiological conditions. Additionally, all the nanocomplexes are evaluated for the inhibition of microbial augmentation against few fungal and bacterial strains. The above results demonstrate that, a consecutive development of these kinds of peptide nanocomplexes may exemplify their uniqueness in biomedical applications as useful molecular-level devices.

Assessment of the scale, coverage and outcomes of the Avahan HIV prevention program for female sex workers in Tamil Nadu, India: is there evidence of an effect?

BACKGROUND

Avahan, the India AIDS Initiative, a large-scale HIV prevention program, using peer-mediated approaches and STI services, was implemented for high-risk groups for HIV in six states in India. This paper describes the assessment of the program among female sex workers (FSWs) in the southern state of Tamil Nadu.

METHODS

An analytical framework based on the Avahan impact evaluation design was used. Routine program monitoring data, two rounds of cross-sectional biological and behavioural surveys among FSWs in 2006 (Round 1) and 2009 (Round 2) and quality assessments of clinical services for sexually transmitted infections (STIs) were used to assess trends in coverage, condom use and prevalence of STIs, HIV and their association with program exposure. Logistic regression analysis was used to examine trends in intermediate outcomes and their associations with intervention exposure.

RESULTS

The Avahan program in Tamil Nadu was scaled up and achieved monthly reported coverage of 79% within four years of implementation. The cross-sectional survey data showed an increasing proportion of FSWs being reached by Avahan, 54% in Round 1 and 86% in Round 2 [AOR=4.7;p=0.001]. Quality assessments of STI clinical services showed consistent improvement in quality scores (3.0 in 2005 to 4.5 in 2008). Condom distribution by the program rose to cover all estimated commercial sex acts. Reported consistent condom use increased between Round 1 and Round 2 with occasional (72% to 93%; AOR=5.5; p=0.001) and regular clients (68% to 89%; AOR=4.3; p=0.001) while reactive syphilis serology declined significantly (9.7% to 2.2% AOR=0.2; p=0.001). HIV prevalence remained stable at 6.1% between rounds. There was a strong association between Avahan exposure and consistent condom use with commercial clients; however no association was seen with declines in STIs.

CONCLUSIONS

The Avahan program in Tamil Nadu achieved high coverage of FSWs, resulting in outcomes of improved condom use, declining syphilis and stabilizing HIV prevalence. These expected outcomes following the program logic model and declining HIV prevalence among general population groups suggest potential impact of high risk group interventions on HIV epidemic in Tamil Nadu.

Autologous Immune Enhancement Therapy for cancer using NK cells and CTLs without feeder layers; our six year experience in India

BACKGROUND

Autologous Natural Killer (NK) cells and Cytotoxic T Lymphocytes (CTLs) based immune-cell therapy, otherwise called as Autologous Immune enhancement therapy (AIET), though has been in clinical practice in several developed nations since early 90s, in India it is in infancy due to lack of technological knowhow. Our institute has been providing the AIET cell expansion services since 2005 and we here in report our experience in 30 such patients of both solid tumours and hematological malignancies.

MATERIALS & METHODS

The number of AIET transfusions in each patient ranged from one to six. All the patients included had Stage III to IV malignancy. AIET was either given along with the chemotherapy or after the completion of a minimum of six cycles of chemotherapy in all the patients. 70 ml of Peripheral Blood was collected each time. The protocol followed was as per Terunuma et al (Breast Cancer 2010) which uses only the patients' autologous plasma for expansion of the Natural Killer Cells and Cytotoxic T lymphocytes from the peripheral blood. The cells were cultured for a period of 10 to 16 days and then transfused to the patients intravenously. The cells were subjected to Flow cytometry before and after the in vitro expansion. Feeder layers were not used in the procedure of in vitro expansion at any stage.

RESULTS

The percentage of NK cells and CTLs after expansion by flow cytometry ranged from 60 to 82 %. There were no adverse reactions in any of the patients following transfusion. The mean prolonged survival time was 15 months and 27% of the patients had Static non-progressive disease after the therapy. Two patients reported significant decrease in Cancer marker levels after AIET and among the terminally ill, two had more than two years survival. All the patients reported improvement in quality of life and resumption of appetite following AIET.

CONCLUSION

Optimal in vitro expansion of NK cells and CTLs of patients with stage III-IV cancer either concurrently or after chemotherapy could be accomplished using autologous serum without use of feeder layers. The In vitro expanded NK cells and CTLs when given intravenously decrease the tumor size and prolong the survival without any adverse effect in our experience.

Our experience of application of Autologous Bone Marrow Stem Cells in critical limb ischemia in six diabetic patients - A five-year follow-up

BACKGROUND

Numerous Clinical studies have reported the safety and efficacy of injection of one Marrow and Peripheral Blood Mononuclear cells in patients with lower limb ischemia. Earlier we have reported the six months follow-up of successful application of autologous bone marrow mononuclear cells in patients with Fontaine Stage IV critical limb ischemia due to diabetes. As a continuation of the previous study, herein we report the long term results of the six patients after a follow-up for five years.

MATERIALS & METHODS

Six Diabetic patients with Fontaine Stage IV critical limb ischemia with ulcers were given intra-lesional injections of their autologous bone marrow mononuclear cells (BMMNC), isolated following the cGMP protocols. The patients have been followed up at regular intervals for five years after the treatment with all relevant clinical investigations.

RESULTS

Six months follow-up results revealed that all the patients showed improvements with appearance of healthy granulation tissue and uniform revascularization. Complete healing was reported at a mean duration of nine months in five patients and one patient died due to a complication of renal failure, peritoneal dialysis and cardiac failure, which were unrelated to the BMMNC injection. Five year continuous follow-up revealed that the healed tissue with or without skin grafting remained healthy in all the five patients and two of the patients are able to walk without support with a pain free walking distance of greater than 100m.There were no adverse effects in any of the patients..

CONCLUSION

Autologous bone marrow stem cell therapy has been found to be salvaging the affected limb in patients with Fontaine Stage IV Critical Limb ischemia patients where revascularization was not feasible. Hence with our experience of six patients we recommend that the same should be considered in patients of similar clinical parameters before considering an amputation.

Repair of Cartilage injuries using in vitro engineered 3D cartilage tissue- Preliminary Results of Our Animal Studies

INTRODUCTION

The cartilage injuries demand novel therapeutic approaches as the success rates of the current conventional strategies for the repair of injured articular cartilages are not that encouraging. Earlier we have reported that the Thermoreversible Gelation Polymer (TGP) is an ideal scaffold for human chondrocyte expansion in vitro. In this study, we report the preliminary results of the in vitro expansion, characterization and experimental in vivo transplantation of chondrocytes in a rabbit model of cartilage injury.

MATERIALS & METHODS

Nine rabbits were included in this study scheduled for two years, after approval by the ethics committee. In the first animal, Chondrocytes were isolated from the weight bearing area of patellar groove in the left hindlimb and cultured in TGP Scaffold and maintained at 37°C in 5% carbon dioxide incubator for 64 days without growth factors. Then the TGP-Chondrocyte construct was transplanted into an experimental defect created in the knee of the right forelimb of the same rabbit. After a period of 10 weeks, a biopsy was taken from the transplanted region and subjected to morphological analysis, characterization by histopathology (H&E stain) and Immunohistochemistry (S-100 staining).

RESULTS

The chondrocytes in the 3D TGP culture had round to oval shaped morphology without any de-differentiation which is otherwise observed in Conventional 2D cultures. A macroscopic structure which resembled cartilage was appreciated in the TGP construct in vitro after 64 days which was then transplanted to the rabbit. The H&E and Immunohistochemistry studies confirmed the presence of chondrocytes in the biopsy tissue.

CONCLUSION

Based on the results, we conclude that the TGP significantly supports the in vitro expansion of chondrocytes for a longer period and the 3D culture using TGP preserves the phenotype of the articular chondrocytes. The tissue thus grown when implanted with the TGP has engrafted well without any adverse reactions and upon confirmation of safety following completion of the entire study with adequate follow-up, human applications could be considered.

Successful transplantation of in vitro expanded human corneal endothelial precursors to corneal endothelial surface using a nanocomposite sheets

BACKGROUND

Though the transplantation of in vitro expanded human corneal endothelial precursors in animal models of endothelial damage by injecting into the anterior chamber has been reported, the practical difficulties of accomplishing such procedure in human patients have been a hurdle to clinical translation. Here we report the successful transplantation of in vitro expanded human corneal precursor cells to an animal eye using a transparent Nano-composite sheet and their engraftment.

MATERIALS & METHODS

Human Corneal endothelial cells (HCEC) were isolated from human cadaver eyes with informed consent and expanded in the lab using a sphere forming assay in a novel Thermoreversible Gelation Polymer (TGP) for 26 days. HCEC obtained by sphere forming assay were seeded in a novel Nano-composite sheet, which was made of PNIPA-NC gels by in-situ, free-radical polymerization of NIPA monomer in the presence of exfoliated clay (synthetic hectorite "Laponite XLG") uniformly dispersed in aqueous media. After a further seven days in vitro culture of HCEC in the Nano-composite sheet, cells were harvested and transplanted on cadaver-bovine eyes (n=3). The cells were injected between the corneal endothelial layer and the Nano-composite sheet that had been placed prior to the injection in close proximity to the endothelial layer. After three hours, the transplanted Nano-composite sheets were removed from the bovine eyes and subjected to microscopic examination. The corneas were subjected to Histo-pathological studies along with controls.

RESULTS

HCEC formed sphere like colonies in TGP which expressed relevant markers as confirmed by RT-PCR. Microscopic studies of the Nanosheets and histopathological studies of the cornea of the Bull's eye revealed that the HCEC got engrafted to the corneal endothelial layer of the bovine eyes with no remnant cells in the Nanosheet.

CONCLUSION

Transplantation of in vitro expanded donor human corneal endothelial cells using a transparent Nano-composite sheet was feasible in bovine eyes and the HCEC an engrafted within three hours of transplantation. Pilot human studies could be planned for utilization of this material and strategy.

RPS: Repeats in Protein Sequences

Repeats are two or more contiguous segments of amino acid residues that are believed to have arisen as a result of intragenic duplication, recombination and mutation events. These repeats can be utilized for protein structure prediction and can provide insights into the protein evolution and phylogenetic relationship. Therefore, to aid structural biologists and phylogeneticists in their research, a computing resource (a web server and a database), Repeats in Protein Sequences (RPS), has been created. Using RPS, users can obtain useful information regarding identical, similar and distant repeats (of varying lengths) in protein sequences. In addition, users can check the frequency of occurrence of the repeats in sequence databases such as the Genome Database, PIR and SWISS-PROT and among the protein sequences available in the Protein Data Bank archive. Furthermore, users can view the three-dimensional structure of the repeats using the Java visualization plug-inJmol. The proposed computing resource can be accessed over the World Wide Web at http://bioserver1.physics.iisc.ernet.in/rps/.

Epigenetic profile of the euchromatic region of human Y chromosome

The genome of a multi-cellular organism acquires various functional capabilities in different cell types by means of distinct chromatin modifications and packaging states. Acquired during early development, the cell type-specific epigenotype is maintained by cellular memory mechanisms that involve epigenetic modifications. Here we present the epigenetic status of the euchromatic region of the human Y chromosome that has mostly been ignored in earlier whole genome epigenetic mapping studies. Using ChIP-on-chip approach, we mapped H3K9ac, H3K9me3, H3K27me3 modifications and CTCF binding sites while DNA methylation analysis of selected CpG islands was done using bisulfite sequencing. The global pattern of histone modifications observed on the Y chromosome reflects the functional state and evolutionary history of the sequences that constitute it. The combination of histone and DNA modifications, along with CTCF association in some cases, reveals the transcriptional potential of all protein coding genes including the sex-determining gene SRY and the oncogene TSPY. We also observe preferential association of histone marks with different tandem repeats, suggesting their importance in genome organization and gene regulation. Our results present the first large scale epigenetic analysis of the human Y chromosome and link a number of cis-elements to epigenetic regulatory mechanisms, enabling an understanding of such mechanisms in Y chromosome linked disorders.

In vivo and in vitro evaluation of highly specific thiolate carrier group copper(II) and zinc(II) complexes on Ehrlich ascites carcinoma tumor model

A new series of copper(II) and zinc(II) complexes have been designed and synthesized using a new type of Schiff bases derived from the reaction of 3-(3-phenyl-allylidene)-pentane-2,4-dione with para substituted aniline and benzene-1,2-dithiol. Their structures have been established by analytical and spectral data. The higher ɛ and low A(‖) values together with positive reduction potentials for these copper complexes suggest that they can mimic the functional properties of naturally occurring proteins. In vivo and in vitro antitumor functions of the complexes against Ehrlich ascites carcinoma tumor model have been investigated. The minimum inhibitory concentration of the complexes has also been investigated against Mycobacterium tuberculosis strain H37Rv. These complexes exhibit significant antitumor, cytotoxic and antituberculosis activity.

Alterations in beta-islets of Langerhans in alloxan-induced diabetic rats by marine Spirulina platensis

Marine Spirulina platensis may potentially influence the metabolic process in animal cells, and the effect of marine Spirulina platensis in normal and alloxan-induced diabetic rats was therefore investigated. Normal and diabetic rats (albino Wistar strain) were orally administered marine Spirulina platensis for 30 days and their blood levels of glucose and insulin and body weight changes were determined. Pancreatic histopathology was also noted. Treatment with marine Spirulina platensis caused significant alterations in the content of these indicators and therefore in the antidiabetic capacity of the treated animals compared to control rats.

Studies on phytoplankton diversity in response to abiotic factors in Veeranam lake in the Cuddalore district of Tamil Nadu

The phytoplankton samples were collected from the Veeranam lake for a period of one year from March-2005 to February-2006. The physico-chemical parameters of water such as air-temperature, water temperature, pH, salinity, dissolved oxygen, electrical conductivity and total dissolved solids were observed and their ranges were: 30.1-36.5 degrees C, 29.0-34.4 degrees C, 7.9-8.4, 1.2-2.5 mgl(-1), 7.6-9.2 microS and 2.5-5.2 mgl(-1). Totally 160 species of phytoplankton belonging to different taxonomic groups were identified. Among these 74 species to belong to Bacillariophyceae, 43 species to Chlorophyceae, 38 species to Cyanophyceae and 5 species to Euglenophyceae. The phytoplankton density was high (1705 cells l(-1)) during the summer season and low (760 cells l(-1)) during the winter season. Bacillariophyceae formed the dominant group. Species diversity index (H'), species richness (SR) and species evenness (J') were calculated.

Laparoscopic transhiatal approach for benign supra-diaphragmatic lesions of the esophagus: a replacement for thoracoscopy?

Benign esophageal lesions are rare conditions and tumors account for about 10% of all esophageal neoplasms. Epiphrenic diverticula occur in the distal esophagus (the lower 10 cm). Currently, thoracotomy/thoracoscopy is the most popular approach for these conditions. We present our experience of 13 patients (1994-2006) with benign supra-diaphragmatic esophageal lesions that we treated with a laparoscopic transhiatal approach. The lesions included in the series were lower esophageal tumors (n = 8) and epiphrenic diverticula (n = 5). Laparoscopic transhiatal stapler excisions of diverticulum and enucleation of tumors were performed for all patients. Intra-operative endoscopy was used in all the procedures. All patients had an uneventful recovery except one with posterior diverticulum, who had an anastomotic leak. He had a prolonged hospital stay and recovered eventually. There was no mortality. Benign lesions of the lower third of the esophagus can be adequately treated through the transhiatal route. This is probably superior to the traditional approaches of thoracotomy/thoracoscopy as it does away with increased morbidity while maintaining adequate access. An endoscopy is of great value in localizing the lesion and assessing the esophageal lumen size during the application of staples. A laparoscopic transhiatal excision is technically feasible for all benign supra-diaphragmatic lesions and epiphrenic diverticula and is the approach of choice.

Laparoscopic surgery for an unusual case of dysphagia: lower oesophageal leiomyoma co-existing with achalasia cardia

Benign tumours of the oesophagus are rare, with an incidence of ten percent. Leiomyomas are the most common benign tumours and are located frequently in the middle and lower third of the oesophagus. Coexisting achalasia cardia is very rare. We present a 63-year-old man with coexisting leiomyoma and achalasia presenting with dysphagia for 25 days. Endoscopy and manometry revealed achalasia cardia at the lower third. Barium swallow showed a tumour proximal to the narrowing. Laparoscopic transhiatal enucleation and cardiomyotomy with Toupet fundoplication was successfully performed. Several conditions have been described to coexist with achalasia cardia, such as cancer, paraoesophageal hernia and hiatal hernia. Based on our experience, we feel that lower oesophageal tumours are best approached by a laparoscopic transhiatal route and the presence of achalasia in this case did not change the approach as cardiomyotomy with fundoplication could also be simultaneously performed. Minimally-invasive surgery for benign oesophageal tumours reduces the morbidity of thoracotomy or laparotomy.

Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach

INTRODUCTION

Appendicitis in unusual locations or situations always poses a diagnostic dilemma and surgery is never straightforward. We aim to highlight the advantages of laparoscopy, including our own modifications, in some unusual presentations of appendicitis.

METHODS

We treated a total of 7,210 patients with appendicitis over 14 years from 1992 to 2006. In this study, we included patients with subhepatic appendicitis (0.08 percent), appendectomy in midgut malrotation (0.09 percent), appendicitis in situs inversus totalis (0.01 percent) and appendicitis in the lateral pouch position (0.01 percent). All patients underwent laparoscopic appendectomy.

RESULTS

Patients with subhepatic appendicitis, appendicitis in situs inversus and appendicitis in the lateral pouch position had an uneventful postoperative course. For the patients who underwent appendectomy as part of the treatment for malrotation and the patient with the perforated subhepatic appendix, hospital stay was slightly prolonged.

CONCLUSION

Most patients in our study did not have a confirmed preoperative diagnosis. Diagnostic laparoscopy through the umbilical port helped confirm the diagnosis. Port positions were then planned according to the exact position of the appendix and the technique was modified to suit each individual patient. In the surgical scenarios described here, laparoscopy is invaluable in both diagnosis and treatment.

PSAP: protein structure analysis package

A computing engine, theProtein Structure Analysis Package(PSAP), has been developed to calculate and display various hidden structural and functional features of three-dimensional protein structures. The proposed computing engine has several utilities to enable structural biologists to analyze three-dimensional protein molecules and provides an easy-to-use Web interface to compute and visualize the necessary features dynamically on the client machine. Users need to provide the Protein Data Bank (PDB) identification code or upload three-dimensional atomic coordinates from the client machine. For visualization, the free molecular graphics programsRasMolandJmolare deployed in the computing engine. Furthermore, the computing engine is interfaced with an up-to-date local copy of the PDB. The atomic coordinates are updated every week and hence users can access all the structures available in the PDB. The computing engine is free and is accessible online at http://iris.physics.iisc.ernet.in/psap/.

Laparoscopic surgery for perforation of Meckel's diverticulum

We report an eight-year-old boy who presented with features of peritonitis and a vague mass in the periumbilical area. Initial clinical diagnosis was an appendicular abscess. Diagnostic laparoscopy revealed an inflammatory mass with pus due to a perforated Meckel's diverticulum. Laparoscopic stapler resection of the lesion was done and the patient recovered uneventfully. Surgical resection is indicated only if the diverticulum is symptomatic or if the base is narrow. Wedge resection of the diverticulum, including anterior wall of ileum, or stapler resection can be performed. Laparoscopy is useful in both diagnosis and treatment. Laparoscopic resection of Meckel's diverticulum is feasible and ideal, especially in specialised centres.

Trichobezoars in the stomach and ileum and their laparoscopy-assisted removal: a bizarre case

A trichobezoar is a ball of swallowed hair that collects in the stomach and fails to pass through the intestines. The risk is greater among the mentally retarded or emotionally disturbed children. We report a 12-year-old girl who presented with features of intestinal obstruction. Endoscopy revealed a trichobezoar in the stomach. Diagnostic laparoscopy also revealed a trichobezoar in the ileum. After gastrotomy and enterotomy, the two trichobezoars were removed through a minilaparotomy. Psychiatric problems associated with these disorders will need attention or recurrence can occur. Trichobezoars may need surgical removal if endoscopy fails. Endoscopical removal may not be possible if the lesion is large and hard. There are some reports of laparoscopy being used in removal surgery. It has the advantages of smaller incisions, better cosmesis and reduced pain.

Laparoscopic esophagogastrectomy without thoracic or cervical access for adenocarcinoma of the gastroesophageal junction: an Indian experience from a tertiary center

BACKGROUND

The phenomenal progress of minimally invasive surgery has imparted its influence on conventional esophagectomy. Currently, more esophagectomies are being performed by laparoscopic and/or thoracoscopic methods. Esophagogastrectomy for the adenocarcinoma of the gastroesophageal (GE) junction has been a conventional treatment. The literature is limited regarding the laparoscopic approach to esophagogastrectomy. The aim of this study was to evaluate the outcome of laparoscopic esophagogastrectomy in the management of adenocarcinoma of the GE junction.

METHODS

From January 1997 to February 2005, laparoscopic esophagogastrectomy was performed in 32 patients. Indication for operation was adenocarcinoma of the GE junction in all patients. Neo-adjuvant therapy was used in two patients (6.88%) only. Initially, our approach to intrathoracic anastomosis without thoracic and cervical access was to introduce the anvil of circular stapler through minilaparotomy incision (n = 22), but later we switched to trans-oral placement of anvil into the distal end of the esophagus (n = 10).

RESULTS

There were 22 men and 10 women. Median age was 61.8 years (range, 39-72). There was no conversion. The laparoscopic esophagogastrectomy was completed in all patients. The pyloromyotomy and feeding jejunostomy were performed in all cases. The median intensive care unit stay was 1 day (range, 1-28); hospital stay was 7 days (range, 5-42). Mean estimated blood loss and mean operative time were 150 ml and 200 min, respectively. At mean follow-up of 14 months (range, 2-40), stage-specific survival was similar to that of other series.

CONCLUSION

In selected cases of adenocarcinoma of the GE junction, laparoscopic esophagogastrectomy offers as good as or better results than open operation in our institution with extensive advance endoscopic and open experience. This study shows that laparoscopic esophagogastrectomy has potential to meet oncologic criteria of clearance and provide the benefits of minimally invasive surgery as well.

Palanivelu hydatid system for safe and efficacious laparoscopic management of hepatic hydatid disease

BACKGROUND

Hydatid disease, being endemic in several areas of the world, is of interest even to surgeons in non-endemic areas because they may encounter the disease due to ease and rapidity of travel as well as immigration. We describe a new device for laparoscopic management of hepatic hydatid disease.

METHODS

The special trocar-cannula system--the Palanivelu hydatid system (PHS)--and the technique of operation are described. A total of 75 patients were operated on using this technique.

RESULTS

In 83.3% of patients, only evacuation of the hydatid cyst by the PHS was done. In 13.7%, this was followed by left lobectomy because the cysts were large, occupying almost the entire left lobe of the liver. The remnant cavity was dealt with by omentoplasty. The average follow-up period was 5.9 years, during which there were no recurrences.

CONCLUSIONS

PHS is successful in preventing spillage, evacuating the contents of hydatid cysts, performing transcystic fenestration, and for dealing with cyst-biliary communications.

Seaweeds for the remediation of wastewaters contaminated with zinc(II) ions

Eleven different species of marine macroalgae were screened at different pH conditions on the basis of zinc(II) biosorption potential. Among the seaweeds, a green alga, Ulva reticulata, exhibited a highest uptake of 36.1 mg/g at pH 5.5 and 100 mg/l initial zinc(II) concentration. Further experiments were conducted to evaluate the zinc(II) biosorption potential of U. reticulata. Sorption isotherm data obtained at different pH (5-6) and temperature (25-35 degrees C) conditions were fitted well with Sips model followed by Freundlich, Redlich-Peterson and Langmuir models. A maximum zinc(II) biosorption capacity of 135.5 mg/g was observed at optimum conditions of 5.5 (pH) and 30 degrees C (temperature), according to the Langmuir model. It was observed from the kinetic data that the zinc(II) biosorption process using U. reticulata follows pseudo-second-order kinetics. Various thermodynamic parameters, such as DeltaG degrees , DeltaH degrees and DeltaS degrees were calculated and they indicated that the present system was a spontaneous and an endothermic process. The influence of the co-ions (Na(+), K(+), Ca(2+) and Mg(2+)) along with zinc(II) present in the wastewater was also studied. Desorption of zinc(II) ions from the zinc(II)-loaded biomass were examined using 0.1 M CaCl(2) at different pH conditions in three sorption-desorption cycles. A fixed-bed column (2 cm i.d. and 35 cm height) was employed to evaluate the continuous biosorption performance of U. reticulata. The column experiments at different bed heights and flow rates revealed that the maximum zinc(II) uptake was obtained at the highest bed height (25 cm) and the lowest flow rate (5 ml/min). Column data were fitted well with Thomas, Yoon-Nelson and modified dose-response models. The column regeneration studies were carried out for three sorption-desorption cycles. A loss of sorption performance was observed during regeneration cycles indicated by a shortened breakthrough time and a decreased zinc(II) uptake.

Modulatory influence of dietary resveratrol during different phases of 1,2-dimethylhydrazine induced mucosal lipid-peroxidation, antioxidant status and aberrant crypt foci development in rat colon carcinogenesis

To shed light on the association of lipid peroxidation and antioxidant status with the development of aberrant crypt foci (ACF), we studied the modulatory influence of resveratrol, supplemented in three dietary regimens (initiation, post-initiation and entire period) on 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis. Rats were administered DMH (20 mg/kg body weight, s.c.) for 15 weeks and were supplemented with resveratrol (8 mg/kg body weight, p.o. everyday) in three dietary regimens. Intestines and colons were analyzed for the levels of diene conjugates (DC), lipid hydroperoxides (LOOHs) and thiobarbituric acid reactive substances (TBARS). Enzymic antioxidants (superoxide dismutase, SOD; catalase, CAT; glutathione peroxidase, GPX; glutathione S-transferase, GST; and glutathione reductase, GR) and non-enzymic reserve (reduced glutathione, GSH; ascorbate; and alpha-tocopherol) were also assessed in the intestine and colon. Unsupplemented DMH exposed rats showed significantly decreased levels/activities of tissue DC, LOOHs, TBARS, SOD, CAT, GSH, GR and significantly elevated (P<0.05) GPX, GST, alpha-tocopherol and ascorbate as compared to control rats. Resveratrol supplementation during the entire period of the study resulted in significant (P<0.01) modulation of lipid peroxidation markers and antioxidants status, which were paralleled with ACF suppression, as compared to DMH-alone treated rats. These results indicate that resveratrol effectively inhibits DMH-induced ACF and colonic tumor development.

Late rejection after transabdominal pre-peritoneal inguinal repair: laparoscopic extraction of mesh

We report a 29-year-old man who developed mesh rejection 3 years after laparoscopic transabdominal pre-peritoneal inguinal repair. The mesh, which was lying in a fluid cavity adherent to the urinary bladder and right iliac vessel, was removed laparoscopically.