Plasmonic nanoparticle's anti-aggregation application in sensor development for water and wastewater analysis

Colorimetric sensors have emerged as a powerful tool in the detection of water pollutants. Plasmonic nanoparticles use localized surface plasmon resonance (LSPR)-based colorimetric sensing. LSPR-based sensing can be accomplished through different strategies such as etching, growth, aggregation, and anti-aggregation. Based on these strategies, various sensors have been developed. This review focuses on the newly developed anti-aggregation-based strategy of plasmonic nanoparticles. Sensors based on this strategy have attracted increasing interest because of their exciting properties of high sensitivity, selectivity, and applicability. This review highlights LSPR-based anti-aggregation sensors, their classification, and role of plasmonic nanoparticles in these sensors for the detection of water pollutants. The anti-aggregation based sensing of major water pollutants such as heavy metal ions, anions, and small organic molecules has been summarized herein. This review also provides some personal insights into current challenges associated with anti-aggregation strategy of LSPR-based colorimetric sensors and proposes future research directions.

Ce1-x O₂Cux Nanoparticles: Synthesis, Characterization and Catalytic Activity for Phenol Degradation

Solid solutions of CuO in CeO₂ have been prepared by the solution combustion method. This method allows the Cu²⁺ ions to dissolve into CeO₂ lattice instead of Ce⁴⁺ ions. This creates charge imbalance and lattice distortion in CeO₂ because of which oxygen vacancies are produced. The presence of Cu in ceria causes decrease in lattice parameters, smaller crystallites, and larger surface area. Both techniques XRD and Raman spectroscopy confirm the presence of cubic phase of CeO₂ with fluorite structure and they also show a peak shift after the introduction of Cu which is an indication of the total symmetry breaking of ceria structure. This may be related with the partial substitution of Ce⁴⁺ by Cu²⁺ cations in the CeO₂ lattice. TEM analysis results provide an average size of 27.4 nm for Cu-doped CeO₂ particles. XPS confirms the Cu²⁺ species in Cu-doped sample. The prepared Cu-Ce materials are explored for phenol degradation. The effect of initial phenol concentration, pH and catalyst amount on phenol degradation is investigated. It is observed that with increase in an initial phenol concentration, the degradation efficiency decreased. The maximum degradation efficiency is observed at pH 3 and 0.5 g/L amount of Cu-doped CeO₂ catalyst.

Nickel Nanocatalyst Ex-Solution from Ceria-Nickel Oxide Solid Solution for Low Temperature CO Oxidation

In this work, in situ growth of Ni nanocatalysts to attach onto the ceria (CeO2) surface through direct Ni ex-solution from the NiO-CeO2 solid solution in a reducing atmosphere at high temperatures with an aim to improve the catalytic activity, and stability for low temperature carbon monoxide (CO) oxidation reaction have been reported. The NiO-CeO2 solid solutions were prepared by solution combustion method, and the results of XRD and RAMAN showed that doping of Ni increases the oxygen vacancies due to charge compensation. Ni is clearly visible in XRD and TEM of Ni ex-solved sample (R-UCe5Ni10) after reduction of NiO-CeO2 (UCe5Ni10) sample by 5% H2/Ar reduction at 1000 °C. TEM analysis revealed a size of 9.2 nm of Ni nanoparticle that is ex-solved on the surface CeO2. This ex-solved sample showed very high catalytic activity (T50 ~ 110 °C), and stability (100 h) for CO oxidation reaction as compared to prepared solid solution samples. This is due to the highly active metallic nano-phase which is ex-solved on the surface of CeO2 and strongly adherent to the support. The apparent activation energy Ni ex-solved sample is found out to be 48.4 kJ mol-1. Thus, the above Ni ex-solved sample shows a practical applicability for the CO reaction.

Low-temperature CO oxidation over Cu/Pt co-doped ZrO2 nanoparticles synthesized by solution combustion

Zirconia (ZrO2) nanoparticles co-doped with Cu and Pt were applied as catalysts for carbon monoxide (CO) oxidation. These materials were prepared through solution combustion in order to obtain highly active and stable catalytic nanomaterials. This method allows Pt2+ and Cu2+ ions to dissolve into the ZrO2 lattice and thus creates oxygen vacancies due to lattice distortion and charge imbalance. High-resolution transmission electron microscopy (HRTEM) results showed Cu/Pt co-doped ZrO2 nanoparticles with a size of ca. 10 nm. X-ray diffraction (XRD) and Raman spectra confirmed cubic structure and larger oxygen vacancies. The nanoparticles showed excellent activity for CO oxidation. The temperature T50 (the temperature at which 50% of CO are converted) was lowered by 175 °C in comparison to bare ZrO2. Further, they exhibited very high stability for CO reaction (time-on-stream ≈ 70 h). This is due to combined effect of smaller particle size, large oxygen vacancies, high specific surface area and better thermal stability of the Cu/Pt co-doped ZrO2 nanoparticles. The apparent activation energy for CO oxidation is found to be 45.6 kJ·mol-1. The CO conversion decreases with increase in gas hourly space velocity (GHSV) and initial CO concentration.

Nanocrystalline ZrO2 and Pt-doped ZrO2 catalysts for low-temperature CO oxidation

Zirconia (ZrO₂) nanoparticles were synthesized by solution combustion using urea as an organic fuel. Brunauer-Emmett-Teller (BET), X-ray diffraction (XRD), thermal gravimetric analysis (TGA), transmission electron microscopy (TEM), UV-vis and Fourier transform infrared (FTIR) measurements were performed in order to characterize the catalyst. The calculated crystallite size of ZrO_2, calculated with the help of the Scherrer equation, was around 30.3 nm. The synthesized ZrO₂ was scrutinized regarding its role as catalyst in the oxidation of carbon monoxide (CO). It showed 100% CO conversion at 240 °C, which is the highest conversion rate reported for ZrO₂ in literature to date. It is found that through solution combustion, Pt²⁺ ions replace Zr⁴⁺ ions in the ZrO₂ lattice and because of this, oxygen vacancies are formed due to charge imbalance and lattice distortion in ZrO₂. 1% Pt was doped into ZrO₂ and yielded excellent CO oxidation. The working temperature was lowered by 150 °C in comparison to pure ZrO₂. Further, it is highly stable for the CO reaction (time-on-stream ≈ 40 h). This is because of a synergic effect between Pt and Zr components, which results in an increase of the oxygen mobility and oxygen vacancies and improves the activity and stability of the catalyst. The effects of gas hourly space velocity (GHSV) and initial CO concentration on the CO oxidation over Pt(1%)-ZrO₂ were studied.

Structural analysis of lead magnesium niobate using synchrotron powder X-ray diffraction and the Rietveld method

The room-temperature synchrotron powder X-ray diffraction pattern of the single phase perovskite lead magnesium niobate (PMN) has shown significant broadening in the q range ∼ 5-7 Å(-1) compared with standard LaB6 synchrotron powder X-ray diffraction data, taken under similar conditions. This broadening/asymmetry lies mainly towards the lower 2θ side of the Bragg peaks. Attempts to fit this data with the paraelectric cubic phase (Pm\bar 3m) and the local rhombohedral phase (R3m) corresponding to polar nanoregions (PNRs) are made using the Rietveld method. Rietveld refinements show that neither cubic (Pm\bar 3m) nor rhombohedral (R3m) symmetry can fit this XRD pattern satisfactorily. The two-phase refinement fits the experimental data satisfactorily and suggests that the weight percentage of the PNRs is approximately 12-16% at room temperature. The unit-cell volume of these rhombohedral PNRs is approximately 0.15% larger than that of the unit cell volume of the paraelectric cubic phase.

Umbilical myiasis in a neonate

There are very few reports of myiasis in neonates and umbilical myiasis is the rarest form. The umbilical stump of a 7-day-old neonate in the postnatal ward was found to be infested with maggots secondary to hatching of housefly eggs.

Effect of antimicrobial Peptide, nisin, on the reproductive functions of rats

Our previous studies have demonstrated that naturally occurring peptide, Nisin possess antibacterial activity and did not interfere with rabbit vaginal mucosa. In this study, the reproductive toxicity of the Nisin in male rats was evaluated. Rats were fed orally with Nisin (10, 25, and 50 mg/kg/day) for 13 weeks. No treatment related mortality was observed. The body weight gain, food consumption and serum biochemical parameters were at par with the control group. Histomorphology of the selected reproductive (testis, epididymis, ventral prostate, and seminal vesicle) and nonreproductive (liver and kidney) tissues was observed to be normal. There was no treatment-related increase or decrease in the expression of testis-specific genes (c-Kit, GATA-1, and HILS-1) and the activity levels of epididymal α-glucosidase, ventral prostate alkaline phosphatase (AlP), liver alanine aminotransferase (AlAT) and aspartate aminotransferase (AAT). Fructose and lactic acid levels in the seminal vesicles also remained unchanged. These studies suggest that Nisin did not affect the normal physiology of these organs. In addition, no adverse effects were observed on the reproductive performance of Nisin-treated male rats and their offspring. In conclusion, the current studies support our earlier studies, which demonstrated suitability of Nisin as a safe and effective microbicide.

Comparative study of syndromic and etiological diagnosis of reproductive tract infections/sexually transmitted infections in women in Delhi

BACKGROUND

The adequacy of the World Health Organization's syndromic approach for the diagnosis and management of sexually transmitted diseases (STDs), especially at primary health centers (PHCs) and at other levels, is still debatable in different settings in India and requires validation.

OBJECTIVES

A cross-sectional study was carried out in women attending the peripheral government clinics of Delhi in order to (1) enumerate their self-reported reproductive tract infection (RTI)/sexually transmitted infection (STI) symptoms; (2) assess their clinical status; (3) determine the syndromic diagnosis of RTI/STI in symptomatic women and etiological diagnosis in both symptomatic and asymptomatic women; and (4) compare the level of agreement between self-reporting of morbidity and syndromic and etiological diagnosis.

MATERIALS AND METHODS

The study was conducted over 26 months in 4090 women attending peripheral government healthcare centers, both rural and urban, in four zones of Delhi. They were recruited into four different study groups: group I, non-pregnant, reporting with symptoms of RTI/STI; group II, with a bad obstetric history or infertility; group III, pregnant women in any trimester attending the antenatal clinic; and group IV, the control group. Gynecological examination, followed by the collection of genital specimens and blood, were performed after informed and written consent was obtained. Every symptomatic patient was managed on the basis of algorithms of the syndromic approach as recommended by the National AIDS Control Organisation (NACO), India. All specimens were transported to the STD Reference Laboratory, Safdarjung Hospital, New Delhi and processed by standard methods to diagnose the various STDs. Laboratory reports were sent to the clinicians and appropriate treatment was instituted. Data were analyzed by applying statistical methods.

RESULTS

Overall, self-reporting of morbidity was 65.0%. However, the percentage of women with some STD-related syndrome was 71.4%. The rural women were observed to have significantly more STD syndromes than their urban counterparts. The etiological diagnosis could be established in only 32.2% of cases.

CONCLUSIONS

This study highlights the wide variation between self-reporting of morbidity and syndromic- and etiology-based diagnosis in women from both rural and urban settings. This has implications for the syndromic approach to STI case management. These observations call for a review of the diagnostic policy for RTIs/STIs by national authorities in order to avoid the overuse of antimicrobials. The study also highlights the need for the introduction and/or strengthening of facilities for simple diagnostic tests for RTIs/STIs, especially at the peripheral healthcare level.

Evaluation of test results of microbiology laboratories of North India for standard tests for syphilis under an external quality assurance scheme

Test results of syphilis serology are critical due to inter- and intralaboratory variability. The accuracy of results is crucial in the control of the disease. This study was aimed to compare results of laboratories and performance of methods for syphilis serology. Results of Veneral Disease Reference Laboratory (VDRL) or rapid plasma reagin (RPR) tests of 25 microbiology laboratories were compared in six proficiency testing sentinel surveys. The performance of laboratories was compared with the results of a hypothetical average laboratory. Of the 141 participants, 104 (73.8%) responded. The inter-laboratory variability was exhibited by 62.2% of samples tested by VDRL and 58.7% by RPR test. Intralaboratory variability was observed in 46.7% samples. There was an insignificant improvement in proficiency testing (PT) performance over the years with a significant improvement in 2007. The common errors involved departure from testing protocols. Syphilis serology proficiency testing is needed in India for reliability in test results.

Antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from peripheral health centres and STD clinic attendees of a tertiary care centre in India

Summary:

The aim of the study was to compare the antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from urban and rural peripheral health centres and from sexually transmitted disease (STD) clinic attendees. Antimicrobial susceptibility testing of 191 N. gonorrhoeae isolates (165 isolates from STD clinic attendees and 26 from peripheral health centres) was carried out in Delhi, India, using the calibrated dichotomous sensitivity technique for penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and nalidixic acid, and minimum inhibitory concentrations were determined using E-test. Penicillin-resistant, ciprofloxacin-resistant, penicillinase-producing N. gonorrhoeae and tetracycline-resistant N. gonorrhoeae strains were higher in STD clinic attendees than in peripheral health centres, probably because of less antibiotic pressure in the peripheral areas. High-level resistance to ciprofloxacin and multiresistant strains were also higher in STD clinic attendees. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in different population subgroups in order to monitor the spread of multiresistant strains and to update the national treatment recommendations.

Changing trends of antimicrobial susceptibility patterns of Neisseria gonorrhoeae in India and the emergence of ceftriaxone less susceptible N. gonorrhoeae strains

OBJECTIVES

To monitor the trend of antimicrobial susceptibility of Neisseria gonorrhoeae isolates from 2002 to 2006 in New Delhi, India under the Gonococcal Antimicrobial Susceptibility Programme and to document the emergence of any new antimicrobial resistance.

METHODS

Antimicrobial susceptibility of 382 N. gonorrhoeae isolates from clinical cases in males and females to penicillin, tetracycline, ciprofloxacin, spectinomycin and ceftriaxone was determined by disc diffusion technique, using WHO reference strains as controls and WHO interpretative criteria. MICs were determined using Etests.

RESULTS

A significant increasing trend of penicillin and ciprofloxacin resistance up to 2003 and 2004, respectively, and subsequent decrease in resistant strains with a concomitant increase in less susceptible strains, was observed. Tetracycline-resistant N. gonorrhoeae increased significantly from 6.7% in 2002 to 22.9% in 2005. Only one isolate was resistant to spectinomycin and nine isolates were less susceptible to ceftriaxone, during this 5 year period. A substantial proportion (23.3%) of strains were multiresistant.

CONCLUSIONS

Emergence of ceftriaxone less susceptible N. gonorrhoeae isolates is a cause for concern, although treatment failure was not observed. An active, continuous and comprehensive programme for monitoring and surveillance of antimicrobial resistance needs to be established in many laboratories, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.

Changing trends in sexually transmitted infections at a Regional STD Centre in north India

BACKGROUND & OBJECTIVES

Sexually transmitted infections (STIs) a major public health problem in India show various trends in different parts of the country. However, there are limited data on the changing profile of laboratory proven STIs in the same clinic over the years. The present study was thus aimed to determine the changing trends of the profile of STIs and HIV seropositivity in STD clinic attendees over a 15 yr period, and also to detect change, if any, in the antimicrobial resistance pattern of Neisseria gonorrhoeae.

METHODS

The STIs were diagnosed clinically and confirmed by standard laboratory techniques. Socio-demographic data were collected through pre-designed proformae. The STI profile and HIV seropositivity were compared between 1990-1993 (A), 1994-1997 (B), 1998-2001 (C) and 2002-2004 (D). Antimicrobial resistance pattern of N. gonorrhoeae was determined by standard techniques and compared between the last three periods.

RESULTS

Of the 78,617 STD attendees, 12,709 (16.2%) had STIs. During period A, genital discharges and during B, C and D, genital ulcerative diseases were predominant. Syphilis was the commonest STI. There was significant rise in the cases of syphilis, herpes progenitalis and genital warts and reduction in that of chancroid, lymphogranulomavenereum (LGV), donovanosis, candidiasis, trichomoniasis and bacterial vaginosis cases. The number of cases with primary syphilis diminished significantly (P<0.001), with a concomitant rise in secondary and early latent syphilis. A rising trend was observed in the HIV seropositivity during the different periods. The association of HIV seropositivity was consistently more in patients presenting with genital ulcers specially syphilis, and rose significantly from A (0.6%) to C (8.8%), but became stationary during D. A drastic change in the antimicrobial resistance of N. gonorrhoeae from B to C and C to D and the emergence of less sensitive isolates to ceftriaxone during the later part of the study were observed.

INTERPRETATION & CONCLUSION

Our study showed a definite changing trend in the profile of STIs in the clinic attendees of a major STD centre during a 15 yr period. However, the significant rise in the cases of viral STIs and syphilis contrasted with reduction in the rest.

CD4/CD8 lymphocyte counts in healthy, HIV-positive individuals & AIDS patients

BACKGROUND & OBJECTIVES

The enumeration of CD4 and CD8 positive cells, surrogate markers for HIV disease progression, is helpful in management and follow up of immunocompromised HIV-positive patients. In assessing the degree of immune deficiency in HIV-positive patients of a particular region, knowledge of reference range of T-cell subset counts of healthy individuals of that particular region is essential. The present cross-sectional study was undertaken to determine the reference range of T-cell subsets in healthy north Indians and to compare the values with those in HIV-positives.

METHODS

Blood samples from 125 HIV seronegative healthy volunteers comprising group I (88 males, 37 females) and 452 HIV- positive patients, divided into group II of asymptomatic (n=137; 93 males, 44 females) and group III of AIDS patients (n=315; 253 males, 62 females) in the age group of 17-60 yr, were analysed for enumeration of CD4+, CD8+ cells/microl by flow cytometry.

RESULTS

In group I, the CD4 and CD8 levels were 687 +/- 219 and 611 +/- 288 cells/microl in males and 740 +/- 255 and 546 +/- 246 cells/microl in females. Overall, a significant depressed level of CD4 (525 +/- 207 cells/microl) and elevated level of CD8 (1174 +/- 484 cells/microl) in group II and (170 +/- 115 and 1051 +/- 586 cells/microl) respectively in group III were observed. Group II patients had highest level of CD8 cells. No asymptomatic women had CD4 count of <200 cells/microl.

INTERPRETATION & CONCLUSION

Our findings on T-cell subset reference ranges of normal healthy north Indians validate the utility of determination of CD4 cell count as a useful predictor of AIDS in Indian conditions and confirm that a significant per cent of AIDS patients had CD4 cell count below 200/microl.

Comparison of disc diffusion results with minimum inhibitory concentration (MIC) values for antimicrobial susceptibility testing of Neisseria gonorrhoeae

BACKGROUND & OBJECTIVE

objectives: As antimicrobial susceptibility testing of Neisseria gonorrhoeae provides guidance for appropriate treatment, there is a need for simple, reliable and cost-effective method for susceptibility testing. The present study was aimed to compare the results of two methods of susceptibility testing, minimum inhibitory concentration (MIC) values by E test with disc diffusion results by Australian Gonococcal Surveillance Programme (AGSP) method in N. gonorrhoeae isolates.

METHODS

Susceptibility testing for ciprofloxacin, penicillin and ceftriaxone using AGSP method was carried out for 301 confirmed consecutive isolates of N. gonorrhoeae. MIC of ciprofloxacin, penicillin and ceftriaxone was determined by E test in 301, 198 and 128 isolates respectively. The results of the two methods were compared by using Kappa statistics.

RESULTS

Moderate levels of agreement for ciprofloxacin (kappa=0.44) and penicillin (kappa=0.54) were observed between the two methods. For ceftriaxone, 96.1 and 0.8 per cent isolates were found to be susceptible and less sensitive respectively by both the methods and per cent agreement between the two methods was 96.9 per cent.

INTERPRETATION & CONCLUSION

Both the methods were easy to perform and gave reproducible results. However, disc diffusion method was cost-effective and more feasible in routine diagnostic laboratories in developing countries like India.

Evaluation of antimicrobial peptide nisin as a safe vaginal contraceptive agent in rabbits: in vitro and in vivo studies

In the midst of the global epidemics of both unwanted pregnancies and sexually transmitted infections (STIs), options that provide protection are ideal. In the present study, nisin, a known antimicrobial peptide, was evaluated for safety and contraceptive potential in vitro and in vivo in the rabbit. A concentration of 400 microg nisin per ml was found to be spermicidal in vitro, and the effect was dose and time dependent. In vivo studies indicated that intravaginal application of 1 mg nisin blocked conception in rabbits. Repeated application of nisin (50 mg/animal per day) in rabbits for 14 consecutive days did not cause local inflammation or damage to the vaginal epithelium. In addition, the rate of diffusion of nisin into the blood via the vaginal mucosal epithelium, and its clearance from the circulation was found to be rapid. No treatment-related changes were observed in the reproductive performance of rabbits after cessation of treatment. Furthermore, no changes were observed in the gestation period, subsequent growth and survival of neonates in these animals. When male rats were given nisin orally for 13 consecutive weeks, no effect was observed on reproductive performance. The number of pups born, survival and growth of pups were unaltered. The affinity studies of nisin revealed that spermatozoa are more susceptible to nisin than red blood cells and vaginal epithelial cells. We suggest that nisin with spermicidal and antimicrobial properties could serve as a safe vaginal contraceptive for future therapeutic interventions in STIs.

Evaluation of beta2 microglobulin level as a marker to determine HIV/AIDS progression

Levels of beta2 microglobulin (beta2M) were evaluated to monitor the progression of HIV disease, as an alternate economical marker to RNA viral load and CD4 cell count in resource poor situations. A cross sectional study of 32 HIV sero-negative controls (Group I), 43 asymptomatic HIV sero-positives (Group II-A), 44 HIV sero-positives with clinical and/or laboratory proven STDs (Group II-B) and 30 with AIDS indicator conditions (Group III) was carried out. beta2M levels were determined using an enzyme immuno assay. Mean +3 SD (3.04mg/l) of concentration of beta2M in sero-negative controls was chosen as threshold of abnormality. A significant rise (p<0.001) in mean beta2M levels (mg/l) from 1.87 +/- 0.39 (Group I) to 2.59 +/- 1.09 (Group IIA), 3.01 +/- 1.27 (Group IIB) to 5.16 +/- 2.48 (Group III) was observed. Higher values of beta2M in the symptomatic phase than those in the asymptomatic phase indicated that elevated levels of beta2M parallel progression of HIV disease and suggest its use as an alternate marker for determining HIV progression.

Expression of integrin receptors on peripheral lymphocytes: correlation with endometrial receptivity

PROBLEM

To investigate the expression of integrin (ITG) cell adhesion molecules on peripheral blood lymphocytes (PBL) and their correlation with endometrial cell ITG expression in fertile and infertile women during peak uterine receptive period (day 19/20).

METHOD OF STUDY

Surface marker expression and quantification of alpha6, alpha4 and beta3 ITG subunits was done by immunohistochemistry, indirect immunofluroscence and cell-enzyme-linked immunosorbent assay methods using endometrial cells and PBL obtained from fertile and infertile (unexplained infertility) women.

RESULTS

The expression of ITGs was significantly (P<0.001) decreased in the endometrial cells of infertile women compared to normal fertile women. These results correlated well with the data obtained using PBL-ITG expression.

CONCLUSIONS

If these preliminary data are consistent in a larger group of patients, the expression of alpha4 and beta3-ITG subunits on PBL may be used as clinical markers to assess endometrial receptivity in infertile women. Moreover, frequent blood sampling is advantageous over repeated endometrial biopsies as the former approach is easier, non-traumatic and avoids intra-uterine infections.

Erythema elevatum diutinum in a patient with human immunodeficiency virus

Erythema elevatum diutinum (EED) is a chronic cutaneous leukocytoclastic vasculitis. This rare disease is characterized by red, brownish-purple, and yellow papules, plaques, and nodules distributed symmetrically about the extremities. There have been recent reports of the disease in association with infection with the human immunodeficiency virus (HIV). We describe the case of a 51-year-old man with HIV who presented with EED, which was successfully treated with dapsone.

Various Presentations of Postcholecystectomy Bile Leak Diagnosed By Scintigraphy

Hepatobiliary scintigraphy is an established method for the diagnosis of a bile leak from the biliary system. A bile leak should be considered in any patient after cholecystectomy who has unexplained abdominal pain after operation. Three patients with bile leak diagnosed by scintigraphy are described, one of whom had an unusual pattern of hepatic subcapsular collection of the bile. The second patient had a bile leak through the postsurgical drainage tube, whereas the third patient had a more typical pattern of leakage into the peritoneal cavity.

Scintigraphic evaluation of colonic transit in two patients with idiopathic chronic constipation

Bowel transit in two women with protracted constipation was evaluated after oral administration of In-111 DTPA in water. Serial abdominal images were obtained for as long as 96 hours to assess transit through the stomach, small bowel, and colon. In both patients, large bowel transit was delayed. A pattern of colonic inertia was observed in one patient, whereas retention in the distal colon was seen in the other patient. Both patients underwent total colectomy with marked symptomatic relief. Colonic transit studies of these patients are presented, and the literature is reviewed.

Photolocalized varicella in a middle-aged adult

We report a case of photolocalized varicella occurring in a middle-aged woman. Photolocalized or actinic varicella is rarely described, and most reported cases have occurred in children. This is the first case in a middle-aged adult.

Scintigraphic detection of a disseminated synovial lymphoma in a postrenal transplant patient

Post-transplant lymphoproliferative disease is a recognized complication of immunosuppressive therapy, however, articular lymphomas involving the synovlum are very rare. Disseminated synovial lymphoma of the knee with hepatic involvement in a patient after renal transplant was suggested on bone/gallium scintigraphy and confirmed by synovial biopsy. Gallium scanning thus was instrumental in the evaluation, staging, and proper treatment of this rare condition.

Scintigraphic localization of recurrent anastomotic site bleeding in the gastrointestinal tract

Scanning with Tc-99m labeled RBC was performed in two patients with recurrent postoperative gastrointestinal bleeding after partial colonic resection. Imaging correctly identified the source of bleeding at the anastomotic site in the large bowel, effectively contributing in the patient's treatment planning. Radionuclide scintigraphy provides a simple, noninvasive modality to diagnose and manage difficult clinical situations such as postoperative bleeding.

Lymphocytes--their possible endocrine role in the regulation of fertility

PROBLEM

Peptide secretion by peripheral lymphocytes obtained from fertile and infertile women.

METHOD

LH, FSH, and prolactin were estimated in the serum and culture supernatants obtained from Con-A stimulated human lymphocytes by RIA.

RESULTS

The levels of LH, FSH and prolactin were low in the culture supernatants obtained from lymphocytes of infertile women, when compared with proven fertile women.

CONCLUSION

The results indicated impairment in endocrine functions of lymphocytes obtained from infertile women. This impairment in lymphocyte function could be one of the causes of infertility in these women.

A comprehensive index for longitudinal monitoring of child health status

The aim of this study was to develop a single comprehensive index of child mortality for longitudinal assessment of health status of children. The need for such a comprehensive index arose from conflicting trends in different child mortality indicators. The data for the study was taken from the Sample Registration System (SRS) reports of the Registrar General of India. SRS is known to provide reliable estimates of births and deaths at the State and the National level. The study included five child mortality indicators, namely, under five mortality rate (U5MR), infant mortality rate, neonatal mortality rate, perinatal mortality rate and still birth rate. These were available for fifteen states of India over the years 1972-1988. To develop this index we modified an earlier method based on factor analysis. Factor analysis of data on various indicators of child mortality revealed two factors which together explained 78% to 93% of the total variation in different years. The first factor was identified as representing mortality after birth and the second as before and during birth. The comprehensive index was obtained as a linear combination of these two factors. The resultant index thus fairly represented all five mortality indicators and provided a comprehensive and reasonably correct picture of child mortality. The lower the magnitude of this index, the better was the child health status. Trends in the index showed that the highest decline in the magnitude was in the state of Kerala followed by Punjab, Andhra Pradesh, Gujarat and Maharashtra in that order. This indicates steady improvement of the child health status over years in these states. In the State of Jammu and Kashmir, the index remained more or less constant over the years though the magnitude was low in the cross-sectional comparison with other states. Thus the comprehensive index developed by using factor analysis of the various mortality indicators can be used for the longitudinal monitoring of child health status in the states of India.

Scintigraphic evaluation of bile dynamics before and after endoscopic sphincterotomy

Endoscopic sphincterotomy has been used for the treatment of many biliary disorders, including extraction of obstructing common bile duct stones. Manometric studies of the sphincter of Oddi and the common bile duct have shown a marked decrease in biliary tract pressures after sphincterotomy. A prospective study of 12 patients with intact gallbladders using hepatobiliary imaging before and after sphincterotomy was performed to assess changes in bile dynamics. Nonfilling of the gallbladder occurred in 9 of the 12 patients after sphincterotomy, indicating significant alteration of bile flow. Such changes in bile dynamics may have serious implications in patients selected for medical dissolution of gallstones. It may also adversely affect specificity of cholescintigraphy in diagnosing acute cholecystitis.

Early pregnancy factor as a marker for assessing embryonic viability in threatened and missed abortions

It is now well recognized that the presence of early pregnancy factor (EPF) can signify the occurrence of fertilization, continuation of pregnancy and the existence of a viable embryo. With this in view, a study was undertaken to observe the potential of EPF as a marker in assessing embryo viability in cases complicated with vaginal bleeding during early pregnancy. The results indicated that the sensitivity of EPF as a marker in predicting threatened or missed abortion was 78.9% and the specificity 95.6%. The positive predictive value was observed to be 93.8% and the negative predictive value 84.6%. Our studies have shown that since EPF is present in viable but absent in non-viable pregnancies, it could be a useful marker of prognostic value in threatened abortions.

Scintigraphic evaluation of multifocal hemangioendothelioma of bone

Multifocal bone involvement was seen on bone scintigraphy in a young woman being examined for a suspected bone lesion noted on pelvic radiographs. Biopsy of the third lumbar vertebral body demonstrated a vascular lesion. The tumor was resected and a bone graft was performed. The patient was followed with serial scans to assess the viability of the bone graft and course of the disease. This report analyzes the scintigraphic characteristics of this rare tumor and emphasizes the importance of bone scintigraphy in the diagnosis, treatment, and follow up of this condition.

Significance of intensity of delayed activity during technetium-99m-RBC gastrointestinal bleeding study

In 27 patients with normal hepatic function, delayed concentration of radioactivity (during 99mTc-RBC gastrointestinal bleeding studies) was compared with liver blood-pool activity. That is, for images at 4 to 24 hr postinjection, grading was accomplished by comparison to the liver blood pool (less than, equal to, or greater than hepatic activity). There was a correlation between the accuracy of scan interpretation (for active bleeding and localization) and the intensity of activity as related to the liver. This simple grading system may be useful for interpretation of delayed images during bleeding studies.

Klippel-Trenaunay-Weber syndrome with recurrent pulmonary embolism

A man with Klippel-Trenaunay-Weber syndrome had worsening pulmonary hypertension secondary to recurrent multiple pulmonary embolism despite anticoagulation. Pulmonary thromboendarterectomy was done. However, the patient expired 10 days after surgery due to another bout of pulmonary embolism from his right arm or right chest wall.

Development of an index of need for health resources for Indian States using factor analysis

An index of need for health resources in the Indian States has been developed using the statistical technique of factor analysis. Data on seven selected indicators measuring various aspects of population health in 17 Indian States for the year 1981 were used to extract factors. Two factors were discovered which together explained 83% of the total variation. The first factor alone, identified as 'proximate determinants', explained 67% of the variation. The second, 'sociomedical background' accounted for 16%. Factor analysis results have been used to derive standardized indices which helped to compare quantitatively the health needs of the people of various States.

Brain morphology in first-episode schizophrenic-like psychotic patients: a quantitative magnetic resonance imaging study

Brain morphology was examined using magnetic resonance imaging in 30 first-episode patients with a schizophreniclike psychosis, 15 chronic schizophrenics, and 20 neurological controls. Statistical analyses of computer-generated measurements of regions of interest were controlled for gender, age, social class, and total brain volume. Lateral ventricular size was increased in both first-episode and chronic schizophrenic patients, with greater significance on the left than on the right side. Only the chronic patients, however, had reduced temporal lobe size, which also was greater on the left side. No major correlations of regional brain morphological measurements with cognitive functioning were found, although some measurements of verbal memory were correlated with parahippocampal size. This is a report of a preliminary study that suggests that some morphological brain changes may be present at the time of first treatment for a psychotic illness, whereas others may occur later in the course of illness. Future prospective studies may determine the clinical significance of these changes and whether they progress with the development of illness chronicity.