Glomerular permeability of macromolecules. Effect of molecular configuration on the fractional clearance of uncharged dextran and neutral horseradish peroxidase in the rat.

Molecular parameters other than size and charge are likely to influence the filtration of macromolecules across the glomerular filter. We have studies, therefore, the glomerular permeability of macromolecules with widely different molecular configuration such as horseradish peroxidase, a plant glycoprotein with an isoelectric point in the physiologic pH range, and dextran, an uncharged sugar polymer of D-glucopyranose. Simultaneous fractional clearances were determined for both test macromolecules in five Wistar-Furth rats. The results indicate that for a molecular radius of 28.45 A, as measured by gel filtration, the sugar polymer has a fractional clearance of 0.483 on the average, exceeding that of the protein tracer, with a value of 0.068, by a factor less than 7. We conclude that other molecular parameters such as shape, flexibility, and deformability play important roles in the transport of macromolecules across the extracellular matrix that constitutes the glomerular filter.     

Cellular image analysis and imaging by flow cytometry

Imaging flow cytometry combines the statistical power and fluorescence sensitivity of standard flow cytometry with the spatial resolution and quantitative morphology of digital microscopy. The technique is a good fit for clinical applications by providing a convenient means for imaging and analyzing cells directly in bodily fluids. Examples are provided of the discrimination of cancerous from normal mammary epithelial cells and the high-throughput quantitation of fluorescence in situ hybridization (FISH) probes in human peripheral blood mononuclear cells. The FISH application will be enhanced further by the integration of extended depth-of-field imaging technology with the current optical system.     

Bactericidal activity of different types of honey against clinical and environmental isolates of Pseudomonas aeruginosa

OBJECTIVES: Honey has had a valued place in traditional medicine for centuries. Renewed interest in honey for various therapeutic purposes, including treatment of infected wounds, has led to the search for different types of honey with antibacterial activity. In this study, we have assessed the antibacterial activity of different types of honey (manuka honey from Australia, heather honey from the United Kingdom, and locally marketed Indian honey). METHODS: The agar dilution method was used to assess the antibacterial activity of honey against 152 isolates of Pseudomonas aeruginosa by determining minimum inhibitory concentrations. RESULTS AND CONCLUSIONS: The locally available (khadikraft) honey produced the best activity against Pseudomonas aeruginosa and was found to be better than all of the imported varieties of therapeutic honey.     

Fatal pulmonary embolism following conservatively managed tendo achilles rupture-A case report

IntroductionTendo achilles (TA) ruptures are commonly encountered in orthopaedic practice. These can be managed operatively or conservatively depending on various factors like patient age, activity levels, co morbidities, patient expectations and surgeon preference. They are usually treated in plaster cast immobilisation if managed conservatively.Case reportWe present a case of fatal pulmonary embolism following conservatively managed Tendo achilles (TA) rupture in a young man treated as an orthopaedic outpatient.DiscussionThere are no current clear guidelines on venous thromboembolism (VTE) prophylaxis in conservatively managed outpatients with cast immobilisation.ConclusionOur case report highlights the importance of recognition of this aspect of patient management and reviews the current literature available on this debatable topic.     

Molecular Epidemiology of Plasmodium falciparum Malaria Outbreak,Tumbes, Peru, 2010–2012

During 2010–2012, an outbreak of 210 cases of malaria occurred in Tumbes, in the northern coast of Peru, where no Plasmodium falciparum malaria case had been reported since 2006. To identify the source of the parasite causing this outbreak, we conducted a molecular epidemiology investigation. Microsatellite typing showed an identical genotype in all 54 available isolates. This genotype was also identical to that of parasites isolated in 2010 in the Loreto region of the Peruvian Amazon and closely related to clonet B, a parasite lineage previously reported in the Amazon during 1998–2000. These findings are consistent with travel history of index case-patients. DNA sequencing revealed mutations in the Pfdhfr, Pfdhps, Pfcrt, and Pfmdr1 loci, which are strongly associated with resistance to chloroquine and sulfadoxine/pyrimethamine, and deletion of the Pfhrp2 gene. These results highlight the need for timely molecular epidemiology investigations to trace the parasite source during malaria reintroduction events.     

Determinants of Patient's Adherence to Hypertension Medications in a Rural Population of Kancheepuram District in Tamil Nadu,South India

Context:

Non-communicable diseases, no longer a disease of the rich, impose a great threat in the developing nations due to demographic and epidemiological transition. This increasing burden of non-communicable diseases and their risk factors is worrisome. Adherence to hypertension (HT) medication is very important for improving the quality of life and preventing complications of HT.

Aim:

To study the factors determining adherence to HT medication.

Settings and Design:

A community-based cross-sectional study was conducted in a rural area of Kancheepuram district, Tamil Nadu, with a total population of around 16,005.

Materials and Methods:

This study was carried out over a period of 6 months (February-July) using a pre-structured and validated questionnaire. All eligible participants were selected by house-to-house survey and individuals not available on three consecutive visits were excluded from the study. The questionnaire included information on demographic characteristics, lifestyle habits, adherence to HT medication, blood pressure, and body mass index (BMI). Caste was classified based on Tamil Nadu Public Service commission.

Statistical Analysis:

Data were entered in MS Excel and analyzed in SPSS version 16. P value <0.05 was considered statistically significant. Ethical Consideration: Informed verbal consent was obtained prior to data collection. The patient''s adherence to HT medication was assessed using the Morisky 4-Item Self-Report Measure of Medication-taking Behavior [MMAS-4].

Results:

We studied 473 hypertensive patients of which 226 were males and 247 were females. The prevalence of adherence was 24.1% (n = 114) in the study population. Respondents with regular physical activity, non-smokers and non-alcoholics were more adherent to HT medication as compared with respondents with sedentary lifestyle, smoking and alcohol intake (P < 0.005). Based on health belief model, the respondents who perceived high susceptibility, severity, benefit had better adherence compared with moderate and low susceptibility, severity, benefit.     

Efficacy of Artemether-Lumefantrine and Dihydroartemisinin-Piperaquine for Treatment of Uncomplicated Malaria in Children in Zaire and Uíge Provinces,Angola

The development of resistance to antimalarials is a major challenge for global malaria control. Artemisinin-based combination therapies, the newest class of antimalarials, are used worldwide but there have been reports of artemisinin resistance in Southeast Asia. In February through May 2013, we conducted open-label, nonrandomized therapeutic efficacy studies of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) in Zaire and Uíge Provinces in northern Angola. The parasitological and clinical responses to treatment in children with uncomplicated Plasmodium falciparum monoinfection were measured over 28 days, and the main outcome was a PCR-corrected adequate clinical and parasitological response (ACPR) proportion on day 28. Parasites from treatment failures were analyzed for the presence of putative molecular markers of resistance to lumefantrine and artemisinins, including the recently identified mutations in the K13 propeller gene. In the 320 children finishing the study, 25 treatment failures were observed: 24 in the AL arms and 1 in the DP arm. The PCR-corrected ACPR proportions on day 28 for AL were 88% (95% confidence interval [CI], 78 to 95%) in Zaire and 97% (91 to 100%) in Uíge. For DP, the proportions were 100% (95 to 100%) in Zaire, and 100% (96 to 100%) in Uíge. None of the treatment failures had molecular evidence of artemisinin resistance. In contrast, 91% of AL late-treatment failures had markers associated with lumefantrine resistance on the day of failure. The absence of molecular markers for artemisinin resistance and the observed efficacies of both drug combinations suggest no evidence of artemisinin resistance in northern Angola. There is evidence of increased lumefantrine resistance in Zaire, which should continue to be monitored.