Weight loss for reduction of proteinuria in diabetic nephropathy: Comparison with angiotensin-converting enzyme inhibitor therapy.

Reduction of weight in obese type 2 diabetes mellitus (T2DM) individuals is emerging as a significant strategy in the reduction of proteinuria in diabetic nephropathy along with control of hyperglycemia, hypertension, and dyslipidemia. The objective was to evaluate the reduction in 24-h proteinuria in T2DM patients with nephropathy by weight loss, with conventional therapy (angiotensin-converting enzyme [ACE] inhibitors) as the control arm. A prospective, randomized controlled trial was conducted between June 2010 and May 2011.

Sulfur(IV)-mediated transformations: from ylide transfer to metal-free arylation of carbonyl compounds.

The development of a direct ylide transfer to carbonyl derivatives and of a sulfoxide-mediated arylation is presented from a unified perspective. Mechanistic studies (including density functional calculations) support a common reaction pathway and showcase how subtle changes in reactant properties can lead to disparate and seemingly unrelated reaction outcomes.

Rarer in a rare.

Though moya moya disease is a disease of Asian origin, it is one of the very rare causes of stroke in India. It is a rare disease mainly characterized by progressive cerebrovascular episode due to the slowly progressive stenosis of supraclinoid segment of bilateral internal carotid arteries, the anterior and the middle cerebral arteries, and very rarely, posterior cerebral arteries. We hereby report a case of a young female who presented to us with the psychiatric complaints and refractory headache since her childhood.

Fulminant holocord intramedullary tubercular abscess with enigmatic presentation.

Background: Intramedullary and subarachnoidal tubercular abscesses are rare forms of spinal tuberculosis as compared with extradural collections secondary to vertebral tuberculosis.

Case Description: We herein present a 33-year-old, apparently healthy male patient who presented clinically as transverse myelitis, with a lesion at detected at conus cauda, developing fulminant holocord intramedullary tubercular abscess, treated with surgical evacuation and much later with anti-tubercular drugs. Atypical clinical, serological, imaging findings in addition to lack of knowledge of occurrence of fulminant intramedullary tuberculosis led to the delay in starting anti-tubercular treatment.

Hearing loss in British Army musicians.

Background: Military musicians increasingly fulfil front line roles. Existing literature suggests that musicians are at greater risk of hearing loss than the general population. It is important to ascertain whether these findings apply to military musicians if they are to be placed in operational acoustically hazardous environments.

A Case of Simultaneous Bilateral Anterior Shoulder Dislocation.

Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence.

Mechanism of the Pummerer reaction: a computational study.

DFT calculations are used to investigate the mechanism of the Pummerer reaction between a chiral sulfoxide and acetic anhydride under classical and stereoselective reaction conditions (without and with additives, respectively). The first step involving acetylation of the sulfoxide with release of acetate is found to be rate-determining in both cases. For the stereoselective Pummerer reaction in the presence of trimethylsilyl triflate (TMSOTf) and N,N-dimethylacetamide (DMAC), TMSOTf- and DMAC-assisted transition states as well as ion exchange reactions are considered to account for the role of TMSOTf and DMAC.

Linezolid-induced serotonin syndrome.

A young drug abuser was admitted to our intensive care unit for organophosphorus poisoning. He required mechanical ventilation and was started empirically on linezolid for suspected nosocomial infection. The patient developed high-grade fever with altered sensorium and clonus.

Checkpoint kinase 1 in DNA damage response and cell cycle regulation.

Originally identified as a mediator of DNA damage response (DDR), checkpoint kinase 1 (Chk1) has a broader role in checkpoint activation in DDR and normal cell cycle regulation. Chk1 activation involves phosphorylation at conserved sites. However, recent work has identified a splice variant of Chk1, which may regulate Chk1 in both DDR and normal cell cycle via molecular interaction.

Primary angiosarcoma of breast: A case report.

Introduction: Primary breast angiosarcoma is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours.

Presentation Of Case: A 28-year-old woman presented with a progressive lump in the right breast for one month.

Severe Thrombocytopenia in an Immune Thrombocytopenic Parturient Non-responder to Medical Line of Treatment: Anaesthetic Management for Splenectomy Combined with Caesarean Section.

We report anaesthesia management of a parturient with severe thrombocytopenia secondary to immune thrombocytopenic purpura (ITP). Her platelet count remained around 3 × 10(9)/l in spite of optimum medical therapy and hence was posted for splenectomy combined with caesarean section. Anaesthesia implications of severe thrombocytopenia comprises risk of central nervous system bleeding, perioperative haemorrhage causing placental hypoperfusion and foetal hypoxia, risk of trauma to compromised airway and risk of epidural haematoma.

Myasthenia gravis and pure red cell aplasia: a rare association.

This is a case of a patient who presented with generalised weakness, dysphagia and ptosis. Upon evaluating the patient, she was found to have myasthenia gravis (MG) with anaemia and hypothyroidism. Further evaluation for the cause of anaemia revealed that the patient had pure red cell aplasia (PRCA).

Swine flu (H1N1 influenza): awareness profile of visitors of swine flu screening booths in Belgaum city, Karnataka.

The 2009 flu pandemic was a global outbreak of a new strain of H1N1 influenza virus often referred colloquially as "swine flu". The objectives of the study were: (1) To know the sociodemographic and awareness profile of visitors attending swine flu screening booths. (2) To reveal sources of information.

Novel method to differentiate 3T3 L1 cells in vitro to produce highly sensitive adipocytes for a GLUT4 mediated glucose uptake using fluorescent glucose analog.

Adipocytes play a vital role in glucose metabolism. 3T3 L1 pre adipocytes after differentiation to adipocytes serve as excellent in vitro models and are useful tools in understanding the glucose metabolism. The traditional approaches adopted in pre adipocyte differentiation are lengthy exercises involving the usage of IBMX and Dexamethasone.

Nek1 phosphorylates Von Hippel-Lindau tumor suppressor to promote its proteasomal degradation and ciliary destabilization.

Loss of function in either VHL or Nek1 leads to cyst formation in tissues, especially in kidneys. Whether there is a connection between pVHL and Nek1 regulation is unknown. Here, we report that the VHL protein (pVHL) may be a substrate of Nek1.

Acute respiratory distress during paradoxical reaction to antituberculous therapy in an 8-month-old child.

Paradoxical reaction during antituberculosis treatment (ATT) is commonly seen as tuberculous lymphadenitis of peripheral lymph node, cerebral tuberculomas, pulmonary infiltrates, and pleural disease. This phenomenon is more commonly associated with extrapulmonary tuberculosis and disseminated tuberculosis. Respiratory distress, as presentation of paradoxical reaction, is rare.

Impact of patient navigation on cancer diagnostic resolution among Northwest Tribal communities.

The patient navigator model has not been widely implemented in American Indian/Alaska Native (AI/AN) communities, but may be effective in improving cancer outcomes for this population. Subjects were enrolled from eight clinics at Tribes throughout the Northwest (n = 1,187). Four clinics received navigation.

Antiphospholipid syndrome presenting as pulmonary thrombosis and pancreatitis in a young man.

The antiphospholipid syndrome and protein-S deficiency are known prothrombotic conditions. The confirmation of the latter in a patient with a recent antiphospholipid syndrome-associated thrombosis may be difficult as protein-S levels are low in a patient in the wake of recent thrombosis, antiphospholipid antibodies themselves may be targeted against protein-S and oral anticoagulation with warfarin may further bring down protein-S levels. We report a case of a 29-year-old man presenting with widespread unprovoked thrombosis in the form of pulmonary thromboembolism, neck vein thrombosis and pancreatitis.

Syncope in a patient being treated for hepatic and intestinal amoebiasis.

A 63-year-old man presented to our hospital with amoebic liver abscess and was treated successfully for the same. During the course of his treatment, he developed syncopal attacks and was found to have Torsades de Pointes on electrocardiogram. The patient was treated with intravenous magnesium and direct current cardioversion.

Portosystemic myelopathy: a rare neurological presentation of portosystemic shunts.

Portosystemic myelopathy is an unusual complication in patients with chronic liver disease with hepatic encephalopathy and portosystemic shunts. Here we present a case of 35-year-old male patient who presented to us with difficulty in walking and progressive stiffness in both lower limbs for two months. He had undergone splenectomy with distal splenorenal shunt 20 years back.