Klf9 plays a critical role in GR -dependent metabolic adaptations in cardiomyocytes.

Glucocorticoids through activation of the Glucocorticoid receptor (GR) play an essential role in cellular homeostasis during physiological variations and in response to stress. Our genomic GR binding and transcriptome data from Dexamethasone (Dex) treated cardiomyocytes showed an early differential regulation of mostly transcription factors, followed by sequential change in genes involved in downstream functional pathways. We examined the role of Krüppel-like factor 9 (Klf9), an early direct target of GR in cardiomyocytes.

Retention Stitches: A Concept of Wound Closure of Knee Arthroplasty in Obese Patients.

Background: Knee joint arthroplasty is a commonly performed procedure. However, number of obese patients undergoing total knee arthroplasty is on a rise. In such cases, post closure using routine techniques, there have been an increasing number of cases of wound dehiscence and complications like persistent discharge and delayed healing.

Case report on thoracoscopic esophagectomy for long segment resistant oesophageal stricture in HIV infected patient.

Introduction: The incidence of Esophageal strictures following esophagitis in human immunodeficiency virus (HIV)-infected patients is profound in majority of cases. Although endoscopic dilatation remains the first line of treatment, surgery is needed for non-dilatable strictures. Sparse literature is available on clinical management for surgical intervention.

(E)-9-oxooctadec-10-en-12-ynoic acid from Ixora brachiata Roxb. increases glucose uptake in L6 myotubes by activating the PI3K pathway.

In an attempt to discover new scaffolds for anti-diabetic activity from plants, we screened extracts from Ixora brachiata Roxb. for their effect on glucose uptake in L6 myotubes. The petroleum (PE) extract of the plant showed a significant increase in insulin stimulated glucose uptake by L6 myotubes.

Calcar femorale grafting in the hemiarthroplasty of the hip for unstable inter trochanteric fractures.

Background: The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar.

NFAT-133 increases glucose uptake in L6 myotubes by activating AMPK pathway.

NFAT-133 is an aromatic compound with cinammyl alcohol moiety, isolated from streptomycetes strain PM0324667. We have earlier reported that NFAT-133 increases insulin stimulated glucose uptake in L6 myotubes using a PPARγ independent mechanism and reduces plasma or blood glucose levels in diabetic mice. Here we investigated the effects of NFAT-133 on cellular signaling pathways leading to glucose uptake in L6 myotubes.

Thoracoscopic part of minimal invasive oesophagectomy in semiprone position: our initial experience.

Introduction: Surgical resection with curative intent is till the mainstay of treatment for resectable esophageal cancer. Minimal invasive oesophagectomy has the potential to lower morbidity and mortality. In all likelihood, thoracoscopic oesophagectomy in semiprone position gives all the benefits of prone position and can be converted to thoracotomy without change in patient position if needed.

ISHKS joint registry: A preliminary report.

Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are the most widely practiced surgical options for arthritis all over the world and its application is rising in India. Indian Society of Hip and Knee Surgeons (ISHKS) has established a joints registry and has been collecting data for last 6 years.

Materials & Methods: All members of ISHKS are encouraged to actively participate in the registry.

Discovery of thiazolyl-phthalazinone acetamides as potent glucose uptake activators via high-throughput screening.

With the aim to discover orally active small molecules that stimulate glucose uptake, high throughput screening of a library of 5000 drug-like compounds was conducted in differentiated skeletal muscle cells in presence of insulin. N-Substituted phthalazinone acetamide was identified as a potential glucose uptake modulator. Several novel derivatives were synthesized to establish structure activity relationships.

Use of Fibula Bridge Graft Technique to Treat a Distal Tibia Non Union- A Case Report.

Introduction: Compound distal tibia fractures have high incidence of nonunions and have varied presentation as far as status of fibula is concerned. If fibula is sufficiently healthy we can use it for bridging the nonunion of tibia.

Case Report: We present a case of 20 year old female with compound and segmental tibia fracture.

Fermentation, Isolation, Structure, and antidiabetic activity of NFAT-133 produced by Streptomyces strain PM0324667.

Type-2 diabetes is mediated by defects in either insulin secretion or insulin action. In an effort to identify extracts that may stimulate glucose uptake, similar to insulin, a high throughput-screening assay for measuring glucose uptake in skeletal muscle cells was established. During the screening studies to discover novel antidiabetic compounds from microbial resources a Streptomyces strain PM0324667 (MTCC 5543, the Strain accession number at Institute of Microbial Technology, Chandigarh, India), an isolate from arid soil was identified which expressed a secondary metabolite that induced glucose uptake in L6 skeletal muscle cells.

Parry-romberg syndrome: a rare entity.

Parry-Romberg syndrome or progressive hemifacial atrophy is vary rare, uncommon, degenerative, poorly understood condition characterized by a slow and progressive atrophy affecting one side of the face. The incidence and the causes of this alteration are unknown. Possible factors that are involved in the pathogenesis include disturbance of fat metabolism, trauma, viral infections, heredity, endocrine disturbances and auto-immunity.

Cavum septi pellucidi in boxers.

Objective: Controversy exists over the significance of the isolated finding of cavum septi pellucidi (CSP) and its prevalence rate in healthy individuals and in professional boxers. Few magnetic resonance imaging (MRI) studies have looked at large cohorts of boxers. The aim of this study was to identify the prevalence and extent of a CSP among professional boxers and to compare these with a control group.

Superselective embolization for control of facial haemorrhage.

A case on the successful management of acute facial bleeding from the maxillary artery by superselective embolization is described. A 26-year-old male sustained a gunshot wound (GSW) to the face leading to profuse bleeding from the site of bullet entry, the nose and the mouth. Local measures failed to arrest the bleeding.

A critical analysis of the value of simultaneous inferior petrosal sinus sampling in Cushing's disease and the occult ectopic adrenocorticotropin syndrome.

The clinical, biochemical, and radiological features of pituitary ACTH-dependent Cushing's syndrome (CS) [Cushing's disease (CD)] are often indistinguishable from those of occult ectopic ACTH-dependent CS (oEAS). We have evaluated, retrospectively, the results of simultaneous bilateral inferior petrosal sinus (IPS) ACTH sampling before and after CRH stimulation in 128 patients with ACTH-dependent CS: 107 patients with CD, 6 with oEAS, 1 with an adrenal adenoma, 1 with a pituitary gangliocytoma, and 1 with Nelson's syndrome; while, in the remaining 12, the source remains unclear. One hundred seven patients received human-sequence CRH (hCRH), and 11 received ovine CRH; another 6 patients underwent stimulation with desmopressin and hCRH, and 4 with desmopressin alone.

Case report: CT and MRI demonstration of hypothalamic and infundibular relapse in childhood acute lymphoblastic leukaemia.

The central nervous system is affected in up to 10% of patients with acute lymphoblastic leukaemia, usually in the form of leptomeningeal infiltration. Parenchymal spread is rare. We report a case in which CT and MRI demonstrated hypothalamic and infundibular relapse.

CT muscle imaging and the clinical assessment of neuromuscular disease.

Twenty patients with neurogenic disorders, polymyositis, or muscular dystrophies were assessed clinically and by CT imaging of limb, limb girdle, and trunk muscles, using a standard protocol. On each side of these patients 26 movements were graded by the MRC scale, and 20 muscles were assessed by CT imaging. The clinical and CT findings could be compared, in a blind evaluation, in 10 muscles on each side.

Glycoprotein hormone alpha-subunit production and plurihormonality in human corticotroph tumours--an in vitro and immunohistochemical study.

Glycoprotein hormone alpha-subunit (alpha SU) is a recognized product of clinically non-functioning, glycoprotein hormone-secreting and somatotroph adenomas but has not been studied systematically in corticotroph tumours. We have performed immunohistochemistry for alpha SU in a consecutive series of four corticotroph tumours causing Nelson's syndrome, three corticotroph macroadenomas, 12 corticotroph microadenomas and one adrenocorticotrophin-secreting bronchial carcinoid tumour. In addition we have assessed alpha SU secretion in vitro in corticotroph adenomas from two subjects with Cushing's disease and two subjects with Nelson's syndrome.

The value of CT scanning in chronic suppurative otitis media.

High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane.

Digital subtraction angiography (DSA) of the extracranial cerebral vessels: a direct comparison between intravenous and intra-arterial DSA.

Fifty patients being investigated for ischaemic cerebrovascular disease underwent both intravenous digital subtraction angiography (IV-DSA) and intra-arterial arch digital subtraction angiography (arch-DSA) to enable a direct comparison to be made between the two techniques. The overall quality of the images obtained by arch-DSA was better than that obtained by IV-DSA, but there was no significant difference between the number and gradation of stenoses detected by the two techniques. No significant stenosis was missed by IV-DSA and the technique was found to be sufficiently accurate for it to be used as a screening procedure for carotid bifurcation stenoses suitable for carotid endarterectomy.

Minimal neuropsychological sequelae following prophylactic treatment of the central nervous system in adult leukaemia and lymphoma.

The potential long-term toxicity of central nervous system prophylaxis (CNS-P) in adult acute lymphoblastic leukaemia (ALL, n = 17) and non-Hodgkin's lymphoma (NHL, n = 7) was investigated in a multidisciplinary study. At least 4 years had elapsed from CNS-P (mean 11.5 years) for all patients.

Patterns of selective involvement of thigh muscles in neuromuscular disease.

In 14 patients with limb girdle muscular dystrophy, polymyositis, and type 3 spinal muscular atrophy, CT scans of the thigh muscles were correlated with single fiber EMG studies in vastus lateralis, semimembranosus and biceps femoris muscles. There was a relation between the extent of CT scan abnormality and increased fiber density in the three muscles studied, except in the most severely affected muscles in which in some muscles the fiber density values were lower than expected. These results were independent of the underlying pathology.

Autopsy validation of MRI in central pontine myelinolysis.

In a fatal case of central pontine myelinolysis (CPM) a low field strength (0.08 Tesla) magnetic resonance image revealed reduction of image intensity in the pons with sparing of two central symmetrical areas in the ventral portion. The latter correlated with preservation of centrally located groups of longitudinal myelinated nerve fibres shown at autopsy.

Chronic untreated tuberculous meningitis.

We describe a 34-year-old man who suffered from tuberculous meningitis for 2 years without receiving antituberculous medication. Our case is compared with other forms of indolent or benign variants of the disease.