Pediatric vasculitides: a generalists approach.

Vasculitis is defined as the presence of inflammation in a blood vessel that may occur as a primary process or secondary to an underlying disease. Primary vasculitides are rare in children. These are defined by both the size of vessels involved and the type of inflammatory response.

Chronic abdominal pain--a radiological solution.

Chronic mesenteric ischaemia is not an uncommon disorder. It is associated with high morbidity and mortality. It presents with chronic abdominal pain and the diagnosis is often missed because of nonspecific clinical findings and limitations of diagnostic studies.

Pro-insulin, C peptide, glucagon, adiponectin, TNF alpha, AMPK: neglected players in type 2 diabetes mellitus.

This article emphasizes (1) the utility of routine measurement of pro-insulin to insulin ratio as a specific marker of insulin resistance and predictor of future T2DM, HT and CAD, (2) routine C-Peptide estimation to determine which T2DM needs insulin and to monitor the effect of newer drugs which promote beta cell regeneration, (3) routine estimation of adiponectin and TNF alpha and monitor response to thiozolidine drugs which increases adiponectin and decreases TNF alpha production by adipocytes, (4) crucial role of AMPK--Cellular energy sensor in mediating the beneficial effects of exercise as well as drugs (adiponectin, metformin) in T2DM, (5) Availability of glucogon suppressors will eliminate the need for giving insulin to T2 DM with normal C Pepetide levels which inevitably causes undesirable weight gain & hypoglycemia.

Aspergilloma in sarcoidosis.

This is a case report of a 48-year-old man, followed up for nearly 30 years who initially developed sarcoidosis at the age of 18 that went into remission after 8 years of treatment. Ten years later, he developed sputum-positive tuberculosis and was cured with anti-tubercular treatment. Following this, there was progression of sarcoidosis to stage IV fibrocystic disease.

Diagnostic criteria of tuberculous sarcoidosis.

With the object to strengthen the clinical status of tuberculous sarcoidosis, we present in this article, the case records published in internationally recognized journals by specialists. From review of clinical material, we have also formulated a table that defines diagnostic criteria of tuberculous sarcoidosis.

Cryptogenic cirrhosis: a vanishing entity.

The diagnosis of cryptogenic cirrhosis (cirrhosis of unknown etiology) has dramatically decreased, following the discovery of hepatitis B virus (1965), hepatitis D virus (1977), hepatitis C virus (1989). Improving the diagnostic criteria for Autoimmune Hepatitis, by devising the scoring system and the recognition of the fact that Nonalcoholic Steatohepatitis can progress to cirrhosis (in 8 to 10 years), further reduced the diagnosis of cryptogenic cirrhosis. Establishing the etiology of cirrhosis in the vast majority of the patients has provided numerous options for its prevention and treatment.

Plasma homocysteine in obese, overweight and normal weight hypertensives and normotensives.

Aim: The aim of the present study was to assess the interrelationship of obesity with plasma homocysteine levels as well as vitamin B12 and folic acid levels in hypertensive and normotensive subjects.

Methods: Sixty-five hypertensive and sixty-five normotensive patients were studied. Plasma homocysteine, vitamin B12 and folic acid, lipid parameters, blood pressure, pulse pressure levels, body mass index were estimated in all the subjects.

Reversal of nail changes after liver transplantation in a child.

We report a 6-year-old girl who received a left-lobe live-related liver transplant for decompensated liver disease after a failed Kasai's surgery for biliary atresia. Preoperatively, her nails were white, dystrophic, brittle with severe onycholysis, clubbing and watch-glass deformities. Nail scrapings were negative for fungus.

Interrelationships of Factor VII activity and plasma leptin with insulin resistance in coronary heart disease.

Objective: An increase of FVII activity (FVIIc) has been proposed to be an independent cardiovascular risk factor. Whether FVII is associated with insulin resistance in coronary heart disease (CHD) is still unknown. We tested the hypothesis that plasma FVII activity and leptin are associated with insulin resistance independently.

Hematological problems and liver disease.

There has been significant progress in the understanding of the pathophysiologic basis of common haematological problems like cytopenias, coagulopathies and thrombophilic disorders in the background of liver disease. Diagnosis has improved with newer tests like detection of JAK2 mutation and better radiological imaging. Additionally, therapeutic options have expanded with availability of drugs like activated factor VII and eltrombopeg and improved expertise in procedures like TIPSS for treatment of the Budd-Chiari syndrome.

Epigenetics--gene silencing.

The discovery of the mechanism of RNA interference by ds RNA by Prof. Andrew Fire and Prof. Craig Mello in 1998, gave them the Nobel Prize in 2006.

Medical Council of India : the rot within.

The Medical Council of India is a statutory national agency charged with several responsibilities. Sadly, it is plagued by inefficiency, arbitrariness and lack of transparency. It has been functioning for some years as the fiefdom of one person--Dr Ketan Desai.

Surgical treatment of lumbar tuberculous spondylodiscitis by transforaminal lumbar interbody fusion (TLIF) and posterior instrumentation.

Study Design: Retrospective case study.

Objective: We present a retrospective clinical study of 15 patients with lumbar and lumbosacral tuberculosis treated by transforaminal lumbar interbody fusion and posterior instrumentation. The purpose is to determine the clinical efficacy of such surgical treatment for lumbar tuberculosis.

Percutaneous nephrolithotomy for 1-2 cm lower-pole renal calculi.

Objectives: The most appropriate management of patients with lower-pole calyceal (LC) stones remains controversial. In this review we discuss the role of percutaneous nephrolithotomy (PCNL) in the management of LC stones 1-2 cm in maximum dimension.

Materials And Methods: A detailed literature review was performed to summarize the recent technical developments and controversies in PCNL.

Interrelationship between coagulation factor VII and obesity in diabetes mellitus (type 2).

We explored the interrelationships of coagulation FVII activity levels with obesity, leptin and insulin resistance in diabetes mellitus (DM Type 2) and in non-diabetic control subjects. We found FVII hypercoagulant activity levels in DM not associated with obesity, leptin levels or insulin resistance. It was found independently associated with hypertriglyceridemia.

Immunological effects and membrane interactions of chitosan nanoparticles.

The objective of this study was to investigate the in vitro and in vivo effects of blank chitosan nanoparticles on various molecular markers such as nitric oxide (NO) production, IL-6 gene expression, and lymphocyte proliferation involved in the wound healing process. In addition, the membrane effects of chitosan nanoparticles were evaluated using phospholipid vesicles as a model membrane. Peripheral blood mononuclear cells (PBMC) were treated with blank chitosan nanoparticles, and the effect on NO production, IL-6 gene expression, and lymphocyte proliferation was evaluated.

Hypersexuality following subthalamic nucleus stimulation for Parkinson's disease.

Subthalamic nucleus (STN) stimulation is an established surgical treatment for Parkinson's disease (PD). Though the motor benefits of STN stimulation are well understood, its cognitive and behavioral effects are still not fully understood. Manic psychosis, hypersexuality, pathological gambling and mood swings are associated with advanced PD.

A novel Global Assessment Scale for Wilson's Disease (GAS for WD).

Wilson's disease (WD) is an inherited disorder of copper metabolism. Despite being treatable, patients with WD suffer severe disabilities due to delay in initiation and difficulty in monitoring treatment. We propose a two tier, Global Assessment Scale for Wilson's Disease (GAS for WD) that grades the multisystemic manifestations of the disease.

Omental torsion.

Omental torsion is a rare cause of acute abdominal pain, and clinically mimics acute appendicitis. A 11-year-old boy presented with symptoms and signs suggestive of appendicitis. A computed tomography of abdomen revealed findings suggestive of omental torsion.