Basic and biomedical Sciences

Main findings: Paraproteins, due to their precipitating nature are
known to artifactually influence various results ranging from
haemoglobin estimation to immunological assays. We describe
herein a case of multiple myeloma on treatment and follow up,
which on routine analysis showed a spuriously high total leucocyte
and platelet count. After decanting the plasma, these parameters
receded to normal levels. The immunoglobulin assay confirmed
the paraproteins.
Summary: Analysis of blood and its components by auto
analyzers have simplified many a complex test. But few variables
have to be borne in mind while scrutinizing the suspect messages
flagged by the analyser. Some of these variables may be
inexplicably linked to the patient’s condition itself. And one of the
most common variable is paraproteins seen in patients with
multiple myeloma. This case aims to highlight some of the lesser
known causes of pre-analytical errors concerning hemoglobin
estimation by auto analyzers.
Potential implications: Paraproteins have been shown to interfere
with a number of clinical laboratory tests due to their precipitating
quality. Although seldom observed in routine diagnostic parlance,
the possible clinical implications of such phenomena must never
be overlooked.

Background: Genetic counsellors are uniquely qualified to address cancer risk, interpretation of genetic results, and the inevitable complications of the subsequent ethical, legal and psychosocial issues that are encountered by individuals dealing with cancer and with the evolution of technology that can aid in screening and testing, it has become increasingly important for a country like India to evolve its healthcare policies accordingly. Main Body: Entry into and the timing of the first genetic counsellor's referral hold importance as they are based on family history, ethnicity, phenotypic expressions, high-risk tumour types, non-oncological findings and incidental findings, and ensure that all prophylactic measures, possible tests, therapies and management options are considered. Testing procedures on the gene-level is based on examination of entire genomes and of specific genes in order to estimate the pathogenicity of the variant. Moreover, risk stratification is an important tenet of genetic counselling that has enormous implications on the psychosocial well-being of the patient and their families. In India, the burden of cancer varies in accordance with gender, religion, socioeconomic status and the resolution of this adversity seems to lie in the development of nationwide policies aimed at improving access to healthcare including evolving technologies for screening and management. Conclusion: Cancer screening, testing, management are all aspects of genetic counselling that should evolve in accordance contemporary developments in the respective fields. Personalised medicine, e-health interventions and population-based screening are some examples of the aforementioned development.

The purpose of the research is to find out the comparative
cytotoxic potentials of Ipomoea Pes-Caprae and Murraya koenigii
fractions (crude methanol, Pet ether, Chloroform) by using brine
shrimp mortality assay. These two plant extracts were tested at
concentration 400, 200, 100, 50, 25, 12.5, 7.25, 3.125 μg/ml. The
extracts of both plants showed remarkable cytotoxic activity.
Following, the ascertainment of LC50 values of the extracts
(crude, Chloroform, pet ether) the extracts of Ipomoea Pes-
Caprae (1.649,5.691, 1.583 μg/ml) and Murraya koenigii( 4.365,
10, 5.370 μg/ml) were respectively compared to a reference drug
vincristin sulphate with LC50 0.839 μg/ml. Ipomoea Pes-Caprae
was determined as more cytotoxic than Murraya koenigii. Where
chloroform extract of Murraya koenigii showed low cytotoxicity
than all the extract of Ipomoea Pes-Caprae.

The bronchial mucus is produced by the goblet cells and the serous cells and is stored until a signal of secretion is emitted. Excess mucus favors complications and the use of mucoactive drugs in the outcome of patients with COPD have been reviewed in several meta-analyzes, the largest includes 26 studies. A total of 21 studies were performed in patients with chronic bronchitis and five in patients with COPD. Most studies were performed with N-acetylcysteine (n = 13). In general, there was a significant reduction in exacerbations (0.05 per patient per month) and in the number of days with disability (0.56 days per patient per month). N-acetylcysteine showed a good tolerability, with a lower number of adverse events when comparing placebo (Odds Ratio: 0.78). The evidence suggests that oral N-acetylcysteine is a safe, cost-effective drug with excellent tolerability, with a well-defined mechanism of antioxidant action when administered orally. Because of the excellent risk-benefit ratio, with a low rate of adverse events, physicians should consider the use of N-acetylcysteine to decrease the exacerbation of symptoms in COPD and other obstructive respiratory diseases. Resumen: El moco bronquial es producido por las células caliciformes y las células serosas y se almacena hasta que una señal de secreción es emitida. El exceso de moco favorece complicaciones y el uso de medicamentos mucoactivos en el desenlace de pacientes con EPOC han sido revisados en varios meta

Medical education increasingly involves online learning experiences to facilitate the standardization of curriculum across time and space. In class, delivering material by lecture is less effective at promoting student learning than engaging students in active learning experience and it is unclear whether this difference also exists online. We sought to evaluate medical student preferences for online lecture or on-line active learning formats and the impact of format on short-and long-term learning gains. Students participated online in either lecture or constructivist learning activities in a first year neurologic sciences course at a US medical school. In 2012, students selected which format to complete and in 2013, students were randomly assigned in a crossover fashion to the modules. In the first iteration, students strongly preferred the lecture modules and valued being told " what they need to know " rather than figuring it out independently. In the cross-over iteration, learning gains and knowledge retention were found to be equivalent regardless of format, and students uniformly demonstrated a strong preference for the lecture format, which also on average took less time to complete. When given a choice for online modules, students prefer passive lecture rather than completing constructivist activities, and in the time-limited environment of medical school, this choice results in similar performance on multiple-choice examinations with less time invested. Instructors need to look more carefully at whether assessments and learning strategies are helping students to obtain self-directed learning skills and to consider strategies to help students learn to value active learning in an online environment.

Platelet satellitism (“adherence of platelets”) is a unique,
infrequent phenomenon characterized by formation of platelet
rosettes around polymorphonuclear leucocytes seen in peripheral
smear prepared from EDTA-mixed blood. Platelets may interact
occasionally with polymorphonuclear leucocytes forming
complexes in particular conditions that may lead to spurious
thrombocytopenia. This phenomenon appears to be induced or
enhanced by presence of EDTA, commonly used anticoagulant. It
is not associated with any definite disease process. The etiology
may be immunological or non-immunological. EDTA-dependent
pseudothrombocytopenia has no pathologic significance other than
potentially placing a patient in jeopardy for inappropriate
treatment of thrombocytopenia that does not exist.

The development and extensive spread of multi-drug resistant bacteria are considered as a major public health concern. Failures to control severe infections due to antibiotic resistance have augmented healthcare costs as well as patient morbidity and mortality. Presently, natural product-based therapeutics are gaining significant attention both for their antimicrobial effectiveness and for not persuading drug resistance. Furthermore, recent developments in nanoscience on new drug delivery systems built on nanostructured materials from plants and microbes have emerged which focus on targeted delivery and controlled release of therapeutic agents. This review examines the recent investigations on the biological activities of plant and bacterial biological material for silver nanoparticle (AgNP) synthesis. Also, the underlying mechanism of antimicrobial activities of silver nanoparticles against human pathogens will be discussed. A fact of the biological activities and/or chemical responses of plants is required, not only for the discovery of new therapeutic agents, but because such evidence may be of value in disclosing new sources of already known biologically active compounds.

Interaction between the iron transporter protein transferrin (Tf) and its receptor at the cell surface is fundamental for most living organisms. Tf receptor (TfR) binds iron-loaded Tf (holo-Tf) and transports it to endosomes, where acidic pH favors iron release. Iron-free Tf (apo-Tf) is then brought back to the cell surface and dissociates from TfR. Here we investigated the Tf-TfR interaction at the single-molecule level under different conditions encountered during the Tf cycle. An atomic force microscope tip functionalized with holo-Tf or apo-Tf was used to probe TfR. We tested both purified TfR anchored to a mica substrate and in situ TfR at the surface of living cells. Dynamic force measurements showed similar results for TfR on mica or at the cell surface but revealed striking differences between holo-Tf-TfR and apo-Tf-TfR interactions. First, the forces necessary to unbind holo-Tf and TfR are always stronger compared to the apo-Tf–TfR interaction. Second, dissociation of holo-Tf-TfR complex involves overcoming two energy barriers, whereas the apo-Tf-TfR unbinding pathway comprises only one energy barrier. These results agree with a model that proposes differences in the contact points between holo-Tf-TfR and apo-Tf-TfR interactions.

Three roots of Inferior alveolar nerve (IAN) is a rare finding in the infratemporal fossa. The nerve had three roots, one from lingual nerve and two from the auriculotemporal nerve which encircled the Middle meningeal artery. This close relation of the artery to the nerve and vice versa may lead to the compression of either of the two structures involved here. Thus, this type of variation is noteworthy for the head and neck surgeons to perform surgeries in the infratemporal region.

In the primary auditory cortex (AI) of barbiturate-anesthetized cats multi-unit responses to tones and to frequency-modulated (FM) tonal stimuli were analyzed. Characteristic frequency (CF), sharpness of toning, minimum threshold, and dynamic range of spike count -intensity functions were determined. Minimum threshold and dynamic range were positively correlated. The response functions to unidirectional FM sweeps of varying linear rate of change of frequency (RCF) that traversed the excitatory frequency response areas (FRAs) displayed a variety of shapes. Preferences for fast RCFs ( > 1000 kHz/s) were most common. Best RCF was not correlated with measures of sharpness of tuning. Directional preference and sensitivity were quantified by a DS index which varied with RCF. About two-thirds of the multi-unit responses showed a preference for downward sweeps. Directional sensitivity was independent of CF and independent of best RCF. Measurements of latencies of phasic responses to unidirectional FM sweeps of different RCF demonstrated that the discharges of a given multi-unit over its effective RCF range were initiated at the same instantaneous frequency (effective F,), independent of RCF. Effective Fis fell within the excitatory FRA of a given multi-unit. The relationships of effective Fis to CF show that responses were evoked only when the frequency of the signal was modulated towards CF and not when modulated away from it, and that responses were initiated before the modulation reached CF. Changes in the range and depth of modulation had only minor, if any, effects on RCF response characteristics, FM directional sensitivity, and effective Fis, as long as the beginning and ending frequencies of FM sweeps fell outside a multi-unit's FRA. Stimulus intensity also had only moderate effects on RCF response characteristics and DS. However, effective Fis were influenced in systematic fashions: with increases in intensity, effective F,s to upward and downward sweeps decreased and increased, respectively. Thus, for higher intensities FM responses were initiated at instantaneous frequencies occuring earlier in the signal. The results are compared with previous data on tone and FM sensitivity of auditory neurons in cortical and subcortical structures, and mechanisms of FM rate and directional sensitivity are discussed. The topographic representations of these neuronal properties in Al are reported in the companion report.

In the primary auditory cortex (AI) of barbiturate-anesthetized cats multi-unit responses to tones and to frequency-modulated (FM) tonal stimuli were analyzed. Characteristic frequency (CF), sharpness of toning, minimum threshold, and dynamic range of spike count -intensity functions were determined. Minimum threshold and dynamic range were positively correlated. The response functions to unidirectional FM sweeps of varying linear rate of change of frequency (RCF) that traversed the excitatory frequency response areas (FRAs) displayed a variety of shapes. Preferences for fast RCFs ( > 1000 kHz/s) were most common. Best RCF was not correlated with measures of sharpness of tuning. Directional preference and sensitivity were quantified by a DS index which varied with RCF. About two-thirds of the multi-unit responses showed a preference for downward sweeps. Directional sensitivity was independent of CF and independent of best RCF. Measurements of latencies of phasic responses to unidirectional FM sweeps of different RCF demonstrated that the discharges of a given multi-unit over its effective RCF range were initiated at the same instantaneous frequency (effective F,), independent of RCF. Effective Fis fell within the excitatory FRA of a given multi-unit. The relationships of effective Fis to CF show that responses were evoked only when the frequency of the signal was modulated towards CF and not when modulated away from it, and that responses were initiated before the modulation reached CF. Changes in the range and depth of modulation had only minor, if any, effects on RCF response characteristics, FM directional sensitivity, and effective Fis, as long as the beginning and ending frequencies of FM sweeps fell outside a multi-unit's FRA. Stimulus intensity also had only moderate effects on RCF response characteristics and DS. However, effective Fis were influenced in systematic fashions: with increases in intensity, effective F,s to upward and downward sweeps decreased and increased, respectively. Thus, for higher intensities FM responses were initiated at instantaneous frequencies occuring earlier in the signal. The results are compared with previous data on tone and FM sensitivity of auditory neurons in cortical and subcortical structures, and mechanisms of FM rate and directional sensitivity are discussed. The topographic representations of these neuronal properties in Al are reported in the companion report.

Social networking addiction is a phrase used to refer to someone
spending too much time using Face book, Twitter and other forms
of social media so much so that it interferes with other aspects of
daily life. Although many studies were done on internet addiction,
no large scale studies were done on social network site addiction
among teenagers. Materials and methods: This study was done
as a cross sectional study during Feb 2013 to May 2013 with the
objectives of assessing the usage pattern of social network sites,
addictive behavior towards its usage and its effects among school
going teenagers from different randomly selected schools in
Chennai. The school authorities were approached and after getting
the consent from them, a day was fixed for data collection using
the preformed predetermined questionnaire by face to face
interview method, after getting informed consent. The data was
entered in MS excel sheet and analysis was done using Epi Info
software version 3.5, 2008. Results: Totally 613 were studied; of
which majority 61% of them were males, mean age of the study
population was 15.27. 85% belonged to nuclear family and 37%
of them belonged to class I socioeconomic status. Among the total
study participants 76.6% (470) use social network sites regularly
with the mean of 1.46 hours per day. The favorite social
networking site was facebook, followed by youtube, twitter,
google pus, what’s app and yahoo messenger. Addictive behavior
was present among 242 (39.5%) of the teenagers which was
significantly associated with male gender (p=0.00001), nuclear
family (p=0.01), every day visits to these sites (p=0.0001), hours
spent per day (p=0.0001), more friends in Social networking than
in real life (p=0.0001) and playing games (p=0.026). Conclusion:
This study had explored that majority of the teenagers were
addicted to social networking sites and hence steps should be
taken to create awareness to the teenagers and their patents
regarding the addictive behaviors and risk factors associated with
the usage of social networking sites.

Three roots of Inferior alveolar nerve (IAN) is a rare finding in the
infratemporal fossa. The nerve had three roots, one from lingual
nerve and two from the auriculotemporal nerve which encircled
the Middle meningeal artery. This close relation of the artery to
the nerve and vice versa may lead to the compression of either of
the two structures involved here. Thus, this type of variation is
noteworthy for the head and neck surgeons to perform surgeries in
the infratemporal region.

This study showed an alternative and non-invasive method for measuring brainwaves using Magnetic Resonance Imaging (MRI) with a gradient echo-echo planar imaging (GE-EPI) sequence. An attempt was made to measure the axonal magnetic fields of delta and theta waves using direct detection with MRI. Time-varying brainwaves produce an axonal current which may induce a magnetic field according to the Biot-Savart law. The MR scanner can detect inhomogeneous magnetic fields caused by weak currents generated in a subject that interact with the main magnetic field, B o , of the scanner. Fifteen healthy volunteers were scanned with closed eyes in a dark imaging room. The GE-EPI sequence was used to acquire 1500 time frame images in an axial plane on a 3.0 T Philips scanner. A Butterworth bandstop filter was applied to filter out physiological signals before the detection of brainwave signals. Fast Fourier Transform (FFT) was used to produce frequency spectra where the brainwave frequencies could be detected. Our study measured an axonal magnetic field of 1.5 ± 0.2 nT for the delta waves and 1.5 ± 0.3 nT for the theta waves. Delta waves were found in the range 1.5-4.0 Hz and theta waves in the range 4.0-6.5 Hz. The waves were found on both sides of the occipital lobe, temporal lobe, and hippocampus. We detected more theta waves (2.1% of the brain slice with 5 mm thickness) than delta waves (1.5% of the brain slice with 5 mm thickness). PLCC for the %| S/S eq | between the delta and theta waves was 0.7584 at p = 0.001 significance level and 95% confidence level. We also applied Short Time Fourier Transform (STFT) with epoch lengths of 3.85 s, 7.7 s, and 30.8 s. But the appearance of brainwave signals was not as clear as using FFT over the entire imaging duration. INDEX TERMS Theta wave, delta wave, brainwave, axonal magnetic field, Fourier transform.

The sound pressure levei (SPL), henceforth termed intensity, of acoustic signals is encoded in the central auditory system by neurons with different forms of intensity sensitivity. However, knowledge about the topographic organization of neurons with these different properties and hence about the spatial representation of intensity, especially at higher levels of the auditory pathway, is limited. Here we show that in the tonotopically organized primary auditory cortex (Ai) of the cat there are orderly topographic organizations, along the isofrequency axis, of several neuronal properties related to the coding of the intensity of tones, viz. minimum threshold, dynamic range, best SPL, and non-monotonicity of spike count -intensity functions to tones of characteristic frequency CCF). minimum threshold, dynamic range, and best SPL are correlated and alter periodicaliy along isofrequency strips. The steepness of the high-intensity descending slope of spike count -intensity functions also varies systematically, with steepest slopes occurring in the regions along an isofrequency strip where low thresholds, narrow dynamic ranges and low best SPLs are found. As a consequence, CF-tones of various intensities are represented by orderly and, for most intensities, periodic, spatial patterns of distributed neuronal activity along an isofrequency strip, For low -to -moderate intensities, the mean relative activity along the entire isofrequency strip increases rapidly with intensity, with the spatial pattern of activity remaining quite constant along the strip. At higher intensities, however, the mean relative activity along the strip remains fairly constant with changes in intensity, but the spatial patterns change markedly. As a consequence of these effects, low-and high-intensity tones are represented by complementary distributions of activity alternating along an isofrequency strip. We conclude that in AI tone intensity is represented by two complementary modes, viz. discharge rate and place. Furthermore, the magnitude of the overall changes in the representation of tone intensity in AI appears to be closely related to psychophysical measures of loudness and of intensity discrimination.

A&&act-The response areas (frequency by intensity) of single neurons in primary auditory cortex of anesthetized cats were studied before and after temporary threshold shifts in cochlear sensitivity induced by an intense pure tone. Cochlear temporary threshold shift was monitored through the threshold of the gross auditory nerve compound action potential and in most cases involved a notch-like loss centered at the characteristic frequency of the unit under study. Only two neurons showed changes in response area that mirrored the changes at the auditory periphery. Most neurons showed more complex changes involving both expansion and contraction of response areas. Expansion of response areas was indicated by lower thresholds at some frequencies and by the emergence of ~nsitivity to previously ineffective frequencies. A change was classified as contraction when the response area after the intense-tone exposure was smaller fhan would be expected by applying the profile of the temporary threshold shift to the initial response area. Contraction of both upper (high intensity) and lower boundaries of response areas was found; in the most extreme cases, neurons were totally unresponsive after the intense-tone exposure.

This paper describes the use of blood spotted filter paper to study
the genotyping of ANKKI / Taq A gene. For the study hundred
patients visiting National Drug Dependence Treatment Centre
(NDDTC) for the treatment of co-morbid alcohol and nicotine
dependence were selected at random. Blood was spotted on to
Whatman 903 filter paper, dried and stored at room temperature.
Genomic DNA was extracted and genotyping was carried out from
dried blood and corresponding whole blood samples. All the
samples collected on to filter paper showed exact match of the
genotyping when compared to fresh blood. At the end of 6 months
of storage the genotyping was carried out successfully from all the
samples. The present study shows that dried blood is suitable for
ANKKI/ Taq A1 genotyping up to a period of 6 months at room
temperatures.

There has been a growing interest in the use of antiepileptic drugs
(AEDs) for neuroprotection, and in the possible role of AEDs in
disease modification (i.e., antiepileptogenesis). Increased
understanding of the mechanisms underlying brain injury has led
to advances in the study of neuroprotection. However, defining the
clinical paradigm and selecting appropriate outcomes to detect
neuroprotective effects present challenges to clinicians studying
the neuroprotective properties of drugs. Established AEDs, such as
phenytoin, phenobarbital, and carbamazepine, have shown
neuroprotective activity in an ischemic/hypoxic model of neuronal
injury. Animal model studies also have suggested that newer
AEDs, such as levetiracetam, topiramate, and zonisamide, may
have neuroprotective or antiepileptogenic properties. However, the
prevention of epileptogenesis by an AED has yet to be
demonstrated in clinical trials. The future of neuroprotection may
involve established and newer AEDs, as well as other compounds,
such as immunophilins, caspase inhibitors, endocannabinoids, and
antioxidants.