Isthmin1, a secreted signaling protein, acts downstream of diverse embryonic patterning centers in development

xloma.fota13 shared this article with you from Inoreader Isthmin1, a secreted signaling protein, acts downstream of diverse embryonic patterning centers in development Via Latest Results for Cell and Tissue Research Abstract Extracellular signals play essential roles during embryonic patterning by providing positional information in a concentration-dependent manner, and many such signals, like Wnt, fibroblast growth factor (FGF), Hedgehog (Hh), and retinoic acid, act by being secreted into the extracellular space, thereby triggering receptor-mediated responses in other cells. Isthmin1 (ism1) is a secreted protein whose gene expression pattern coincides with that of early dorsal determinants, nodal ligand genes like sqt and cyc, and with fgf8 during various phases of zebrafish development. Ism1 functions in early embryonic patterning and development are poorly understood; however, it has recently been shown to interact with nodal pathway genes to control organ asymmetry in chicken. Here, we show that misexpression of ism1 deletion constructs disrupts embryonic patterning in zebrafish and exhibits genetic interactions with both Fgf and nodal signaling. Unlike Fgf and nodal pathway mutants, CRISPR/Cas9-engineered ism1 mutants did not show obvious developmental defects. Further, in vivo single molecule fluorescence correlation spectroscopy (FCCS) showed that Ism1 diffuses freely in the extra-cellular space, with a diffusion coefficient similar to that of Fgf8a; however, our measurements do not support direct molecular interactions between Ism1 and either nodal ligands or Fgf8a in the developing zebrafish embryo. Together, data from gain- and loss-of-function experiments suggest that zebrafish Ism1 plays a complex role in regulating extracellular signals during early embryonic development. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cancers, Vol. 13, Pages 54: Targeting the Roots of Recurrence: New Strategies for Eliminating Therapy-Resistant Breast Cancer Stem Cells

xloma.fota13 shared this article with you from Inoreader Cancers, Vol. 13, Pages 54: Targeting the Roots of Recurrence: New Strategies for Eliminating Therapy-Resistant Breast Cancer Stem Cells Via Cancers Cancers, Vol. 13, Pages 54: Targeting the Roots of Recurrence: New Strategies for Eliminating Therapy-Resistant Breast Cancer Stem Cells Cancers doi: 10.3390/cancers13010054 Authors: Margaret L. Dahn Paola Marcato Cancer stem cells (CSCs) are functionally defined in our laboratories by their impressive tumor-generating and self-renewal capacity; clinically, CSCs are of interest because of their enhanced capacity to evade conventional therapies [...] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation Between Invasive and Noninvasive Technique of Intracranial Pressure Measurement in Children With Traumatic Brain Injury: An Observational Study

xloma.fota13 shared this article with you from Inoreader Correlation Between Invasive and Noninvasive Technique of Intracranial Pressure Measurement in Children With Traumatic Brain Injury: An Observational Study Via Journal of Neurosurgical Anesthesiology - Published Ahead-of-Print Background: Direct measurement of intracranial pressure (ICP) is an invasive technique with potential complications, which has prompted the development of alternative, noninvasive, methods of ICP assessment. The aim of this study was to determine the relationship between noninvasive ultrasound-based measurement of optic nerve sheath diameter (ONSD), transcranial Doppler-derived pulsatility index (PI), and invasive ICP measurements in children with traumatic brain injury (TBI). Methods: Children aged 1 to 18 years undergoing invasive ICP monitoring following TBI were included in the study. Noninvasive ONSD and PI measurements were compared with simultaneous invasive ICP. Results: In all, 406 measurements of ONSD and PI were obtained in 18 patients. ONSD and PI correlated with ICP (r=0.76 and 0.79, respectively), combining ONSD and PI resulted in an even stronger correlation with ICP (r=0.99). Formulas were derived from mixed-effect models that best fitted the data for noninvasive ICP estimation. A combination of ONSD and PI had the highest ability to detect ICP >20 mm Hg (area under the receiver operating characteristic curve=0.99, 95% confidence interval: 0.99-1.00). Optimal cutoff values for the prediction of intracranial hypertension were 5.95 mm for ONSD (sensitivity, 92%; specificity, 76%) and 1.065 for PI (sensitivity, 92%; specificity, 87%). Conclusions: In children with TBI, a combination of ONSD and PI strongly correlates with invasive ICP and has potential to screen for intracranial hypertension noninvasively. ONSD and PI may be useful tools for assessing ICP where invasive monitoring is unavailable or contraindicated. The authors have no funding or conflicts of interest to disclose. Address correspondence to: Gyaninder P. Singh, DM. E-mail: drsingh_gp@yahoo.co.in. Received August 2, 2020 Accepted November 20, 2020 Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Médecine & Droit

Le contentieux de la régularité externe des décisions rendues par les juridictions ordinales des médecins Publication date: Available online 22 December 2020 Source: Médecine & Droit Author(s): Nadia Miloudia

Fallait-il sacrifier le secret professionnel sur l'autel de la santé publique ? Publication date: Available online 7 December 2020 Source: Médecine & Droit Author(s): Bruno Py

Non, le COVID ne mérite pas les justes combats de l'époque du Sida pour le respect du secret médical Publication date: Available online 5 December 2020 Source: Médecine & Droit Author(s): Philippe Biclet

COVID-19: quel rôle pour les comités d'éthique? Publication date: Available online 28 November 2020 Source: Médecine & Droit Author(s): Henri-Corto Stoeklé, Achille Ivasilevitch, Elisabeth Hulier-Ammar, Dominique Reynaert, Christian Hervé

La Direction des Affaires Juridiques et des Droits des Patients de l'APHP et la première vague de la pandémie Covid-19 Publication date: Available online 23 November 2020 Source: Médecine & Droit Author(s): Jacques Belghiti, Marie Pierre Dilly-Rushenas, Sandra Fournier, Magali Richard Piauger, Soisic Iroz, Daniel Vittecoq, Charline Nicolas, Emmanuel Martinod

Corrigendum à « Les grands magasins de la médecine de Milton Friedman » [Med. Droit (Paris). (2020)]. doi:10.1016/j.meddro.2020.07.002 Publication date: Available online 19 November 2020 Source: Médecine & Droit Author(s): Mathieu Ginier-Gillet

Erratum à « L'expertise médicale au temps des pandémies : l'exemple des cancers » [Med. Droit 2020 (2020) 92–95] Publication date: Available online 18 November 2020 Source: Médecine & Droit Author(s): Rémy J. Salmon, Catherine Buffet, Christine Estève

Editorial Board Publication date: October 2020 Source: Médecine & Droit, Volume 2020, Issue 164 Author(s):

L'ADN, la reine des preuves imparfaites Publication date: October 2020 Source: Médecine & Droit, Volume 2020, Issue 164 Author(s): Catherine Ménabé

Le harcèlement : évolution du droit français et problématiques de l'évaluation des victimes Publication date: October 2020 Source: Médecine & Droit, Volume 2020, Issue 164 Author(s): François Van Maris, Gaëtan Prissette, Cécile Manaouil

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Tropical Medicine

Current status and future prospects of bacilli-based vector control Joleen Savianne Almeida, Ajeet Kumar Mohanty, Savita Kerkar, Sugeerappa Laxmanappa Hoti, Ashwani Kumar Asian Pacific Journal of Tropical Medicine 2020 13(12):525-534 Mosquito-borne diseases such as malaria, filariasis, dengue, chikungunya, Japanese encephalitis, yellow fever and Zika contribute significantly to health problems of developing as well as developed nations. Vector control is central to control of vector borne diseases. In the last four-five decades, biological control methods have been inducted in the integrated vector management strategy, advocated nationally as well as globally by the World Health Organization. Currently, biological control of vectors is globally acknowledged as the best available strategy in the wake of growing concerns about vector resistance as well as adverse effects of insecticides on the environment and non-target fauna co-inhabiting the same ecological niches as vectors. In India and elsewhere, efforts are ongoing to screen newer isolates to bring forth new biolarvicidal products of public health importance. In this review, by carrying out extensive literature survey, we discuss advances thus far and the prospects of bacilli-based control of vectors and vector borne diseases.

Patterns of hepatitis B virus exposure and associated predictors in Vietnam: A crosssectional study Minh C Duong, Phuc V.D. Le, Oanh N.K. Pham, Hien D.T. Pham, Toan B Nguyen, Hai T Phan Asian Pacific Journal of Tropical Medicine 2020 13(12):535-541 Objective: To examine the magnitude of isolated anti-HBc and other HBV serological patterns and associated predictors among adults seeking general health check-up at a large health center in Vietnam. Methods: All 564 outpatients seeking general health checkup between January 2016 and December 2016 were asked to undertake HBV surface antigen, surface antibody, IgG and IgM core antibody (anti-HBc total), platelet counts, and liver function testing. An administered questionnaire was used to collect information regarding demography, in-house sources of infection, lifestyle, health condition and treatment, and HBV vaccination. Results: Male gender (P=0.043), age (P=0.000), living in urban areas (P=0.040), HBV vaccination status (P=0.033), and ALT (P=0.040) were associated with isolated anti-HBc. HBV infection was associated with HBV vaccination status (P=0.001), ALT levels (P=0.010), AST levels (P=0.020), and platelet counts (P=0.007). Past/resolved HBV infection was associated with AST levels (P=0.005), ALT levels (P=0.014), and age (P=0.000). Conclusions: Isolated anti-HBc is quite prevalent. Predictors of isolated anti-HBc include male gender, living in rural areas, and HBV non-vaccination. The prevalence of isolated anti-HBc also increases with age. To timely detect occult HBV infection and prevent transmission, anti-HBc testing should be included in the health check-up for high risk individuals and screening program where HBV nucleic acid test is not available. To prevent transmission, clinicians need to pay more attention on those who are at risk of having isolated anti-HBc and closely follow-up patients with isolated anti-HBc and educate them about the prevention of HBV infection.

Morphological and molecular characterization of Acanthamoeba isolated from contact lens paraphernalia in Malaysia: Highlighting the pathogenic potential of T4 genotype Rosnani Hanim Mohd Hussain, Nur Syahirah Mohamad Isa, Khairul Ameera Kamaruddin, Mohamed Kamel Abdul Ghani, Naveed Ahmed Khan, Ruqaiyyah Siddiqui, Tengku Shahrul Anuar Asian Pacific Journal of Tropical Medicine 2020 13(12):542-549 Objective: To determine the morphological and molecular characterization of Acanthamoeba isolates from contact lens paraphernalia in Malaysia and to investigate their pathogenic potential based on the physiological tolerance. Methods: One hundred and eighty contact lens wearers donated their contact lens, lens storage cases and lens solutions between 2018 and 2019. The samples were inoculated onto 1.5% non-nutrient agar plates for 14 d. Polymerase chain reaction (PCR) was performed and the amplified PCR products were sequenced and compared with the published sequences in GenBank. The pathogenic potential of positive isolates was further tested using temperature-tolerance and osmo-tolerance assays. Acanthamoeba species were categorized into three distinct morphological groups established by Pussard and Pons. Results: Acanthamoeba was successfully isolated from 14 (7.8%) culture-positive samples in which 11 belong to morphological group II and 3 belong to morphological group III, respectively. The sequencing of 18S ribosomal RNA gene led to the identification of the T4 genotype in all the isolated strains. In vitro assays revealed that 9 (64.3%) Acanthamoeba isolates were able to grow at 42 °C and 1 M mannitol and were thus considered to be highly pathogenic. Conclusions: To the best of our knowledge, this is the first report identifying the Acanthamoeba genotype and their pathogenic potential among contact lens wearers in Malaysia. The potentially pathogenic T4 genotype isolated in this study is the most predominant genotype responsible for human ocular infection worldwide. Hence, increasing attention should be aimed at the prevention of contamination by Acanthamoeba and the disinfection of contact lens paraphernalia.

Multiplex real-time PCR revealed very high prevalence of soil-transmitted helminth infections among aborigines in Peninsular Malaysia Nurulhasanah Othman, Noorizan Miswan, Weng-kin Wong, Boon-huat Lim, Rahmah Noordin Asian Pacific Journal of Tropical Medicine 2020 13(12):550-556 Objective: To determine the true prevalence of soil-transmitted helminth infections in the Malaysian aborigines using real-time PCR. Methods: A total of 122 aborigines from seven tribes were recruited from settlements and nearby hospitals which served the communities, located in four states in Peninsular Malaysia. The stool samples were examined for the presence of soil-transmitted helminth using real-time PCR and microscopy. The latter included the direct wet mount and formalin-ether concentration technique (FECT). The infection load in FECT-positive samples was determined by the Kato-Katz method. Rotorgene real-time analyzer detected five helminth species using two sets of assays. Results: The real-time PCR detected soil-transmitted helminth in 98.4% samples (n=122), which were 1.56 times higher than by microscopy. Ascaris lumbricoides and Trichuris trichiura were detected in more than 90% of the samples, while hookworm was detected in 46.7% (Necator americanus) and 13.9% (Ancylostoma sp.) of the samples. Comparison with previous reports on the Malaysian aborigines showed that the real-time PCR markedly improved the detection of Ascaris lumbricoides, hookworm and Strongyloides stercoralis. The real-time PCR detected poly-helminths in 92.6% of the samples compared to 28.7% by microscopy. In addition, 27 samples (22.1%) showed amplification of Strongyloides stercoralis DNA. Conclusions: The real-time PCR showed very high prevalence rates of soil-transmitted helminth infections in the aborigines and is the recommended method for epidemiological investigation of soil-transmitted helminth infections in this population.

Fermentation of mulberry leaves with Cordyceps militaris enhanced anti-adipogenesis activity in 3T3-L1 cells through down-regulation of PPAR-γ pathway signaling Lu Guo, Jum Soon Kang, Young Hoon Park, Beong Il Je, Dae Youn Hwang, Woo Hong Joo, Young Whan Choi Asian Pacific Journal of Tropical Medicine 2020 13(12):557-565 Objective: To establish an efficacious and efficient fermentation method of enhancing the anti-adipogenesis effect of mulberry (Morus alba) leaves using Cordyceps militais. Methods: Dried mulberry leaves, dried mulberry leaves with 50% raw silkworm pupa and raw silkworm pupa were fermented with Cordyceps militais for 4 weeks at 25 °C, after which the dried mulberry leaves and fermented product were extracted with 70% ethanol and subjected to high performance liquid chromatography (HPLC). The contents of cordycepin, pelargonidin, chlorogenic acid, iso-quercetin and caffeic acid were determined. We then used the 3T3-L1 cells to investigate whether extracts of fermentation enhanced anti-adipogenesis activity in vitro. Results: HPLC showed that fermentation changed the contents of cordycepin, pelargonidin, chlorogenic acid, iso-quercetin and caffeic acid. Furthermore, fermented dried mulberry leaves with 50% raw silkworm pupa had a better efficacy of anti-adipogenesis than dried mulberry leaves, fermented dried mulberry leaves and fermented silkworm pupa and inhibited triglycerides accumulation and glucose consumption. Additionally, fermented dried mulberry leaves with 50% raw silkworm pupa inhibited PPAR-γ signaling. Conclusions: Fermentation with Cordyceps militaris enhanced anti-adipogenesis efficacy of mulberry leaves.

In vitro efficacy of new synthetic benzimidazole-related compounds against Schistosoma mansoni adult worms Amira Taman, Samia El-Bardicy, Menerva Tadros, Magda Ayoub, Basem Mansour, Fouad El-Shehabi, Samar N El-Beshbishi Asian Pacific Journal of Tropical Medicine 2020 13(12):566-572 Objective: To evaluate the in vitro antischistosomal activity of two new synthetic benzimidazole-related compounds: NBTP-OH and NBTP-F. Methods: Schistosoma adult worms were recovered from mice infected with Schistosoma mansoni cercaria, washed and then incubated in the culture media with different concentrations of compounds NBTP-OH and NBTP-F up to 72 h. Scanning electron microscopy was conducted to report morphological changes. Results: Incubation of adult Schistosoma mansoni with 10 μg/mL of NBTP-OH for 48 h killed 81.25% of worms. The calculated LC50 and LC90 72 h post-incubation were 6.8 μg/mL and 9.8 μg/ mL, respectively. Exposure of worms to 10 μg/mL of NBTP-F killed 89.5% of worms after 48 h, mostly males (83.3%), the LC50 and LC90 after 72 h of incubation were 4.8 μg/mL and 6.9 μg/mL, respectively. Worms incubated for 72 h with these compounds revealed swelling and deformity of oral sucker, disorganization and erosion of the tegument when examined with scanning electron microscopy. Conclusions: NBTP-OH and NBTP-F possess in vitro antischistosomal activities; however, in vivo studies should be conducted to examine their antischistosomal effects.

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Hazardous Materials

Possible application of stable isotope compositions for the identification of metal sources in soil Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Liuwei Wang, Yuanliang Jin, Dominik J. Weiss, Nina J. Schleicher, Wolfgang Wilcke, Longhua Wu, Qingjun Guo, Jiubin Chen, David O'Connor, Deyi Hou

Biochar for simultaneously enhancing the slow-release performance of fertilizers and minimizing the pollution of pesticides Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Xiongfang An, Zhansheng Wu, Wen Shi, Huihua Qi, Luohong Zhang, Xiaolin Xu, Bing Yu

Nitrogen-doped porous biochar derived from marine algae for efficient solid-phase microextraction of chlorobenzenes from aqueous solution Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Rongting Ji, Yarui Wu, Yongrong Bian, Yang Song, Qian Sun, Xin Jiang, Longjiang Zhang, Jiangang Han, Hu Cheng

Pre-coagulation with cationic flocculant-composited titanium xerogel coagulant for alleviating subsequent ultrafiltration membrane fouling by algae-related pollutants Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Min Xu, Xiaomeng Wang, Bo Zhou, Lixiang Zhou

Methane-associated micro-ecological processes crucially improve the self-purification of lindane-polluted paddy soil Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Jing Yuan, Jue Shentu, Jiaying Feng, Zhijing Lu, Jianming Xu, Yan He

Enhanced adsorptive removal of sulfamethoxazole from water using biochar derived from hydrothermal carbonization of sugarcane bagasse Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): G. Prasannamedha, P. Senthil Kumar, R. Mehala, T.J. Sharumitha, D. Surendhar

Adsorption behaviors of the pristine and aged thermoplastic polyurethane microplastics in Cu(II)-OTC coexisting system Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Xiang-Dong Xue, Cheng-Ran Fang, Hai-Feng Zhuang

Toxic effects of naturally-aged microplastics on zebrafish juveniles: A more realistic approach to plastic pollution in freshwater ecosystems Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Abraão Tiago Batista Guimarães, Ives Charlie-Silva, Guilherme Malafaia

Staged assessment for the involving mechanism of humic acid on enhancing water decontamination using H2O2-Fe(III) process Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Bo Yang, Xin Cheng, Yongli Zhang, Wei Li, Jingquan Wang, Zixin Tian, Erdeng Du, Hongguang Guo

Enhanced photocatalytic degradation of glyphosate over 2D CoS/BiOBr heterojunctions under visible light irradiation Publication date: 5 April 2021 Source: Journal of Hazardous Materials, Volume 407 Author(s): Qiang-Yong Tang, Man-Jie Yang, Si-Yuan Yang, Yue-Hua Xu

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Otology

Middle ear mucosal compartm Mahendra Kumar Taneja Indian Journal of Otology 2020 26(3):115-121 Mucosal folds of middle ear are not a significant barrier in spread of infection cholesteatoma spread towards the least resistance and usually follow the folds. The mucosa of the middle ear is continuous with that of the pharynx via Eustachian tube. It covers the ossicles, muscles, nerves and forms the inner layer of tympanic membrane. Mucosal fold are of two types Composite Fold – these are of ligament with lining mucosa. Duplicate Fold – Fusion of two expanding sacs in absence of any interposing structure. Epitympanic Diaphragm it is an oblique dividing septum between the posterior superior attic and anteroinferior mesotympanium. It comprises of anterior malleolar ligament, lateral malleolar ligament, posterior malleolar ligament, lateral incudal fold, tensor tympani fold and posterior incudal ligament fold. Tympanic Isthimus is 2.5 mm elongated narrow space in epitympanic diaphragm present naturally and provides ventilation. Key message is tensor tympani fold and anterior Pouch of VonTroltsch is responsible for ventilation of anterior compartment. It is extremely important to understand and restore the functional anatomy, proper gas exchange and mucosal clearance from the middle ear compartment. The obstruction site is at tympanic isthimus. It is crucial to visualise and clearance of disease to restore ventilation. In surgical procedures of ear just removal of tensor tympani fold along with resection of Cog provides good results by providing ventilation of attic, mastoid air cells and a successful tympanoplasty.

Speech recognition in noise in patients with type II diabetes Somayeh Falahzadeh, Sima Tajik, Faezeh Azadi, Farnoosh Farjadi Indian Journal of Otology 2020 26(3):122-126 Context: The chronic diabetes is associated with damage to the sensory and cognitive regions brain. The central auditory system is susceptible to the damage caused by high glucose level. Aims: Since the healthy auditory system plays an important role in communication, this study examined speech recognition in noise performance of these people so as to better identify the harmful impacts of diabetes on the auditory processing. Settings and Design: This cross-sectional comparative study compares the speech recognition in noise performance of 30 diabetic patients and 30 normal individuals aged 30–55 years with quick speech in noise (Q-SIN) test. Subjects and Methods: All people had normal hearing and the speech recognition performance in silent, the Persian version of the Q-SIN test was used. Statistical Analysis Used: Results of signal-to-noise ratio loss (SNR loss) and recognition of words at different SNR levels were analyzed with Chi-square test and independent t-test in two groups. Results: There was a significant difference between diabetic patients and normal individuals in mean of SNR loss (P < 0.05). The comparison of word recognition scores in each SNR showed no significant difference in 25, 20 SNRs between the two groups (P > 0.05), but the performance of diabetic patients was weaker in 15, 10, 5, 0 SNR (P < 0.05). Conclusions: In the absence of hearing loss, the diabetic patients have a significant speech perception disorder, especially at lower levels of SNRs, compared to normal people of the same age. Impaired speech comprehension in the presence of a competitive message can result from the damage to central auditory processing as a result of diabetes.

Auditory brainstem response to level-specific CE-CHIRP® threshold estimation in normal-hearing adults Ahmad Aidil Arafat Dzulkarnain, Suhaila Ahmad Shuckri, Noraidah Ismail Indian Journal of Otology 2020 26(3):127-131 Background: The aim of the present study was to compare the hearing thresholds between pure tone audiometry (PTA) and auditory brainstem response (ABR) from level-specific (LS) CE-Chirp® and click stimuli in normal adult subjects. Materials and Methods: Twenty-four adults with normal audiometric thresholds participated in the study. The ABR was recorded from the study participants at 80 dBnHL until their respective auditory thresholds using both the LS CE-Chirp® and click stimuli. Study Design and Statistical Analysis: A quasi-experimental study design was used. Audiometric thresholds (low frequencies [LFs], mid frequencies [MFs], and high frequencies [HFs]) and the ABR thresholds from both stimuli were compared using the Friedman test with Wilcoxon signed-rank test as the post hoc analysis. Results: No statistically significant difference was identified between the PTA and the ABR to LS CE-Chirp® thresholds at LFs and only small differences (<6 dB) median thresholds differences were identified at the MFs and HF. The amplitudes of wave III and V were larger for ABR to LS CE-Chirp® as compared to the ABR from the click stimulus. Conclusion: This study concluded that the ABR to LS CE-Chirp® has closer thresholds than the audiogram as compared to the ABR from click in normal-hearing adult subjects. At the suprathreshold (80 dBnHL), the ABR amplitudes of wave III, and V were larger in LS CE-Chirp® than the click stimulus.

Vestibular evaluation in patients with congenital profound hearing loss using ice cold water caloric test and rotational chair test Arun Dehadaray, Viraj Gaikwad, Maitri Kaushik, Prasun Mishra, Sai Belsare Indian Journal of Otology 2020 26(3):132-134 Introduction: With the introduction of newborn hearing screening, hearing problems are often detected at the neonatal stage and in early infancy, and holistic approach including not only auditory but also vestibular function is needed. This study hopes to establish some corelation between cochlear and vestibular system dysfunction in a patient born with congenital profound hearing loss (CPHL). Materials and Methods: In this observational and descriptive study conducted at a tertiary care hospital, we evaluated eighty patients with bilateral CPHL from 2016 to 2018. After taking a detailed history and thorough ear, nose, and throat examination, the patients underwent vestibular function evaluation by ice cold water caloric test (ICCT) and rotational chair test (RCT) in the outpatient department, and the duration of nystagmus was calculated based on which hypoactive or absent vestibular function was found out. Results: In the present study, out of eighty patients with CPHL, vestibular function of 62 (77.50%) was normal, 9 (11.25%) hypoactive, and 9 (11.25%) with absent vestibular function. Conclusion: In the outpatient department where sophisticated equipment and laboratory facilities are not available, ICCT can be used to determine the vestibular function and also RCT can be used. From the present study, it can be concluded that vestibular dysfunction is present in 22.50% of patients with CPHL with the use of ICCT and RCT. There is a strong possibility of genetic origin etiology for vestibular dysfunction. The present study also concludes that consanguinity may be major etiological factor for vestibular dysfunction.

Influence of cardiovascular risk factors on cochlear dysfunction Nemanja Radivojevic, Nenad Arsovic, Zoran Dudvarski, Vladimir Nesic, Ljiljana Cvorovic, Snezana Babac, Aleksandra Radivojevic Indian Journal of Otology 2020 26(3):135-140 Background: Cochlear dysfunction can arise not only from various factors such as ear diseases but also from systemic disorders of the body. The occurrence of otologic symptoms such as hearing loss, dizziness, and tinnitus can be due to cardiovascular disorders. Therefore, current understandings in the field of the diagnosis and therapy of cardiovascular diseases (CVDs) should include, among others, evidence of otologic disorders. Objective: The aim of this study is to determine the association between risk factors for CVD and cochlear dysfunction. Methods: The cross-sectional study included 128 participants with major CVD risk factors who underwent auditory function examination (pure tone audiometry). Results: There were 52 women (40.6%) and 76 men (59.4%) in total. The mean age of the participants was 58 years (a range of 28–83 years). The mean age among participants with hearing loss was 60 (±10.88), whereas the mean age among participants that had normal hearing thresholds was 54 (±12.18). Sensorineural hearing loss (SNHL) was measured in 59% of participants, of most frequent mild degree hearing loss. The prevalence of SNHL was higher in participants with arterial hypertension (P < 0.001, OR = 5.881, 95% CI 2.694–12.837) and the most common among them was moderate degree hearing impairment (38%). There is also a statistically significant association of SNHL with dyslipidemia and elevated body mass index (P < 0.001, [OR]: 4.118, 95% [CI]: 1.873–9.053 and P< 0.001, [OR]: 1.517, 95% [CI]: 1.237–1.859 ) with moderate and profound hearing loss. Conclusion: Based on the data obtained, it seems that the presence of major cardiovascular risk factors was a significant predictor for cochlear dysfunction.

Examination of ototoxicity induced by imatinib, being a tyrosine kinase inhibitor: An experimental study Emine Elif Altuntas, Kasim Durmus, Adem Bora, Nergiz Hacer Turgut, Hatice Terzi, Ahmet Kutluhan Indian Journal of Otology 2020 26(3):141-146 Objectives: Two rats were excluded from the study. Because otitis media developing one rat in Group C (7th dayof the experiment) and bleeding-related death one rat in Group I-50 (14th day of the experiment). While the side effects of imatinib are investigated in the literature, it is remarkable that the case reports suggesting an ototoxic side effect also take place among the publications. The aim of this study was to investigate whether or not imatinib has any ototoxic effect on rats via auditory brainstem response (ABR) responses. Materials and Methods: Rats were divided into three groups as Group C (0.25 mL/kg/day), Group I-30 (30 mg/kg/day), and Group I-50 (50 mg/kg/day). In the ABR record, hearing threshold, latency, amplitude, and interpeak latency values on test days were recorded and assessed. Results: In the assessment made in terms of mean V Wave latency within the group, a difference was determined at all stimulus intensities at 8 kHz in Group I-50 (P < 0.05). In the within-group assessment performed in terms of mean Wave III latency, there were differences in Groups I-30 and I-50 (P < 0.05). In the within-group assessment performed in terms of I–III interpeak latency mean values, there was a difference at 4 kHz and 70 dB in Group I-30 (P < 0.05). In the within-group assessment in terms of mean III–V interpeak latency values, the difference between the groups was significant on the 7th day at 6 kHz and 50 dB (P = 0.044) and on the 14th day at 8 kHz and 70 dB (P = 0.036). In the within-group assessment in terms of Wave I amplitude mean values, the change in the amplitude values at 4 kHz (P = 0.003) and 6 kHz (P = 0.018) in Group I-50 was significant. Conclusion: It was observed that imatinib application caused elongation in latency and interpeak latency values and changes in amplitude values. These differences were not enough to state that imatinib is having an ototoxic side effect.

Vestibular epilepsy: Clinical presentation, diagnosis, and management Ajay Philip, GR Haripriya, Manju Deena Mammen, Anjali Lepcha, Ann Mary Augustine Indian Journal of Otology 2020 26(3):147-150 Background: Vestibular epilepsy as a cause of vertigo is rare. This clinical entity occurs primarily due to epileptic activity in parts of the cortex that represents the vestibular system. It is often distinctive with sudden, brief episodes of vertigo followed by rapid recovery without sequelae. In vestibular epilepsy, vertigo is not simply an aura, but constitutes a part of the seizure, and maybe its only manifestation. Aim: The aim of this study was to describe the clinical profile of patients diagnosed with vestibular epilepsy who presented to the neurotology clinic in our hospital in the past 7 years from January 1, 2014, to May 1, 2020, and to present their clinical features, diagnosis, and management. Materials and Methods: This was a retrospective observational clinical study based on the medical records of all patients diagnosed with vestibular epilepsy who presented during the period January 1, 2014–May 1, 2020, to our neurotology clinics. Each patient's history and neurotological examination were documented. All investigations carried out such as audiovestibular tests, electroencephalogram, cardiac tests, and imaging were noted. Results: Ten patients were diagnosed with vestibular epilepsy in our clinic during this time period, with a prevalence of vestibular epilepsy being 0.001%. The main subjective aura in our patients was vestibular disturbance in the form of rotatory type of vertigo which lasted for a few seconds. These symptoms were followed by abnormal movements of limb and loss of consciousness (LOC) in six patients. The patients who experienced a LOC had cardiology workup. Electronystagmogram was abnormal in three patients, while magnetic resonance imaging showed an abnormality in three patients. All patients were started on anticonvulsant drugs and showed a good response to treatment. Conclusion: Vestibular epilepsy is a rare but treatable cause of transient dizziness. The diagnosis of vestibular epilepsy is often missed or delayed and should be considered when brief episodic spontaneous vertigo occurs with LOC and unresponsive to standard vestibular treatment. Treatment with anticonvulsants seems to give relief of symptoms.

Efficacy of medical grade manuka honey in acute otitis externa: A pilot study Amit Kumar, Shweta Mittal, Amit Kumar Tyagi, Hano Romesh, Saurabh Varshney, Manu Malhotra Indian Journal of Otology 2020 26(3):151-154 Introduction: Manuka honey has been used in chronic diabetic ulcers and traumatic wounds. We have used Manuka honey in cases of otitis externa because of its antibacterial and anti-inflammatory properties. Objectives: The objective was to study the efficacy of topical applications of Manuka honey in the patients of acute otitis externa. Materials and Methods: Patients with acute otitis externa without any prior ear complaint or intervention were selected for the study after informed and written consent. All patients selected for the study were packed with Manuka honey-impregnated umbilical tape and pain scores; canal wall edema was recorded on days 0, 1, 3, and 7. Results: A total of 20 patients were included in our study. Twenty patients followed us on day 1, 15 patients on day 3, and seven patients followed us till day 7. The mean pain score for day 0 was 5.35, and the mean pain score decreased to 2.95 on day 1, and the difference was statistically significant. Conclusion: Manuka honey appears to be an effective therapeutic agent in the management of otitis externa.

Effect of middle ear surgery on taste in patients with chronic otitis media Vijin Ravindran, Deviprasad Shetty, K S Gangadhara Somayaji Indian Journal of Otology 2020 26(3):155-158 Objective: The objective was to identify the gustatory changes in patients with chronic otitis media due to chorda tympani nerve involvement and to identify the gustatory changes with minimal manipulation, stretching, and cutting of the nerve during surgery and its postoperative recovery. Methodology: A total of 100 patients were selected. Clinical assay, with tests based on “taste strips” with different concentrations of salt, sweet, bitter, and sour, was done preoperatively. The taste strips used were sodium chloride for salt, sucrose for sweet, quinine sulfate for bitter, and citric acid for sour. The same was tested postoperatively after 1 week, 1 month, and 6 months. Analysis: Of the total 100 patients, 22 patients had squamosal disease, and the remaining 78 patients had mucosal disease. Fourteen patients were found to have taste changes preoperatively, of whom nine recovered their taste 1 week following surgery. Remaining five patients recovered at 1 month following the surgery. It was also observed that, in all the 25 patients where the nerve was cut, postoperative changes were noted, which recovered completely at the end of 6 months, except in two patients. In patients where the nerve was stretched, patients showed more gustatory alterations when compared with patients where the nerve was minimally manipulated. Conclusion: We conclude from our study that cutting the nerve produced less gustatory alterations, when compared with patients where the nerve was stretched. We also concluded that chronic inflammation of the middle ear itself can cause gustatory alterations, and these changes recovered once the disease was cleared.

Assessment of vestibulotoxicity of neem leaf (Azadirachta indica) in a rat animal model Rosdan Salim, Mohd Khairi Md Daud, Maithrea Suresh Narayanan, Aziah Ab Rani Indian Journal of Otology 2020 26(3):159-162 Introduction: Otomycosis is a challenging and frustrating entity for both patients and otolaryngologists for it frequently requires long-term treatment and follow-up, yet the recurrence rate remains high. The management is directed toward intense aural toileting with administration of topical antifungals. There has been increased resistance to classical antifungal agents, typically involving the azoles and polyenes. This has led into the research of medicinal plants as an alternative treatment for treating fungal infections. Objective: This study aims to investigate the possible vestibulotoxic effects of neem leaf (Azadirachta indica), a commonly used home remedy on the inner ear in a rat animal model. Methodology: Twenty healthy, mature Wistar albino rats were divided into three groups: Groups A (eight animals), B (eight animals), and C (four animals). They underwent baseline vestibular parameter testing, following which an endoscopic-guided transtympanic instillation of aqueous and alcohol neem extract was performed into the right middle ear of the rats in Groups A and B, while normal saline was instilled into the right middle ear of rats in Group C. Vestibular parameter testing was repeated on the rats in both groups post instillation of transtympanic neem at 4-h, 24-h, 48-h, 72-h, 1-week, 2-week, and 3-week intervals. Results: There was no deterioration in all vestibular parameters recorded post instillation of neem extract within the middle ear. Conclusion: Neem extract is a safe alternative in the treatment of otomycosis in the presence of tympanic membrane perforation as it poses no vestibulotoxic side effects.

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