Amlan Gupta

Fabrication of Smooth Electrospun Nanofibrous Gelatin Mat for Potential Application in Tissue Engineering

This study involves the fabrication of smooth bead-free gelatin nanofibers by the electrospinning technique. An attempt has been made to understand the change in the morphology of the nanofibers produced with the change in electrospinning parameters with a preliminary in vitro and in vivo evaluation of the nanofibrous mat or the nanomat. In this study, the electrospinning of gelatin has been investigated by varying several parameters such as applied voltage, flow rate, solvent composition, and gelatin concentration. Cell culture studies and histopathological studies suggest that the gelatin nanomat is biocompatible and shows signs of resconstruction in a week with no deleterious effects. GRAPHICAL ABSTRACT

Gastric xanthelasma: an unusual endoscopic finding.

Gastric xanthelasma is a rarely encountered finding in upper gastrointestinal (GI) endoscopy. It is characterised by yellowish-white plaque in the stomach especially in the antrum or the pyloric region. Histologically it consists of foamy macrophages in the lamina propria. It is a benign condition but its appearance mimics malignancy and it is found to be associated with various conditions, some of which are considered premalignant so, histological confirmation is necessary. We present a case of a 44-year-old man who presented to the medicine outpatient department for intermittent pain in epigastrium for the last 2 years. His physical examination was normal. His haematological and biochemical investigations were also normal. His upper GI endoscopy revealed yellowish-white plaque in fundus of the stomach, which was diagnosed as gastric xanthelasma by histological examination with associated chronic gastritis.

Infectious disease markers in blood donors at Central Referral Hospital, Gangtok, Sikkim.

Sir, A safe blood is a critical component in improving health care and in preventing the spread of infectious diseases globally. Yet the quality and safety of blood transfusion is still a concern for a health-care personnel. The extent of infectious disease markers of major blood-borne pathogens [hepatitis B (HBV), hepatitis C (HCV), human immunodeficiency virus (HIV), syphilis and malarial parasite] was observed as with age and sex distribution for the donor population of the blood bank of a tertiary care hospital of Gangtok during 2001-2008. Of the 3735 donors, 2423 (64.87%) were replacement and 1312 (35.13%) voluntary donors; male donors were 3434 (91.94%) and females were 301 (8.06%) with overall seroprevalence of major blood-borne pathogens (HIV, HBV, HCV and Syphilis) was 1.63%. The sero-positivity of HIV, HBsAg, anti- HCV, and syphilis was 0.32, 0.78, 0.27 and 0.27%, respectively. Unlike other studies,[1,2] which showed a lower prevalence of HIV, HBsAg, and anti-HCV in voluntary donors, we observed a higher HIV, HBsAg, and anti-HCV sero- positivity in voluntary donors as compared to replacement donors, though the difference in prevalence in these two groups was not statistically significant [Chi-square test (with Yates correction) = 0.02974 (P = 0.10); 0.01495; (P = 0.9027); 1.738 (P = 0.1874) respectively]. Whereas syphilis positivity was found to be higher in replacement donors as compared to voluntary donors though not statistically significant [Chi-square test (with Yates correction) = 0.4513 (P = 0.5017)], which was in agreement with other studies.[1,2] HIV and anti-HCV sero-positivity was nil from 2001 to 2005 among our donors. There was no significant change in the prevalence of HIV, HBsAg, HCV, and syphilis positivity over the period (Chi - square for trend = 5.913, P = 0.0120; 0.01728, P = 0.6776; 2.440, P = 0.1183; 0.04003, P = 0.8414, respectively). There was no HIV, HCV and syphilis positive case among female donors in our study population. The HBV positivity was the only infection found in one female donor in our total female donors in the age group of 21-40, which was statistically significant (P = 0.0062). There were no HIV and syphilis positive cases below the age of 21 years. No sample showed malarial parasites. There was not a single case positive for co-infection with two or more infectious agents. Though the screening tests used for these infections were not 100% sensitive or specific,[3,4] and the approximation of the infectious disease markers in our donor population was less, there is no scope of complacency.

Fourth branchial pouch sinus - an unusually late initial presentation.

ObjectiveHere we present an unusual case of a male patient with 4th branchial pouch sinus with an initial presentation of pseudothyroiditis at an unusually late age of 20 years.MethodCase report and a review of the world literature concerning 4th branchial pouch sinus is presented.ResultThe patient was diagnosed by radiology and endoscopy and treated surgically. Histopathology revealed chronic inflammatory changes, which pointed towards recurrent sub clinical low-grade inflammations over the years keeping the condition occult till 20 years of age.ConclusionAccording to available literature it almost always presents in the first decade of life when it might be misdiagnosed. However our report shows it may also exist with sub clinical inflammations or infections and present at a much later stage in life, when the possibility of such a sinus shouldn’t be ruled out on the basis of lack of history of recurrent neck inflammations.

An attempt to define the type of biopsy in a sinonasal lesion showing bony erosion.

ObjectivesTo present a case of sino-nasal destructive mass initially diagnosed as an inflammatory lesion following punch biopsy from the lesion however the post surgical histopathology was diagnostic of Grade 2 angiocentric immunoproliferative lesion (AIL). The reasons for the initial misdiagnosis are analyzed.Materials and methodsA 76-year-old male patient presenting with progressive bilateral nasal obstruction for 1 year. Repeated punch biopsies from the mass were suggestive of an inflammatory lesion.ResultThe patient underwent surgical exenteration of the mass and the final histopathology report suggested AIL Grade 2. The patient was thereafter treated with chemotherapy and radiotherapy.ConclusionInitial superficial punch biopsies lead to incorrect diagnosis leading to an unnecessary surgical exenteration. The explanations for the initial misdiagnosis are given below and appropriate diagnostic protocols, mode and depth of biopsy are suggested based on the case study.

Large gastric ulcer: Result of foreign body-induced giant cell reaction

A granuloma is an organized and compact mass of mature mononuclear phagocytes. Granulomas are reported to form in various organs and sites of the body. Granulomas in stomach are rarely encountered. Foreign body granulomas are formed as a result of reaction of the tissues to a foreign body which is immunologically inert. Food granuloma is type of foreign body granuloma which is formed in response to food particles like vegetable matters or cereals. These granulomas can be distinguished from other types of granulomas with ease because of their characteristic morphologic features. We report the case of a 29-year-old male who developed a large gastric ulcer as a result of foreign body-induced giant cell reaction, which was probably of vegetative origin. He was treated with the regimen for Helicobacter pylori , rabeprazole and sucralfate. This treatment resulted in partial healing of the ulcer with persistence of food granuloma; hence, the patient was referred for surgery.

Scar free healing mediated by the release of aloe vera and manuka honey from dextran bionanocomposite wound dressings

Scar preventive dextran based bionanocomposite dressings containing aloe vera (AV) and manuka honey (MH) were developed as wound care devices. This work was a challenge to fabricate herbal dressing that promotes healing, which at the same time is biocompatible, non-toxic, biodegradable, and cost effective in terms of the simplicity of application in complex chronic wound situations. With this aim, we synthesized in-situ crosslinked dextran/nanosoy/glycerol/chitosan (DNG/Ch) nanocomposite membranes via solvent casting technique followed by subsequent addition of AV and MH to obtain DNG/Ch/AV and DNG/Ch/MH herbal dressings. The drug release kinetics of the bionanocomposite dressings indicated an initial burst release of AV and MH, followed by controlled release when examined in-vitro using non-fickian and quasi-fickian model. Antibacterial studies confirmed >99% antibacterial activity against both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) and bacterial adherence test demonstrated its efficacy for arresting microbial invasion. Wound healing analysis conducted in-vivo showed enhanced epithelialization in the terms scar prevention and aesthetics with absolute wound contraction for the mice treated with AV loaded dressings after 14th post wounding day. Histological features displayed ordered deposition of collagen with a thin epidermis layer. Hence, the present herbal dressing could function without many cytotoxicity and biocompatibility issues.