Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Surgical Management of Inguinal Hernia in A Kid

Protrusion of an abdominal organ through the inguinal canal is called inguinal hernia. Inguinal hernias are less frequent in ruminants. A two month old female cross bred kid was presented with soft swelling in the left inguinal region. Clinical examination revealed that unilateral reducible inguinal hernia. Herniorraphy resulted in complete reduction of the hernia.</jats:p

Clinical profile of diabetes in the young seen between 1992 and 2009 at a specialist diabetes centre in South India

Aim: To describe the trends and clinical profile of young diabetic patients (YD) attending a tertiary diabetes centre in south India. Methods: We reviewed medical records of 2630 YD patients (age at onset &#8804;25 years) registered between 1992 and 2009. Patients were classified as type 1 diabetes (T1DM), type 2 diabetes (T2DM) gestational diabetes mellitus (GDM) and other types. Retinopathy was assessed initially by direct and indirect ophthalmoscopy and later by retinal photography, nephropathy if urine protein excretion was &gt; 500mg/day, neuropathy if vibration perception threshold on biothesiometry was &#8805;20V. Results: The percentage of YD patients rose from 0.55% in 1992 to 2.5% in 2009 (trend chi square, 15.1, p&lt;0.001). Of the 2630 YD subjects registered, 1135 (43.2%) had T1DM, 1262 (48.0%) had T2DM, 118 (4.5%) had GDM and 115 (4.4%) other types. T1DM patients were younger, had lower body mass index, waist circumference, systolic and diastolic blood pressures, and less family history of diabetes compared to T2DM (p&lt;0.001 for each). Retinopathy was seen in 71.9% and 77.3% nephropathy in 22.1% and 12.1% and neuropathy in 34.5% and 21.4% of T2DM and T1DM respectively in those with &#8805;15 years duration of diabetes. Conclusions: The percentage of YD in south India is increasing, predominantly due to early onset T2DM

A Case Report on Schistosomus Reflexus in a Goat

Schistosomus reflexus is a rare cases of foetal anomaly observed in sheep and goat, but commonly seen in cattle. It is characterized by a marked ventral curvature of the spine and the occiput of the head lies near the sacrum. The body and chest walls are bent laterally and the thoracic and abdominal viscera are exposed.the pelvis is deformed.liver is cystic and abnormal in shape.The rumen is occasionally distended with fluid.The limb are usually ankylosed and rigid.in rare cases the limbs and head may be enclosed in a complete sac of skin.(Robert J, 1971).A one year old female goat presented with difficulty in birth since eight hours and delivered the foetus by manual traction.</jats:p

Microwave controlled Electromagnetically Induced Transparency inside an RF cavity

Restricted Access. Book chapter from Proceedings of International Conference on Fibre Optics and Photonics on Tera-Hertz Imaging (T3A)held at Chennai India, December 9-12, 2012We detail the construction of a microwave cavity resonator at 3.0357 GHz. We describe the effect of this resonator on the Electromagnetically Induced Transparency (EIT) phenomenon shown by Rubidium-85 atoms enclosed within the resonator