"Less is more" - this is becoming the global quote on event of alarming rise in the prevalence of obesity among all age groups. The perspective of adipose tissue as merely a fat depot has changed in recent times. Focus is now being laid on the metabolic and inflammatory functions of the adipose tissue which is modulated through adipocytokines. Adipocytokines have been found to control insulin sensitivity, inflammatory activity, neuroendocrine activity, cardiovascular function, food and water intake, breeding, and bone metabolism. Few of these adipokines play a role in the positive metabolism promoting good health, while few of them pose adverse effects. Omentin is a recently identified novel adipocytokine and it falls under the category of being a good adipokine. Plasma omentin-1 levels are significantly decreased in patients with obesity, insulin resistance, and diabetes that contribute to the major components of the metabolic syndrome and other disease conditions like atherosclerosis, autoimmune disorders etc and that the review focuses on the comprehensive effects of omentin on all the major systems of the body.

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Chromium, a known contact sensitizer, is present at high levels in certain detergent bars (40-50 p.p.m.) sold in India. A concern was whether chromium present in such detergent bars could sensitize users or their use lead to the elicitation of allergic contact dermatitis. Chromium present in detergent bars was analyzed for its valence state. It was found to be trivalent [Cr (III)] and not hexavalent [Cr (VI)]. An elicitation test on normal volunteers, as well as on volunteers who were sensitive to chromium, was carried out to determine the elicitation potential of chromium (III) in the bars. Of the 48 volunteers who completed the study, 30 did not show any positive response to either potassium dichromate, the positive control, or the detergent bar containing chromium (III). 18 volunteers who were identified as chromium-sensitive showed a positive response to potassium dichromate but not to the detergent bar containing trivalent chromium. This study clearly showed that the detergent bar with 40-50 p.p.m. of trivalent chromium did not elicit any allergic contact dermatitis even in individuals known to be chromium-sensitive. Hexavalent chromium (potassium dichromate) did however, elicit allergic contact dermatitis in these subjects.

Various techniques have been described for management of anomalous origin of the left coronary artery from the pulmonary artery presenting in adults. Three patients, 1 male and 2 females, aged 27-37 years, underwent transpulmonary pericardial patch closure with concomitant left internal thoracic artery anastomosis to the left anterior descending artery, under standard cardiopulmonary bypass, thus creating a two-coronary system. One patient had concomitant mitral valve repair. All 3 survived the operation. Postoperative angiography in 2 patients revealed good antegrade flow with decreased collaterals in one and competitive inhibition with increased collaterals in the other. This procedure is considered to be the safest and simplest in this subset of patients.

Persistence of the fifth aortic arch (PFAA) is a rare condition that results in the presence of an abnormal vessel originating from the distal ascending aorta proximal to the innominate artery. The distal connection and underlying cardiac or great vessel anomaly define the varied clinical presentations of this condition. CLINICAL SUMMARYA 1-year-old girl presented with cyanosis. On echocardiographic evaluation, she was given a diagnosis of tetralogy of Fallot with pulmonary atresia, patent ductus arteriosus, and collateral-dependent pulmonary blood flow. Angiocardiographic analysis showed a large vessel arising from the distal ascending aorta close to the innominate artery and joining the pulmonary artery (PA) confluence (Figure 1). Intraoperatively, she was found to have an abnormal artery (PFAA) arising from the posterior aspect of the ascending aorta close to the innominate artery and joining the PA confluence (Figure 2). She underwent total correction with closure of the ventricular septal defect, detachment of the PFAA from the ascending aorta, and pericardial patch plasty of the PA confluence. Right ventricle-PA continuity was established by using a valved porcine PA conduit. Her postoperative course was uneventful.