Nickel challenge up regulates CD69 expression on T lymphocyte sub-sets from patients with nickel induced contact dermatitis

Background: Persistent antigenic stimulation due to repeated exposure to nickel may lead to chronic inflammation resulting in allergic contact dermatitis (ACD).Objectives: This study was performed to assess nickel induced immune activation among patients sensitized against nickel.Patients and Methods: A total of 35 patients (29 females and 6 males; mean age 36±9 years) with nickel contact dermatitis and 20 patch test negative healthy individuals  (14 females and 6 males; mean age 29±7 years) were included in this study. Peripheral blood of patients and controls was incubated with nickel sulfate for 24 hours. Immune activation was assessed by CD69 up-reg- ulation on T lymphocyte sub-sets by flow cytometry.Results: Base line expression of CD69 on CD8+ lymphocytes was higher among patients compared to controls (4.1±1.3%vs2.8±1.1%;p<0.009). There was no difference in proportions of CD±CD69+ cells between patients and controls (3.2±0.9%vs2.3±0.8%). Exposure to nickel induced expression of CD69 on a significantly higher proportion of CD4+ lympho- cytes (22.1±6.2%) of the ACD patients compared to controls (2.8±2.5%;p<0.0001). Similarly nickel induced CD69 expression on a higher proportion of CD8+ lymphocytes (18.2±5.3%) from ACD patients compared to the controls (1.9±1.8%;p<0.0006).Conclusion: CD69 molecule appears to be an important regulator of immune response in nickel contact dermatitis.   Keywords: Nickel, CD4+, CD8+, CD69, contact dermatitis

Nickel challenge up regulates CD69 expression on T lymphocyte sub-sets from patients with nickel induced contact dermatitis

Background: Persistent antigenic stimulation due to repeated exposure to nickel may lead to chronic inflammation resulting in allergic contact dermatitis (ACD). Objectives: This study was performed to assess nickel induced immune activation among patients sensitized against nickel. Patients and Methods: A total of 35 patients (29 females and 6 males; mean age 36\ub19 years) with nickel contact dermatitis and 20 patch test negative healthy individuals (14 females and 6 males; mean age 29\ub17 years) were included in this study. Peripheral blood of patients and controls was incubated with nickel sulfate for 24 hours. Immune activation was assessed by CD69 up-regulation on T lymphocyte sub-sets by flow cytometry. Results: Base line expression of CD69 on CD8+ lymphocytes was higher among patients compared to controls (4.1\ub11.3%vs2.8\ub11.1%;p<0.009). There was no difference in proportions of CD\ub1CD69+ cells between patients and controls (3.2\ub10.9%vs2.3\ub10.8%). Exposure to nickel induced expression of CD69 on a significantly higher proportion of CD4+ lymphocytes (22.1\ub16.2%) of the ACD patients compared to controls (2.8\ub12.5%;p<0.0001). Similarly nickel induced CD69 expression on a higher proportion of CD8+ lymphocytes (18.2\ub15.3%) from ACD patients compared to the controls (1.9\ub11.8%;p<0.0006). Conclusion: CD69 molecule appears to be an important regulator of immune response in nickel contact dermatitis. DOI: https://dx.doi.org/10.4314/ahs.v19i1.19 Cite as: Zahid S, Mustafa A, Dina A, Sawsan B, Felwa A, Mohammed G, et al. Nickel challenge up regulates CD69 expression on T lymphocyte sub-sets from patients with nickel induced contact dermatitis. Afri Health Sci. 2019;19(1). 1460-1466. https://dx.doi. org/10.4314/ahs.v19i1.1

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Distal Phalanx Intraosseous Epidermoid Cyst

Summary:. An intraosseous epidermal cyst is a benign cystic lesion that occurs in the bones. It is assumed to be caused by congenital causes or trauma, and because the cyst forms in the soft tissue surrounding the bone, it can lead to bone loss. Intraosseous epidermal cysts have a well-defined radiolucent lesion with cortical extension on radiography. Due to clinical and radiological signs being similar, it is vital to distinguish an intraosseous epidermal cyst from other diseases that develop at the distal phalanx. A rare example of intraosseous epidermal cysts at the distal phalanx is reported. We describe the clinical, radiological, and pathologic aspect of this lesion, as well as our current therapeutic strategy