A comparison of efficacy and safety with add on therapy of pioglitazone in adult patients of psoriasis with and without metabolic syndrome

Background: Psoriasis is a chronic disease involving skin with systemic manifestations whose etiology remains unknown. In recent times, an increased occurrence of metabolic syndrome has been seen in psoriatic patients and potential role of antihyperglycemic in such conditions is being evaluated.Methods: This was a prospective, controlled, randomized, open label comparative clinical study conducted on 51 psoriatic patients. The patients were divided into two groups with and without MS and both these groups were further randomised to receive either standard therapy alone (topical 0.05% betamethasone dipropionate applied twice daily) or therapy with pioglitazone 15 mg orally once daily as add on to standard treatment. The study was conducted over a period of 12 weeks and the primary efficacy outcome was assessed by a change in psoriasis area severity index (PASI). The secondary outcomes were achievement PASI 50/75 and change in parameters of metabolic syndrome (MS). Change in quality of life assessed using dermatological life quality index (DLQI). Results: Both the treatments significantly reduced the PASI score in psoriatic patients with and without MS, maximum being at 12 weeks. In patients with and without MS, pioglitazone caused a greater reduction in PASI score and DLQI score though it was found comparable to ST alone. Significant improvement in parameters of metabolic syndrome was observed in pioglitazone treated group.Conclusions: Pioglitazone given as add on therapy caused an additional improvement in clinical severity and QOL in both the group of psoriatic patients with and without metabolic syndrome. Role of pioglitazone needs to be further explored with higher recommended dose range (30 mg and 45 mg) to demonstrate the usefulness of this drug in psoriatic patients

Phenylephrine induced fixed drug eruption: a rare case of cross sensitivity

Fixed drug eruption (FDE) is a type of dermatosis characterized by recurrent lesions at exactly the same sites with each administration of the causative agents. FDEs are common types of drug eruptions amongst all cutaneous drug-induced side effects, mostly by intermittent exposure. Multiple drugs with common chemical structure can cause same type of lesions at same site called as cross sensitivity. There are many causative agents and the incidence of FDEs for a particular drug depends on the frequency of its use. Though usually not severe or fatal, cosmetic embarrassment is main problem, especially when they recur on the previously affected sites leaving behind residual hyperpigmentation. Phenylephrine is a sympathomimetic agent, given orally for the symptomatic relief of nasal congestion. It is also commonly combined with other ingredients in preparations intended for the relief of cough and cold symptoms. Considering the frequent use of Phenylephrine, associated drug eruptions generally appear to be rare, cross sensitivity with pseudoephedrine is even rarer. In our case phenylepherine was self-administered to control cold induced congestion and patient developed FDE on vermillion of upper lip, which healed after 2 weeks leaving hyperpigmentation and reappear on same site after re-challenge also. She has history of FDEs due to pseudoephedrine on same site on lips. This is a rare case of sympathomimetics induced FDE with cross sensitivity between phenylepherine and pseudoephedrine; hence we are reporting it here

Influence of host plant (Terminalia arjuna)defences on the evolution of feeding behaviourin the tasar silkworm

Both under indoor and outdoor rearing conditions, early instars of Antheraea mylitta showed differential preference for eating towards developmentally different leaves of host plant, Terminalia arjuna. Semi-mature leaves were preferred by first, second and third instar of A. mylitta. Nutritional-value study of leaves of different age groups with respect to soluble protein and electrophoretic profile showed that young leaves are nutritionally rich compared to semi-mature and mature leaves. However, growth response and survival of larvae were better on semi-mature leaves compared to young and mature leaves. When analysed, semi-mature leaves showed protease inhibitor activity intermediate between young and mature leaves. This observation suggests optimal defence theory, where young and semi-mature leaves having high fitness and high probability of attack tend to have higher concentration of defence metabolites. Differential inhibition of midgut and bovine proteases by host plant protease inhibitor indicates that the tasar silkworm might have detoxified or evolved proteases that are insensitive to the leaf protease inhibitor of the host plant. Thus the differential feeding behaviour of larvae of tasar silkworm is an adaptation for coexistence of the insect and its host plant

Management outcomes in pubic diastasis: our experience with 19 patients

<p>Abstract</p> <p>Background</p> <p>Pubic diastasis, a result of high energy antero-posterior compression (APC) injury, has been managed based on the Young and Burguess classification system. The mode of fixation in APC II injury has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the posterior pelvic ring elements in these injuries.</p> <p>Methods</p> <p>The study included a total of 19 patients with pubic diastasis managed by us from May 2006 to December 2007. There was a single patient with type I APC injury who treated conservatively. Type II APC injuries (13 patients) were treated surgically with symphyseal plating using single anterior/superior plates or double perpendicularly placed plates. Type III injuries (5 patients) in addition underwent posterior fixation using plates or percutaneous sacro-iliac screws. The outcome was assessed clinically (Majeed score) and radiologically.</p> <p>Results</p> <p>The mean follow-up was for 2.9 years (6 months to 4.5 years). Among the 13 patients with APC II injuries, the clinical scores were excellent in one (7.6%), good in 6 (46.15%), fair in 4 (30.76%) and poor in 2 (15.38%). Radiological scores were excellent in 2 (15.38%), good in 8 (61.53%), fair in 2 (15.38%) and poor in one patient (7.6%). Among the 5 patients with APC III injuries, there were 2 patients each with good (50%) and fair (50%) clinical scores while one patient was lost on long term follow up. The radiological outcomes were also similar in these. Complications included implant failure in 3 patients, postoperative infection in 2 patients, deep venous thrombosis in one patient and bladder herniation in one of the patients with implant failure.</p> <p>Conclusions</p> <p>There is no observed dissimilarity in outcomes between isolated anterior and combined symphyseal (perpendicular) plating techniques in APC II injuries. Single anterior symphyseal plating along with posterior stabilisation provides a stable fixation in type III APC injuries. Limited dissection ensuring adequate intactness of rectus sheath is important to avoid long term post-operative complications.</p

Plant products as an alternative phytotherapeutics to regulate thrombosis – A review

Thrombosis, a life-threatening disease causes thrombus formation within blood vessels to obstruct the flow of blood through vascular system. The disease causes morbidity and mortality of arterial and venous thrombosis which can result in acute infraction and deep vein thrombosis. Majority of clotting factors are serine proteases and are present as precursors of proteolytic enzymes known as zymogens that circulate in inactivated forms but get activated in response to injury in blood vessels. The serine proteases are involved in coagulation, anticoagulation, and fibrinolysis. Thrombin and fibrin are the main key therapeutic target for the treatment of thrombosis. Commercially available antithrombotic and thrombolytic drugs are known to be associated with serious side effects like bleeding, hypertension, and haemorrhage therefore natural products have been suggested as best replacement of synthetic antithrombotic and thrombolytic drugs with less side effects for human health. Plants have been suggested as potential source of anticoagulants against thrombosis with fewer or no side effects

Effect of timing of cord clamping on iron stores of infants born to anemic mothers

Objective: To study the effect of timing of cord clamping on the iron stores of infants born to anemic (hemoglobin [Hb] 7-10 g/dl)mothers, and if late clamping leads to polycythemia. Design: Randomized comparative trial. Setting: Tertiary care hospital in ametropolitan city. Participants: Term, healthy, and vaginally delivered neonates without any congenital malformations or birth asphyxia,born to booked anemic (Hb 7-10 g/dl) mothers having no medical or pregnancy-related complications were included in the study.Interventions: The pregnant mothers were randomized into three groups, and their umbilical cords were clamped at 1, 2, and 3 min.Neonatal hematocrit was estimated by the capillary method at 24 h of life, and infant’s (Hb) and ferritin were obtained at 3 monthsof life. Main Outcome Measures: Hematocrit at 24 h of life and serum iron and ferritin levels at 3 months of age. Results: Theoutcome variables significantly associated (p&lt;0.05) with hematocrit were cord clamping time, maternal Hb and cord Hb, and ferritin.That associated with infant’s Hb were cord clamping time and cord Hb and ferritin. Whereas, only cord clamp time was significantlyassociated with infant’s ferritin. None of the neonates had polycythemia, and Hb and ferritin were found to be the highest in those whosecord was clamped at 3 min. Conclusion: In resource-constrained countries, where iron deficiency anemia is a major public healthproblem, delaying the umbilical cord clamping by up to 3 min will reduce the incidence of infantile anemia. It will serve as an additionalcost-effective intervention in anemia control program without any adverse effect of polycythemia

Esculetin Downregulates the Expression of AML1-ETO and C-Kit in Kasumi-1 Cell Line by Decreasing Half-Life of mRNA

One of the most frequent genetic aberrations in acute myeloid leukemia (AML) is chromosomal translocation between AML1/RUNX1 on chromosome 21 and ETO gene on chromosome 8 resulting in the expression of chimeric oncogene AML1-ETO. Although patients with t(8;21) translocation have good prognosis, 5-year survival is observed only in 50% of the cases. AML1-ETO translocation is usually accompanied by overexpression of mutant C-Kit, a tyrosine kinase, which contributes to uncontrolled proliferation of premature blood cells leading to relapse and poor prognosis. We illustrate the potential use of esculetin on leukemic cell line, Kasumi-1, bearing t(8;21) translocation and mutated C-Kit gene. Esculetin decreases the expression of AML1-ETO at both protein and transcript level within 24 hours of treatment. Half-life of AML1-ETO mRNA was reduced from 7 hours to 1.5 hours. Similarly half-life of C-Kit mRNA was reduced to 2 hours from 5 hours in esculetin treated cells. Esculetin also perturbed the expression of ectopically expressed AML1-ETO in U937 cells. The decreased expression of AML1-ETO chimeric gene was associated with increased expression of LAT1 and RUNX3 genes, targets of AML1. We envisage that discovery of a drug candidate which could target both these mutated genes would be a considerable breakthrough for future application

Emerging Preservation Techniques for Controlling Spoilage and Pathogenic Microorganisms in Fruit Juices

Fruit juices are important commodities in the global market providing vast possibilities for new value added products to meet consumer demand for convenience, nutrition, and health. Fruit juices are spoiled primarily due to proliferation of acid tolerant and osmophilic microflora. There is also risk of food borne microbial infections which is associated with the consumption of fruit juices. In order to reduce the incidence of outbreaks, fruit juices are preserved by various techniques. Thermal pasteurization is used commercially by fruit juice industries for the preservation of fruit juices but results in losses of essential nutrients and changes in physicochemical and organoleptic properties. Nonthermal pasteurization methods such as high hydrostatic pressure, pulsed electric field, and ultrasound and irradiations have also been employed in fruit juices to overcome the negative effects of thermal pasteurization. Some of these techniques have already been commercialized. Some are still in research or pilot scale. Apart from these emerging techniques, preservatives from natural sources have also shown considerable promise for use in some food products. In this review article, spoilage, pathogenic microflora, and food borne outbreaks associated with fruit juices of last two decades are given in one section. In other sections various prevention methods to control the growth of spoilage and pathogenic microflora to increase the shelf life of fruit juices are discussed

QCD Spin Physics: Partonic Spin Structure of the Nucleon

We discuss some recent developments concerning the nucleon's helicity parton distribution functions: New preliminary data from jet production at RHIC suggest for the first time a non-vanishing polarization of gluons in the nucleon. SIDIS measurements at COMPASS provide better constraints on the strange and light sea quark helicity distributions. Single-longitudinal spin asymmetries in W-boson production have been observed at RHIC and will ultimately give new insights into the light quark and anti-quark helicity structure of the nucleon.Comment: Talk presented at the "International School of Nuclear Physics, 33rd Course: From Quarks and Gluons to Hadrons and Nuclei", Erice, Italy, 16 - 24 September 2011; 12 pages, 9 figure