The synthesis, characterization and thermal chemistry of modified norbornenyl PMR endcaps

As part of a program to further the understanding of the polymerization of Nadic-Endcapped PMR systems, a series of model Norbornenyl-Imides has been synthesized and their thermal behavior explored. Their syntheses and characterizations as well as their rearrangement and polymerization chemistry are described. Monomer isomerization at temperatures as low as 125 C and oligomer formation at somewhat higher temperatures are observed. Approximate relative rates for competing isomerization pathways are established and some information is obtained about the details of oligomer formation. The relationship of this data to current PMR systems is briefly discussed

Oral Pemphigus Vulgaris: Case Report

BACKGROUND: Pemphigus is a potentially life threatening autoimmune disease that causes blisters and erosions of the skin and the mucous membrane. The epithelial lesions are a result of auto-antibodies that react with desmosomal glycoproteins that are present on the cell surface of the keratinocyte. The autoimmune  reaction against these glycoproteins causes a loss of cell to cell adhesion, resulting in the formation of  intraepithelial bullae. Eighty to ninety percent of patients with pemphigus vulgaris develop oral lesions and in 60% of cases oral lesions are the first sign. Timely recognition and therapy of oral lesion is critical as it may prevent skin involvement. If treatment is instituted during this time, the disease is easier to control and the chance for an early remission of the disorder is enhanced.CASE DETAILS: This case report describes the case of a patient who complained of ulcers of the mouth and difficulty in swallowing since 20 days, who was diagnosed as having Pemphigus vulgaris. Due to early  diagnosis, lower doses of medication for a shorter period of time could control the disease.CONCLUSION: Dental professionals must be sufficiently familiar with the clinical manifestations of  pemphigus vulgaris to ensure early diagnosis and treatment which in turn determines the prognosis and course of the disease.KEYWORDS: Pemphigus, oral lesions, mucous membrane, chronic oral ulcers, pemphigus vulgari

Periodic Peritoneal Dialysis in End Stage Renal Disease: Is it Still Relevant? A Single Center Study from India

Background: High cost of maintenance hemodialysis (HD) and continuous ambulatory peritoneal dialysis (PD) in India has made renal replacement therapy out of reach of many patients with end stage renal disease (ESRD). Repeated puncture PD although inferior to HD biochemically, is easily and freely available across Rajasthan, India, and is simple to perform, and does not require sophisticated machines, thus making it an attractive option for dialysis for ESRD. Aim: To analyze the outcomes of periodic PD in patients with ESRD requiring dialysis support. Subjects and Methods: A prospective study analyzing the data of patients who underwent PD between August 2010 and January 2013 in Sawai Man Singh Hospital, Jaipur, India was conducted. Patients were divided into three groups based on the time period between first and second session of PD. Detailed demographic and clinical data during the study period were collected along with PD related complications. The main outcome studied was technique survival 1 year post initiation of PD. Results: 234 patients received an initial session of PD, of which 174 had a good response and were included in the study. 19 patients received the second PD within 7 days of first (Group 1), 45 patients within 8–14 days (Group 2) and 110 patients within 15–21 days (Group 3). The overall 1 year technique survival was 68.4% (91/133), with a rate of 50% (5/10), 56.8% (21/37), and 75.6% (65/86) for Group 1, Group 2, and Group 3, respectively. The time duration between first and second PD proved to be reliable indicator of the subsequent response, with a technique survival rate significantly lower in Group 1 patients compared to Groups 2 and 3 (P = 0.04). Median dialysis free days were 11, 16 and 21 days in Group 1, Group 2, and Group 3, respectively. Peritonitis rate observed was 2.1% (49/2261) during the study period. Conclusion: Periodic PD is a simple, safe and cheap procedure, which can be considered as used as a palliative measure in terminal uremia in underprivileged areas.Keywords: Peritoneal dialysis, End stage renal disease, Renal replacement therap

Tocilizumab induced immunosuppression in a case of adult-onset still’s disease: are these newer biologics double edged sword?

Adult-onset still’s disease (AOSD) is a rare multisystemic inflammatory disorder of unknown etiology characterised by high spiking fever, evanescent skin rash, arthralgias, arthritis, neutrophilic leucocytosis. Initial treatment strategy includes use of hands-on drugs like non-steroidal anti-inflammatory drugs, low dose corticosteroids, conventional DMARDs. But as the disease progresses to severe form, targeted and biologic DMARDs could be the option for management. Interleukin-6 being one among the many cytokines involved in the pathogenesis of AOSD, has made itself a target for the treatment of refractory cases. Tocilizumab, a recombinant humanized anti IL-6 monoclonal antibody, is one such biologic drug available in the market that has proven its therapeutic efficacy in several clinical trials. We are presenting a case of 37-year-old female patient, known case of AOSD for 4 years. Patient was initially maintained on low dose corticosteroid and conventional DMARD like hydroxychloroquine and methotrexate. Flare ups of the disease warranted the use of tocilizumab and tofacitinib in this patient. After clinical as well as pathological improvement with tocilizumab 2 years before, signs of immunosuppression were observed when tocilizumab was reintroduced for the treatment. Patient suffered from acute pyelonephritis, septicemia, shock, oropharyngeal candidiasis and bronchitis which could be owned to immunosuppressive action of tocilizumab. One can reduce the chances of infection and other adverse effects by careful periodic monitoring of various laboratory parameters like total W.B.C., total platelet count and liver enzymes. Cautious selection of the patient is needed for the treatment with newer biologic agents

The dust, planetesimals and planets of HD 38529

HD 38529 is a post-main sequence G8III/IV star (3.5 Gyr old) with a planetary system consisting of at least two planets having Msin(i) of 0.8 MJup and 12.2 MJup, semimajor axes of 0.13 AU and 3.74 AU, and eccentricities of 0.25 and 0.35, respectively. Spitzer observations show that HD 38529 has an excess emission above the stellar photosphere, with a signal-to-noise ratio (S/N) at 70 micron of 4.7, a small excess at 33 micron (S/N=2.6) and no excess <30 micron. We discuss the distribution of the potential dust-producing planetesimals from the study of the dynamical perturbations of the two known planets, considering in particular the effect of secular resonances. We identify three dynamically stable niches at 0.4-0.8 AU, 20-50 AU and beyond 60 AU. We model the spectral energy distribution of HD 38529 to find out which of these niches show signs of harboring dust-producing plantesimals. The secular analysis, together with the SED modeling resuls, suggest that the planetesimals responsible for most of the dust emission are likely located within 20-50 AU, a configuration that resembles that of the Jovian planets + Kuiper Belt in our Solar System. Finally, we place upper limits (8E-6 lunar masses of 10 micron particles) to the amount of dust that could be located in the dynamically stable region that exists between the two planets (0.25--0.75 AU).Comment: 23 pages, including 1 table and 5 figures. Accepted for publication in Ap

Protein complex directs hemoglobin-to-hemozoin formation in Plasmodium falciparum

Malaria parasites use hemoglobin (Hb) as a major nutrient source in the intraerythrocytic stage, during which heme is converted to hemozoin (Hz). The formation of Hz is essential for parasite survival, but to date, the underlying mechanisms of Hb degradation and Hz formation are poorly understood. We report the presence of a ∼200-kDa protein complex in the food vacuole that is required for Hb degradation and Hz formation. This complex contains several parasite proteins, including falcipain 2/2', plasmepsin II, plasmepsin IV, histo aspartic protease, and heme detoxification protein. The association of these proteins is evident from coimmunoprecipitation followed by mass spectrometry, coelution from a gel filtration column, cosedimentation on a glycerol gradient, and in vitro protein interaction analyses. To functionally characterize this complex, we developed an in vitro assay using two of the proteins present in the complex. Our results show that falcipain 2 and heme detoxification protein associate with each other to efficiently convert Hb to Hz. We also used this in vitro assay to elucidate the modes of action of chloroquine and artemisinin. Our results reveal that both chloroquine and artemisinin act during the heme polymerization step, and chloroquine also acts at the Hb degradation step. These results may have important implications in the development of previously undefined antimalarials

Industry-Government-University Cooperative Research Program for the Development of Structural Materials from Sulfate-Rich FGD Scrubber Sludge

The main aim of our project was to develop technology, which converts flue gas desulfurization (FGD) sulfate-rich scrubber sludge into value-added decorative materials. Specifically, we were to establish technology for fabricating cost effective but marketable materials, like countertops and decorative tiles from the sludge. In addition, we were to explore the feasibility of forming siding material from the sludge. At the end of the project, we were to establish the potential of our products by generating 64 countertop pieces and 64 tiles of various colors. In pursuit of our above-mentioned goals, we conducted Fourier transform infrared (FTIR) and differential scanning calorimetry (DSC) measurements of the binders and co-processed binders to identify their curing behavior. Using our 6-inch x 6-inch and 4-inch x 4-inch high pressure and high temperature hardened stainless steel dies, we developed procedures to fabricate countertop and decorative tile materials. The composites, fabricated from sulfate-rich scrubber sludge, were subjected to mechanical tests using a three-point bending machine and a dynamic mechanical analyzer (DMA). We compared our material's mechanical performance against commercially obtained countertops. We successfully established the procedures for the development of countertop and tile composites from scrubber sludge by mounting our materials on commercial boards. We fabricated more than 64 pieces of countertop material in at least 11 different colors having different patterns. In addition, more than 100 tiles in six different colors were fabricated. We also developed procedures by which the fabrication waste, up to 30-weight %, could be recycled in the manufacturing of our countertops and decorative tiles. Our experimental results indicated that our countertops had mechanical strength, which was comparable to high-end commercial countertop materials and contained substantially larger inorganic content than the commercial products. Our moisture sensitivity test suggested that our materials were non-water wettable and did not disintegrate on submerging the product in water for at least two months. Countertop polishing techniques were also established