Development and validation of an UPLC method for the quantification of ethambutol in rat plasma

The method is applicable for pharmacokinetic studies after the oral administration of free EMB in rats, also with scope to extend the method to evaluate EMB-loaded solid lipid nanoparticles.

Burn injury caused by laptop computers

Laptop burn is a real condition and medical reports indicate that using a laptop across the legs can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. A 24-year-old man presented with an asymptomatic reddish brown pigmentation on the thighs. After an extensive work-up, burning caused by use of a laptop was observed. Burning was induced in 3 days by using laptop for 4 h daily. Laptop should be used in properly ventilated and air-conditioned rooms. The most effective way of preventing erythema is to use the laptop on the table or desk.

Abstract P1-09-03: The use of MRI in the evaluation of breast cancer

Background: The availability of Magnet Resonance Imaging (MRI) has increased in the United States over the last decade. Its use for the diagnosis and staging of breast cancer remains undetermined. We examined the trends and frequency of MRI use in women with newly diagnosed breast cancer in Texas and evaluated the factors associated with a receipt of an MRI.

Methods: The Texas Cancer Registry (TCR) Medicare linked data were used to identify incident breast cancer cases between 1/1/2003-12/30/2007. We included female patients, 65 and older enrolled in both Medicare Parts A and B for 3 months prior to diagnosis and 12 months after diagnosis, and not enrolled in an HMO plan during the same period. Patients diagnosed at autopsy were excluded. Bivariate and multivariate logistic regression analysis was performed to determine the factors associated with receipt of MRI. A Cochran-Armitage trend test was performed to examine the trends in use of MRI over study period. A p-value <0.05 was considered statistically significant.

Results: Of the 292,297 patients diagnosed with breast cancer between 2003 and 2007, 18, 856 patients met the inclusion criteria. Of these, 1268 (6.72%) received an MRI. The overall use of breast MRI has increased significantly in Texas from 2.25% of women diagnosed in 2003 to 13.9% of women diagnosed in 2007 (p<0.001). In the bivariate analysis we found that age, race, number of comorbidities, poverty level, education level, and region were associated with the receipt of MRI at the time of breast cancer diagnosis. In the multivariate analysis after adjusting for those covariates, we found that women of advancing age, black race (34%) and presence of any comorbidity (29%) to be significantly less likely to get an MRI, while those with regional disease and higher level of education were more likely to receive MRI (table 1).

Conclusion: Breast MRI in newly diagnosed breast cancer in the state of Texas increased six fold during the study period. While use has increased in Texas, receipt of MRI does not appear to be uniform. To identify the group of women who would benefit most from MRI, more in depth analyses of the role of socio-economic components on receipt of MRI and patient outcomes is needed.

Multivariate analysis: Odds of receiving an MRI at the time of breast cancer diagnosisVariableOdds of MRI (95% CI)P-valueAge Group <.000165-691 70-740.784 (0.672-0.913) 75-790.518 (0.433-0.620) 80-840.415 (0.335-0.514) 85-890.215 (0.145-0.319) >900.098 (0.044-0.223) Race 0.0463White1 Black0.658 (0.492-0.880) Hispanic0.967 (0.587-1.592) Others0.931 (0.545-1.592) Comorbidity <.000101 10.713 (0.607-0.839) 20.712 (0.545-0.931) >20.304 (0.192-0.479) Education Level 0.00011st Quartile (highest)1 2nd Quartile0.743 (0.617-0.896) 3rd Quartile0.594 (0.464-0.760) 4th Quartile (lowest)0.544 (0.404-0.733) Urban/Rural <.0001Big Metro1 Metro0.467 (0.389-0.560) Urban0.558 (0.405-0.768) Less Urban0.882 (0.706-1.101) Rural1.022 (0.642-1.628) Stage 0.01710/In situ1 Localized1.135 (0.932-1.381) Regional1.334 (1.067-1.667) Distant1.166 (0.775-1.755) Unknown0.663 (0.414-1.063) 

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-09-03.

Clinical implications of referral bias in the diagnostic performance of exercise testing for coronary artery disease

BACKGROUND

Exercise testing with echocardiography or myocardial perfusion imaging is widely used to risk-stratify patients with suspected coronary artery disease. However, reports of diagnostic performance rarely adjust for referral bias, and this practice may adversely influence patient care. Therefore, we evaluated the potential impact of referral bias on diagnostic effectiveness and clinical decision-making.

METHODS AND RESULTS

Searching PubMed and EMBASE (1990-2012), 2 investigators independently evaluated eligibility and abstracted data on study characteristics and referral patterns. Diagnostic performance reported in 4 previously published meta-analyses of exercise echocardiography and myocardial perfusion imaging was adjusted using pooled referral rates and Bayesian methods. Twenty-one studies reported referral patterns in 49 006 patients (mean age 60.7 years, 39.6% women, and 0.8% prior history of myocardial infarction). Catheterization referral rates after normal and abnormal exercise tests were 4.0% (95% CI, 2.9% to 5.0%) and 42.5% (36.2% to 48.9%), respectively, with odds ratio for referral after an abnormal test of 14.6 (10.7 to 19.9). After adjustment for referral, exercise echocardiography sensitivity fell from 84% (80% to 89%) to 34% (27% to 41%), and specificity rose from 77% (69% to 86%) to 99% (99% to 100%). Similarly, exercise myocardial perfusion imaging sensitivity fell from 85% (81% to 88%) to 38% (31% to 44%), and specificity rose from 69% (61% to 78%) to 99% (99% to 100%). Summary receiver operating curve analysis demonstrated only modest changes in overall discriminatory power but adjusting for referral increased positive-predictive value and reduced negative-predictive value.

CONCLUSIONS

Exercise echocardiography and myocardial perfusion imaging are considerably less sensitive and more specific for coronary artery disease after adjustment for referral. Given these findings, future work should assess the comparative ability of these and other tests to rule-in versus rule-out coronary artery disease.

Genomic architecture of HIV-1 infection: current status & challenges

Studies on host genomics have revealed the existence of identifiable HIV-1 specific protective factors among infected individuals who remain naturally resistant viraemia controllers with little or no evidence of virus replication. These factors are broadly grouped into those that are immune associated (MHC, chemokines, cytokines, CTLs and others), linked to viral entry (chemokine co-receptors and ligands), act as post-entry restriction elements (TRIM5a, APOBEC3) and those associated with viral replication (cytokines and others). These features have been identified through multiple experimental approaches ranging from candidate gene approaches, genome wide association studies (GWAS), expression analysis in conjunction with functional assays in humans to primate based models. Several studies have highlighted the individual and population level gross differences both in the viral clade sequences as well as host determined genetic associations. This review collates current information on studies involving major histocompatibility complex (MHC) as well as non MHC genes in the context of HIV-1 infection and AIDS involving varied ethnic groups. Special focus of the review is on the genetic studies carried out on the Indian population. Further challenges with regard to therapeutic interventions based on current knowledge have been discussed along with discussion on documented cases of stem cell therapy and very early highly active antiretroviral therapy (HAART) interventions.

Abstract C108: Therapeutic potential of anticancer polyherbal formulations

Background: Cancer is a leading cause of death worldwide and poses a huge health challenge (1). The global burden of cancer continues to increase despite advances in cancer therapeutics. There is renewed interest in plant-based drugs and growing appreciation of the use of polyherbal formulations (2). Multitargeted polyherbal formulations provide synergistic or additive preventive effects when the agents are combined could theoretically permit the administration of the lowest active dose of each agent and therefore lower the potential for adverse side effects. Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies and generally considered resistant to chemo- and radiotherapies. Resisting cell death and angiogenesis are two important hallmarks of cancer cells. Therefore, apoptosis and blocking of angiogenesis are crucial therapeutic approaches. The present study aims to evaluate the anticancer potential of four polyherbal formulations on human hepatocellular carcinoma (Hep-G2) cells and their antiangiogenic potential on chick-chorioallantoic membrane.

Materials and Methods: The following were the studies carried out: (i) cytotoxicity using MTT [3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay; (ii) apoptosis detection using Annexin V-FITC Propidium Iodide staining and flow cytometry [the frequency of annexin-positive cells (apoptotic) was determined using BD FACSDiva software]; (iii) DNA fragmentation and chromatin condensation evaluated with Hoechst 33258 staining and flourescent microscopy; and (iv) evaluation of atiangiogenic potential the formulations using ex-ovo chick Chorio-Allantoic Membrane (CAM) assay.

Results: All four formulations (VK, MK, KG, and GTK) showed significant cytotoxicity with inhibitory concentration (IC50) of 48.6, 57.0, 41.7, and 48.3 µg/ml, respectively at 24h and 32.4, 31.2, 37.5, 29.9 µg/ml, respectively at 48h of treatment. Maximum apoptosis was observed at concentration of 100 µg/ml in HepG2 cells after 48 h of treatment. Treatment induced apoptosis (cumulative) was 98.8% (VK), 94% (MK), 91.7% (KG), and 97.9% (GTK) at 100 µg/ml, in comparison to 88.6% for paclitaxel (10 µg/ml). Apoptosis was further confirmed by the observation of DNA fragmentation and chromatin condensation in fluorescent microscopy. The formulation VK showed maximum anti-neoplastic activity followed by GTK, MK, and KG. It is interesting to note that the cell death pattern observed with the polyherbal formulations is comparable to that of the synthetic single molecule drug paclitaxel. The microscopic evaluation and morphometric image analysis of area of vascularization revealed that all four formulations showed significant inhibition of neo-vascularization. Maximum anti-angiogenic activity was observed at 100 µg/ml. Inhibition of vascularization observed at 100 µg/ml was 36.6 ± 3.5 mm2 (VK), 30.9 ± 7.0 mm2 (MK), 32.6 ± 6.6 mm2 (KG), and 33.2 ± 4.3 mm2 (GTK). On the other hand, thalidomide resulted in 36.4 ± 3.6 mm2 at 10 µg/ml.

Conclusions: All four classic polyherbal formulations showed significant anticancer and antiangiogenic activity compared to chemothereputic drugs. However, VK and MK showed the maximum anticancer and antiangiogenic activity, respectively.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):C108.

Citation Format: Gaurav Sharma, Rama Jayasundar, Shyam S. Chauhan, Thirumurthy Velpandian. Therapeutic potential of anticancer polyherbal formulations. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr C108.

Iron oxide nanoparticle agglomeration influences dose rates and modulates oxidative stress-mediated dose-response profiles in vitro

Spontaneous agglomeration of engineered nanoparticles (ENPs) is a common problem in cell culture media which can confound interpretation of in vitro nanotoxicity studies. The authors created stable agglomerates of iron oxide nanoparticles (IONPs) in conventional culture medium, which varied in hydrodynamic size (276 nm-1.5 μm) but were composed of identical primary particles with similar surface potentials and protein coatings. Studies using C10 lung epithelial cells show that the dose rate effects of agglomeration can be substantial, varying by over an order of magnitude difference in cellular dose in some cases. Quantification by magnetic particle detection showed that small agglomerates of carboxylated IONPs induced greater cytotoxicity and redox-regulated gene expression when compared with large agglomerates on an equivalent total cellular IONP mass dose basis, whereas agglomerates of amine-modified IONPs failed to induce cytotoxicity or redox-regulated gene expression despite delivery of similar cellular doses. Dosimetry modelling and experimental measurements reveal that on a delivered surface area basis, large and small agglomerates of carboxylated IONPs have similar inherent potency for the generation of ROS, induction of stress-related genes and eventual cytotoxicity. The results suggest that reactive moieties on the agglomerate surface are more efficient in catalysing cellular ROS production than molecules buried within the agglomerate core. Because of the dynamic, size and density-dependent nature of ENP delivery to cells in vitro, the biological consequences of agglomeration are not discernible from static measures of exposure concentration (μg/ml) alone, highlighting the central importance of integrated physical characterisation and quantitative dosimetry for in vitro studies. The combined experimental and computational approach provides a quantitative framework for evaluating relationships between the biocompatibility of nanoparticles and their physical and chemical characteristics.

Mechanism of HIV-1 RNA dimerization in the central region of the genome and significance for viral evolution

The genome of HIV-1 consists of two identical or nearly identical RNA molecules. The RNA genomes are held in the same, parallel orientation by interactions at the dimer initiation site (DIS). Previous studies showed that in addition to interactions at DIS, sequences located 100 nucleotides downstream from the 5' splice site can dimerize in vitro through an intermolecular G-quartet structure. Here we report that the highly conserved G-rich sequence in the middle portion of the HIV-1 genome near the central polypurine tract (cPPT) dimerizes spontaneously under high ionic strength in the absence of protein. The antisense RNA does not dimerize, strongly indicating that RNA dimerization does not exclusively involve A:U and G:C base pairing. The cation-dependent reverse transcriptase pausing profile, CD spectra profile, and cation-dependent association and thermal dissociation characteristics indicate G-quartet structures. Different forms of G-quartets are formed including monomers and, significantly, intermolecular dimers. Our results indicate that RNA genome dimerization and parallel alignment initiated through interactions at DIS may be greatly expanded and stabilized by formation of an intermolecular G-quartet at a distant site near the cPPT. It is likely that formation of G-quartet structure near the cPPT in vivo keeps the RNA genomes in proximity over a long range, promoting genetic recombination in numerous hot spots.

Utility of saliva and hair follicles in donor selection for hematopoietic stem cell transplantation and chimerism monitoring

Selection of an HLA identical donor is a critical pre-requisite for successful hematopoietic stem cell transplantation (HSCT). Most transplant centers utilize blood as the most common source of DNA for HLA testing. However, obtaining blood through phlebotomy is often challenging in patients with conditions like severe leucopenia or hemophilia, pediatric and elderly patients. We have used a simple in-house protocol and shown that HLA genotypes obtained on DNA extracted from saliva or hair are concordant with blood and hence can be used for selection of donors for HSCT or organ transplantation. Similarly, for post-HSCT chimerism monitoring, non-availability of pre-transplant DNA samples poses a major limitation of reference STR fingerprints. This study shows that DNA obtained post-HSCT from hair follicles can be used to generate pre-transplant patient specific fingerprints while the STR profiles obtained in saliva samples cannot as these display a mixed state of chimerism.

Plekhg4 is a novel Dbl family guanine nucleotide exchange factor protein for rho family GTPases

Mutations in the PLEKHG4 (puratrophin-1) gene are associated with the heritable neurological disorder autosomal dominant spinocerebellar ataxia. However, the biochemical functions of this gene product have not been described. We report here that expression of Plekhg4 in the murine brain is developmentally regulated, with pronounced expression in the newborn midbrain and brainstem that wanes with age and maximal expression in the cerebellar Purkinje neurons in adulthood. We show that Plekhg4 is subject to ubiquitination and proteasomal degradation, and its steady-state expression levels are regulated by the chaperones Hsc70 and Hsp90 and by the ubiquitin ligase CHIP. On the functional level, we demonstrate that Plekhg4 functions as a bona fide guanine nucleotide exchange factor (GEF) that facilitates activation of the small GTPases Rac1, Cdc42, and RhoA. Overexpression of Plekhg4 in NIH3T3 cells induces rearrangements of the actin cytoskeleton, specifically enhanced formation of lamellopodia and fillopodia. These findings indicate that Plekhg4 is an aggregation-prone member of the Dbl family GEFs and that regulation of GTPase signaling is critical for proper cerebellar function.

siRNA: a new approach to target neuropathic pain

Neuropathic pain remains one of the most challenging of all the neurologic diseases and represents a large unmet need of the medical world. It often requires patience on the part of the patient and the physician who must try a variety of different medications on a trial and error basis until a satisfactory regimen is established. The development of efficacious therapies with minimum side effect profiles has been the subject of intense research and development in the pharmaceutical industry. Emergence of biologic approaches, such as antibodies, short interfering RNA (siRNA), and gene therapy, offer powerful therapeutic possibilities to treat neuropathic pain and other associated neurologic dysfunction. This review describes the progress that has been made to relieve neuropathic pain using siRNA as a tool for treatment. Further, the review discusses the limitations of using naked siRNA as a therapeutic and a scope for the use of suitable packaging or delivery systems.

Per-colorant-channel color barcodes for mobile applications: an interference cancellation framework

We propose a color barcode framework for mobile phone applications by exploiting the spectral diversity afforded by the cyan (C), magenta (M), and yellow (Y) print colorant channels commonly used for color printing and the complementary red (R), green (G), and blue (B) channels, respectively, used for capturing color images. Specifically, we exploit this spectral diversity to realize a three-fold increase in the data rate by encoding independent data in the C, M, and Y print colorant channels and decoding the data from the complementary R, G, and B channels captured via a mobile phone camera. To mitigate the effect of cross-channel interference among the print-colorant and capture color channels, we develop an algorithm for interference cancellation based on a physically-motivated mathematical model for the print and capture processes. To estimate the model parameters required for cross-channel interference cancellation, we propose two alternative methodologies: a pilot block approach that uses suitable selections of colors for the synchronization blocks and an expectation maximization approach that estimates the parameters from regions encoding the data itself. We evaluate the performance of the proposed framework using specific implementations of the framework for two of the most commonly used barcodes in mobile applications, QR and Aztec codes. Experimental results show that the proposed framework successfully overcomes the impact of the color interference, providing a low bit error rate and a high decoding rate for each of the colorant channels when used with a corresponding error correction scheme.

Biomedical applications of nano-antioxidant

For centuries now, antioxidants have been known to provide better health by neutralizing the free radicals which are continuously produced in the human body. In normal circumstances, self-antioxidant defense system of the human body is capable of quantitatively managing the free radicals. However, in certain cases, which are at the threshold of developing diseases like diabetes and Alzheimer's, the human body calls for an external source of antioxidants. Since orally delivered antioxidants are easily destroyed by acids and enzymes present in the human system, only a small portion of what is consumed actually gets absorbed. Hence, there is a recognized and urgent need to develop effective methods for efficiently delivering antioxidants to the required sites. This chapter provides an in-depth overview and analysis of two such methods and processes-nano-encapsulation and nano-dendrimers. Among the various nanoscale delivery mechanisms, nano-encapsulation has emerged as a key and efficient delivery process. Designed as a spongelike polymer, nano-encapsulated antioxidants provide a protective vehicle which keeps antioxidants from being destroyed in the human gut and ensures their better absorption in the digestive tract. In fact, the nano-capsules bind themselves to the intestinal walls and pour antioxidants directly into the intestinal cells, which allow them to be absorbed directly into the blood stream. Another distinguished and popular mode for delivering antioxidants is that of nano-polymers known as dendrimers. Dendrimers involve multiple branches and sub-branches of atoms radiating out from a central core. Dendrimers afford a high level of control over their architectural design, including their size, shape, branching length or density, and surface functionality. Such flexibility makes these nanostructures ideal carriers in biomedical applications such as drug delivery, gene transfection, and imaging. Antioxidant dendrimers, made out of numerous units of antioxidants connected with each other in a branched fashion, provide numerous possible sites to couple with an active species and have enhanced free radicals scavenging potency. These dendrimer chains are biocompatible, biodegradable with nontoxic degradation products, and well suited for targeted drug delivery and other biomedical applications. Recent successes in simplifying and optimizing the synthesis of dendrimers, such as the "lego" and "click" approaches, provide a large variety of structures while at the same time reducing the cost of their production. The use of these highly branched, nanometer-sized, polymeric materials as nano-antioxidants for prevention and treatment of human diseases, associated with oxidative stress, is of immense public health relevance globally.

Genetic testing in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a cost-effectiveness analysis

BACKGROUND

The CYP2C19 genotype is a predictor of adverse cardiovascular events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) treated with clopidogrel.

OBJECTIVES

We aimed to evaluate the cost-effectiveness of a CYP2C19*2 genotype-guided strategy of antiplatelet therapy in ACS patients undergoing PCI, compared with two 'no testing' strategies (empiric clopidogrel or prasugrel).

METHODS

We developed a Markov model to compare three strategies. The model captured adverse cardiovascular events and antiplatelet-related complications. Costs were expressed in 2010 US dollars and estimated using diagnosis-related group codes and Medicare reimbursement rates. The net wholesale price for prasugrel was estimated as $5.45 per day. A generic estimate for clopidogrel of $1.00 per day was used and genetic testing was assumed to cost $500.

RESULTS

Base case analyses demonstrated little difference between treatment strategies. The genetic testing-guided strategy yielded the most QALYs and was the least costly. Over 15 months, total costs were $18 lower with a gain of 0.004 QALY in the genotype-guided strategy compared with empiric clopidogrel, and $899 lower with a gain of 0.0005 QALY compared with empiric prasugrel. The strongest predictor of the preferred strategy was the relative risk of thrombotic events in carriers compared with wild-type individuals treated with clopidogrel. Above a 47% increased risk, a genotype-guided strategy was the dominant strategy. Above a clopidogrel cost of $3.96 per day, genetic testing was no longer dominant but remained cost-effective.

CONCLUSIONS

Among ACS patients undergoing PCI, a genotype-guided strategy yields similar outcomes to empiric approaches to treatment, but is marginally less costly and more effective.

Bioassay of Artemisia annua leaf extracts and artemisinin against larvae of Culex quinquefasciatus and Culex tritaeniorhynchus

Using in vitro bioassays, we evaluated the crude methanol, ethanol, chloroform, and acetone leaf extracts of Artemisia annua as well as pure artemisinin against late 3rd and early 4th instars of Culex quinquefasciatus and Cx. tritaeniorhynchus. Based on the lethal concentration for 50% mortality (LC50) and lethal concentration for 90% mortality (LC90) values, the chloroform leaf extract was the most toxic, followed by methanol, ethanol, and acetone. The LC50 and LC90 values for chloroform extract were 0.18 and 9.65 ppm against Cx. quinquefasciatus and 0.91 and 8.73 ppm against Cx. tritaeniorhynchus, respectively. The LC50 and LC90 values for artemisinin, dissolved in chloroform, were significantly higher, 14.31 and 296.39 ppm for Cx. quinquefasciatus and 4.13 and 50.36 ppm for Cx. tritaeniorhynchus, respectively.

OA01.11. Toxicity study and testicular regeneration property of swarna vanga

Purpose:

Method:

Result:

Conclusion:

A Comparative Study of Neuroprotective Effect of Single and Combined Blockade of AT1 Receptor and PARP-1 in Focal Cerebral Ischaemia in Rat

Background

Cerebral ischaemia results in enhanced expression of type 1 angiotensin receptor and oxidative stress. Free radicals due to oxidative stress lead to excessive DNA damage causing overactivation of poly (ADP-ribose) polymerase-1 resulting in neuronal death. Activation of both type 1 angiotensin receptors and poly (ADP-ribose) polymerase-1 following cerebral ischaemia takes place simultaneously, but until now, no study has explored the effect of combined blockade of both angiotensin type 1 angiotensin receptor and poly (ADP-ribose) polymerase-1 in cerebral ischaemia.

Aim

Our purpose was to compare the effect of single and combined treatment with angiotensin type 1 angiotensin receptor blocker, candesartan, and the poly (ADP-ribose) polymerase-1 inhibitor, 1, 5 isoquinolinediol, on brain damage and oxidative stress in transient focal cerebral ischaemia in rats.

Method

Transient focal cerebral ischaemia was induced in Sprague-Dawley rats by an intraluminal technique for two-hours following 48 h of reperfusion. Candesartan (0·05 mg/kg) was administered just after initiation of ischaemia followed by a repeat administration at 24 h while 1, 5 isoquinolinediol (0·1 mg/kg) was given one-hour after of ischaemia. After 24 h of reperfusion, neurological deficit was evaluated in the different treatment groups. After 48 h of reperfusion, the rats were sacrificed and the brain was isolated. Ischaemic brain damage by 2,3,5 triphenyl tetrazolium chloride staining, oxidative stress markers, and levels of reactive oxygen species were determined biochemically.

Result

Single treatment with candesartan and 1, 5 isoquinolinediol significantly reduced neurological deficit, infarct, and oedema volume as compared to ischaemic control and different vehicle groups for each of the drugs. However, treatment with candesartan + 1, 5 isoquinolinediol offered greater reduction in neurological deficit, cerebral infarct volume, and oedema as compared to single-drug treatments. Furthermore, treatment with candesartan + 1, 5 isoquinolinediol significantly decreased oxidative stress as compared to single treatments with each drug.

Conclusion

The study suggests that blockade of either type 1 angiotensin receptor or poly (ADP-ribose) polymerase-1 alone provides neuroprotection, but the better result was achieved when both type 1 angiotensin receptor and poly (ADP-ribose) polymerase-1 were blocked together by the combined use of their pharmacological inhibitor in transient cerebral ischaemia in rat.

Health-care seeking among people with cough of 2 weeks or more in India. Is passive TB case finding sufficient?

SETTING

Thirty districts of India.

OBJECTIVES

To estimate 1) the proportion of people with cough of ≥2 weeks, 2) those who did not seek care from a health care provider for cough, and 3) their characteristics.

METHODOLOGY

A cross-sectional community-based survey in which 4562 people (aged ≥18 years) were interviewed.

RESULTS

Of the 4562 individuals interviewed, 437 (9.5%, 95%CI 7.2-11.8) had cough ≥2 weeks; this was more frequent in those >55 years of age (14%) and in those from districts in eastern (12%) and northern (11%) states of India. Of those with cough, 300 (69%, 95%CI 60-77) had not sought care from any health care provider. Not seeking care was more frequent in people residing in rural areas (73%) compared with urban areas (53%), and in the districts of eastern (82%) and northern (74%) states compared to districts from the southern (46%) and western (54%) states.

CONCLUSIONS

Nearly a tenth of those interviewed aged ≥18 years had cough of ≥2 weeks. About two thirds, especially those from rural areas, had not visited a health care provider for the cough. This finding has huge implications for India's current mostly passive case-finding strategy for detecting and controlling tuberculosis.

Hypoglossia Type 1A: report of a case and review of literature with focus on clinical investigations

Hypoglossia is a rare entity which is reported sporadically. Hypoglossia has often occurred in an association with limb anomalies and, therefore, these cases have been grouped together as hypoglossia-hypodactylia within oromandibular limb hypogenesis syndromes. The literature on this condition is reviewed, and a case of hypoglossia has also been presented. An investigative protocol to aid in the treatment planning of a patient with hypoglossia has also been suggested.

Evaluation of buspirone for relapse-prevention in adults with cocaine dependence: an efficacy trial conducted in the real world

Cocaine dependence is a significant public health problem for which there are currently no FDA-approved medications. Hence, identifying candidate compounds and employing an efficient evaluation process is crucial. This paper describes key design decisions made for a National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) study that uses a novel two-stage process to evaluate buspirone (60 mg/day) for cocaine-relapse prevention. The study includes pilot (N=60) and full-scale (estimated N=264) trials. Both trials will be randomized, double-blind, and placebo-controlled and both will enroll treatment-seeking cocaine-dependent participants engaged in inpatient/residential treatment and scheduled for outpatient treatment post-discharge. All participants will receive contingency management in which incentives are given for medication adherence as evaluated by the Medication Events Monitoring System (MEMS). The primary outcome measure is maximum days of continuous cocaine abstinence, as assessed by twice-weekly urine drug screens (UDS) and self-report, during the 15-week outpatient treatment phase. Drug-abuse outcomes include cocaine use as assessed by UDS and self-report of cocaine use, other substance use as assessed by UDS and self-report of substance use (i.e., alcohol and/or illicit drugs), cocaine bingeing, HIV risk behavior, quality of life, functioning, and substance abuse treatment attendance. Unique aspects of the study include conducting an efficacy trial in community treatment programs, a two-stage process to efficiently evaluate buspirone, and an evaluation of mediators by which buspirone might exert a beneficial effect on relapse prevention.

Displaced osteochondral fracture of the lateral femoral condyle associated with an acute anterior cruciate ligament avulsion fracture: a corollary of "the lateral femoral notch sign"

Anterior cruciate ligament (ACL) rupture is usually accompanied by bone contusions resulting from impact of tibia on femur. The injury sometimes becomes manifest as a depression on the lateral femoral condyle giving rise to "lateral femoral notch" sign. The authors describe a rare case of impaction of the tibia and femur resulting in an osteochondral fracture rather than the usual bone contusion, which frequently occurs with ACL rupture. Open reduction and internal fixation of both the ACL avulsion fracture and the osteochondral fracture from the lateral femoral condyle were done, and the patient had a good outcome at 1-year follow-up. Level of evidence V.

Carrier density dependence of the nonlinear absorption of intense THz radiation in GaAs

We study the carrier density dependence of nonlinear terahertz (THz) absorption due to field-induced intervalley scattering in photoexcited GaAs using the optical-pump/THz-probe technique. The intervalley scattering in GaAs is strongly dependent on the photo-carrier density. As the carrier density is increased from 1 × 10(17) to 4.7 × 10(17) cm(-3), the nonlinear absorption bleaching increases. However, if the carrier density is increased further above 4.7 × 10(17) cm(-3), the trend reverses and the bleaching is reduced. The initial increase in absorption bleaching is because, unlike low THz field, high THz field experiences intervalley scattering and nonparabolicity of the conduction band. On the other hand, a simple electron transport model shows that the reduction in intervalley scattering is mainly due to the increase in the electron-hole scattering rate with the increase in the carrier density. This increase in the electron-hole scattering rate limits the maximum kinetic energy attainable by the electrons and thus reduces the observed nonlinear absorption.

Image microarrays derived from tissue microarrays (IMA-TMA): New resource for computer-aided diagnostic algorithm development

BACKGROUND

Conventional tissue microarrays (TMAs) consist of cores of tissue inserted into a recipient paraffin block such that a tissue section on a single glass slide can contain numerous patient samples in a spatially structured pattern. Scanning TMAs into digital slides for subsequent analysis by computer-aided diagnostic (CAD) algorithms all offers the possibility of evaluating candidate algorithms against a near-complete repertoire of variable disease morphologies. This parallel interrogation approach simplifies the evaluation, validation, and comparison of such candidate algorithms. A recently developed digital tool, digital core (dCORE), and image microarray maker (iMAM) enables the capture of uniformly sized and resolution-matched images, with these representing key morphologic features and fields of view, aggregated into a single monolithic digital image file in an array format, which we define as an image microarray (IMA). We further define the TMA-IMA construct as IMA-based images derived from whole slide images of TMAs themselves.

METHODS

Here we describe the first combined use of the previously described dCORE and iMAM tools, toward the goal of generating a higher-order image construct, with multiple TMA cores from multiple distinct conventional TMAs assembled as a single digital image montage. This image construct served as the basis of the carrying out of a massively parallel image analysis exercise, based on the use of the previously described spatially invariant vector quantization (SIVQ) algorithm.

RESULTS

Multicase, multifield TMA-IMAs of follicular lymphoma and follicular hyperplasia were separately rendered, using the aforementioned tools. Each of these two IMAs contained a distinct spectrum of morphologic heterogeneity with respect to both tingible body macrophage (TBM) appearance and apoptotic body morphology. SIVQ-based pattern matching, with ring vectors selected to screen for either tingible body macrophages or apoptotic bodies, was subsequently carried out on the differing TMA-IMAs, with attainment of excellent discriminant classification between the two diagnostic classes.

CONCLUSION

The TMA-IMA construct enables and accelerates high-throughput multicase, multifield based image feature discovery and classification, thus simplifying the development, validation, and comparison of CAD algorithms in settings where the heterogeneity of diagnostic feature morphologic is a significant factor.

Menopause and the oral cavity

Menopause is associated with a large number of symptoms ranging from physical to psychological. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to be aware of the symptoms and health care needs of peri-menopausal/menopausal/postmenopausal women. This article attempts to provide an insight into the multifarious oral manifestations at menopause along with the relevant prosthodontic implications.

Synthesis and characterization of (E)-N'-(substituted benzylidene)isonicotinohydrazide derivatives as potent antimicrobial and hydrogen peroxide scavenging agents

A series of (E)-N'-(substituted benzylidene)isonicotinohydrazide derivatives were synthesized by coupling isoniazid with differently substituted aldehydes and benzophenones in the presence of absolute ethanol along with catalytic amount of glacial acetic acid. The structure of all the synthesized compounds were confirmed and characterized by using various spectral technique like IR, 1H NMR, 13C NMR and mass spectroscopy. All the synthesized compounds were evaluated for their antimicrobial activity in terms of zone of inhibition, minimum inhibitory concentration, minimum bactericidal concentration and minimum fungicidal concentration in camparison to the standard drugs. The results revealed that all synthesized compounds had shown potent to mild biological activity. Among the synthesized derivatives, (E)-N'-(3,4-dimethoxybenzylidene)isonicotinohydrazide 2e, (E)-N'-(3,4,5-trimethoxybenzylidene)isonicotinohydrazide 2f and (E)-N'-(4-hydroxy-3-methoxybenzylidene)isonicotinohydrazide 2g were found to be the most effective antimicrobial compounds, whereas compounds 2g and 2k were the most potent antioxidants with significant hydrogen peroxide scavenging activity.

Genetic correlates influencing immunopathogenesis of HIV infection

Variability to HIV infection, its progression as well as responsiveness to antiretroviral therapy (ART) is observed among individuals including viraemia controllers or exposed uninfected, rapid versus slow progressors and ART responders compared to non responders. This differential responsiveness/vulnerability to HIV-1 is governed by multiple host genetic factors that include HLA, cytokines, chemokines, their receptors and others. This review highlights the influence of these genetic factors on HIV/AIDS outcome; however, in India, the information in this area is very limited and most of these genetic studies have been conducted in Caucasian and South African populations. Considering, the population specific differences in the frequencies of protective or susceptibility favouring alleles and their influence on the disease outcome, it is of utmost importance to strengthen ongoing efforts towards defining largely unknown genetic propensity in Indian population, particularly by recruitment of large cohorts of well categorized exposed uninfected individuals, rapid, long term non progressors and elite viraemic controllers. Multi-parametric analysis of these potentially interactive immunogenetic variables in these cohorts may help to define potential targets for diagnostics and therapy in a population specific manner.

TARGETING OF MACROPHAGE FOAM CELLS IN ATHEROSCLEROTIC PLAQUE USING OLIGONUCLEOTIDE-FUNCTIONALIZED NANOPARTICLES

Macrophage foam cells are key components of atherosclerotic plaque and play an important role in the progression of atherosclerosis leading to plaque rupture and thrombosis. Foam cells are emerging as attractive targets for therapeutic intervention and for imaging the progression of disease. Therefore, designing nanoparticles (NPs) targeted to macrophage foam cells in plaque is of considerable therapeutic significance. Here we report the construction of an oligonucleotide functionalized NP system with high affinity for foam cells. Nanoparticles functionalized with a 23-mer poly-Guanine (polyG) oligonucleotide are specifically recognized by the scavenger receptors on lipid-laden foam cells in vitro and ex vivo. The enhanced uptake of polyG-functionalized NPs by foam cells is inhibited in the presence of acetylated-LDL, a known ligand of scavenger receptors. Since polyG oligonucleotides are stable in serum and are unlikely to induce an immune response, their use for scavenger receptor-mediated targeting of macrophage foam cells provides a strategy for targeting atherosclerotic lesions.

Mucosal fixed drug eruption in a patient treated with ornidazole

BACKGROUND

Therapeutic drugs have been observed to cause a wide spectrum of adverse oral effects such as dry mouth, gingival enlargement, taste disturbance, oral mucosal ulceration, halitosis, etc.

OBSERVATIONS

A rare case of intra-oral fixed drug eruption (FDE) induced by ornidazole presenting on the hard palate, an extremely rare site for FDE, in a 40-year-old male is reported.

CONCLUSIONS

Ornidazole is a relatively newer 5-nitroimidazole derivative commonly prescribed for Amoebic dysentery in developing countries. FDE is a rare adverse drug effect characterized by onset of round/oval, erythematous macules on the skin or mucosa that can be associated with itching and burning sensation. The exact mechanism causing FDE is unknown.

Integration of digital gross pathology images for enterprise-wide access

Background:

Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS).

Methods:

Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then “wrapped” according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis.

Results:

In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive.

Conclusions:

Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a “DICOM wrapper” for multisystem compatibility.

One-step fabrication of polymeric Janus nanoparticles for drug delivery

With its unique structure of two compartments, Janus particles can be used for many applications for which monomorphic particles are inadequate, including to be used as a drug delivery system to deliver multiple payloads with widely different solubility. Here we report on a fluidic nanoprecipitation system (FNPS), capable of fabricating biocompatible Janus polymeric nanoparticles comprised of the FDA-approved polymer poly(lactic-co-glycolic acid) (PLGA). The FNPS contains dual inlets, one for each half of the particle, that insert into the precipitation stream. The system provides a one-step approach for production of Janus polymeric particles with submicrometer diameters and is likely amenable to substantial scale-up. To the best of our knowledge, this is the first demonstration of biocompatible Janus nanoparticles that encapsulate a hydrophobic drug (paclitaxel) on one side and a hydrophilic drug (doxorubicin hydrochloride) on the other.