Physicochemical characterization of chitosan/nylon6/polyurethane foam chemically cross-linked ternary blends

Chitosan/nylon6/polyurethane foam (CS/Ny6/PUF) ternary blend was prepared and chemically cross-linked with glutaraldehyde. Structural, thermal and morphological studies were performed for the prepared ternary blends. Characterizations of the ternary blends were investigated by Fourier transform infrared spectroscopy (FTIR), thermo gravimetric analysis (TGA), differential scanning calorimetry (DSC), X-ray diffraction (XRD) and scanning electron microscope (SEM). The FTIR results showed that the strong intermolecular hydrogen bonds took place between CS, Ny6 and PUF. TGA and DSC studies reveal that the thermal stability of the blend is enhanced by glutaraldehyde as crosslinking agent. Results of XRD indicated that the relative crystalline of pure CS film was reduced when the polymeric network was reticulated by glutaraldehyde. Finally, the results of scanning electron microscopy (SEM) indicated that the morphology of the blend is rough and heterogeneous, further it confirms the interaction between the functional groups of the blend components.

Dosimetric comparison between bone marrow sparing intensity-modulated radiation therapy and conventional techniques in the treatment of cervical cancer: a retrospective study

PURPOSE

To investigate enlargement of prostate volume by edema during brachytherapy seed implantation and develop a nomogram model to calculate air-kerma strength (AKS) required for implantation of the enlarged transient prostatic volume.

MATERIALS AND METHODS

The prostate volume was measured prior and after seed implantation using trans-rectal ultrasound imaging in the operating room to obtain volume enlargement. A nomogram model was developed that calculates AKS required for implantation of the enlarged transient prostate volume with optimal dose coverage.

RESULTS

The measured prostate enlargement in this study was up to 60% of the initial volume. The effective prostatic volume enlargement was calculated for three isotopes: 125I, 103Pd and 131Cs. The effective volume enlargement for 125I implants was relatively small (< 10%) because of its long half-life. For 103Pd and 131Cs with short half-lives, additional AKS up to 20% and 30%, respectively, might be required to provide appropriate dose coverage of possible enlarged prostatic volumes.

CONCLUSIONS

Prostate volume enlargement should be considered to obtain optimal dose coverage particularly for short half-life isotopes such as 131Cs and 103Pd. The nomogram model developed in this work provides the AKS required for implants with a wide range of prostatic volume enlargements (5-100%) for three isotopes.

KEYWORDS

prostate brachytherapy, nomogram, airkerma strength, edema, volume enlargement.

Olmsted syndrome: report of two cases

Olmsted syndrome is an uncommon genetic disorder with symmetrical, diffuse, transgredient, mutilating palmoplantar keratoderma and periorificial hyperkeratosis. Olmsted syndrome in a female patient is particularly rare, and we report two unrelated female patients of Olmsted syndrome, who presented with perioral hyperkeratosis and palmoplantar keratoderma. One of our patients also had woolly hair from birth and flexion contracture of a digit, while the other had pseudoainhum. There was no cardiac involvement. Hence, the diagnosis of Olmsted syndrome was made.

Balanitis xerotica obliterans in children and its incidence under the age of 5 years

OBJECTIVE

To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years.

METHODS

Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period. Epidemiological data were obtained from the Office for National Statistics, UK.

RESULTS

A total of 346 foreskin samples were received and BXO was found in 182 (52.6%). There were 31 children under the age of 5 years circumcised for preputial pathology. BXO was reported in 6 (19.3%) and chronic inflammation in 16 (51.6%) of these patients. The foreskin was reported normal in 2 (6.5%) and the remaining 7 (22.6%) patients had preputial cysts or other pathology. Epidemiological population data analysis revealed the incidence of BXO per year to be 3.01 cases/1000 boys under 15 years of age and 0.322 cases/1000 boys under 5 years.

CONCLUSION

The incidence of BXO in boys noted in our study is higher than previously reported. BXO can result in significant complications and should be considered in children even under 5 years.

Congenital hypotrichosis, eruptive milia, and palmoplantar pits: a case report with review of literature

We report a ten-month-old male infant, presenting with congenital hypotrichosis of scalp, absence of eyebrows and eyelashes. He also had multiple milia over face and extremities along with palmoplantar pits. The infant was born to third degree consanguineous marriage. None of the family members had similar disease. Histopathology was consistent with milia. Based on these findings, a diagnosis of unclassified ectodermal dysplasia was made.

Epithelioid hemangioendothelioma: a rare vascular tumor

Epithelioid hemangioendothelioma is an intermediate-grade vascular tumor arising from the vascular endothelium, which usually arises in soft tissue, and skin involvement is extremely rare. We report a case that presented with primary cutaneous tumor involving the whole limb and was present since birth.

Potent anti-inflammatory activity of ursolic acid, a triterpenoid antioxidant, is mediated through suppression of NF-κB, AP-1 and NF-AT

BACKGROUND

Ursolic acid (UA), a pentacyclic triterpenoid carboxylic acid, is the major component of many plants including apples, basil, cranberries, peppermint, rosemary, oregano and prunes and has been reported to possess antioxidant and anti-tumor properties. These properties of UA have been attributed to its ability to suppress NF-κB (nuclear factor kappa B) activation. Since NF-κB, in co-ordination with NF-AT (nuclear factor of activated T cells) and AP-1(activator protein-1), is known to regulate inflammatory genes, we hypothesized that UA might exhibit potent anti-inflammatory effects.

METHODOLOGY/PRINCIPAL FINDINGS

The anti-inflammatory effects of UA were assessed in activated T cells, B cells and macrophages. Effects of UA on ERK, JNK, NF-κB, AP-1 and NF-AT were studied to elucidate its mechanism of action. In vivo efficacy of UA was studied using mouse model of graft-versus-host disease. UA inhibited activation, proliferation and cytokine secretion in T cells, B cells and macrophages. UA inhibited mitogen-induced up-regulation of activation markers and co-stimulatory molecules in T and B cells. It inhibited mitogen-induced phosphorylation of ERK and JNK and suppressed the activation of immunoregulatory transcription factors NF-κB, NF-AT and AP-1 in lymphocytes. Treatment of cells with UA prior to allogenic transplantation significantly delayed induction of acute graft-versus-host disease in mice and also significantly reduced the serum levels of pro-inflammatory cytokines IL-6 and IFN-γ. UA treatment inhibited T cell activation even when added post-mitogenic stimulation demonstrating its therapeutic utility as an anti-inflammatory agent.

CONCLUSIONS/SIGNIFICANCE

The present study describes the detailed mechanism of anti-inflammatory activity of UA. Further, UA may find application in the treatment of inflammatory disorders.

Progeria in siblings: a rare case report

Progeria, also known as Hutchinson-Gilford syndrome, is an extremely rare, severe genetic condition wherein symptoms resembling aspects of aging are manifested at an early age. It is an autosomal dominant disorder. It is not seen in siblings of affected children although there are very few case reports of progeria affecting more than one child in a family. Here we are presenting two siblings, a 14-year-old male and a 13-year-old female with features of progeria, suggesting a possible autosomal recessive inheritance.

Health-related quality of life in patients reliant upon mitrofanoff catheterisation

OBJECTIVE

Aim of the study was determine health care outcomes from the patients' perspective in patients reliant on Mitrofanoff catheterisation for bladder emptying.

SUBJECTS/PATIENTS

Patients over the age of 16 dependent on Mitrofanoff catheterisation for bladder emptying were asked to complete a health care outcome questionnaire, the SF-36 (®) Health Survey v2. Quality of life measures for 8 health concepts were compared against published data for the normal population.

RESULTS

Out of a total of 25 patients who were eligible for enrolment into our study, we were able to contact 19 patients. The norm-based score for Physical Functioning (PF=50.4), Role Physical (RP=53.8), Bodily Pain (BP=55.6), Vitality (VT=56.9), Social Functioning (SF=51.5), Role Emotional (RE=52.2), and Mental Health (MH=54.6) were all higher than those reported within the normal population (normal=50.0). Physical and mental component summary measures were higher than in the normal population. When compared against age-matched norms our patient group scored higher than the normal population for all measures except Physical Functioning (50.4 vs. 53.4) and physical component summary (51.9 vs. 53.5). The self-reported scores for Vitality, Mental Health and the mental component summary were all statistically significantly better than those seen in the age-matched control population (p<0.01).

CONCLUSIONS

Quality of life in patients dependent on Mitrofanoff catheterisation for bladder emptying is good. The SF-36 measures 8 major health care outcomes and in our patients these measures of health were similar to those seen in the general population, rather than the poorer outcomes reported in patients with other chronic medical conditions.

Naxos disease in two siblings

Naxos disease is a rare cardiocutaneous disorder characterized by palmoplantar keratoderma, woolly hair and arrythmogenic right ventricular cardiomyopathy. We report two siblings with Naxos disease with right middle lobe syndrome in one of them.

Influence of photon energy on the quality of prostate intensity modulated radiation therapy plans based on analysis of physical indices

The goal of the present study was to study the effects of low- and high-energy intensity-modulated photon beams on the planning of target volume and the critical organs in cases of localized prostate tumors in a cohort of 8 patients. To ensure that the difference between the plans is due to energy alone, all other parameters were kept constant. A mean dose volume histogram (DVH) for each value of energy and for each contoured structure was created and was considered as completely representative for all patients. To facilitate comparison between 6-MV and 15-MV beams, the DVH-s were normalized. The different parameters that were compared for 6-MV and 15-MV beams included mean DVH, different homogeneity indices, conformity index, etc. Analysis of several indices depicts more homogeneous dose for 15-MV beam and more conformity for 6-MV beam. Comparison of all these parameters showed that there was little difference between the 6-MV and 15-MV beams. For rectum, 2 to 4 % more volume received high dose with the 6-MV beam in comparison with the 15-MV beam, which was not clinically significant, since in practice much tighter constraints are maintained, such that Normal Tissue Complication Probability (NTCP) is kept within 5 %. Such tighter constraints might increase the dose to other regions and other critical organs but are unlikely to increase their complication probabilities. Hence the slight advantages of 15-MV beam in providing benefits of better normal-tissue sparing and better coverage cannot be considered to outweigh its well-known risk of non-negligible neutron production.

Protective effects of selenocystine against γ-radiation-induced genotoxicity in Swiss albino mice

Selenocystine (CysSeSeCys), a diselenide aminoacid exhibiting glutathione peroxidase-like activity and selective antitumor effects, was examined for in vivo antigenotoxic and antioxidant activity in Swiss albino mice after exposure to a sublethal dose (5 Gy) of γ-radiation. For this, CysSeSeCys was administered intraperitoneally (i.p.) to mice at a dosage of 0.5 mg/kg body weight for 5 consecutive days prior to whole-body γ-irradiation. When examined in the hepatic tissue, CysSeSeCys administration reduced the DNA damage at 30 min after radiation exposure by increasing the rate of DNA repair. Since antigenotoxic agents could alter the expression of genes involved in cell cycle arrest and DNA repair, the transcriptional changes in p53, p21 and GADD45α were monitored in the hepatic tissue by real-time PCR. The results show that CysSeSeCys alone causes moderate induction of these three genes. However, CysSeSeCys pretreatment resulted in a suppression of radiation-induced enhancement of p21 and GADD45α expression, but did not affect p53 expression. Further analysis of radiation-induced oxidative stress markers in the same tissue indicated that CysSeSeCys significantly inhibits lipid peroxidation and prevents the depletion of antioxidant enzymes and glutathione (GSH) levels. Additionally, it also prevents radiation-induced DNA damage in other radiation sensitive cellular systems like peripheral leukocytes and bone marrow, which was evident by a decrease in comet parameters and micronucleated polychromatic erythrocytes (mn-PCEs) frequency, respectively. Based on these observations, it is concluded that CysSeSeCys exhibits antigenotoxic effects, reduces radiation-induced oxidative stress, and is a promising candidate for future exploration as a radioprotector.

Short term urinary catheterized patients in intensive care unit (ICU)--a need to screen

Catheter-Associated Urinary Tract Infection (CAUTI) is the second most commonly reported healthcare associated infection, accounting for upto 40% of all nosocomial infections. Silent catheter associated bacteriuria comprises a huge reservoir of resistant organism in hospitals particularly in critical care units. We prospectively studied 100 newly short-term catheterized patients in a tertiary care hospital. Samples collected on day three and daily thereafter for semi quantitative urine culture and pus cell count. Antibiotic sensitivity was tested using Kirby-Bauer disc diffusion method. Out of hundred patients, 32 showed growth on fifth day and remaining 68 samples were culture negative up to seventh day. None of the culture positive samples had pus cells. Escherichia coli (35%) was the predominant isolate followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecium, Candida spp (15% each) and Coagulase negative Staphylococcus (5%). Among the Gram negative organisms, four strains of Escherichia coli and two strains of Klebsiella pneumonia were Extended Spectrum Beta Lactamases (ESBL) producers and 33.3% were Multidrug resistant Pseudomonas aeruginosa. Multidrug resistant pathogens in an asymptomatic short-term catheterized patient are a major reservoir in hospitals. This emphasizes the importance of periodic surveillance for nosocomial infections in hospital and the periodic screening will also help us to frame antibiotic policy in a new tertiary care hospital.

"Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples"

Increasing frequency of methicillin resistant Staphylococcus aureus (MRSA) infections and changing patterns in antimicrobial resistance have led to renewed interest in the use of macrolide-lincosamide-streptogramin (MLS) antibiotics to treat such infections. Inducible macrolides, lincosamides, type B streptogramins (MLS(Bi)) resistance has to be identified to avoid clinical failure of clindamycin therapy. Hence we wanted to study the incidence of inducible clindamycin resistance in MRSA and methicillin susceptible Staphylococcus aureus (MSSA). Staphylococcus aureus was isolated in 1049 patients over a period of two years from various clinical materials. All the isolates were tested for inducible clindamycin resistance by disc diffusion induction test (D-zone test). A total of 726 MSSA and 323 MRSA were tested for the inducible clindamycin resistance (MLS(Bi)) by D-zone test. Inducible resistance to clindamycin (MLS(Bi)) where D test was positive was observed in 42.1% of MRSA and 3.4% of MSSA. Inducible resistance to clindamycin (MLS(Bi)) was found to be higher in MRSA than MSSA isolates. Clindamycin is one of the important alternative antibiotics to treat MRSA infections in resource poor countries. To avoid treatment failure with clindamycin, prior D testing is necessary.

Prevalence and correlates of Herpes Simplex Virus-2 and syphilis infections in the general population in India

OBJECTIVES

To determine the prevalence and correlates of Herpes Simplex Virus-2 (HSV-2) and syphilis infections in the general population in India.

METHODS

2456 adults were surveyed in Hyderabad, Bangalore and Chandigarh in India. Socio-demographic and lifestyle characteristics were obtained through a questionnaire, and a dried blood spot (DBS) was collected from all individuals aged 18 years and over; sexual behaviour was collected from those aged 18-49 years. DBS samples were tested for HSV-2 and syphilis serology. The association between HSV-2 and syphilis infections with socio-demographic and behavioural variables was analysed using multivariable logistic regression.

RESULTS

The prevalence of HSV-2 and syphilis was 10.1% and 1.7%, respectively. Geographic differences in HSV-2 prevalence were significant, while for syphilis it was comparable. Urban-rural differences in prevalence were only seen for syphilis. For both infections, the prevalence between males and females was not significantly different. In males and females, HSV-2 prevalence increased significantly with increasing age; for syphilis, a slight trend was seen only in females. In a multivariable analysis, HSV-2 infection in males and females was associated with site, religion and testing positive for syphilis, in addition to reporting ≥ 2 lifetime partners in the previous year among males and being ever married or having had sex with a non-regular partner in the last year among females.

CONCLUSIONS

The burden and geographic heterogeneity of HSV-2 and syphilis infections in India are significant. A national household and DBS-based sexually transmitted infection (STI) surveillance system would enable monitoring, especially in relation to the HIV epidemic, and planning of evidence-based prevention and treatment programmes.