Use of Anti-Craving Agents in Soldiers with Alcohol Dependence Syndrome

BACKGROUND

In a search for an effective 'anti-alcohol pill', three modern anti-craving agents have been studied in alcoholics of Army/ DSC, Air Force, Navy and Coast Guard.

METHODS

129 patients of alcohol dependence syndrome were randomly assigned to three groups where topiramate, acamprosate and naltrexone were used as anti-craving agents in a year long prospective study. Of these 92 patients completed the study.

RESULT AND CONCLUSION

Topiramate (76.3%) appears to be significantly more effective (p<0.01) in sustaining abstinence, though naltrexone (57.7%) and acamprosate (60.70%) offer moderate relapse-prevention efficacy. Side effects of all the three agents have been mild, transient and self-limiting. We recommend a trial of topiramate, before invaliding out of any alcoholic soldier.

Binding of estrogen receptor alpha promoter to nuclear proteins of mouse cerebral cortex: effect of age, sex, and gonadal steroids

Majority of estrogen actions in the brain are mediated by estrogen receptor (ER) alpha which in turn is regulated by several factors like circulating levels of gonadal steroid hormones 17beta-estradiol and testosterone, sex and age of the organism. The expression of ERalpha is regulated through interaction between cis-elements of its promoter and proteins present in the nuclei. Here, we have used electrophoretic mobility shift assay (EMSA) to analyze the effect of age, sex, 17beta-estradiol, and testosterone on the binding of ERalpha promoter (-91 to +46 bp) to nuclear proteins from the mouse cerebral cortex. EMSA revealed the formation of three specific complexes in all groups. However, the intensity of these complexes varied as a function of age, sex and treatment with 17beta-estradiol and testosterone. Nuclear proteins from the cerebral cortex of both sexes showed reduced binding with promoter fragment in old mice. Further, competition analysis indicated stronger binding in females than males of both ages. The extent of binding was reduced by 17beta-estradiol and testosterone treatment in both ages and sexes. Thus, these findings demonstrate differential binding of nuclear proteins to mouse ERalpha promoter which may account for different functions of estrogen in the brain.

Surface properties of Indonesian-made narrow dynamic compression plates

The enormous need of orthopaedic (surgical) implants such as osteosynthesis plates is difficult to be fulfilled in developing countries commonly rely on imported ones. One of the alternatives is utilization of local resources, but only after they have been proven safe to use, to overcome this problem. Surface properties are some of the determining factors of safety for those implants. We have succeeded in developing prototype of osteosynthesis plate and the results indicate that Indonesian-made plates need improvement with regards to the surface quality of physical characterization.

Non-familial multiple keratoacanthomas in a 70 year-old long-term non-progressor HIV-seropositive man

We describe here multiple keratoacanthomas in an Human Immunodeficiency Virus (HIV)-seropositive 70 year-old man. The patient had multiple epithelial tumors of the skin showing rapid growth, histopathological features of a keratoacanthoma and a conspicuous tendency toward spontaneous remission. A diagnosis of nonfamilial multiple keratoacanthoma was established. The patient had a CD4 count of 633 cells/microL. The HIV disease in our patient was of a nonprogressive nature with CCR5-positive T cells.

Microbubble-enriched lavage fluid for treatment of experimental peritonitis

Background

Relaparotomies and closed postoperative peritoneal lavage (CPPL) are performed to treat persistent peritonitis. This experimental animal study compared open abdominal lavage with CPPL, and evaluated the potential of microbubble-enriched lavage fluids to improve the efficiency of CPPL and reduce clinical morbidity, mortality and cost.

Methods

Fluorescent polystyrene spheres were injected intraperitoneally into 22 male Wistar rats to simulate localized peritonitis. After 18 h the rats received open abdominal lavage and CPPL, with and without microbubbles. Microbubbles were obtained by adding ultrasound contrast agents to continuous ambulatory peritoneal dialysis fluid.

Results

Open abdominal lavage was 3·5 times more effective in particle removal than CPPL, owing to better fluid dynamics. The introduction of air–liquid interfaces in the form of microbubbles made CPPL up to 2·4 times more effective than lavage without bubbles. Best detachment results were obtained when microbubbles with a flexible surfactant shell and longer blood elimination half-life were used.

Conclusion

Open abdominal and CPPL lavage techniques are not efficient beyond a certain duration and volume as they do not cause bacterial detachment from the peritoneal membrane. Using surface tension forces from microbubbles significantly enhanced polystyrene particle detachment. These findings may have great consequences for the treatment of patients with peritonitis.

A comparative study on characterization of textile wastewaters (untreated and treated) toxicity by chemical and biological tests

Toxicity of textile wastewaters (untreated and treated) and their ingredient chemicals was quantified in terms of their chemical characteristics, fish (Gambusia affinis) mortality and end point growth responses of duckweed (Lemna aequinoctialis) in short-term bioassays. Other parameters of fish bioassay were erythrocyte morphology and its counts. Despite of a definite correlation between data of biological tests (LC/EC(50) values) with that of chemical tests, biological tests were found to be relatively more sensitive to both wastewaters and ingredient chemicals. Amongst all the examined parameters of test organisms, fish RBCs (morphology and counts) sensitivity to pollutants in the wastewaters was usually maximum and therefore, their study should be included in the routine fish bioassay. Other advantage of biological test such as on Lemna is even detection of eutrophic potential of wastewaters, as noted at their higher dilutions. The ingredient chemicals (major) contributing maximum toxicity to textile dye wastewater were, acids (HCl and H(2)SO(4)), alkali (Na(2)O SiO(2)), salt (NaNO(2)) and heavy metal (Cu), whereas dyes (4) were relatively less toxic.

Calcifying pseudotumor of scrotum: a case report

Calcifying fibrous pseudotumors of the testicular and paratesticular soft tissue are relatively rare. We would like to report the first documented case of calcifying fibrous pseudotumor of the tunica vaginalis in Indian medical literature. This is a case of a 55 year old male who presented with a painless scrotal mass of 10 years duration. Histological sections showed dense hyalinised bands of collagen with focal collections of plasma cells and lymphocytes. Multiple round to oval concentrically laminated psammomatous bodies were seen.

Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient

Leishmaniasis, a globally prevalent parasitic disease, occurs in three forms, viz, visceral, cutaneous and mucocutaneous. It is transmitted by female Phlebotomus sandflies. Human immunodeficiency virus (HIV) infection is increasing worldwide and several reports indicate a rising trend of VL / HIV co-infection, modifying the traditional anthroponotic pattern of VL transmission. India is one of the countries having the largest burden of leishmaniasis; nevertheless, there are very few HIV / leishmania co-infection cases reported so far. We report a 35-year-old homemaker infected with the human immunodeficiency virus; she presented with an oral ulcer. The investigations carried out on her revealed that she was afflicted by visceral leishmaniasis and the oral ulceration was a part of the same. This is only the second such case from the Indian subcontinent and more significantly from a non-endemic area.

Evidence for non-HFE linked hemochromatosis in Asian Indians

BACKGROUND

Hereditary hemochromatosis is commonly due to two HFE1 (Histone Family E1) gene mutations - H63D and C282Y. Mutations in the Asian Indians are less well studied.

AIMS

The aim of this preliminary study was to find out the prevalence of HFE gene mutations in nonviral liver cirrhosis patients.

SETTINGS AND DESIGN

Unexplained liver cirrhosis cases with transferrin saturation> 45%, attending the gastroenterology clinic in the years 2004 and 2005 were subjects of the prospective study. Asymptomatic individuals with negative family history of hemolytic anemia or liver disease served as controls.

MATERIALS AND METHODS

The clinical presentation was recorded in the patients. Transferrin saturation was estimated by standard colorimetric technique. The two common mutations in HFE1 gene and Y250X mutation of TFR (transferrin receptor) gene were studied by polymerase chain reaction based methods.

RESULTS

A majority of the cases were sporadic, but family history was positive in four patients. In one family with multiple affected members, there was clear evidence of autosomal dominant inheritance. Seven out of 31 (22.6%) of unexplained cirrhosis cases were positive for mutations. One was homozygous for H63D. In healthy controls, prevalence was 8.1% (6/74). None of the patients or controls was positive for C282Y mutation of HFE1 or Y250X of TFR gene.

CONCLUSIONS

Thus, in a number of cases of hemochromatosis in Indians, a gene with dominant inheritance may be involved in causation of the phenotype. The prevalence of HFE mutations in Indians is comparable to that reported from neighboring countries. It is worth studying other mutations in HFE gene and other iron overload genes in cryptogenic cirrhosis cases.

Transcription of estrogen receptor alpha and beta in mouse cerebral cortex: effect of age, sex, 17beta-estradiol and testosterone

Estrogen actions are mainly mediated by estrogen receptor (ER)alpha and ERbeta which in turn are regulated by several factors including age, sex and gonadal steroid hormones 17beta-estradiol and testosterone. In the present study, we have used nuclear run-off assay to examine the effect of these factors on the rate of transcription of ERalpha and ERbeta of mouse cerebral cortex. The run-off assay result was further corroborated with the measurement of steady state level of ERalpha and ERbeta mRNA by semiquantitative RT-PCR method. Our results reveal that ERalpha transcription rate decreases in old mice of both sexes, whereas ERbeta transcription rate decreases only in old females when compared to their adult counterparts. 17beta-Estradiol supplementation reduces the transcription rate of ERalpha and ERbeta in all groups except in adult male while testosterone treatment down regulates the transcription rate of ERalpha and ERbeta in all groups. The semiquantitative RT-PCR analysis reveals that the level of ERalpha mRNA decreases in old male but shows no effect in old female as compared to adult counterpart. In contrast, ERbeta transcript level decreases in old mice of both sexes. Furthermore, ERalpha mRNA level is higher in adult female than in adult male but no sex-dependent difference is seen in ERbeta mRNA level. Supplementation of 17beta-estradiol shows no significant alteration but testosterone reduces the ERalpha level in male mice, while 17beta-estradiol and testosterone down regulate the ERalpha level in female mice of both ages. In case of ERbeta, 17beta-estradiol decreases the transcript level in all groups except adult male while testosterone treatment results in the down regulation of transcript level in all groups. Thus these findings suggest differential effects of age, sex, 17beta-estradiol and testosterone supplementation on the transcription of mouse ER genes which may account for differences in the protein levels of ERalpha and ERbeta and their functions in the brain.

Aging of Brain: Role of Estrogen

The brain undergoes many structural and functional changes during aging. Some of these changes are regulated by estrogens which act mainly through their intracellular receptors, estrogen receptor ERalpha and ERbeta. The expression of these receptors is regulated by several factors including their own ligand estrogen, and others such as growth hormone and thyroid hormone. The levels of these factors decrease during aging which in turn influence estrogen signaling leading to alterations in brain functions. In the present paper, we review the effects of aging on brain structure and function, and estrogen action and signaling during brain aging. The findings suggest key role of estrogen in the maintenance of brain functions during aging.

Expression of estrogen receptor (ER) α and β in mouse cerebral cortex: Effect of age, sex and gonadal steroids

Estrogen receptor (ER), which mediates the multiple effects of estrogen in brain, is regulated by several factors including its own ligand. In the present study, we have examined the effect of age, sex and gonadal steroids (estrogen and testosterone) on the level of ERalpha and ERbeta in the cerebral cortex of AKR mice. Adult and old mice of both sexes were divided into four groups: intact, gonadectomized, 17beta-estradiol treated and testosterone treated. Western blot analysis showed higher level of ERalpha and ERbeta in the cerebral cortex of adult female than male mice. ERbeta level decreased significantly with advancing age in both sexes, whereas 17beta-estradiol supplementation decreased ERalpha level in old male and increased in old female, it also increased ERbeta level in old male and adult female. On the other hand, testosterone treatment decreased ERalpha level significantly in old female and ERbeta level in adult female but increased ERbeta level in male mice of both ages. Thus, these findings showed that the expression of ERalpha and ERbeta protein is differentially influenced by age, sex and gonadal steroids in the mouse cerebral cortex, suggesting differences in ER-mediated brain functions.

Assessment, management and spatial distribution of ground water for irrigation in Rupnagar district of Punjab (India)

Ground water samples for geo-referenced sites were collected and analyzed for various chemical constituents for assessing their quality for irrigation. These waters were categorized as good and marginal sodic based upon the values of EC and RSC. The ground water quality map of the area was prepared and digitized using GIS software and blockwise area under different categories was commuted, which indicates that Kharar block (46.7 percent of the TGA) has maximum area under marginally sodic water as compared to the Anandpur Sahib block with 8.5 percent of its TGA under marginally sodic waters.

Penicillamine induced pseudoxanthoma elasticum with elastosis perforans serpiginosa

Long term D-penicillamine therapy, especially when used to treat Wilson's disease has been shown to cause elastosis perforans serpiginosa, pseudoxanthoma elasticum perforans and other degenerative dermatoses. We report a 23-year-old male patient who presented with multiple firm papules, nodules over the neck, axillae, front of elbows for five years. He was a known case of Wilson's disease on long-term treatment with penicillamine for the past 12 years. The papulonodular lesions were non-tender and some were discrete while others were arranged in a circinate pattern. There was central scarring of the skin within the circinate lesions. In addition, there were several small yellowish papules on both sides of the neck which eventually became confluent to form plaques. Histopathology confirmed the diagnosis of elastosis perforans serpiginosa and pseudoxanthoma elasticum. He was treated with cryotherapy (using liquid nitrogen through cryojet) for former lesions. The lesions showed remarkable improvement after five sittings. Now the patient is under trientine hydrochloride (750 mg twice daily) for Wilson's disease.

Structural transition in nanostructured Eu2O3 under high pressures

We report here studies on the effect of high pressure on the structural properties of nano-sized Europium sesquioxide (Eu2O3) up to a pressure of about 16.4 GPa. At ambient conditions, the starting sample was found to be predominantly cubic type Eu2O3 or in Eu3+ state with a trace of Eu2+. The presence of Eu2+ state is assumed to be arising due to the non-stoichiometric Eu(1-x)O phase which is obtained from XPS studies by the deconvolution of the Eu 3d-core levels. The Raman studies at ambient show a strong peak at about 333 cm(-1), which is known to occur due to the Fg mode of cubic Eu2O3 and in a similar way, the XRD data shows major peaks corresponding to the cubic phase of Eu2O3. A Mao-Bell type diamond anvil cell (DAC) was used to generate high pressures for XRD and Raman spectroscopy studies. It was observed that the material undergoes a structural change from cubic to monoclinic structure with an on set transition pressure at around 2 GPa and completes at around 8 GPa. This has been inferred from the fact that above about 2.0 GPa pressure, Raman studies show the emergence of a new peak corresponding to the monoclinic phase which increases in intensity and shifts further with increase in pressure, while the XRD studies show that above about 2.0 GPa, the peaks corresponding to monoclinic phase emerge, which show a slight increase in preferred orientation as the pressure is increased. A detailed discussion has been provided to explain this fact.

Endosulfan and quinalphos residues and toxicity to soil microarthropods after repeated applications in a field investigation

Endosulfan (1,4,5,6,7,7-hexachloro-8,9,10-trinorborn-5-en-2,3-ylenedimethylsulphite) and quinalphos (O,O-diethyl O-quinoxalin-2-yl phosphorothioate) persistence and their effect on soil microarthropods were studied after repeated applications in cotton fields. Dissipation behavior of insecticides after repeated applications was observed from 78 to 292 days after the first insecticide treatment. At any given time the concentrations of endosulfan beta residues were always higher as compared to endosulfan alpha. From 78 to 85 days, 5.0% and 20.4% decrease in alpha and beta endosulfan residues was observed, respectively. Endosulfan beta isomer decreased up to 93.0% in 292 days. Endosulfan sulfate was detected as a major metabolite in the soil samples. Total endosulfan residues decreased by 86.6% from 78 to 292 days. The amounts of quinalphos residues were less as compared to endosulfan at any given time. The residues observed after 78 days of application were 0.88 ng g-1 d wt. soil. At the end of 145 days, a 35.0% decrease in quinalphos residue was observed, which decreased further by 50.9% in 292 days. Among the soil microarthropods studied, Acarina was more sensitive to the applied insecticides as compared to Collembola. Three days after the last treatment, up to 94.5% (p < 0.01) and 71.2% (p < 0.05) decrease in Acarina population was observed in endosulfan and quinalphos treated fields, respectively, compared to control field. In general, no noticeable change in Collembola population was observed after the insecticide treatments.

Angiosarcoma of scalp: a case report

Cutaneous angiosarcomas are rare and constitute less than 1% of all malignant mesenchymal tumours. Most angiosarcomas of skin arise in the following clinical settings: 1. face and scalp of elderly 2. following lymphoedema and 3. post radiation. We present a case of an elderly man presenting with scalp lesion of 18 months duration. Histological examination of the biopsy revealed features of an angiosarcoma, which showed imunohistochemical positivity for factor VIII related antigen.

Variability in the coat protein gene of Papaya ringspot virus isolates from multiple locations in India

The coat protein (CP) sequences of eleven Papaya ringspot virus (PRSV) isolates originating from different locations in India were determined, analysed and compared with the sequences of other isolates of PRSV. The virus isolates from India exhibited considerable heterogeneity in the CP sequences. The CP-coding region varied in size from 840-858 nucleotides, encoding protein of 280-286 amino acids. Comparative sequence analysis revealed that the PRSV isolates originating from India were divergent up to 11%. Though the PRSV isolates were differentiated in to two clusters, yet the sequence variation could not be correlated with the geographical origin of the isolates. Implication of the sequence variation in the coat protein derived transgenic resistance in papaya is discussed.

Observations on the traditional phytotherapy among the inhabitants of Parvati valley in western Himalaya, India

The present paper deals with the field observations recorded on the traditional indigenous therapeutic applications of the plants used by the inhabitants of the Parvati valley of Kullu district in western Himalaya of India. The Parvati valley is inhabited by different ethnic groups like Gujjars, Gaddis, Malanis, Kulluvis and others. These inhabitants have been dependent on the ambient plant resources for food, fuel, fiber, timber, household articles and medicines to a great extent for ages. Even today a number of plants of the local flora are used for curing various ailments and diseases. First-hand information about 50 plant species belonging to 45 genera and 28 families were recorded during extensive field surveys carried in Parvati valley during 2000-2002. The information is given in a tabular form as scientific names of plants in alphabetic order followed by family and field numbers of the voucher specimens collected. Information on local/vernacular names of plants, uses, parts used, names of ailments and modes of usage are given in detail. Information on traditional uses and commercial uses as well as biological activities of the related species is included on the basis of the existing relevant literature so as to present a comprehensive account.

Biologics in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic progressive disease of the joints associated with significant morbidity, deformity, and impaired quality of life. A satisfactory remission of disease is seldom achieved, so therapy is aimed at controlling joint damage and pain with preservation of joint mobility. Until recently, NSAIDs, followed by DMARDs, was considered the treatment of choice. However, many patients fail to gain a satisfactory response to DMARDs or response declines over time. Biologics such as IL-1 receptor antagonist (anakinra), and anti TNF-alpha agents (Etanercept, Infliximab, and Adalimumab) are now available. The anti TNF and IL-1 therapies exert their anti-inflammatory action by neutralizing the activities of TNF-alpha and IL-1 respectively. In contrast to older DMARDs, these agents have rapid onset of action with fewer side effects and have pronounced disease reducing activity in patients who have previously been treated with other DMARDs, when administered as monotherapy or in combination with methotrexate. They have been shown to be at least as effective as methotrexate in reducing clinical disease activity and reducing radiographic progression. Biological agents are generally well tolerated, although their long-term safety needs to be determined. Some concerns have been raised that anti TNF-alpha therapy can increase the risk of serious infections, since TNF-alpha plays an important role in host defense. In light of limitations of cost and lack of long-term safety and efficacy data, newer agents for the time being are used as second- or third-line agents in patients with active RA. The dilemma is that which patients with RA are most suitable for such therapy, since it is still not possible to accurately predict which patient with RA will develop severe disease. One alternative approach may be to limit the use in patients who can afford it, and who are at high risk of radiographic progression and disability.