Overweight, obesity and adiposity in survivors of childhood brain tumours: a systematic review and meta-analysis

Survivors of childhood brain tumours (SCBT) have increased cardiometabolic risks, but the determinants of these risks are unclear. This systematic review aims to compare the prevalence of overweight and obesity as well as adiposity measures between SCBT and non-cancer controls. The PubMed, EMBASE, MEDLINE, CINAHL and the Cochrane Library databases were searched. The primary outcomes were the prevalence of overweight and obesity based on body mass index. The secondary outcomes were adiposity measures including percent fat mass, waist-to-hip and waist-to-height ratios. Forty-one studies were included in the meta-analysis. The prevalence of overweight and obesity combined was similar between overall SCBT, SCBT excluding craniopharyngioma and non-cancer controls (42.6%, 95% CI 30.1-55.1 vs. 31.7%, 95% CI 20.4-43.0 vs. 40.4%, 95% CI 34.0-46.8). We also found that SCBT have higher percent fat mass (mean difference 4.1%, 95% CI 2.0-6.1), waist-to-hip ratio (mean difference 0.07, 95% CI 0.02-0.13) and waist-to-height ratio (mean difference 0.06, 95% CI 0.01-0.10) than non-cancer controls. We conclude that SCBT have similar overweight and obesity distribution but higher adiposity than non-cancer controls. More studies were needed to explore the determinants of adiposity and its contribution to cardiometabolic outcomes in SCBT.

Intratumoral heterogeneity: pathways to treatment resistance and relapse in human glioblastoma

Intratumoral heterogeneity (ITH) has increasingly being described for multiple cancers as the root cause of therapy resistance. Recent studies have started to explore the scope of ITH in glioblastoma (GBM), a highly aggressive and fatal form of brain tumor, to explain its inevitable therapy resistance and disease relapse. In this review, we detail the emerging data that explores the extensive genetic, cellular and functional ITH present in GBM. We discuss current experimental models of human GBM recurrence and suggest harnessing new technologies (CRISPR-Cas9 screening, CyTOF, cellular barcoding, single cell analysis) to delineate GBM ITH and identify treatment-refractory cell populations, thus opening new therapeutic windows. We will also explore why current therapeutics have failed in clinical trials and how ITH can inform us on developing empiric therapies for the treatment of recurrent GBM.

Demodex canis targets TLRs to evade host immunity and induce canine demodicosis

Widespread incidence of Demodex mites throughout the mammalian class and occasional serious and fatal outcomes in dogs warrant an insight into the host-parasite interface especially. Therefore, this study was aimed to unravel the interplay between innate immune response and canine demodicosis. The dogs diagnosed to have natural clinical demodicosis were allocated into two groups; dogs with localized demodicosis (LD) and with generalized demodicosis (GD). The expression of toll-like receptors (TLRs) 2, 4 and 6 genes in peripheral blood mononuclear cells of these dogs was quantified by real-time PCR. Significantly increased TLR2 gene expression, while significantly diminished TLR4 and TLR6 gene expressions were observed in demodicosed dogs (LD and GD) as compared with the healthy ones. Even the expression of TLR2 gene was found to differ significantly between the dogs with LD and GD. Therefore, it can be inferred that clinical demodicosis in dogs is coupled with an up-regulation of TLR2 and down-regulation of TLR4 and TLR6 gene expressions. Overexpression of TLR2 gene might be responsible for Demodex-induced clinical manifestations, while TLR4 and TLR6 gene down-regulations could be the paramount strategy of Demodex mites to elude the host-immune interface.

MiSNPDb: a web-based genomic resources of tropical ecology fruit mango (Mangifera indica L.) for phylogeography and varietal differentiation

Mango is one of the most important fruits of tropical ecological region of the world, well known for its nutritive value, aroma and taste. Its world production is >45MT worth >200 billion US dollars. Genomic resources are required for improvement in productivity and management of mango germplasm. There is no web-based genomic resources available for mango. Hence rapid and cost-effective high throughput putative marker discovery is required to develop such resources. RAD-based marker discovery can cater this urgent need till whole genome sequence of mango becomes available. Using a panel of 84 mango varieties, a total of 28.6 Gb data was generated by ddRAD-Seq approach on Illumina HiSeq 2000 platform. A total of 1.25 million SNPs were discovered. Phylogenetic tree using 749 common SNPs across these varieties revealed three major lineages which was compared with geographical locations. A web genomic resources MiSNPDb, available at http://webtom.cabgrid.res.in/mangosnps/ is based on 3-tier architecture, developed using PHP, MySQL and Javascript. This web genomic resources can be of immense use in the development of high density linkage map, QTL discovery, varietal differentiation, traceability, genome finishing and SNP chip development for future GWAS in genomic selection program. We report here world’s first web-based genomic resources for genetic improvement and germplasm management of mango.

An insight into the possible mechanisms of antispermatogenic action of Dalbergia sissoo in male mice

This study investigated the possible mechanisms of antispermatogenic action of Dalbergia sissoo in Parkes male mice. Mice were orally administered aqueous leaf extract of Dalbergia sissoo (50 and 100 mg kg^-1 body weight day^-1 for 35 days) and various testicular indices such 3β- and 17β-hydroxysteroid dehydrogenase (HSD) activities, Western blot analyses of StAR, cytochrome P450scc and caspase-3, germ cell apoptosis by TUNEL, and lipid peroxidation and antioxidant enzymes activities were assessed. A significant increase in lipid peroxidation level and a marked decrease in activities of superoxide dismutase, catalase, 3β- and 17β-HSD were noted in the testis of Dalbergia-treated mice compared to controls. The treatment also had adverse effect on expression levels of StAR and cytochrome P450scc in the testis. There was an increase in the number of TUNEL-positive germ cells and in expression level of caspase-3 in testes of Dalbergia-treated mice, especially in those treated with 100 mg dose compared to controls. By 56 days of withdrawal therapy, the alterations induced in the above parameters recovered to control levels. Our results thus suggest that Dalbergia treatment interferes with steroidogenesis and produces oxidative stress in the testis, which may induce germ cell apoptosis leading to suppression of spermatogenesis.

Risk Factors for Reoperation and Performance-Based Outcomes After Operative Fixation of Foot Fractures in the Professional Athlete: A Cross-Sport Analysis

Background:

Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population.

Hypothesis:

Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on postoperative performance or league participation. However, National Football League (NFL) athletes would have a significantly greater decline in performance due to the high-impact nature of the sport.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

Athletes in the National Basketball League (NBA), NFL, Major League Baseball (MLB), and National Hockey League (NHL) undergoing operative fixation of a foot fracture were identified through a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were collected for each sport. League participation and game performance data were collected before and after surgery. Statistical analysis was performed, with significance accepted as P ≤ 0.05.

Results:

A total of 77 players undergoing 84 procedures met the inclusion criteria. Overall, 98.7% (76/77) of players were able to return to play, with a median time to return across all sports of 137 days. Players returned to preoperative performance levels within 1 season of surgery. Six players (7.8%) sustained refracture requiring reoperation, all of whom were in the NBA. Percentage of games started during the season after primary operative treatment was a predictive factor for reinjury (99% vs 40%, P = 0.001).

Conclusion:

Athletes returned to play at a high rate after foot fracture fixation, with excellent postoperative performance levels, regardless of sport and fracture location. NBA athletes sustaining fifth metatarsal and navicular fractures are at greater risk of reinjury compared with other athletes. Returning to high levels of athletic participation soon after surgery may predispose athletes to refracture and subsequent reoperation.

Clinical Relevance:

Players, coaches, and team physicians should be aware of the impact of foot fractures on career performance and longevity to best guide therapy.

Natural antibody responses to Plasmodium falciparum MSP3 and GLURP(R0) antigens are associated with low parasite densities in malaria patients living in the Central Region of Ghana

Background

Plasmodium falciparum genetic diversity and multiplicity of infection (MOI) are parasite features that have been suggested to influence the acquisition of protective immunity against malaria. This study sought to assess the relationship between MOI and parasite density (PD) in malaria patients living in the Central Region of Ghana and to determine whether naturally occurring antibody levels against P. falciparum GLURP (PF3D7_1035300) and MSP3 (PF3D7_1035400) antigens are associated with decreased parasite load.

Methods

Dried filter paper blood blots were obtained from children and adults diagnosed with uncomplicated P. falciparum malaria. Microscopy was used to estimate P. falciparum parasite density and polymerase chain reaction (PCR) amplification of the polymorphic regions of msp1 (PF3D7_0930300) and msp2 (PF3D7_0206800) was used for parasite genotyping and MOI determination. ELISA was used to measure the serum IgG concentration of R0 fragment of GLURP (GLURP(R0)) and MSP3 antibodies.

Results

All 115 samples were positive for P. falciparum by PCR using either the msp1 or msp2 genotyping primer sets. The most prevalent msp1 and msp2 alleles were KI and 3D7, respectively. The geometric mean (GM) for MOI determined by both msp1 and msp2 genotyping was 1.3 for the entire population and was generally higher in children than in adults. Seropositivity was estimated at 67 and 63% for GLURP(R0) and MSP3 antibodies, respectively, and antibody titers were negatively correlated with parasite density.

Conclusions

The negative correlation between naturally occurring GLURP(R0) and MSP3 antibody levels and parasite density observed in this study suggest that augmenting the antibody response with the GMZ2 vaccine could enhance protection in the Central Region of Ghana.

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-017-2338-7) contains supplementary material, which is available to authorized users.

A new era of studying p53-mediated transcription activation

To prevent tumorigenesis, p53 stimulates transcription by facilitating the recruitment of the transcription machinery on target gene promoters. Cryo-Electron Microscopy studies on p53-bound RNA Polymerase II (Pol II) reveal that p53 structurally regulates Pol II to affect its DNA binding and elongation, providing new insights into p53-mediated transcriptional regulation.

The effectiveness of interventions to treat hypothalamic obesity in survivors of childhood brain tumours: a systematic review

BACKGROUND

Survivors of childhood brain tumours (SCBT) are at risk of type 2 diabetes and cardiovascular diseases. Obesity is a major driver of cardiometabolic diseases in the general population, and interventions that tackle obesity may lower the risk of these chronic diseases. The goal of this systematic review was to summarize current evidence for the presence of interventions to manage obesity, including hypothalamic obesity, in SCBT.

METHODS

The primary outcome of this review was the body mass index z-score change from baseline to the end of the intervention and/or follow-up. Literature searches were conducted in PsycINFO, CINAHL, the Cochrane Library, Medline, SPORTDiscus, EMBASE and PubMed. Two reviewers completed study evaluations independently.

RESULTS

Eleven publications were included in this systematic review (lifestyle intervention n = 2, pharmacotherapy n = 6 and bariatric surgery n = 3). While some studies demonstrated effectiveness of interventions to manage obesity in SCBT and alter markers of obesity and cardiometabolic risk, the evidence base was limited and of low quality, and studies focused on hypothalamic obesity. We conclude that there is urgent need to conduct adequately powered trials of sufficient duration, using existing and novel therapies to manage obesity, reduce the burden of cardiometabolic disorders and improve outcomes in SCBT.

Estimation of genetic parameters and genetic trends for milk yield traits in Jamunapari goats in semiarid tropics

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The heritability for milk yield traits were moderate to high.

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The repeatability estimates were moderate to high for milk yield traits.

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The genetic trends for milk yield traits were positive.

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Phenotypic trends for MY90, MY140 and TMY were positive.

The Jamunapari goats are reared as dairy animals in semi-arid conditions, therefore it is necessary to evaluate the genetic potential for the genetic improvement of milk production traits. The data comprised of 2217 phenotypic records for milk yield at 90 days (MY90) and 140 days (MY140), total milk yield (TMY) and lactation length (LL) obtained from the progeny of 173 sires and 446 dams during the period 1990–2013. The data were analysed using mixed linear models exploring random effects due to direct additive, maternal and permanent environment variance due to animal. The most appropriate genetic models for milk yield traits were those that included permanent environment effects due to the animal. The direct additive heritability estimates were 0.15 ± 0.05, 0.26 ± 0.07, 0.25 ± 0.08 for MY90, MY140 and TMY, respectively. The additive heritability estimate for LL was low and non-significant at 0.02 ± 0.03. The repeatability estimates were moderate to high ranging from 0.68 to 0.73 for milk yield traits. The repeatability for lactation length was 0.20 ± 0.03. Maternal variances were low ranging from 0.03 for MY90 to 0.13 for TMY. There was an increase in mean milk yield of 0.25, 0.70 and 0.72 kg/year respectively at 90 and 140 days, and for TMY. Genetic trends and phenotypic trends for MY90, MY140 and TMY were positive and indicated significant improvement in milk traits due to selective breeding.

H2O2 sensing through electrochemically deposited thionine coated ITO thin film

Progression and initiation of different diseases including pulmonary diseases, alzheimer's and tumors are linked with the oxidative stress, an important cause of cell damage. Different antioxidant enzymes are involved in detoxifying reactive oxygen species including hydrogen peroxide (H2O2) that is generated in response to various stimuli and has important role in cell activation & bio-signaling processes. Herein, we developed hydrogen peroxide electrochemical sensor based on horseradish peroxidase (HRP) entrapped polymerized thionine (PTH) film. Electrochemical deposition of thionine (dye) on indium tin oxide (ITO) surface was carried out through chornoamperometry followed by cyclic voltammetry. Deposited thionine thin film obtained was checked for its stability at different scan rates. The PTH-modified electrodes showed linear dependence of peak current with scan rate within the range of 20 to 100 mV s-1. Thionine used as electron transfer mediator between heme site of HRP and electrode. Cyclic voltammetry showed increase in the reduction peak current due to electrocatalytic reduction of H2O2. The sensor detection limit range from 10-1 _ 102 µM and limit of detection was 0.1µM. The proposed sensor has good storage response, cost effective, high sensitivity and wide linear range that could be used for the fabrication of other enzyme based biosensors.

Clinical Study to Analyze the Intramuscular Anatomy of Musculocutaneous Perforators of Anterolateral Thigh Flaps

Background Anterolateral thigh (ALT) flap is a common flap used for many microsurgical reconstructive procedures. Majority of these flaps are based on the musculocutaneous perforators, which, after arising from source artery, course through the bulk of the vastus lateralis muscle. The vascular anatomy of the ALT flap has been often decried as its limiting factor.

Methods In this prospective study conducted over 3 years, 207 cases of ALT flap were evaluated. During the harvest of ALT flap, musculocutaneous perforators were laid open through the vastus lateralis, and its variations and pattern were studied for clinical anatomy as well as impact of anatomy on the viability of the flap postoperatively.

Results The perforators were recognized to be grouped into three broadly distinguishable anatomical patterns: linear (I), branching (Y), or tortuous (S). While the majority of perforators (51%) were linear “I” perforators, serpentine “S” and branching “Y” perforators were 28 and 21%, respectively. The clinical outcomes were also related to the simplicity of these perforators course as linear “I” perforators had 100% flap viability.

Conclusion During the harvest of 207 ALT flaps through 3 years, it could be deciphered that the musculocutaneous perforators traverse through the bulk of vastus lateralis muscle in only three types of patterns (IYS pattern). This identification of pattern could help in prevention of injury while delineating the perforators. Identification and typing of anatomical variation of the musculocutaneous perforator within the vastus muscle could lead to a predictable and safer harvest of the ALT flap.

Association of aldose reductase gene polymorphism (C-106T) in susceptibility of diabetic peripheral neuropathy among north Indian population

AIM/HYPOTHESIS

Polymorphism in aldose reductase (ALR) gene at nucleotide C(-106)T (rs759853) in the promoter region is associated with susceptibility to development of diabetic peripheral neuropathy. The aim of this study was to detect the association of the C (-106)T polymorphism of ALR gene and its frequency among patients with type 2 diabetes mellitus with and without peripheral neuropathy.

METHODS

The study subjects were divided into three groups. Group I included 356 patients with diabetes having peripheral neuropathy. Group II included 294 patients with diabetes without peripheral neuropathy and group III included 181 healthy subjects. Genotyping of ALR C(-106)T SNPs was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct sequencing methods. The genetic risk among the groups was compared and tested by calculating odds ratio with 95% class interval.

RESULTS

ALR 106TT genotype was significantly higher in group I compared to group II with an odds ratio of 2.12 (95% CI: 1.22-3.67; p<0.01). Recessive model (CC+CT vs. TT), as well as T allele distribution also showed significant association to develop neuropathy with relative risk of 1.97 (95% CI: 1.16-3.35; p<0.01) and 1.36 (95% CI: 1.07-1.72; p=0.01) respectively.

CONCLUSION/INTERPRETATION

In conclusion, the ALR C-106T polymorphism was associated with higher risk of peripheral neuropathy in patients with type 2 diabetes mellitus.

Neonatal hypothyroidism affects testicular glucose homeostasis through increased oxidative stress in prepubertal mice: effects on GLUT3, GLUT8 and Cx43

Thyroid hormones (THs) play an important role in maintaining the link between metabolism and reproduction and the altered THs status is associated with induction of oxidative stress in various organs like brain, heart, liver and testis. Further, reactive oxygen species play a pivotal role in regulation of glucose homeostasis in several organs, and glucose utilization by Leydig cells is essential for testosterone biosynthesis and thus is largely dependent on glucose transporter 8 (GLUT8). Glucose uptake by Sertoli cells is mediated through glucose transporter 3 (GLUT3) under the influence of THs to meet energy requirement of developing germ cells. THs also modulate level of gap junctional protein such as connexin 43 (Cx43), a potential regulator of cell proliferation and apoptosis in the seminiferous epithelium. Although the role of transient neonatal hypothyroidism in adult testis in terms of testosterone production is well documented, the effect of THs deficiency in early developmental period and its role in testicular glucose homeostasis and oxidative stress with reference to Cx43 in immature mice remain unknown. Therefore, the present study was conducted to evaluate the effect of neonatal hypothyroidism on testicular glucose homeostasis and oxidative stress at postnatal days (PND) 21 and 28 in relation to GLUT3, GLUT8 and Cx43. Hypothyroidism induced by 6-propyl-2-thiouracil (PTU) markedly decreased testicular glucose level with considerable reduction in expression level of GLUT3 and GLUT8. Likewise, lactate dehydrogenase (LDH) activity and intratesticular concentration of lactate were also decreased in hypothyroid mice. There was also a rise in germ cell apoptosis with increased expression of caspase-3 in PTU-treated mice. Further, neonatal hypothyroidism affected germ cell proliferation with decreased expression of proliferating cell nuclear antigen (PCNA) and Cx43. In conclusion, our results suggest that neonatal hypothyroidism alters testicular glucose homeostasis via increased oxidative stress in prepubertal mice, thereby affecting germ cell survival and proliferation.

Evaluation of Oxidative Stress and Antioxidant Status in Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. Gaseous and noxious particles play an important role in this process. Antioxidants are the substances that may protect cells from the damage caused by unstable molecules known as free radicals. The increased oxidative stress in patients with COPD is the result of an increased burden of inhaled oxidants, as well as increased amounts of reactive oxygen species (ROS) generated by various inflammatory, immune and epithelial cells of the airways. A total of 150 subjects with COPD and 100 healthy controls subjects were enrolled in this study from the period October 2015 to January 2016. The investigation included measurements of plasma superoxide dismutase activity (SOD), catalase activity (CAT), glutathione content (GSH) reduced form, (GPx) glutathione peroxidase, glutathione reductase (GR) and lipid peroxidation (LPO). Absorbance was measured by UV spectrophotometer. The estimated values of SOD, catalase, GPx, GSH and GR were found to be significantly (P = 0.0001) lower among the cases compared with controls. But, the levels of MDA were higher (P = 0.0001) in cases as compared to control group and there was significant difference in the oxidative stress parameters among the various stages of COPD. The post hoc analysis revealed that SOD was significantly (P < 0.01) lower among the mild, moderate and severe patients compared with very severe patients. The catalase was also observed to be significantly (P = 0.01) lower among mild, moderate and severe patients than very severe patients. The GPx was found to be significantly (P = 0.002) lower among the mild, moderate and severe patients compared with very severe patients. MDA was observed to be significantly higher in mild, moderate and severe patients compared with very severe (P = 0.001). GR was significantly (P = 0.003) lower among mild, moderate and severe patients than very severe patients. However, there was no significant difference in GSH among severity of COPD patients. This study suggests that oxidant and antioxidant imbalance plays an important role in various stages of severity of COPD. These results revealed the presence of an oxidative stress in subjects with COPD, and it is proportionate to the severity of disease.

Shisha (waterpipe) smoking initiation among youth in Malaysia and global perspective: a scoping review (2006-2015)

OBJECTIVE

To explore the initiating factors of waterpipe tobacco smoking (WTS) among youth.

STUDY DESIGN

The analytic framework for this scoping review was performed using the methodology outlined by Arksey and O'Malley, which includes identification of the research question, study selection, charting the data, collating, summarizing and reporting the results that were primarily guided by the research question; 'what is known about the initiation of shisha smoking among youth?'

METHODS

Electronic databases such as Cochrane, MEDLINE and PsycINFO were used to search for relevant articles. Articles included were all in English and published within the year of 2006 to 2015. Inclusion criteria; i) age range of 10 to 29 years; ii) examined the reasons why youth started or tried WTS; iii) in full text. Therefore, 26 articles were included in this scoping review.

RESULTS

This review has identified and classified the initiating factors of WTS among youth in four subtopics: individual factors, interpersonal influences, cigarettes and alcohol use, and media influences. Individual factors and interpersonal influences played an important role in initiation factors of WTS among youth.

CONCLUSION

This study concludes that public health professionals within the Southeast Asia region need to promote innovative preventive measures through peer-to-peer led interventions that are also easily assessable on social media platforms. The public health messages need to address the misconceptions of risk associated to WTS use.

Identification, antifungal resistance profile, in vitro biofilm formation and ultrastructural characteristics of Candida species isolated from diabetic foot patients in Northern India

PURPOSE

Diabetic foot ulcers are a serious cause of diagnostic and therapeutic concern. The following study was undertaken to determine the fungal causes of diabetic foot ulcers, with their phenotypic and genotypic characterisation.

MATERIALS AND METHODS

A total of 155 diabetic foot ulcers were studied for 1 year. Deep tissue specimen was collected from the wounds, and crushed samples were plated on Sabouraud dextrose agar with chloramphenicol (0.05 g). Identification was done by growth on cornmeal agar, germ tube formation and urease test. For molecular identification, conserved portion of the 18S rDNA region, the adjacent internal transcribed spacer 1 (ITS1) and a portion of the 28S rDNA region were amplified, using the ITS1 and ITS2 primers. Antifungal susceptibility against voriconazole, fluconazole and amphotericin B was determined by standard broth microdilution method. Biofilm formation was studied in three steps. First, on the surface of wells of microtiter plates followed by quantification of growth by fungal metabolism measurement. Finally, biofilms were analysed by scanning electron microscopy (SEM).

RESULTS

Fungal aetiology was found in 75 patients (48.38%). All were identified as Candida species (100%). The prevalence of different species was Candida tropicalis (34.6%), Candida albicans (29.3%), Candida krusei (16.0%), Candida parapsilosis (10.6%), Candida glabrata (9.33%). All were susceptible to amphotericin B (100%). On microtiter plate, all the isolates were viable within 48 h showing biofilms. The metabolic activity of cells in the biofilm increased with cellular mass, especially in the first 24 h. On SEM, majority showed budding yeast form.

CONCLUSION

Non-albicans Candida spp. with potential biofilm forming ability are emerging as a predominant cause of diabetic foot ulcers.

A Comprehensive Review on Role of Nanoparticles in Therapeutic Delivery of Medicine

BACKGROUND

The effective targeted drug delivery system is significant for future development of medicinal product and healthcare. There are also different types of nanostructures which include solid lipid nanoparticles, liposomes, dendrimers, nanostructured lipid carriers, lipid drug conjugate, liquid crystalline particles, polymeric nanocrystals, polymeric nanoparticles and superparamagnetic nanoparticles which have been considered as advanced carriers in drug delivery system. Method & Discussion: In this regard, nano carriers are bringing revolution in therapeutic delivery of drug as compared to conventional delivery systems by overcoming the limitations of usual methods.

CONCLUSION

The objective of this review is to cover the drug delivery system of various therapeutic drugs and biomolecules by means of polymeric nanoparticles, dendrimers, liposomal nanoparticles and magnetic nanoparticles by describing the methods of formulation development.

Does First Serum Beta-Human Chorionic Gonadotropin Value Prognosticate the Early Pregnancy Outcome in an In-Vitro Fertilisation Cycle?

Background:

Pregnancies achieved through in-vitro fertilisation (IVF) are associated with adverse first trimester outcomes in comparison to spontaneously achieved pregnancies. In view of this, it is imperative to predict the success as well as prognosticate the pregnancy outcome of an IVF cycle not only for the clinicians but also the couples undergoing IVF. Serum beta-human chorionic gonadotropin (β-hCG) value has, thus, been used as a biomarker for pregnancy outcome after IVF and also an aid in counselling and management of the patient.

Aim:

The main objective of this study was to compare the predictive value of the first serum β-hCG value and the pregnancy outcome after an IVF cycle (whether fresh or frozen embryo transfer) in the two subgroups of patients.

Settings and Design:

The study was conducted at Assisted Reproductive Technology Centre of a tertiary care hospital, and it was a retrospective cohort study.

Methods and Materials:

A retrospective study was performed for post-IVF pregnancies at a single IVF centre from March 2014 to February 2015 with serum β-hCG values less than or equal to 1000 mIU/ml. The initial serum values of β-hCG on the day 16 of embryo transfer were correlated with first trimester pregnancy outcome and ongoing pregnancy rate (>12 weeks gestation).

Results:

Of the 208 post-IVF pregnancies included in the study, the group with β-hCG more than 500 mIU/ml had statistically significant higher ongoing pregnancy rates and a lesser poor pregnancy outcome.

Conclusion:

The study concluded that an early serum β-hCG value can be used as a predictor of a successful or an adverse first trimester pregnancy outcome helping in better counselling and monitoring of the high-risk precious IVF pregnancies.

How Harmful Can Herbal Remedies Be? A Case of Severe Acute Tubulointerstitial Nephritis

Acute interstitial nephritis (AIN) is a condition in which acute kidney injury (AKI) is characterized by the histological finding of interstitial inflammation. Hyponidd is an ayurvedic drug containing Momordica charantia, Gymnema sylvestre, Swertia chirata, etc., used for the treatment of Type 2 diabetes mellitus (DM) and polycystic ovarian disease as an insulin sensitizer. There are no case reports of AIN caused by this drug yet. We report a biopsy-proven case of AKI due to severe AIN associated with the use of hyponidd tablet in a 60-year-old male with DM and hypertension. As these types of various indigenous compounds are used as home remedies in our country, awareness about the possible adverse effects of these agents among physicians is very important in the early diagnosis and management.

Gaseous microflow modeling using the Fokker-Planck equation

We present a comparative study of gaseous microflow systems using the recently introduced Fokker-Planck approach and other methods such as: direct simulation Monte Carlo, lattice Boltzmann, and variational solution of Boltzmann-BGK. We show that this Fokker-Plank approach performs efficiently at intermediate values of Knudsen number, a region where direct simulation Monte Carlo becomes expensive and lattice Boltzmann becomes inaccurate. We also investigate the effectiveness of a recently proposed Fokker-Planck model in simulations of heat transfer, as a function of relevant parameters such as the Prandtl, Knudsen numbers. Furthermore, we present simulation of shock wave as a function of Mach number in transonic regime. Our results suggest that the performance of the Fokker-Planck approach is superior to that of the other methods in transition regime for rarefied gas flow and transonic regime for shock wave.

Collagen cross-linking in recalcitrant corneal ulcers: A case series

Introduction: Corneal ulcer is a leading cause of blindness worldwide. Many of these patients don’t respond to conventional treatment with topical agents. Collagen cross-linking (CXL) has been suggested to avoid complications requiring emergency keratoplasty. Subjects and methods: Six eyes with presumed bacterial keratitis not responding to conventional treatment underwent CXL with ultraviolet A rays and transepithelial riboflavin. Patients with Descematocele and perforated ulcers were excluded. Preoperatively and postoperatively slit lamp examination of cornea and visual acuity recording was done. Postoperative outcome included subjective symptoms like relief in pain, photophobia, lacrimation and objective signs like improvement in epithelisation, corneal scarring with vascularisation. Results: Four of the six eyes healed completely with scarring at 2 months follow-up. One of the patients developed Descematocele on 12 days which perforated later. Other patient developed Descematocele on 20 days post CXL. Of the subjective symptoms, pain and epiphora improved in all the patients except one. Photophobia improved only a week after CXL in four out of six patients. Epithelial defect completely healed over time in four out of six cases. All the cases who responded to treatment developed superficial and deep vascularisation of the cornea. Decrease in corneal edema and scarring was noted in four out of the six cases. Conclusion: The collagen cross-linking has a beneficial role as an adjuvant to medical therapy in recalcitrant bacterial keratitis. It helps in relief of pain and healing of ulcer. Larger randomized control trails with longer follow-up are required to come to a definite conclusion. Nepal J Ophthalmol 2016; 8(15): 47-53