Azathioprine as a therapeutic modality for the treatment of severe adult atopic dermatitis

Atopic dermatitis is a difficult disease to treat. A few reports suggest that azathioprine may be effective in the treatment of atopic dermatitis. We therefore, evaluated the role of azathioprine in adult atopic dermatitis not adequately controlled with conventional therapy. Four patients of adult atopic dermatitis were treated with azathioprine 50 mg twice daily orally for 3-4 months. All the patients had complete remission after therapy. There were no significant side effects. Therefore, azathioprine can be considered a better and safer alternative drug in recalcitrant adult atopic dermatitis.

Multiple lichen striatus--an unusual presentation

A 2-year-old mare child presented with multiple hypopigmented, flat topped papules with a bilateral distribution along the lines of Blaschko. A 7-year-old girl presented with multiple hypopigmented macules arranged linearly along the left upper and lower limb and also on the back along the lines of Blaschko. Three discrete lines in three distinct anatomical areas in a case of lichen striatus do not appear to have been described.

Origin of negative thermal expansion in cubic ZrW2O8 revealed by high pressure inelastic neutron scattering

Isotropic negative thermal expansion has been reported in cubic ZrW2O8 over a wide range of temperatures (0-1050 K). Here we report the direct experimental determination of the Grüneisen parameters of phonon modes as a function of their energy, averaged over the whole Brillouin zone, by means of high pressure inelastic neutron scattering measurements. We observe a pronounced softening of the phonon spectrum at P = 1.7 kbar compared to that at ambient pressure by about 0.1-0.2 meV for phonons of energy below 8 meV. This unusual phonon softening on compression, corresponding to large negative Grüneisen parameters, is able to account for the observed large negative thermal expansion.

Matrix effects during potassium and calcium determinations in rice saplings using X-ray spectrometery

For selectively excited calcium K X-rays in rice saplings, the relations alpha = N(KR)[1 + A gamma + B beta/(1 + alpha)] and 1/N(Ca) = alpha/beta + b + c beta are found to support the enhancement of potassium K X-rays and N(Ca) calcium K X-ray counts during potassium and calcium determinations, respectively. Here alpha, beta and gamma are weight fractions of potassium, calcium and the matrix substrate, respectively, N(KR) is the relative potassium K X-ray counts of the sample to that of pure potassium and A, B, a, b and c are constants. Tests of these relations, using eight known mixtures of CaCO3, KNO3 and Na2B4O7 10H2O (borax), have further supported the findings.

Studies of ion-exchange resin complex of chloroquine phosphate

High-potency adsorbates of chloroquine phosphate (CQP) were prepared by the batch method using a polyacrylic acid ion-exchange resin. Taste evaluation of the adsorbates shows significant masking of the bitterness of the drug. The complex formation was complete at pH 6.0. Stability studies at 37 degrees C, 45 degrees C, and 60 degrees C indicated that the complex was stable at all conditions for 1 month. In vitro release studies revealed complete drug elution from the complex at pH 1.2 and 2.0.

Wilson's disease--early onset and lessons from a pediatric cohort in India

OBJECTIVE

To study the clinical profile at presentation and on follow up in cases of Wilson's disease presenting at this hospital.

METHODS

Case records of children diagnosed as Wilson's disease (WD) admitted in the hospital or attending the Pediatric outpatient department were retrospectively studied with regard to clinical features, investigations, and family screening at the time of presentation. Note was made of the treatment received by the patients. Clinical profile on follow up was recorded with respect to side effects of treatment, and whether patient improved, deteriorated or remained the same, either from the records or by calling the patient for a follow up, if possible.

RESULTS

Analysis of 25 children with Wilson's disease comprising 19 index cases and 6 siblings detected on family screening, revealed mean age of onset for the hepatic presentation was 6.8 years versus 8 years for the neurologic patient. A quarter of index cases has a family history strongly suspicious for Wilson disease which has been earlier overlooked. Clinical presentation was hepatic in 5 patients, purely neurologic in 5, mixed hepatic and neurologic in 9, hemolytic anemia in 1 and polyarthritis in 1. Patients received treatment with D penicillamine, zinc, pyridoxine and low copper diet. Follow upon 18 patients revealed improvement in majority, residual dysarthria in seven,prolonged persistence of KF rings in 15 and complications like renal tubular acidosis with osteopenia in one.

CONCLUSION

The early age of onset of symptoms, prolonged KF rings persistence and progression of symptoms among sibs despite therapy is of interest as it may be related to a high copper intake, which may be due to the practice of using brass or copper utensils for cooking Since a large number of children has either a past history of jaundice or sibling deaths due to jaundice or cirrhosis, a high index of suspicion and screening for KF rings is emphasized as a simple and cost effective way of detecting a curable disease at an early stage and family screening of all index cases is imperative. Progression of symptoms among sibs on oral zinc and low dose pencillamine suggests inadequacy of zinc alone for prophylaxis.

In vitro antioxidant activity of piperine

Oxygen radical injury and lipid peroxidation have been suggested as major causes of atherosclerosis, cancer, liver disease and the aging process. Piperine, having an antiinflammatory effect, has been demonstrated in in vitro experiments to protect against oxidative damage by inhibiting or quenching free radicals and reactive oxygen species and hydroxyl radicals. The effect on lipid peroxidation was also examined and IC50 values were calculated. Piperine was found to act as a hydroxyl radical scavenger at low concentrations, but at higher concentrations, it activated the fenton reaction resulting in increased generation of hydroxyl radicals. Whereas it acts as a powerful superoxide scavenger and IC50 is 1.82 mM, a 52% inhibition of lipid peroxidation was observed at a dose of 1400 microM with an IC50 of 1.23 mM. The results depict that piperine possesses direct antioxidant activity against various free radicals. This study also opens newer views on the potential efficacy of piperine in protecting tissues from peroxidative damage.

Giant cell tumor of rib--rare location on the anterior aspect

Giant cell tumor rarely occurs in ribs, where it presents posteriorly. We present a report of a giant cell tumor of bone occurring anteriorly in the rib with a review of the literature.

Lichen planus treated with betamethasone oral mini-pulse therapy

Ten Patients, 6 males and 4 females between 7-60 years of age having lichen planus for I month to 2 years were treated with betamethasone 5mg orally on two consecutive days in a week for 3 months. There was excellent (75-100%) response in 6 (60%) patients and good (50-75%) in 4 (40%) patients. None of the patients had significant side effects of the therapy and there were no treat-ment failures. Betamethasone on two consecutive days in a week as oral mini pulse therapy may be a safe, effective and a better therapeutic alternative for the treatment of lichen planus.

Tuberculosis of the foot

In 44 patients with tuberculosis of the foot we identified five radiological patterns of lesions; cystic, rheumatoid, subperiosteal, kissing and spina ventosa. Cystic destruction had the best outcome and rheumatoid the poorest. All the patients were cured after antituberculous treatment for 18 months, and none required surgery.

Tuberculosis of the foot

In 44 patients with tuberculosis of the foot we identified five radiological patterns of lesions; cystic, rheumatoid, subperiosteal, kissing and spina ventosa. Cystic destruction had the best outcome and rheumatoid the poorest. All the patients were cured after antituberculous treatment for 18 months, and none required surgery.

X-ray diffraction study of anisotropic thermal expansion in ZrMo2O8

Temperature-dependent X-ray diffraction measurements are reported for ZrMo2O8in the trigonal phase from 80 to 925 K. The measurements reveal highly anisotropic thermal expansion coefficients with average values of −3.9 × 10−6and 52 × 10−6 K−1for theaandccell parameters, respectively.

Olmsted syndrome

A 20-year-old Sikh man had palmoplantar keratoderma, flexion deformity of digits, universal alopecia, keratotic plaques at the angles of mouth, gluteal cleft, knees and dorsal aspects of the metacarpophalangeal joints of the hand; features of Olmsted syndrome. He had normal nails, teeth, oral mucosa and normal joint movements. Treatment with acitretin, 25mg/day for three and a half months, followed by 25mg once daily alternating with 50mg once daily for 3 months resulted in significant improvement.

Ewing's sarcoma of os calcis: case report with a review of literature

A rare case of Ewing's sarcoma of os calcis is described here. Its atypical clinical and radiological features often delay the diagnosis. These features and review of literature are discussed.