Scenario of Leprosy and Pattern of Disability in Post-elimination Era: A Seven Year Study from a Tertiary Care Hospital of Kashmir Valley

Leprosy is an infectious disease associated with fear, aversion and social stigma, mostly due to crippling deformities. As prevalence of leprosy decreases, so does the experience with disease, especially for younger physicians. Leprosy can have a significant impact on the quality of life (QOL) of the affected person owing to the chronic nature, disabilities and deformities associated with the disease. A high degree of social stigma in a conservative place like Kashmir further complicates the problem. This has necessitated the need to revisit realms of disabilities in leprosy in our region. Aim of study was to understand the profile of leprosy patients, categorize the pattern of disabilities and assess its impact on the QOL of persons affected with leprosy in our region. This cross-sectional study was conducted in a tertiary care hospital, over a period of 7 years. All patients diagnosed with leprosy were included in the project following an Institutional ethical committee clearance. Detailed history followed by a meticulous examination was done in all patients with distinctive attention to recording of disabilities. Grading of disabilities was done using the world health organization (WHO) grading of 1988. The assessment of QOL was done using WHOQOL-BREF scale. Out of the 90 cases, 42 patients (46.67%) were found to suffer from a total of 72 disabilities with majority suffering from more than one, averaging 1.7 disabilities per person. 48 patients (53.33%) did not have any disability. Fourteen cases (15.56%) had grade 1 disability while grade 2 and grade 3 disability were seen in 23 (25.56%) and 5 (5.55%) cases respectively. The assessment of QOL using WHOQOL-BREF scale demonstrated the quality of life to be worst for the physical domain (median 42) followed by environmental (median 48), global (median 49), psychological (median 56) and social relations domain (median 57). Disabilities and deformities are commonly encountered in our leprosy patients and can have a significant physiological, psychological, economic and social impact on the patient. The disease has a significant impact on the QOL of patients contrary to previous beliefs. Our data also indicates the need for community level studies and interventions to overcome the problem of late diagnosis and proper management as well as proper after care for deformities/ disabilities.

An outlook on coronavirus disease 2019 detection methods / 药物分析学报

Diagnostic testing plays a fundamental role in the mitigation and containment of coronavirus disease 2019(COVID-19),as it enables immediate quarantine of those who are infected and contagious and is essential for the epidemiological characterization of the virus and estimating the number of infected cases worldwide.Confirmation of viral infections,such as COVID-19,can be achieved through two general approaches:nucleic acid amplification tests(NAATs)or molecular tests,and serological or antibody-based tests.The genetic material of the pathogen is detected in NAAT,and in serological tests,host antibodies produced in response to the pathogen are identified.Other methods of diagnosing COVID-19 include radiological imaging of the lungs and in vitro detection of viral antigens.This review covers different approaches available to diagnosing COVID-19 by outlining their advantages and short-comings,as well as appropriate indications for more accurate testing.

In vitro antimicrobial and synergistic effect of essential oil from the red macroalgae Centroceras clavulatum (C. Agardh) Montagne with conventional antibiotics

Objective: To study the chemical profile, antimicrobial properties, and synergistic effect with known antibiotics of essential oil extracted from the marine red macroalgae Centroceras clavulatum (C. Agardh) Montagne, collected in Morocco. Methods: The chemical composition of the oil was analyzed by gas chromatography-mass spectrometry. The oil was evaluated for antibacterial (Pseudomonas aeruginosa, Escherichia coli, Bacillus subtilis, Micrococcus luteus, Staphylococcus aureus, and Klebsiella pneumoniae), and antifungal activity (Candida albicans, Candida glabrata, Candida krusei, and Candida parapsilosis), by the disc diffusion method. The minimum inhibitory and minimum microbicidal concentrations of the oil were determined, as well as the synergistic effects of its application combined with the antibiotics ciprofloxacin and fluconazole, by the checkerboard method. Results: Thirty molecules were identified in the essential oil, comprising 96.27% of the total oil composition. Monoterpenes such as carvacrol (36.06%) were the most abundant compounds, followed by caryophyllene (14.67%), endo-borneol (9.04%), pyroterebic acid (3.23%) and caryophyllene oxide (3.13%). The oil exhibited a moderate antimicrobial activity with inhibition zone diameters ranging from 9.0 to 15.0 mm. The minimum inhibitory concentration values varied between 0.9 and 14.7 mg/mL, and Bacillus subtilis and Escherichia coli were the more sensitive bacteria with 0.9 and 1.9 mg/mL, respectively. The minimum microbicidal concentration values ranged from 0.4 to 14.7 mg/mL. A significant synergic action was observed when the oil was applied in combination with ciprofloxacin and fluconazole, with fractional inhibitory concentration index values ranging from 0.31 to 0.50. Synergy was found in 80% of the combinations and a 2 to 16-fold reduction of antibiotics MIC was observed. Conclusions: Our findings suggest that the essential oil of Centroceras clavulatum should be further appraised for its potential use in the management of multi-drug resistant microorganisms, with the purpose to restore the activity of standard antimicrobial drugs.

In vitro antimicrobial and synergistic effect of essential oil from the red macroalgae Centroceras clavulatum (C. Agardh) Montagne with conventional antibiotics

Objective: To study the chemical profile, antimicrobial properties, and synergistic effect with known antibiotics of essential oil extracted from the marine red macroalgae Centroceras clavulatum (C. Agardh) Montagne, collected in Morocco. Methods: The chemical composition of the oil was analyzed by gas chromatography-mass spectrometry. The oil was evaluated for antibacterial (Pseudomonas aeruginosa, Escherichia coli, Bacillus subtilis, Micrococcus luteus, Staphylococcus aureus, and Klebsiella pneumoniae), and antifungal activity (Candida albicans, Candida glabrata, Candida krusei, and Candida parapsilosis), by the disc diffusion method. The minimum inhibitory and minimum microbicidal concentrations of the oil were determined, as well as the synergistic effects of its application combined with the antibiotics ciprofloxacin and fluconazole, by the checkerboard method. Results: Thirty molecules were identified in the essential oil, comprising 96.27% of the total oil composition. Monoterpenes such as carvacrol (36.06%) were the most abundant compounds, followed by caryophyllene (14.67%), endo-borneol (9.04%), pyroterebic acid (3.23%) and caryophyllene oxide (3.13%). The oil exhibited a moderate antimicrobial activity with inhibition zone diameters ranging from 9.0 to 15.0 mm. The minimum inhibitory concentration values varied between 0.9 and 14.7 mg/mL, and Bacillus subtilis and Escherichia coli were the more sensitive bacteria with 0.9 and 1.9 mg/mL, respectively. The minimum microbicidal concentration values ranged from 0.4 to 14.7 mg/mL. A significant synergic action was observed when the oil was applied in combination with ciprofloxacin and fluconazole, with fractional inhibitory concentration index values ranging from 0.31 to 0.50. Synergy was found in 80% of the combinations and a 2 to 16-fold reduction of antibiotics MIC was observed. Conclusions: Our findings suggest that the essential oil of Centroceras clavulatum should be further appraised for its potential use in the management of multi-drug resistant microorganisms, with the purpose to restore the activity of standard antimicrobial drugs.

A importância da farmácia clínica no contexto hospitalar / The importance of clinical pharmacy in the hospital context / La importancia de la farmacia clínica en el contexto hospitalario

Objetivo: Descrever a importância e a contribuição da farmácia clínica na promoção em saúde dentro de uma organização hospitalar, destacando os consensos sobre esta temática na literatura científica especializada. Método: revisão narrativa realizada por meio de busca online na Biblioteca Virtual de Saúde, com os seguintes descritores: Farmácia clínica; Hospital; Farmacêutico. Delimitou-se o período de 2010 a 2020, ou seja, nos últimos 10 anos, e artigos disponibilizados na íntegra. Os dados de cada estudo foram extraídos, sendo elaborado um quadro com as principais variáveis para analisar o perfil dos artigos coletados. Resultados: Após o cruzamento dos descritores, foi possível encontrar uma amostra de 64 artigos inicialmente. Adotando o critério de inclusão relacionado à necessidade de os artigos serem publicados no idioma português, dos últimos 10 anos e disponibilizados em sua íntegra, observou-se que, deste total, 31 atendiam a estes critérios. Por fim, a amostra final foi composta por 12 artigos. O farmacêutico clínico hospitalar tem diferentes responsabilidades, contribuindo para a promoção à saúde através da aquisição, provisão e controle de insumos essenciais ao paciente internado; tem função indispensável na prevenção de reações adversas e dos riscos das interações medicamentosas; garante a segurança do paciente por meio do uso racional dos medicamentos prescritos pelos médicos; e tem uma participação ativa na adesão ao tratamento e prevenção de agravos em geral. Considerações finais: a farmácia clínica hospitalar apresenta importância para a saúde pública de uma forma geral e o farmacêutico clínico torna-se uma peça chave dentro da equipe multiprofissional hospitalar

Objective: To describe the importance and contribution of clinical pharmacy in health promotion within a hospital organization, highlighting the consensus on this topic in the specialized scientific literature. Method: narrative review carried out through an online search in the Virtual Health Library, with the following descriptors: Clinical pharmacy; Hospital; Pharmaceutical. The period from 2010 to 2020 was delimited, that is, in the last 10 years, and articles made available in full. The data for each study were extracted, and a table was created with the main variables to analyze the profile of the collected articles. Results: After crossing the descriptors, it was possible to find a sample of 64 articles initially. Adopting the inclusion criterion related to the need for articles to be published in the Portuguese language, from the last 10 years and made available in its entirety, it was observed that, of this total, 31 met these criteria. Finally, the final sample consisted of 12 articles. The hospital clinical pharmacist has different responsibilities, contributing to health promotion through the acquisition, provision and control of essential supplies to inpatients; it plays an indispensable role in preventing adverse reactions and the risks of drug interactions; guarantees patient safety through the rational use of medicines prescribed by doctors; and has an active participation in adherence to treatment and prevention of diseases in general. Final considerations: the hospital clinical pharmacy is important for public health in general and the clinical pharmacist becomes a key part of the hospital multiprofessional team

Objetivo: Describir la importancia y contribución de la farmacia clínica en la promoción de la salud dentro de una organización hospitalaria, destacando el consenso sobre este tema en la literatura científica especializada. Método: revisión narrativa realizada mediante búsqueda online en la Biblioteca Virtual en Salud, con los siguientes descriptores: Farmacia clínica; Hospital; Farmacéutico. Se definió el período de 2010 a 2020, es decir, en los últimos 10 años, y se pusieron a disposición los artículos en su totalidad. Se extrajeron los datos de cada estudio y se elaboró una tabla con las principales variables para analizar el perfil de los artículos recolectados. Resultados: Luego de cruzar los descriptores, fue posible encontrar inicialmente una muestra de 64 artículos. Adoptando el criterio de inclusión relacionado con la necesidad de que los artículos se publiquen en lengua portuguesa, de los últimos 10 años y estén disponibles en su totalidad, se observó que, de este total, 31 cumplían con estos criterios. Finalmente, la muestra final estuvo conformada por 12 artículos. El farmacéutico clínico hospitalario tiene diferentes responsabilidades, contribuyendo a la promoción de la salud a través de la adquisición, provisión y control de insumos esenciales para pacientes hospitalizados; juega un papel indispensable en la prevención de reacciones adversas y los riesgos de interacciones medicamentosas; garantiza la seguridad del paciente mediante el uso racional de los medicamentos recetados por los médicos; y tiene una participación activa en la adherencia al tratamiento y prevención de enfermedades en general. Consideraciones finales: la farmacia clínica hospitalaria es importante para la salud pública en general y el farmacéutico clínico se convierte en una pieza clave del equipo hospitalario multiprofesional.

Development and psychometric evaluation of performance-based upper extremity motor control test (PB-UE-MCT) for people with cerebral palsy / Desenvolvimento e avaliação psicométrica do Teste de Controle Motor das Extremidades Superiores com Base no Desempenho (PB-UE-MCT) para pessoas com paralisia cerebral

Abstract Introduction Upper extremity disorders limits the performance in the activities of daily living, especially, in bilateral (two-handed) activities. Objective This study was designed to develop a performance-based upper extremity motor control test (PB-UE-MCT) and to measure its psychometric properties (including, convergent validity, intrarater reliability, and interrater reliability) for people with cerebral palsy (CP). Method The PB-UE-MCT was developed in three phases, including planning, construction, and psychometric evaluation. The participants included 50 people with CP with an age range of 6 to 18 years. To measure internal consistency, Cronbach's alpha was run (n=50). Intrarater and interrater reliability was measured for 25 participants. To assess convergent validity, the correlations of the PB-UE-MCT with the Manual Ability Classification System (MACS) and with the Selective Control Upper Extremity Scale (SCUES) were calculated. Results The values obtained for Cronbach's alpha (.90 to .96) indicated the excellent internal consistency of the PB-UE-MCT. The ICC values for intrarater reliability and interrater reliability were between .84 and .99 and between .89 and .99, respectively. The correlation coefficients obtained for the items of the PB-UE-MCT and those of the MACS were between .51 and .73. The correlation coefficients of the items of the PB-UE-MCT with those of the SCUES were in the range of .67 to .98, which proves the PB-UE-MCT's good to excellent levels of convergent validity. Conclusion The results confirm that the PB-UE-MCT is a valid and reliable tool for evaluating the upper extremity performance of people with CP through task analysis.

Resumo Introdução Distúrbios dos membros superiores limitam o desempenho nas atividades da vida diária, especialmente em atividades bilaterais (com as duas mãos). Objetivo Desenvolver um teste de controle motor de membros superiores baseado em desempenho (PB-UE-MCT) para avaliar pessoas com paralisia cerebral espástica. Método O PB-UE-MCT inclui planejamento, construção e avaliação psicométrica. Os participantes incluíram 50 pessoas com paralisia cerebral entre 6 e 18 anos. Para medir a consistência interna, o alfa de Cronbach foi executado (n = 50). A confiabilidade intra-examinador foi medida para 25 participantes que realizaram o teste duas vezes com um intervalo de duas semanas. Para confiabilidade entre avaliadores, dois examinadores administraram separadamente o teste a 25 participantes. Para avaliar a validade convergente, foram calculadas as correlações do PB-UE-MCT com o Manual Ability Classification System (MACS) e com a Selective Control Upper Extremity Scale (SCUES). Resultados Os valores obtidos para o alfa de Cronbach (0,90 a 0,96) indicaram a excelente consistência interna do PB-UE-MCT. Os valores de ICC para confiabilidade intraexaminador e confiabilidade interexaminador estavam entre 0,84 e 0,99 e entre 0,89 e 0,99, respectivamente. Os coeficientes de correlação obtidos para os itens do PB-UE-MCT e do MACS ficaram entre 0,51 e 0,73. Os coeficientes de correlação dos itens do PB-UE-MCT com os das SCUES situaram-se na faixa de 0,67 a 0,98, o que comprova os níveis de validade convergente bons a excelentes do PB-UE-MCT. Conclusão O PB-UE-MCT é uma ferramenta válida e confiável para avaliar o desempenho dos membros superiores de pessoas com paralisia cerebral durante a realização de tarefas.

COVID-19 during pregnancy: vertical transmission, diagnosis and maternal-fetal complications

The current pneumonia outbreak of COVID-19 has been declared a pandemic by the World Health Organization on March 11, 2020. With its indiscriminate spread across continents, authors are likely to see women with COVID-19 canvassed across all trimesters of pregnancy. To date, few reports have provided information about this disease in pregnant patients. Authors conducted a literature review to summarize the results concerning intrauterine transmission, diagnostic challenges and maternal-fetal outcomes of pregnant women with COVID-19 pneumonia.

Vertical transmission of SARS-CoV-2: a brief literature review

As COVID-19 virus is still spreading, more infections in pregnant women are likely to be seen. At this time, very little is known about vertical transmission of SARS-COV-2 from infected pregnant woman to her infant. Authors reviewed the risk of vertical transmission of COVID-19 by using data of published articles and official websites up to May 11, 2020. The searches revealed 16 articles (12 case reports/series and 4 retrospective studies) collectively comprising 194 infected pregnant women with COVID-19. 140 cases of neonates delivered from pregnant women with COVID-19 were collected. The SARS-COV-2 nucleic acid test, in day 2, was positive in 4 newborns. Based on limited data, there is no evidence for vertical transmission of COVID-19. Some studies suggestive of maternal-fetal transmission deserve careful evaluation before a definitive finding.

Contrasting the expression pattern change of polyamine oxidase genes and photosynthetic efficiency of maize (Zea mays L.) genotypes under drought stress

The aim of this study was to contrast the effects of drought stress on polyamine oxidases gene expression andactivity as well as photosynthetic efficiency in relatively tolerant (Karoon) and sensitive (260) maize genotype.d Reduction in leaf relative water content as a result of drought led to increase in root growth, butdiminished shoot growth indices. Under drought stress, activity of antioxidant enzyme, catalase, significantlyincreased in both genotypes, whereas significant higher activity of superoxide dismutase and peroxidase wasonly observed in Karoon genotype. Expression of polyamine oxidase (PAO) genes (zmPAO1, zmPAO2,zmPAO3, zmPAO4, zmPAO5, zmPAO6) and activity of enzymatic polyamine oxidation was increased in bothgenotypes under drought stress. The enhancement in PAO gene expression and enzyme activity was moreprominent in Karoon cultivar compared to 260. Chlorophyll a fluorescence and fast induction kinetics werenegatively influenced by drought stress. These parameters were more affected in 260 cultivar compared withKaroon. Our results suggest that under drought stress, higher activity of polyamine oxidase pathway in backconversion of Spermine and spermidine to putrescine (protectant of photosynthetic apparatus) as well as higherantioxidant enzymes activity in Karoon cultivar, may play a role in higher efficiency of photosynthetic processin this cultivar

Comparison of Two Different Ozone Injection Sites for Knee Osteoarthritis, Tibio-femoral Joint versus Supra-patellar Recess: An Open Randomized Clinical Trial

Background:The aim of this study was to compare the efficacy of ozone injection at Tibio-femoral joint with Supra-patellar recess on knee osteoarthritis (OA).Methods: In this randomized, controlled clinical trial, 99 patients with symptomatic knee OA were randomized into two groups. 47 patients selected to receive 7-8 ml ozone (20 μg/ml) through Tibio-femoral joint injection, and 49 patients received 10 ml ozone (20μg/ml) through supra-patellar recess injection by using in-plane ultrasound-guided. The primary outcome was the change from baseline in the visual analogue scale (VAS)(0-100 mm) pain score during 3 months after injection. Secondary outcome measures included the Western Ontario and McMaster universities OA Index (WOMAC), Lequesne index, time “Up and Go” (TUG) test, single-limb stance (SLS) tests, patient satisfaction, and adverse effects. All of these measurements were evaluated at the base time, 48 hours, 2 weeks, 1 month, 2 months, and 3 months after injection.Results:Both groups had significantly improvement in the primary and secondary outcome measures. VAS pain score except at the 3–month follow-up (16.8±13.3 versus 18.1±16.6, 95% CI, -7.33 to 4.73, p =0.6), WOMAC pain score, WOMAC stiffness score at all evaluated times, and WOMAC total score at 48 hours after injection (95% CI, -19.4 to -4.9) were significantly better among Tibio-femoral ozone injection compare to Supra-patellar recess injection (95% CI, -20.68 to -6.51,p<0.001)). In both groups satisfaction, TUG and SLS times were improved, but no significant difference was seen between groups (p>0.05). At the 3-month follow-up, WOMAC pain and total scores for only Tibio-femoral joint injection group as well as WOMAC function, TUG and SLS times for both groups were gradually coming back to the baseline.Conclusion:Ozone injection in both groups was associated withpain relief, functional improvement, and quality of life in patient with knee OA. Pain and stiffness of joint were improved better in Supra-patellar recess ozone injection

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial

OBJECTIVES@#One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO.@*MATERIALS AND METHODS@#This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).@*RESULTS@#Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122).@*CONCLUSION@#Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial

OBJECTIVES@#One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO.@*MATERIALS AND METHODS@#This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).@*RESULTS@#Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122).@*CONCLUSION@#Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

Preoperative imaging of the inferior alveolar nerve canal by cone-beam computed tomography and 1-year neurosensory recovery following mandibular setback through bilateral sagittal split ramus osteotomy: a randomized clinical trial

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO.MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122).CONCLUSION: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

High-grade endometrial stromal sarcoma :a case report

Uterine sarcomas are tumors of poor prognosis characterized by a great histopathological heterogeneity. High endometrial stromal sarcomas (ESS) occurring at a late age, with high mitotic activity and / or tumor necrosis, are very poorly prognostic tumors.If it is accepted that the standard treatment of uterine sarcomas is surgical, the place of adjuvant treatment remains controversial.We report a case of a high-grade ESS referred to initially on MRI and diagnosed on pathological examination of a hysterectomy performed in a 64-year-old postmenopausal woman with postmenopausal bleeding.

Efeitos citotóxicos da duloxetina nas linhagens celulares MKN45 e NIH3T3 e efeitos genotóxicos em linfócitos sanguíneos periféricos humanos / Cytotoxic effects of duloxetine on mkn45 and nih3t3 cell lines and genotoxic effects on human peripheral blood lymphocytes

ABSTRACT BACKGROUND: Gastric cancer is the second leading cause of cancer-related death globally. Unfortunately, the survival rate of the gastric cancer patients who underwent chemotherapy following surgery has been less than a half. Besides, chemotherapy has many side effects. Current evidence suggests that some antidepressants like duloxetine have growth-inhibiting effects against a number of cancer cell lines. OBJECTIVE: Thus, the aim of this study was to determine the cytotoxic and genotoxic effects of duloxetine on gastric cancer. METHODS: In this regard, the cytotoxicity and genotoxicity of duloxetine were investigated in MKN45 and NIH3T3 cell lines by MTT assay and on peripheral blood lymphocytes by MN assay. For this purpose, cells were cultured in 96 wells plate. Stock solutions of duloxetine and cisplatin were prepared. After cell incubation with different concentrations of duloxetine (1, 10, 25, 50, 100 and 200 μL), MTT solution was added. For micronucleus assay fresh blood was added to RPMI culture medium 1640 supplemented, and different concentrations of duloxetine (1, 10, 25, 50, 100 and 200 μL) were added. RESULTS: The cytotoxicity of duloxetine on MKN45 cancer cell line and NIH3T3 normal cell line were studied followed by MTT assay. duloxetine exhibited higher IC50 in the MKN45 cells in comparison with the NIH3T3 cells. In addition, genotoxic effect of duloxetine was evaluated by micronucleus assay. The results revealed that duloxetine induced more DNA damage at 100 and 200 μM and no significant difference at 200 μM with respect to cisplatin, but it had less genotoxic effects at 100 and 50 μM concentrations. CONCLUSION: Although, in this study, duloxetine had less genotoxicity than cisplatin in concentrations under 200 μM and showed cytotoxic effects as well, due to its IC50, it cannot be considered as a better choice for gastric cancer therapies with respect to cisplatin as a common anticancer drug.

RESUMO CONTEXTO: O câncer gástrico é a segunda principal causa de morte relacionada ao câncer globalmente. Infelizmente, a taxa de sobrevivência dos pacientes com câncer gástrico que se submeteram à quimioterapia após a cirurgia, tem sido inferior à metade. Além disso, a quimioterapia tem muitos efeitos colaterais. Evidências atuais sugerem que alguns antidepressivos como a duloxetina têm efeitos inibidores de crescimento contra um número de linhas de células cancerosas. OBJETIVO: Assim, o objetivo deste estudo foi determinar os efeitos citotóxicos e genotóxicos da duloxetina sobre o câncer gástrico. MÉTODOS: A este respeito, a citotoxicidade e a genotoxicidade da duloxetina foram investigadas em linhas celulares MKN45 e NIH3T3 por ensaio de MTT e por ensaio de MN em linfócitos periféricos de sangue. Para este efeito, as células foram cultivadas em 96 placas. Soluções de estoque de duloxetina e cisplatina foram preparadas. Após incubação celular com diferentes concentrações de duloxetina (1, 10, 25, 50, 100 e 200 μL), a solução de MTT foi adicionada. Para o teste do micronúcleo o sangue fresco foi adicionado ao meio de cultura RPMI 1640 suplementado, e as concentrações diferentes de duloxetina (1, 10, 25, 50, 100 e 200 μL) foram adicionadas. RESULTADOS: A citotoxicidade da duloxetina na linha celular cancerosa MKN45 e NIH3T3 linha celular normal foram estudadas e seguidas pelo ensaio de MTT. A duloxetina exibiu maior IC50 nas células MKN45 em comparação com as células NIH3T3. Além disso, o efeito genotóxico da duloxetina foi avaliado pelo ensaio de micronúcleos. Os resultados revelaram que a duloxetina induziu mais dano de DNA em 100 e 200 μM e não houve diferença significativa em 200 μM em relação à cisplatina, mas teve menos efeitos genotóxicos nas concentrações de 100 e 50 μM. CONCLUSÃO: Embora, neste estudo, a duloxetina tenha menos genotoxicidade do que a cisplatina em concentrações inferiores a 200 μm e também tenha mostrado efeitos citotóxicos, devido ao seu IC50, não pode ser considerada como uma escolha terapêutica melhor para o câncer gástrico no que diz respeito à cisplatina como uma droga anticâncer comum.

Efeitos citotóxicos do aripiprazol nas linhagens celulares MKN45 e NIH3T3 e efeitos genotóxicos nos linfócitos sanguíneos periféricos humanos / Cytotoxic effects of aripiprazole on mkn45 and nih3t3 cell lines and genotoxic effects on human peripheral blood lymphocytes

ABSTRACT BACKGROUND: Gastric cancer is known as the fourth most common cancer. Current treatments for cancer have damaged the sensitive tissues of the healthy body, and in many cases, cancer will be recurrent. Therefore, need for treatments that are more effective is well felt. Researchers have recently shifted their attention towards antipsychotic dopamine antagonists to treat cancer. The anticancer activities of aripiprazole remain unknown. OBJECTIVE: This study aimed to evaluate the efficacy and safety of aripiprazole on gastric cancer and normal cell lines. METHODS: In this regard, the cytotoxicity and genotoxicity of aripiprazole were investigated in MKN45 and NIH3T3 cell lines by methyl tetrazolium assay and on peripheral blood lymphocytes by micronucleus assay. For this purpose, cells were cultured in 96 wells plate. Stock solutions of aripiprazole and cisplatin were prepared. After cell incubation with different concentrations of aripiprazole (1, 10, 25, 50, 100 and 200 μL), methyl tetrazolium solution was added. For micronucleus assay fresh blood was added to RPMI culture medium 1640 supplemented, and different concentrations of aripiprazole (50, 100 and 200 μL) were added. RESULTS: The finding of present study showed that the IC50 of aripiprazole in the cancer cell line (21.36 μg/mL) was lower than that in the normal cell line (54.17 μg/mL). Moreover, the micronucleus assay showed that the frequency of micronuclei of aripiprazole at concentrations below 200 μM was much less than cisplatin. CONCLUSION: Aripiprazole can be a good cytotoxic compound and good candidate for further studies of cancer therapy.

RESUMO CONTEXTO: O câncer gástrico é conhecido como o quarto câncer mais comum. Os tratamentos atuais para o câncer danificaram os tecidos sensíveis do corpo saudável e, em muitos casos, o cancro será recorrente. Portanto, a necessidade de tratamentos que são mais eficazes é desejada. Recentemente, os pesquisadores mudaram sua atenção para os antagonistas antipsicóticos da dopamina para tratar o câncer. As atividades anticâncer de aripiprazol permanecem desconhecidas. OBJETIVO: Este estudo objetivou avaliar a eficácia e a segurança do aripiprazol no câncer gástrico e nas linhagens celulares normais. MÉTODOS: A este respeito, a citotoxicidade e a genotoxicidade do aripiprazol foram investigadas em linhas celulares MKN45 e NIH3T3 por ensaio de metil tetrazólio e em linfócitos periféricos de sangue por ensaio de micronúcleos. Para este efeito, as células foram cultivadas em 96 placas. As soluções de estoque de aripiprazol e cisplatina foram preparadas. Após incubação celular com diferentes concentrações de aripiprazol (1, 10, 25, 50, 100 e 200 μL), a solução de metil tetrazólio foi adicionada. Para o ensaio do micronúcleo o sangue fresco foi adicionado ao meio de cultura RPMI 1640 suplementado, e as concentrações diferentes de aripiprazole (50, 100 e 200 μL) foram adicionadas. RESULTADOS: O presente estudo mostrou que o IC50 de aripiprazol na linhagem celular cancerosa (21,36 μg/mL) foi menor do que na linha celular normal (54,17 μg/ mL). Além disso, o ensaio de micronúcleos demonstrou que a frequência de micronúcleos de aripiprazol em concentrações inferiores a 200 μM foi muito inferior à cisplatina. CONCLUSÃO: O aripiprazol pode ser um bom composto citotóxico e bom candidato para estudos adicionais da terapia do câncer.

Cardiac abnormalities among chronic hemodialysis patients

Objective: The annual mortality of cardiovascular diseases of dialysis patients is higher than the general population. The tranc-thoracic echocardiography allows the evaluation of the heart structure and function within the trated patients by hemodialysis in order to identify patients with cardiovascular high risk. Methods: This work is a descriptive retrospective study. The objective is to determine the major cardiac abnormalities diagnosed with echocardiography in patients with chronic hemodialysis and to list their epidemiological, clinical and biological characteristics at the time of the study. Results: The average age of our patients is of 50.2 ± 7 years with an average hemodialysis endurance of 12.1± 2.4 years. The main etiologies of the chronic renal failure were essentially the diabete type 2, the arterial hypertension and chronic nephritis tubule-interstitial. The most cardiac abnormalities was the left ventricular hypertrophy. The presence of a systolic or diastolic arterial hypertension has been noted as a significant factor fostering the LVH within the chronic hemodialysis (p=0.002).The anemia is not said to be associated to the development of the left ventricular hypertrophy(p=0.09). Conclusions: This study revealed the etiology leading to chronic renal failure insufficiency. Echocardiography accurately diagnosed cardiac abnormalities such as left ventricular hypertrophy. The study allowed to detect the factors involved in the development of this HVG especialy systolic arterial hypertension. This result permit us to act on these factors in order to prevent the cardiovascular events to which hemodialysis patients will be exposed.

A Survey on the Short-term Outcome of Microlumbar Discectomy with General versus Spinal Anesthesia

BACKGROUND: Surgery on the lower thoracic and lumbosacral spine is possible with both general and spinal anesthesia, but most spine surgeons are reluctant to perform the surgery with spinal anesthesia. We aimed to conduct a survey on the short-term outcome of microlumbar discectomy in the patients who had been treated under general or spinal anesthesia. METHODS: In this prospective study, we performed a survey on 72 patients who underwent microlumbar discectomy under general anesthesia (group A) or spinal anesthesia (group B). Demographic characteristics, American Society of Anesthesiologists physical status, duration of operation, blood loss, and complications were all documented. Preoperative and early postoperative (at the time of discharge) disability and pain were assessed by using Japanese Orthopedic Association (JOA) scoring system and a visual analog scale questionnaire. RESULTS: The two groups were homogenous preoperatively. The mean intraoperative blood loss was less and the mean operating time was shorter in group A than in group B, but there was no statistically significant difference between groups. The rate of postoperative improvement in JOA score and improvement in pain were similar between groups. Anesthetic complications were unremarkable. CONCLUSIONS: Simple lumbar disc operations in the otherwise healthy patients can be safely performed under either spinal or general anesthesia. Both anesthetic methods led to comparable outcomes with minimal complications.

Downregulation of extracellular matrix and cell adhesion molecules in cumulus cells of infertile polycystic ovary syndrome women with and without insulin resistance

Objective: The extracellular matrix [ECM] of the cumulus oocyte complex [COC] is composed of several molecules that have different roles during follicle development. This study aims to explore gene expression profiles for ECM and cell adhesion molecules in the cumulus cells of polycystic ovary syndrome [PCOS] patients based on their insulin sensitivity following controlled ovarian stimulation [COS]

Materials and Methods: In this prospective case-control study enrolled 23 women less than 36 years of age who participated in an intracytoplasmic sperm injection [ICSI] program. Patients were subdivided into 3 groups: control [n=8, fertile women with male infertility history], insulin resistant [IR] PCOS [n=7], and insulin sensitive [IS] PCOS [n=8]. We compared 84 ECM component and adhesion molecule gene expressions by quantitative real-time polymerase chain reaction array [qPCR-array] among the groups

Results: We noted that 21 of the 84 studied genes differentially expressed among the groups, from which 18 of these genes downregulated. Overall, comparison of PCOS cases with controls showed downregulation of extracellular matrix protein 1 [ECM1]; catenin [cadherin-associated protein], alpha 1 [CTNNA1]; integrin, alpha 5 [ITGA5]; laminin, alpha 3 [LAMA3]; laminin, beta 1 [LAMB1]; fibronectin 1 [FN1]; and integrin, alpha 7 [ITGA7]. In the IS group, there was upregulation of ADAM metallopeptidase with thrombospondin type 1 motif, 8 [ADAMTS8] and neural cell adhesion molecule 1 [NCAM1] compared with the controls [P<0.05]

Conclusion: Downregulation of ECM and cell adhesion molecules seem to be related to PCOS. Gene expression profile alterations in cumulus cells from both the IS and IR groups of PCOS patients seems to be involved in the composition and regulation of ECM during the ovulation process. This study highlights the association of ECM gene alteration as a viewpoint for additional understanding of the etiology of PCOS