Evaluation of dry eyes in children with vernal kerato-conjunctivitis using clinical tests and ocular surface analysis

Purpose: To evaluate dry eyes in children with vernal kerato?conjunctivitis (VKC) and correlate it with symptoms, clinical findings, and ocular surface analysis (OSA) parameters. Methods: Children with clinically diagnosed VKC underwent complete ophthalmological examination, Schirmer’s testing, modified ocular surface disease index (OSDI) scoring, Bonini grading, fluorescein tear?film break?up time (TBUT), VKC – Collaborative Longitudinal Evaluation of Keratoconus (CLEK) scoring, and OSA. Children with a TBUT of < 10 s were defined to have dry eyes. The above?mentioned parameters were compared between dry eye and non?dry eye VKC children. Results: The mean age of the 87 children included in the study was 9.1 ± 2.9 years. Dry eyes were seen in 60.9% [95% confidence interval (CI); 51% to 71%]. The mean TBUT was 13.4 ± 3.8 and 5.9 ± 1.9 s in non?dry and dry eye groups, respectively (P < 0.001). The mean value of Schirmer’s test was 25.9 ± 9.8 and 20.8 ± 8.6 mm in the non?dry and dry eye groups, respectively (P = 0.01). The two groups did not differ in their OSDI scores, Bonini grading, and CLEK scores. The OSA parameter of non?invasive break?up time (NIBUT) was 8.3 ± 3.2 s in non?dry eye group and 6.4 ± 2.9 s in dry eye group, P = 0.008. The lower lid Meibomian gland (MG) loss was 7.4% in non?dry eye group and 12.2% in dry eye group, P = 0.028. Other OSA parameters did not differ significantly among the two groups. Conclusion: Dry eyes are seen in two?thirds of pediatric VKC. Evaluation of dry eyes should be incorporated in their clinical evaluation. Among OSA parameters, NIBUT and lower lid MG loss are associated with dry eyes in pediatric VKC patients.

Estimation and comparison of thrombocyte count by peripheral blood smear method and automated method in women with pregnancy

Background: Thrombocyte is important and very essential component of blood and have significant role in maintenance of hemostasis. Thrombocyte count is an important investigation done in various acquired and congenital coagulable states which include conditions like pregnancy. Thrombocyte count is routinely done by automated hematology analyzer method. The automated hematology analyzer counters are not usually available at all centres especially in peripheral and rural side though thrombocytes can also be assessed from the peripheral blood smears, which can be easily and precisely done at any set up. Aim and objective of this study was to compare the thrombocyte estimation by peripheral blood smear method and automated hematology analyzer in pregnant women.Methods: Thrombocyte estimation was done from samples taken from 120 normal pregnant women between December 2018 to March 2019, where samples were Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated. Thrombocyte was counted manually using PBS (Leishman stain) and hematology analyzer (Sysmex XN1000 series). Thrombocyte counts were expressed in Mean and standard Deviation. Statistical analysis was done by student’s t test using MS excel and SPSS version 17.Results: Thrombocyte count by PBS have mean value of 2.04 lacs/mm3 with standard deviation of 0.56 lacs/mm3 and by automated method have mean value of 1.89 lacs/mm3 and standard deviation of 0.71 lacs/mm3 with p value 0.010. Thus, there was no statistically significant difference found between two methods.Conclusions: Estimation of thrombocyte count on the basis of manual thrombocyte count is a reliable technique and can be used to validate automated thrombocyte counts. It can also be used in under resourced laboratories, where there are no automated counters of good precision available. In fact, all the tests showing abnormal thrombocyte counts must be reported only after cross examining on PBS.

Development of α-tocopherol surface-modified targeted delivery of 5-fluorouracil-loaded poly-D, L-lactic-co-glycolic acid nanoparticles against oral squamous cell carcinoma

Objective: The aim of the study to develop surface modified targeted moiety α-tocopherol (α-t) encapsulated with 5-fluorouracil (5-FU)-poly-D, L-lactic-co-glycolic acid nanoparticles (PLGA NPs) toward the anticancer activity against oral squamous cell carcinoma (OSCC). Materials and Methods: 5-FU was conjugated with the polymer, PLGA by ionic cross-linking and α-tocopherol use as a functionalized surface moiety. Characterization, drug entrapment efficiency, and in-vitro drug release system were optimized at different pH 7.4 and pH 4.5. The in-vitro cell was performed to optimize the anticancer activity through MTT assay and apoptotic staining assay was also performed by flow cytometry to evaluate the cellular apoptotic activity and cellular uptake. Results: The particle size was distributed within an average range of 145–162 nm, the polydispersity index values lie 0.16–0.30, and the surface charge was at the negative side, –17mV to –23mV. The in vitro drug release system showed more sympathetic situation at pH 7.4 as compared to pH 4.5, for targeted NPs, approximately 86% and 69%, respectively. The non-targeted 5-FU-PLGA NPs showed drug release of 83% and 64% at pH 7.4 and 4.5 subsequently. In vitro anticancer activity confirmed the intense inhibition by α-t-FU-PLGA NPs of 79.98% after 96 h treatment of SCC15 cells and confirmed the steady-state inhibition of 83.74% after 160 h incubation in comparison to 5-FU-PLGA NPs. Subsequently, the early apoptosis, 27.98%, and 16.45%, and late apoptosis, 47.29%, and 32.57%, suggested the higher apoptosis rate in targeted NPs against OSCC. Conclusions: The surface modified α-t-FU-PLGA NP was treated over SCC15 cells, and the oral cancer cells have shown the high intensity of cellular uptake, which confirmed that the target moiety has successfully invaded over the surface of cancer cells and shown advanced targeted delivery against OSCC

Comparison of Efficacy and Tolerability of Immediate Release Glucosamine HCL And Glucosamine HCL Sustained Release Formulation in the Treatment of Knee Osteoarthritis; A Randomised Clinical Trial

Background: Osteoarthritis (OA) is the most common form of and a leading cause of chronic disability between fourth and fifth decade of life, with a prevalence ranging between 17-60.6% in India. Objective: To compare the efficacy and safety profile of glucosamine HCl- sustained release (GLU-SR) with that of Glucosamine HCl- immediate release (GLU-IR) in patients with knee osteoarthritis (OA). Methods: This was an open labelled, randomised, controlled trial conducted in a tertiary care hospital at Kanpur. The study involved 60 patients with knee OA, randomised to receive single oral dose of 1,500 mg GLU-SR and GLU-IR for 60 days with 30 patients in each group. The primary efficacy being reduction in pain and improvement in function was assessed using visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Intention-to-treat principle, repeated measure of ANOVA and mixed model analysis were used for statistical analysis. The history of adverse reactions experienced was collected throughout the study period. Results: There was a significant reduction in algo functional indices as primary outcome measure in both the groups (P < 0.001). A significant difference (P < 0.05) in the number of patients reporting ADR in the GLU-SR arm (38% lesser) was noted as compared to GLU-IR arm, with no difference in the use of rescue medications in both arms. Conclusions: From the observations made in this study it is concluded that GLU-SR is as effective as GLU-IR in the management of knee OA; with an advantage of having a better safety profile.

Rupture of Gravid Bicornuate Uterus as a Rare Cause of Acute Abdomen: A Case Report.

Pregnancy in rudimentary horn of uterus is a rare and fatal complication of mullerian duct anomaly. We report one such female presenting with acute abdomen and amenorrhea to highlight the importance of keeping this in differential diagnosis of acute abdomen of women of child bearing age.

Anti-cancerous/Anti-bacterial Activities of Allicin Generated In situ from Diastereo Pure Alliins by Alliinase.

Aims: To facilitate allicin generation in-situ from pure diastereomers of alliin by enzymatic reaction of alliinase and assess its anti-cancerous/anti-bacterial activities. Study Design: Chemical synthesis and in-vitro assay of anti-cancerous/anti-bacterial activities. Place and Duration of Study: Protein Research Laboratory, Research Resources Center, University of Illinois at Chicago, between February 2014 and February 2015. Methodology: Cancer cell viability assay MTT assay, bacterial plate-diffusion growth inhibition assay, and flow cytometry cell cycle analysis have been used to demonstrate the anticancerous/ anti-pathogen activities of the in-situ allicin. Diastereomers of alliin are produced by H2O2 oxidation of deoxyalliin, which is prepared by mixing L-cysteine and allyl bromide. Deoxyalliin and diastereomers of alliin are purified to high purity with repeated fractional crystallization. In addition, fluorenylmethyloxycarbonyl (Fmoc) protected alliin and alliin methyl ester are synthesized and purified with RP-HPLC to test the importance of amino and carboxyl groups of alliin in alliinase enzymatic reaction. Alliinase is produced by a simple and effective method from an aqueous garlic extract Results: Results from spectrophotometric alliinase activity assay indicate that (+)-L-alliin is more reactive toward alliinase than (-)-L-alliin, and both amino and carboxyl groups of the cysteine portion of alliin are critical in alliinase enzymatic reaction. Results from cancer cell viability assay MTT assay, bacterial plate-diffusion growth inhibition, and flow cytometry cell cycle analysis confirm that the in-situ allicin is as active as allicin purified from aqueous garlic extract or allicin synthesized chemically in a dose-dependent manner. Conclusion: We describe here facile pathways to synthesize diastereomerically pure alliins and isolate allinase. The in-situ allicin conversed from alliin by allinase is very active. The data obtained here provide useful information on the design of the in-situ allicin strategy.

Anomalous Branching Pattern of Axillary Artery on Relation to Long Thoracic Nerve and its Clinical Significance.

An unusual anomalous branching pattern of axillary artery was observed in the middle aged male cadaver during routine cadaveric dissection. The lateral thoracic artery was found to emerge from third part of axillary artery forming a common trunk with subscapular artery and posterior circumflex humeral on left side. It was also noted that, the long thoracic nerve was passing between the two branches of lateral thoracic artery. Such course of long thoracic nerve makes it highly vulnerable to compression and injury, which may manifest as winging scapula. Sound knowledge of such neurovascular variations is important for surgeons, anesthesiologists and orthopedic surgeons, which may prevent diagnostic errors.

Comparison of the Effect of Glitazones and DPP-IV Inhibitors in Type 2 Diabetics as Add on Therapy on Insulin Sensitivity and Serum hs-CRP Levels.

To study & compare the effect of glitazones and DPP-IV inhibitors as add on therapy on Insulin sensitivity and serum hs-CRP levels in type 2 diabetes mellitus patients.Thirty patients (previously known cases of type 2 DM), aged above 18 years, were randomly included in the study. Group A, Glimepiride + Metformin + Pioglitazone (G + M + P) and Group B, Glimepiride + Metformin + Sitagliptin (G + M+ S). The study drugs were given on the basis of physician's discretion and the doses of study drugs were fixed according to their clinical presentation & followed up for a period of 3 months.The glycosylated haemoglobin (HbA1c) at the start of study (day 0) of group A was 10.39 ± 0.67 and in group B was 10.10 ± 0.62.The mean value of HbA1c at the end of the study period (day 90) in group A was 9.46 ± 0.61 and in group B was 9.04 ± 0.58. Insulin resistance at the start of the study (day 0) in group A, was 5.549 ±0.59 and in group B was 6.66 ± 0.76, The mean values of IR at the day 90, in group A was 3.42 ± 0.37 and in group B was 3.82 ± 0.61. The mean value of hs-CRP at the start of study (day 0) in group A was 4.34 ± 0.77 and in group B was 6.78 ± 1.18. The mean value of hs-CRP at the end of the study period (day 90) in group A was 2.8 ± 0.63 and in group B was 4.51 ± 0.73. There was no significant intra group or intergroup difference found in the above mentioned study paramaters .Both the study drug groups reduced HbA1c, insulin resistance, though there was no any significant difference. There was decrease in hs-CRP levels in both the groups. Moreover these combination therapies were safe and no serious adverse effects were reported.

Ewing's Sarcoma of the Rhinomaxillary Complex: A case Report with Review of Literature.

Ewing's Sarcoma of bone (ESB) is a rare primary malignant tumor of bone, belonging to Ewing's Sarcoma Family of Tumors (EFT) and are neuro-ectodermal in origin. These tumors are characterized histopathologically as small round blue cell tumors (SRBCT) containing cytoplasmic glycogen, cytogenetically by a (t:11;22) or (q:24;12) translocation and molecularly by the presence of EWS and FLI1 fusion transcripts. ESB is primarily a pediatric tumor, uncommon in the Asian population, affecting the axial skeleton and rarely the jaw bones. ESB poses a diagnostic challenge as it shares many features with other malignant tumors whose managements are substantially different. We present the clinical, radiographic histopathological and immuno histochemical features of ESB involving the left rhinomaxillary complex in a young Indian male. We also discuss the differential diagnosis and current treatment modalities in management of ESB.

Human immunodeficiency virus-1 Tat protein: immunological facets of a transcriptional activator.

Human immunodeficiency virus-1 (HIV-1) infection is characterized by chronic immune activation and progressive loss of CD4+ T cells, leading to a wide array of immune dysfunction, particularly involving immune response directed against viral antigens. HIV-1 encodes for fifteen proteins, which might serve as a target for immune recognition. Immune response to the envelope proteins have been studied more due to their presence on the surface of the virus. Recent studies on HIV vaccine development have focused on the Gag and Pol proteins. The transactivator Tat and Rev proteins have also been the focus of immunization studies due to their potent regulatory activity. The Tat (transactivator of transcription) protein although being nuclear in localization is also released from infected cells and acts on uninfected cells. Extracellular Tat seems to play an important role in AIDS pathogenesis. Furthermore, a correlation has been found between anti-Tat immune response and slow progression of the disease. Although several studies have shown Tat as a potential vaccine candidate with encouraging results, there are also reports raising doubt about its efficacy in multi-component HIV vaccine strategy. Here, we have addressed the issue of immune response to the most indispensable HIV-1 regulatory protein Tat.

Biological response modifiers in cancer therapy.

Biological response modifiers improve the body's ability to fight cancer by immunostimulation. Although a century has passed since the first attempt was made to stimulate the host immune system against cancer, only the past decade has witnessed the scientific use of biological response modifiers. Recent advances in tumour immunology have enabled the development of specific agents targeted against cancer cells. Various biological response modifiers include monoclonal antibodies, interferons, interleukins, tumour necrosis factor, colony stimulating factors and anticancer vaccines. Monoclonal antibodies directed against tumour-specific agents have been approved for the treatment of breast cancer (trastuzumab), non-Hodgkin's lymphoma (rituximab) and for the diagnosis of certain cancers (oncoscint). Interferons are indicated for the treatment of certain leukaemias and Kaposi's sarcoma to inhibit tumour proliferation and angiogenesis. Interleukin-2 is the most widely studied interleukin, and is used for immunostimulation in metastatic renal cell carcinoma and malignant melanoma. Haematopoletic growth factors are often combined with chemotherapy and radiotherapy to restore bone marrow function and treat complications such as infection and bleeding. Thalidomide, which suppresses tumour necrosis factor-alpha production and has antiangiogenic properties, is currently under evaluation in several cancers. Various anticancer vaccines are being developed using tumour cells, carbohydrates, peptides and heat-shock proteins as antigens. DNA-based vaccinations and the use of recombinant bacteria and viruses to deliver antigens or the DNA coding for them are also being investigated. However, the optimum choice of antigen, delivery vector and adjuvant, and administration regimen for some of these biological response modifiers are still being investigated.