Magnetic ocular prosthesis for shallow contracted socket

Contracted sockets with poor retention of ocular prosthesis are difficult to manage especially when it is a dry socket. A 50-year-old lady with history of irradiation to the socket following enucleation for retinoblastoma reported to us with severe socket contracture, dry socket, and inadequate lid closure with a poorly retained ocular prosthesis. She was using a stone in the socket for support with a cracked stock ocular prosthesis placed over it. A two-piece ocular prosthesis was created with a base and shell with neodymium-boron-ferrous magnets in each part, with good retention and positioning, and this was cosmetically acceptable to the patient. To the best of our knowledge, this is the first report of such a two-piece magnetic ocular prosthesis.

Lipid profiles with increase blood lead level: Risk of cardiovascular disease in battery workers of Lucknow City.

In order to investigate the effects of lead exposure on risk of cardiovascular disease during Occupational battery workers i.e. lead exposure, plasma cholesterol and its fractions as high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride (T.G.) were determined in various battery workers in Lucknow city U.P., India. Increased risk of cardiovascular disease was observed in the various battery workers. Total cholesterol in the battery workers and control group was 142.14±31.92 (mg/dl) and 95.72±11.57 (mg/dl) respectively, which is higher in the battery workers than that of present in control group, While LDL cholesterol in the battery workers and control group was 158.30±22.70 (mg/dl) and 103.77± 4.62 (mg/dl) respectively. HDL cholesterol in the battery workers and control group was 38.80±10.13 (mg/dl) and 65.53±6.52 (mg/dl) respectively. The triglyceride levels were 162.06±90.85 (mg/dl) and 138.62±5.65 (mg/dl) in the battery workers and control group respectively, which is not affected [p > 0.05]. The LDL/HDL and Total cholesterol/HDL cholesterol ratio, Blood pressure, and blood lead level, was also higher in the battery workers, Results suggest that lead exposure increases cholesterol synthesis and transport to peripheral tissues whereas reverse cholesterol transport to the liver is not affected.

Concurrent mycetoma and chromomycosis.

Chromoblastomycosis and Madura foot are chronic localised mycotic infection of the skin and subcutaneous tissue that follows the implantation of the fungi through minor trauma, mainly found in persons working outdoors on bare foot. In cases where both Madura and chromoblastomycosis are present, the treatment becomes difficult with low cure rates and frequent relapses. Here, we present such a very rare case of a 38-year-old cattle farmer who presented with verrucose nodules, tumefaction and multiple discharging nodules on the left lower 1/3 rd leg and foot since last 9 years. Direct KOH mount of the verrucose tissue showed Fonsecaea pedrosoi sclerotic muriform bodies and a biopsy of one granule discharging nodule demonstrated fungal mycetoma. He was put on tab. Itraconazole 200 mg o.d. and cotrimoxazole bid for 6 months with very little improvement. The rarity of this combination is most probably due to different geographical distribution.

Functionalization and evaluation of PEGylated Carbon Nanotubes as novel Drug delivery for methotrexate.

Several delivery systems are developed to target methotrexate to cancer tissues with limited success due to low drug loading, size control, toxicity, and scale up and also the cost of formulation. Off late, carbon nanotubes have been projected as a promising carrier for many drugs including anticancer agents. The present work is an attempt to investigate the potentialities of multi-walled carbon nanotubes (MWCNT) as a carrier for targeting methotrexate to cancer tissues. MWCNTs were functionalized using DSPE-mPEG 2000 and was then reacted with methotrexate (MTX) to produce MWCNT-mPEG-MTX conjugate. The conjugate was characterized for particle size, loading efficiency, morphology & rate of drug release. The result indicated that about 2.26 mg of Methotrexate per mg of MWCNTs were loaded with 56.5% entrapment efficiency. Particle size of the MWCNT conjugate was found to be less than 200nm with polydispersity index of 0.286 post lyophilization of the product. The MWCNT conjugate was found to release the drug faster in acidic medium than at neutral pH. However, in both neutral and acidic media, the release was continuous over the period of 48 hours.

Assessment of urban air pollution and it’s probable health impact.

The present study deals with the quantitative effect of vehicular emission on ambient air quality during May, 2006 in urban area of Lucknow city. In this study, SPM, RSPM, SO2, NOx and 7 trace metals associated with RSPM were estimated at 10 representative locations in urban area and one village area for control. Beside this, air quality index (AQI), health effects of different metals and mortality were assessed. The 24 hr average concentration of SPM, RSPM, SO2 and NOx was found to be 382.3, 171.5, 24.3 and 33.8 μg m-3 respectively in urban area and these concentrations were found to be significantly (p<0.01) higher by 94.8, 134.8, 107.4 and 129.6% than control site respectively. The 24 hr mean of SPM and RSPM at each location of urban area were found to be higher than prescribed limit of National Ambient Air Quality Standard (NAAQS) except SPM for industrial area. The 24 hr mean concentration of metals associated with RSPM was found to be higher than the control site by 52.3, 271.8, 408.9, 75.81, 62.7, 487.54 and 189.5 % for Fe, Cu, Pb, Zn, Ni, Mn and Cr respectively. The inter correlation of metals Pb with Mn, Fe and Cr; Zn with Ni and Cr; Ni with Cr; Mn with Fe and Cu with Cr showed significant positive relation either at p<0.05 or p<0.01 level. Metals Pb, Mn and Cr (p<0.01) and Cu (p<0.05) showed significant positive correlation with RSPM. These results indicate that ambient air quality in the urban area is affected adversely due to emission and accumulation of SPM, RSPM, SO 2 , NO x and trace metals. These pollutants may pose detrimental effect on human health, as exposure of these are associated with cardiovascular and respiratory diseases, neurological impairments, increased risk of preterm birth and even mortality and morbidity.

Efficacy of species specific anti-scorpion venom serum (AScVS) against severe, serious scorpion stings (Mesobuthus tamulus concanesis Pocock)--an experience from rural hospital in western Maharashtra.

BACKGROUND: Death caused by scorpion envenoming is a common event in the tropical and subtropical countries including many regions in India. Severe scorpion envenoming causes an autonomic storm producing multi-system organ-failure (MSOF) and death. OBJECTIVES: To determine the efficacy of Anti-scorpion venom serum (AScVS) in patients stung by scorpions (Mesobuthus tamulus concanesis Pocock--earlier called Buthus tamulus); to compare it with other modalities of therapy and to detect complications, if any, arising out of AScVS treatment. METHODS: Total 48 patients of severe, serious scorpion envenoming syndrome were studied during the period from 1992 to 2002. In 17 patients AScVS was the only mode of treatment. Others had received adjunctive therapy along with AScVS. RESULTS: 47 patients out of 48 scorpion sting victims recovered completely. Recovery period in patients given AScVS (10 hours) was faster than those who received alpha blockers (16-42 hours). No anaphylactic reaction with AScVS was observed. CONCLUSIONS: AScVS is effective and safe method of therapy in severe scorpion envenoming syndrome.

Botulinum toxin in ophthalmic plastic surgery.

Botulinum toxin chemodenervation has evolved greatly over the past 30 years since its introduction in the 1970s for the management of strabismus. Among ophthalmic plastic surgeons, botulinum toxins are often used as the first line treatment for facial dystonias. These toxins are also efficacious for the temporary management of various other conditions including keratopathies (through so called chemo-tarsorraphy), upper eyelid retraction, orbicularis overaction-induced lower eyelid entropion, gustatory epiphora, Frey's syndrome, and dynamic facial rhytids such as lateral canthal wrinkles (crow's feet), glabellar creases and horizontal forehead lines. This article describes the pharmacology, reconstitution techniques and common current applications of botulinum toxins in ophthalmic plastic surgery.

Tumor retention and biodistribution studies of etoposide loaded tripalmitin nanoparticles after intratumoral administration in Dalton's Iymphoma tumor bearing mice

The objective of the present work is to study the biodistribution and tumor retention properties of etoposide (anticancer agent) and etoposide loaded tripalmitin nanoparticles (ETPL) after intratumoral administration in Dalton's lymphoma tumor bearing mice. ETPL nanoparticles were prepared by melt-emulsification and high pressure homogenization followed by spray drying technique. The nanoparticles were uniform and possessed 387 nm mean diameter and negative charge with excellent redispersibility in aqueous media. Radiolabeling of etoposide and ETPL nanoparticles with Technetium-99m (99mTc) resulted in complexes with high labeling efficiency and low radiocolloid formation. The labeled complexes showed good in vitro stability as indicated by low transchelation in presence of DTPA and cysteine and stability in human serum. Biodistribution and tumor retention studies were performed for etoposide and ETPL nanoparticles after intratumoral injection in mice bearing Dalton's lymphoma tumor. Etoposide experienced rapid clearance from the tumor, while the disposition of ETPL nanoparticles was slower. The tissue concentrations of ETPL nanoparticles increased with time (i.e. at 6h and 24h post injection) indicating its retention in tumor site for a longer time. Tumor retention of both etoposide and ETPL nanoparticles was studied upto 48h post injection. The tumor concentration of both etoposide and ETPL nanoparticles was high initially (8.57 percent and 41.8 percent injected dose at 0.5h post injection) and decreased with time (0.12 percent and 1.68 percent injected dose at 48h post injection). The concentration of etoposide rapidly declined from the tumor site while the tumor retention of ETPL nanoparticles was significantly higher than free etoposide (P < 0.001) at all the time points studied. The over all many fold higher tumor retention of ETPL nanoparticles (14 folds even at 48h post injection) compared to etoposide, coupled with lower tissue distribution signifies...

Radiolabeling, biodistribution and tumor imaging of stealth liposomes containing methotrexate

To study the utility of sterically stabilized liposomes (stealth liposomes) in tumor scintigraphy by studying its biodistribution and accumulation in target tissue after radiolabeling with Technetium-99m (99mTC). Conventional and Stealth liposomes were prepared by lipid film hydration method using methotrexate as model anticancer drug. Radiolabeling of the liposomes was carried out by direct labeling using reduced 99mTc. Experimental conditions for maximum labeling yield were optimized. The stability studies were carried out to check binding strength of the radiolabeled complexes. The blood kinetic study was carried out in rabbits after giving the labeled complex by intravenous administration through ear vein. The biodistribution studies were carried out in the Ehrlich ascites tumor (EAT) bearing mice after intravenous administration through tail vein, showed prolonged circulation in blood and significant increase in the accumulation in tumor for the sterically stabilized liposomes compared to the conventional liposomes. The gamma scintigraphic image shows the distribution of the stealth liposomes in liver, spleen, kidney and tumor. The study gives precise idea about the use of stealth liposomes in tumor scintigraphy and organ distribution studies.

Lymphatic transport of orally administered drugs.

Several therapeutic molecules such as lipophilic drugs and peptides suffer from the problems of low oral bioavailability. Improvement of their bioavailability and simultaneous prevention of the oral degradation of the prone molecules appears to be a challenge. Lymphatic system, which is responsible for the maintenance of fluid balance, immunity and metastatic spread of cancers, is also found to play a major role in the oral absorption of lipids and lipophilic drugs from intestine. The specialized structure of gut associated lymphoid tissue can be utilized as a gateway for the delivery of particulate systems containing drugs. Even though a large gap has existed in the field of lymphatic drug delivery, the introduction of a large number of lipophilic drugs and peptides has brought a renewed interest of research in this area. In this review, the mechanisms of intestinal lymphatic drug transport, approaches taken for the delivery of macromolecules, lipophilic and peptide drugs, biochemical barriers involved in intestinal drug absorption, and animal models used in the studies of intestinal lymphatic drug transport has been discussed.

Issues related to disability in India: a focus group study.

BACKGROUND: Systematic research into disability has been scarce, especially from India, even though an estimated 5% of the population may have significant disability due to physical disorders. Depression as a common psychiatric disorder affects about 3%-5% of the population. Thus, the impact of disability related to physical, mental and substance use disorders is enormous and it influences resource allocation and policy planning. METHODS: The issues relating to disability were addressed through a qualitative multicentered study. Focus groups were conducted at three sites in Chennai, Bangalore and Delhi on three themes: (i) parity, stigmatization and social participation; (ii) current practices and needs; and (iii) the General Disability Model as proposed by the World Health Organization. The focus groups were homogeneous and included members from six categories of participants: individuals with physical disability, individuals with mental disability, individuals with alcohol/drug-related disability, family members of mentally disabled persons, family members of physically disabled persons and health professionals. In all, 118 groups were conducted with a mean (SD) group size of 8.6 (1.6). RESULTS: Patients with mental and alcohol/drug-related disability were more discriminated against than those with physical disability. Awareness regarding the existing laws and social programmes was uniformly poor across the three centres. Stigmatization was a major reason for under-utilization of the meagre resources available. There was poor awareness of the Disability Act, 1996. The consumers felt more comfortable with the earlier terms of 'handicap' and 'impairment'. CONCLUSIONS: The study has implications for policy planning, clinical decision-making and social behaviour. Awareness of the laws, facilities and programmes needs to be increased, especially regarding the Disability Act, 1996 among consumers as well as health professionals. More disability-friendly facilities are required.

Incidence of meningitis in Manipal.

One thousand one hundred and seventy cerebro spinal fluid (CSF) samples from clinically diagnosed meningitis patients were subjected to macroscopic and microscopic examination. CSF samples were also cultured. Five percent CSF samples were positive for bacterial (4.3%) and fungal (0.7%) organisms. Gram positivity was observed in 6.4% samples. The percentage of bacterial isolates was highest in newborn and infants (6.1%) and (4.3%) in patients of 1-12 years age group. Cryptococcus species were isolated from 8 adult patients. Among Gram positive bacterial isolates, coagulase negative Staphylococci was highest (8%), followed by Pneumococci (6%) and B-haemolytic Streptococci (2%). Among Gram negative bacilli, Pseudomonas aeruginosa was predominant (42%) followed by Klebsiella species (20%) though Klebsiella was predominant in newborns and infants.

Incidence of post operative wound infection and their antibiogram in a teaching and referral hospital.

A total of 406 post-operative clean wounds were studied for the presence of sepsis and antibiogram of organisms were established. The over all post-operative sepsis rate was 13% (clinical) and 12% (bacteriological). Staphylococcus aureus (32%) and Pseudomonas species (21%) were the commonest organisms recovered and Netilmycin, Cephaloridine and Norfloxacin were the most effective antibiotics against both Gram positive and negative infections. This study reflects the change in pattern of infecting bacterial flora in case of post operative wound infections and its antibiogram.

Role of iron and copper during benzene toxicity.

Role of transition metal ions in expression of benzene toxicity has been suggested. Intraperitoneal administration of benzene to female albino rats daily for 10 days resulted in accumulation of iron in liver nuclei, without any change in copper content. Incubation of hydroquinone (HQ), one of the principal metabolites of benzene with rat liver nuclei resulted in formation of thiobarbituric acid reactive products (TBAR). However, presence of bathocuproine, a copper chelator and EDTA, an iron chelator caused significant inhibition of TBAR release. Thus, the present study revealed that iron accumulation and involvement of copper in nuclear damage induced by HQ.

Post orchiectomy management in stage II testicular seminoma.

Twenty eight patients with stage II A and twenty patients with stage II B testicular seminoma were treated at this institute between January 1982 and December 1988. The three year crude survival observed in this retrospective analysis was 82% and 75% respectively. Post orchiectomy infradiaphragmatic radiotherapy was the mainstay of the treatment. In stage II A 4 patients were administered adjuvant chemotherapy as well. Prophylactic Mediastinal Irradiation (PMI) was not employed as a routine in this subgroup. Eight patients (28%) relapsed (Mediastinal Nodes--4, Pulmonary--3, Scrotal--1). In stage II B twelve patients were treated with primary abdominal radiotherapy and of them 4 were delivered PMI as well. Induction chemotherapy was administered in remaining 8 patients. Seven patients (35%) relapsed (Pulmonary-4, Mediastinal Nodes-3). Mediastinal recurrence was noted only in those who were treated with abdominal radiotherapy alone. Though salvage chemotherapy proved successful in 5 of the seven patients (70%) with nodal relapse, none of the patients with extranodal relapse responded to subsequent chemotherapy. For stage II A we recommend abdominal radiotherapy alone and for stage II B Induction chemotherapy is advised keeping radiotherapy reserved for residual mass. We do not advocate PMI as a routine in stage II testicular seminoma as no survival benefit is observed.

Transesophageal echocardiography for the detection of left atrial thrombus.

We performed transesophageal two-dimensional echocardiography (TEE) and compared its results with those of transthoracic echocardiography (TTE) in a series of 120 patients with rheumatic mitral stenosis (MS). The patients were selected from a pool of 2000 patients of rheumatic heart disease assessed earlier by clinical examination and TTE. The selection criteria for TEE included one or more of the following: 1. Atrial fibrillation, 2. Embolic episode, 3. Before closed mitral valvotomy or balloon mitral valvuloplasty, 4. Large left atrium (LA) and 5. Evidence of clot or spontaneous echo-contrast in LA. The aim was to study the usefulness of TEE as compared to TTE in the detection of thrombus in LA. LA thrombus was imaged in 34/120 TEE studies as compared to 21/120 TTE studies. In 12/13 patients in whom TTE failed, the clot was present in the left atrial appendage (LAA). In the remaining one patient, poor echo window for TTE was responsible. In 2/6 patients with embolic episode, neither TTE nor TEE could document the presence of clot in LA. The procedure of TEE was well tolerated and there were no complications. We conclude that TEE is a safe and valuable adjunct to TTE with better diagnostic ability for the detection of LA thrombus and should be performed in all patients with MS in whom a clot in LA is suspected or needs to be excluded.

Leiomyosarcoma of the ovary.

A diagnosis of leiomyosarcoma of ovary was made in a 60 year old female presenting with generalised weakness and abdominal lump. On clinical examination, a hard, big mass with some cystic areas was found occupying the pelvic cavity. Chest X-ray revealed presence of metastases. Deranged renal function and structure due to extrinsic pressure were evident on pyelography and USG. USG also suggested the ovarian origin of the mass. Fine needle aspiration biopsy was suggestive of leiomyosarcoma. Laparotomy was carried out for excision of tumor along with bilateral salpingo-oophorectomy and hysterectomy. Post-operatively renal functions normalized. A course of radiotherapy was given. At 6 months' follow-up, abdomino-pelvic sonography was normal but lung metastases were found to be enlarged. The patient was asked to follow up for chemotherapy but did not come. She died 18 months after treatment, as revealed through correspondence.