Fouling of ion exchange membranes used in the electrodialysis reversal advanced water treatment: A review.

Electrodialysis self-reversal (EDR) technology has attracted in the treatment of water for domestic and industrial uses. The self-reversal consists of a frequent reversal of the direction of current between the EDR-cell electrodes to combat fouling of ion exchange membranes (IEMs). Irrespective of the EDR self-cleaning processes, the role of natural organic matter and their complexing ability with metal ions on IEMs fouling is partially understood. The objective of this review is to identify the research gaps present in the elucidation of IEM fouling routes. The common IEMs' foulants are identified, and several fouling mechanisms are briefly discussed. The effectiveness of self-cleaning mechanisms to reduce IEMs fouling is also be discussed. Dissolved organic carbon (DOC) possesses high chelation which forms metal complexes with di and trivalent cations found in water. The role of ternary complexes, e.g. M2+/3+-DOC and membrane surface, on membrane fouling via surface bridging, are also addressed. Finally, mitigation methods of IEMs membrane fouling are also discussed.

Lichen sclerosus: role of occlusion of the genital skin in the pathogenesis.

Lichen sclerosus (LS) is a chronic inflammatory skin disease, which most commonly involves the anogenital region. The etiology of LS is obscure, but genetic susceptibility, autoimmune mechanisms, infective agents like human papillomavirus and spirochaetes, and Koebner phenomenon has been postulated as causative factors. We report our observation in 6 patients (3 males and 3 females) with histologically proven lichen sclerosus that showed relative sparing of the uncovered areas of the genitals, thereby suggesting that the occlusion of the genital skin may be playing a greater role in the causation of LS than is currently thought, in both sexes.

Photodegradation of triphenylamino methane (magenta) by photosensitizer in oxygenated solutions.

Reactive oxygen species (ROS), namely superoxide anion (O2*-, singlet oxygen (1O2), are potentially important substances for the mineralization of toxic organic molecules. The utility of hematoporphyrindihydrochloride (HPDHC) as a photosensitizer to generate ROS and their subsequent role in the destruction of magenta (MaG) in aqueous media is the main concern. The light irradiation of oxygenated aqueous solution of HPDHC and 1.5 x 10(-5) mol dm(-3) MaG at pH 3 yielded micromolar levels of NO3(-) ions. A higher rate of photodegradation (1.02 mol dm(-3) min(-1)) at pH 3 was observed compared to that of at pH 6 (0.68 mol dm(-3) min(-1)). Experiments were carried out in the presence of 1,4-diazabicyclo[2.2.2]octane (DABCO) as singlet oxygen (1O2) quencher and bezoquinone (BQ) as superoxide anion (O2*-) quencher. Only BQ was able to stop photodegradation suggesting that the photooxidation of MaG is mainly caused by O2*-, which is generated by an electron transfer from the excited HPDHC to ground-state oxygen. The presence of iron(II) at pH 3.0, compared to that without iron(II), showed a higher rate of photodegradation due to the formation of extremely reactive hydroxyl radicals (HO*) upon dismutation of O2*- anion through H2O2 intermediate. The formation of O2*-, H2O2, and HO* is therefore evident, which may act as active sites for subsequent photodegradation of MaG.

Efficacy and safety of the topical sensitizer squaric acid dibutyl ester in Alopecia areata and factors influencing the outcome.

BACKGROUND: Immunotherapy with sqauric acid dibutyl ester (SADBE) is a well-accepted therapy for alopecia areata. OBJECTIVE: To study efficacy, safety, and factors influencing the outcome in the treatment of alopecia areata. METHOD: During a 4-year period, 70 patients of alopecia areata, unresponsive to conventional therapies, were treated with SADBE for a period of 4 months and thereafter depending on the response with initial therapy. The percent scalp hair loss was calculated using "Severity of Alopecia Tool" (SALT) score before and after the therapy. RESULTS: Out of 70 patients, 6 were lost to follow-up and 4 could not develop sensitization; therefore, data of 60 patients was available for analysis. The overall success rate was 43%. In patients with <50% scalp involvement; the success rate was better (68%) than in those with >50% involvement (29%). The response was better in patients with late onset and shorter duration of disease. Family history of alopecia areata or other autoimmune diseases, personal or family history of atopy, presence of auto antibodies in serum, and presence of nail changes were associated with poorer prognosis. Out of 26 patients who responded, relapse occurred in 21 (81%) patients. CONCLUSION: In conclusion, SADBE is an effective and well-tolerated mode of therapy in Indian patients of AA, although the long-term results of SADBE were not encouraging.

Genital elephantiasis and sexually transmitted infections - revisited.

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

Saxophone penis revisited.

Saxophone deformity of the penis is commonly secondary to diseases causing chronic lymphatic obstruction. Lymphogranuloma venereum (LGV) is an important cause for this deformity. A case of LGV in genito-anorectal syndrome with a saxophone penis is reported along with the contrast-enhanced computed tomography (CECT) findings of anorectal involvement, and a probable hypothesis for this typical appearance of the penis.

Eczema herpeticum complicating Parthenium dermatitis.

Parthenium dermatitis is one of the most common causes of airborne contact dermatitis in India. Eczema herpeticum has been reported in association with various eczematous conditions, including Parthenium dermatitis. We report a case of eczema herpeticum in association with Parthenium dermatitis. Because Parthenium dermatitis is a common condition in this region, one should be aware of this complication so that appropriate treatment is not delayed.

Alopecia areata associated with idiopathic primary hypophysitis.

Alopecia areata has been reported in association with various autoimmune diseases. Idiopathic primary hypophysitis is an organ specific autoimmune disease affecting the pituitary gland. We report a case of alopecia areata occurring in a patient of idiopathic primary hypophysitis. The constellation of the two diseases can be explained by autoimmunity, which is a major aetiologic factor in both diseases. To the best of our knowledge, this is the first report of such an association.

Iatrogenic swollen penis.

We report what we think is the first case of localised angioedema of the glans penis as a result of contact allergy to prilocaine in EMLAP cream. We also propose a new term, contact angioedema for this condition.

Study of apoptosis in skin lesions of leprosy in relation to treatment and lepra reactions.

In leprosy on treatment, one factor contributing to the healing of skin lesions with minimal fibrosis may be apoptosis of inflammatory cells, even though apoptosis is sparse in leprosy as compared to tuberculosis. The degree of apoptosis in skin lesions of leprosy was studied by histopathologic examination (HPE) and by DNA fragmentation and electrophoresis. The effect of various parameters on apoptosis was noted in untreated disease, during treatment at 3 and 6 months, and in lepra reactions in different parts of the spectrum of leprosy. Of the 31 patients, 13 had paucibacillary (PB) and 18 multibacillary (MB) disease. Twenty one patients were in reaction: 16 had type 1 reaction and 5 had type 2 reaction. The controls included patients with non-granulomatous skin diseases; there were no normal controls, and no separate controls for cases with reaction. Apoptosis occurred more frequently in patients with leprosy as compared to the controls. In both PB & MB lesions, apoptosis was observed to increase progressively with treatment at 3 and 6 months, and was more prominent in the MB cases at 6 months of treatment. When lesions in either type 1 or type 2 reaction were compared to lesions not in reaction, a significant increase in apoptosis (p = 0.014) was found only in lesions with type 2 reaction and those which were at 6 months of treatment. The type of treatment regimen, or oral steroids given for reactions, did not significantly alter the degree of apoptosis. Our observations indicate that increased apoptosis is present in leprosy lesions and that in leprosy it progressively increases with anti-leprosy treatment up to 6 months. If the process of apoptosis in skin lesions is followed up for a longer period of time, the degree of apoptosis may be expected to decline. The study of apoptosis may help to understand the mechanism of clearance of bacilli and resolution of granulomas in leprosy patients.

Laugier-Hunziker pigmentation.

Laugier-Hunziker pigmentation (LHP) is an acquired disorder of hypermelanosis characterized by mucocutaneous hyperpigmentation. LHP may resemble various disorders characterized by mucocutaneous pigmentation. A 58-year-old lady presented with progressively increasing number of variable sized, hyperpigmented macules over the lips, fingers, toes and nails. There was no family history of similar illness. Systemic examination and all relevant investigations were within normal limits. Histopathology of a skin lesion had features consistent with LHP. The diagnosis of LHP must be made only after relevant investigations to rule out any associated systemic involvement. This case further highlights that LHP is not restricted to European countries.