Extended Flight Bouts Require Disinhibition from GABAergic Mushroom Body Neurons.

Insect flight is a complex behavior that requires the integration of multiple sensory inputs with flight motor output. Although previous genetic studies identified central brain monoaminergic neurons that modulate Drosophila flight, neuro-modulatory circuits underlying sustained flight bouts remain unexplored. Certain classes of dopaminergic and octopaminergic neurons that project to the mushroom body, a higher integrating center in the insect brain, are known to modify neuronal output based on contextual cues and thereby organismal behavior. This study focuses on how monoaminergic modulation of mushroom body GABAergic output neurons (MBONs) regulates the duration of flight bouts. Octopaminergic neurons in the sub-esophageal zone stimulate central dopaminergic neurons (protocerebral anterior medial, PAM) that project to GABAergic MBONs. Either inhibition of octopaminergic and dopaminergic neurons or activation of GABAergic MBONs reduces the duration of flight bouts. Moreover, activity in the PAM neurons inhibits the GABAergic MBONs. Our data suggest that disinhibition of the identified neural circuit very likely occurs after flight initiation and is required to maintain the "flight state" when searching for distant sites, possibly related to food sources, mating partners, or a suitable egg-laying site. VIDEO ABSTRACT.

Hydroxychloroquine-induced erythroderma.

Erythroderma is characterized by diffuse erythema and scaling of the skin involving more than 90% of the total body skin surface area. Drug-induced erythroderma has rarely been reported with hydroxychloroquine. We report a case of a 50-year-old female patient, with systemic lupus erythematosus, who developed itchy lesions all over the body 1 month after starting treatment with hydroxychloroquine. Drug-induced erythroderma was suspected. Hydroxychloroquine was withdrawn and the patient was treated with emollients, mid-potency corticosteroids, and oral antihistamines. A biopsy was done which confirmed the diagnosis of erythroderma. She recovered with treatment and was discharged. A careful history and clinical examination to search for potential causative factors will help prevent disabling sequelae in erythroderma.

Effect of the insulin plant (Costus igneus) leaves on dexamethasone-induced hyperglycemia.

UNLABELLED: Costus igneus, commonly known as insulin plant in India, belongs to the family Costaceae. Consumption of the leaves are believed to lower blood glucose levels, and diabetics who consumed the leaves of this plant did report a fall in their blood glucose levels. OBJECTIVES: The present study was planned to evaluate the effect of the leaves of Costus igeus on dexamethasone-induced hyperglycemia in male Wistar rats. Four groups of male Wistar rats (n= 6) were treated with 10 mg/kg/day of dexamethasone subcutaneously for 20 days. From day 11 to day 20, different groups received 100, 250 or 500 mg/kg/day of powdered leaves of Costus igeus in distilled water orally or Glibenclamide 500 microg/kg orally. On the 20th day, after overnight fasting, a retro-orbital puncture was performed for obtaining blood samples to estimate the fasting blood glucose level, and the same procedure was followed on the other eye 1 hour after a glucose load of 2.5 g/kg orally for estimation of post-glucose load blood glucose levels. Fasting blood sugar and postglucose load blood sugar levels were raised in the group that received dexamethasone when compared to normal controls (P < 0.001), whereas 250 and 500 mg/kg powdered leaf of Costus igeus and Glibenclamide 500 microg/kg decreased the dexamethasone-induced hyperglycemia (P < 0.01). The leaves of Costus igeus reduced the fasting and postprandial blood sugar levels, bringing them towards normal, in dexamethasone-induced hyperglycemia in rats.

Is Kikuchi-Fujimoto disease a manifestation of systemic lupus erythematosus?

A 32-year-old woman presented with fever and swelling in the axillae of 2 months' duration, and erythema of the face, fluid-filled lesions on the trunk, oral ulcers, crusting of the lips, and redness and watering of the eyes for 3 days. The patient was initially diagnosed with tuberculous lymphadenitis and was given antituberculous treatment. One month later, she developed the present complaints (see below). The patient was photosensitive. There was no joint pain or Raynaud's phenomenon. She had experienced three intrauterine deaths in the past with no live births. On examination, the patient was pale. Bilateral axillary lymphadenopathy was present. The lymph nodes were mobile, non-tender, and not matted. Mucocutaneous examination revealed a malar eruption, flaccid bullae on the back (Fig. 1), crusting of the lips (Fig. 2), oral ulcers, and redness and discharge from the eyes. On investigation, immunoglobulin G (IgG), IgM, and IgA for tuberculosis were negative. There was anemia and leukopenia, the erythrocyte sedimentation rate (ESR) was raised, albumin in urine was positive, enzyme-linked immunosorbent assay (ELISA) for human immunodeficiency virus (HIV) was negative, and venereal disease research laboratory (VDRL) test was nonreactive. Antinuclear antibody (ANA), dsDNA, and antiphospholipid antibody were positive. Fine needle aspiration cytology (FNAC) of the axillary lymph node showed loss of nodal architecture. The extensive infiltrate consisted of lymphocytes, histiocytes, immunoblasts, and necrosis of cortical and paracortical areas. There was histiocytic necrotizing lymphadenitis without granulocytic infiltration. These features were suggestive of Kikuchi-Fujimoto's disease (Fig. 3). Skin biopsy showed epidermal atrophy, basal cell vacuolation, focal hyperkeratosis, pilosebaceous atrophy, and follicular plugging. The dermis showed edema and a lymphocytic infiltrate in the upper dermis and around the blood vessels. These features were suggestive of systemic lupus erythematosus (SLE). Direct immunofluorescence of lesional skin showed a strong continuous basement membrane zone (BMZ) band of C3 and fibrinogen and a strong discontinuous granular BMZ band of IgG. IgA was negative. Covered skin showed moderate and strong positivity for IgM and IgG, respectively. C3, IgA, and fibrinogen were negative. These findings were suggestive of SLE (Fig. 4). Based on the clinical findings and investigations, a diagnosis of Kikuchi-Fujimoto's disease with SLE was made.

Clinico-epidermiological studies on tinea versicolor.

One hundred and twenty patients with tinea versicolor who attended the outpatient department of Dermatology, K.M.C Hospital, Mangalore were studied with reference to their clinical features, age and sex distribution, relation to climate and personal habits. The disease was commonest among the age group of 21-30 years (30%). It was found to be distributed predominantly over the neck (71.6%), chest (58.3%) and back (70%). Inmost of the patients, lesions were observed first and also aggravated during summer months. One fourth of the patients either had systemic diseases or were on immuno-suppressant drugs. The disease was continuous in spite of taking treatment in 21.6% of patients. 38.3% of patients gave a positive family history. Even though the disease is resistant to treatment, avoiding the predisposing factors like increased sweating, sharing the towels and clothes, malnutrition, synthetic clothings will help to control the disease.