Combination of Thin-Layer Chromatography and Mass Spectrometry Using Cluster-Induced Desorption/Ionization.

Desorption/ionization induced by neutral clusters (DINeC) was employed for mass spectrometry (MS) of oligopeptides and lipids after separation by means of thin-layer chromatography (TLC). Clear and fragmentation-free spectra were obtained from the TLC plates without any further sample treatment. Mass-resolved chromatograms were deduced when scanning the TLC plates with the cluster beam along the direction of solvent movement. Using vancomycin and noncovalently bound complexes, the soft nature of DINeC was demonstrated also when used in combination with TLC. As a test application, TLC and DINeC-MS were employed to separate and detect different phospholipids obtained from egg yolk.

Adverse outcome of methotrexate and mini pulse betamethasone in the treatment of lichen planus.

The objectives of this study were to compare the adverse outcome of methotrexate and mini pulse betamethasone therapy in the treatment of lichen planus. It was a clinical trial conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Patients in Group-A, (n = 23) were treated with methotrexate (10 mg) single morning dose and group-B (n = 21) were treated with mini pulse betamethasone (5 mg) single morning dose on 2 consecutive days during the period of 12 weeks. Adverse outcomes were measured by clinical examination and laboratory investigations during follow up visits. Anemia 3 (14.2%) and edema 12 (57.1%) developed in group-B but none in group-A. In group-B, dyspepsia 15 (71.4%), acne 10 (47.6%), mooning face 8 (38.1%), striae 8 (38.1%) and hypertrichosis 4 (19.0%) developed but none in group-A. Intermittent diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher among group-B compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A. Laboratory investigations showed abnormality in platelet count and SGPT in group-A but none in group-B. The adverse effects of methotrexate on haematological parameter and liver functions were mild and could be prevented by reducing the dose but the adverse effects of betamethasone were unavoidable. The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus.

Epidemiological determinants of psoriasis.

A cross-sectional study was conducted on 102 cases having clinical manifestation of psoriasis with a view to evaluate the epidemiological determinants of psoriasis. Psoriasis constituted 1.49% of the total dermatological disorder. Seventy patients (68.6%) were males and thirty two (31.4%) were females with a male to female ratio of 2.18:1. The mean age was 30.76±13.17 years in male and 26.94±14.94 years in female. Sixteen (15.7%) patients had one or more family member having psoriasis with male and female in equal frequency. Regarding precipitating factors, psoriasis was developed after trauma in 4.9%, infection 3.9%, stressful life events 6.9% and drugs 2.9%; and was exacerbated after trauma in 5.9%, infection 5.9%, stressful life events 35.3% and drugs 12.7%. The disease showed improvement in summer (27.5%) and found deteriorated in winter (47.1%). Sunlight had beneficial effect in 33.3% of cases. During pregnancy improvement was observed in 50% but flare up in 22.2% of cases. Fifty percent of patients were smokers, 41.2% were non-smokers and 13.7% were ex-smokers. Forty percent had Body Mass Index (BMI) between 22 to 26 Kg/m², 40.2% had less than 22 Kg/m² and 15.7% had above 26 Kg/m². It was concluded that the prevalence of psoriasis among dermatological patients was similar to results reported in Turkey and in Northern India. The precipitating factors, such as smoking, stressful life events, infection, trauma, sunlight, pregnancy, drugs, and seasonal variations could influence the development of psoriasis and affect its clinical expression.

Tuberculous pleural effusion.

Despite prevention programs, tuberculosis is still endemic in developing countries. Extrapulmonary tuberculosis is increasing globally in the face of recent emergence of Human Immunodeficiency Virus (HIV) infection. Pleural tuberculosis is a common problem in daily clinical practice. We assessed 26 cases of tuberculous pleural effusion admitted in Bangabandhu Sheikh Mujib Medical University from 2002 to 2007. The diagnosis was based upon clinical examination, tuberculin reaction, imaging, pleural fluid analysis and response to antitubercular chemotherapy a surrogate clinical determinant. Apparently promising newer biochemical pleural fluid measurements were not utilized due to a number of limitations. The presenting symptoms found in this prospective analysis are fever (100%), nonproductive cough (73%), pleuritic chest pain (38%), loss of weight (38%) and shortness of breath (38%). A high index of suspicion after confident exclusion of malignancy and pneumonia is a clue to diagnosis. Out of 80 cases of extrapulmonary tuberculosis admitted during the study period, tuberculous pleural effusion constitutes 32.50%.

Cutaneous sporotricosis.

Sporotrichosis, a deep fungal infection caused by Sporothrix schenckii, is a rare disease. Infection acquired by traumatic implantation of fungus to the skin. Our patient a 40 years old woman presented with multiple erythematous, ulcerated, crusted nodules of different size and shape situated over the right little finger to upper arm along the course of the lymphatic in a linear fashion. Microscopic examination and culture of the discharge from the skin lesion was done. Sporothrix schenckii was detected on microscopic examination (Yeast form) and on culture (Mycelial form). The patient was treated with Itraconazole at a dose of 100 mg twice in a day for 6 months. She was clinically cured of the disease by 6 months and then the treatment was stopped. We do not commonly encounter sporotrichosis in our practice. We are therefore, prompted to report the case.

Histopathological changes in different stages of alopecia areata.

Alopecia areata is a common disorder affecting any of the hair bearing areas of the body. Most of the cases are diagnosed on the clinical ground only. Histopathological changes may help in the diagnosis in difficult cases. The present study was designed to observe the histopathologic changes of alopecia areata at different stages. Thirty consecutive patients suffering from alopecia areata were enrolled. Face to face interview was performed using a structured pre-tested questionnaire. At the initial visit, one 4mm punch scalp biopsy specimen was taken from an area of hair loss. Biopsy specimens were sent in a test tube filled with formalin to the department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU) where tissue was processed, sectioned and slides were prepared. Haematoxylin and eosin stains were used. Aanagen hairs were decreased in all stages of alopecia areata. Telogen hairs increased in acute and chronic stages whereas catagen hairs increased markedly in sub-acute stage. Although miniaturized (atrophic) follicle was frequently found in chronic stage. It was absent in acute and sub-acute stages. Moderate to dense peribulbar infiltration of lymphocytes were observed in acute stage and mild to moderate infiltration in sub-acute stage. In chronic stage either no or mild infiltrations were observed. Peribulbar infiltration of eosinophils and macrophages were seen in all stages of alopecia areata. Alopecia areata can be diagnosed with some confidence, even when inflammatory infiltrate is absent, based on increased numbers of telogen hairs in the acute and chronic stages, increased miniaturized hairs in chronic stage and markedly increased catagen hairs in sub-acute stage.

Topical tazarotene cream (0.1%) in the treatment of facial acne: an open clinical trial.

BACKGROUND: Tazarotene is a new 3rd generation topical acetylenic retinoid. It normalizes keratinocyte differentiation, reduces keratinocyte proliferation and decreases expression of inflammatory markers. Tazarotene was approved by U.S.F.D.A. in 1997 for acne vulgaris. OBJECTIVES: To evaluate the efficacy and safety of topical tazarotene 0.1% cream in the treatment of facial acne. MATERIALS AND METHODS: 67 patients with facial acne in the age range of 13-30 years were enrolled in the study. Purposive sampling was done. Patients were treated with topical Tazarotene cream (0.1%) and were instructed to apply the medication as a thin film over the affected area in the evening once daily for 12 weeks. Follow-up was done at 2nd, 4th week, 8th week and at 12th week. RESULTS: Of the 67 patients, 53% got remission, 9% had good response, 34% had poor response and there was no response in 4% of the patients by 12 weeks of treatment. Among the patients, 9 (13.43%) developed mild side effects. CONCLUSION: Topical tazarotene cream (0.1%) is a effective and safe treatment option for acne vulgaris affecting face. It is mostly effective in grade-1 and grade-2 acne.

Study on association of cutaneous tuberculosis with pulmonary tuberculosis.

BACKGROUND: Tuberculosis continues to be a health problem in many countries. There may be simultaneous multiple organ involvement. Diagnosis of one organ disease may lead to missing off diagnosis of other organ involvement. OBJECTIVES: The present study was done to analyze the association of cutaneous tuberculosis with pulmonary tuberculosis. MATERIAL AND METHODS: Through purposive sampling a total of 23 patients of suspected cutaneous tuberculosis were primarily enrolled in this cross sectional study. History was taken and examinations were done to find out types of cutaneous lesions and to explore a pulmonary involvement. Investigations including CBC with ESR, Mantoux test and skin biopsy were done for each and every patient. Those who had cutaneous tuberculosis on histopathology chest x-ray were done to detect pulmonary lesions. After investigations 2 patients were excluded due to absence of tubercular infection. Finally 21 patients were included in this study. Data were collected in a predesigned structured questionnaire. RESULTS: Out of 21 patients 16 (76.19%) were male and 5 (23.81%) were female with a male to female ratio of 3.2:1. Age range varies from 5-70 years with a mean of 29.76 +/- 1 8.2 years. MT was positive in 76.20% of patients. CXR showed 23.81% of the patients with cutaneous TB had simultaneous pulmonary involvement. The association is statistically significant (p < 0.05). CONCLUSIONS: Patients with cutaneous tuberculosis may have pulmonary involvement in a statistically significant number. In any patient with cutaneous TB, meticulous systemic examinations and relevant investigations have to be done to explore pulmonary involvement.

Expression of a colorectal antigen defined by a new monoclonal antibody, CO-TL1.

A murine monoclonal antibody (MoAb CO-TL1, IgG1) has been raised by differential screening of hybridoma supernatants on sections of human large and small intestines, followed by screening on colon adenomas as well as on colorectal carcinomas. In both paraffin sections and cryostat sections, the antibody stained strongly all cell types in adult, neonatal and fetal human colorectal epithelium, that is, the goblet cells, the columnar cells and the endocrine cells. No staining was observed in the remaining parts of the normal gastrointestinal tract and other tissues. As revealed by immuno electron microscopy the epitope was present in the apical and basolateral cell membranes, the Golgi complex, secretory vesicles of goblet and columnar cells, and also in granules of the endocrine cells. The epitope in colorectal tissue sections was resistant to the deglycosylation enzymes neuramidase, diastase and hyaluronidase indicating its proteinaceous nature. This colorectal antigen remained expressed in 100% of colorectal adenomas (n = 39) and 86% (n = 29) of colorectal carcinomas. The expression was reduced in undifferentiated carcinomas. The CO-TL1 antibody detected also most other gastrointestinal adenocarcinomas and a few carcinomas of the ovary, uterus, breast, gallbladder and pancreas. However, it never detected carcinomas derived from the thyroid, lung, liver, bladder, kidney, prostate, testis, serous membranes of body cavities and skin. A wild-type variant protein of > 300 kDa of the colorectal antigen was identified in normal colorectal epithelium. In colorectal tumours, however, two tumour variant forms were found of 160-200 and 115-140 kDa, respectively. Our data indicate that this new MoAb CO-TL1 can be considered as a useful marker, which identifies normal colorectal epithelium and gastrointestinal tumours and especially colorectal tumours with high accuracy and excludes tumours originated from thyroid, lung, liver, bladder, kidney, prostate, testis, mesothelium and skin.

Cystic medulloblastoma.

In children medulloblastoma is a commonly encountered posterior fossa midline tumour in which cystic degeneration is not uncommon. A cystic medulloblastoma without solid component has, however, not been described. We report a 12-year-old boy with a posterior fossa midline cystic lesion on CT with surgical and histological confirmation of the diagnosis.