Extenders and cryosolutions for Grumata (Prochilodus vimboides) sperm preservation.

BACKGROUND: Prochilodus vimboides populations are being reduced in rivers due to changes in their habitat, overfishing, urbanization, and pollution. OBJECTIVE: To evaluate the effect of sperm extender solutions for short-term storage and cryosolutions for freezing sperm of Prochilodus vimboides. MATERIALS AND METHODS: For short-term storage, the sperm was diluted in 0.9% NaCl, 1.2% NaCl, 5% glucose, 5% BTS, or 6% MIII. Sperm motility was evaluated after 0, 24, 48, and 72 h of short-term storage at 4-6 degree C. For cryopreservation, sperm samples were diluted in the same extenders and factorially combined with three cryoprotectants (dimethylsulfoxide, methyl glycol, and ethylene glycol). After thawing, sperm motility and oxidative stress parameters were evaluated. RESULTS: Dilution of samples in BTS preserved sperm motility >40% for up to 48 h. Samples cryopreserved in 5% glucose and methylglycol presented higher sperm motility, lower catalase, and lipid peroxidation activities. CONCLUSION: Prochilodus vimboides sperm can be cooled for up to 48 h in an extender solution of 5% BTS and cryopreserved in 5% glucose and methyl glycol. doi.org/10.54680/fr22410110612.

Dermatological effects of Curcuma species: a systematic review.

Curcuma and its derivatives are associated with anti-inflammatory and antioxidant activities in the skin. They exhibit beneficial effects in wound healing and prevention of chronic ultraviolet B damage and may prevent facial redness such as rosacea and flushing. This review aims to provide an up-to-date and rigorous synthesis of studies that demonstrated the clinical efficacy of curcuminoids in the skin. We evaluated studies published in the MEDLINE-PubMed/PMC (National Library of Medicine) databases, and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for this review. This search included papers published in the past 10 years in controlled clinical trials, double-blind and randomized controlled studies, and case studies. The search resulted in 12 studies published in the past 10 years. Curcuma species (Curcuma longa and Curcuma aeruginosa) and curcumin were found to produce various dermatological effects, including influencing antioxidant and anti-inflammatory processes in the production of hyaluronan, increasing skin moisture, and reducing axillary hair growth. Curcuma was also found to reduce thickness, erythema, pruritus, burning and pain in psoriasis lesions and to improve radiodermatitis lesions. Our review results show that Curcuma species may play a role in skin health management and may exhibit various dermatological effects, thus it could be a new therapeutic arsenal for dermatology professionals. Nevertheless, more clinical trials should be conducted with humans to establish the optimum delivery method and dosages for different dermatological conditions.

Identification of relevant regions on structural and nonstructural proteins of Zika virus for vaccine and diagnostic test development: an in silico approach.

Zika virus (ZIKV) is an arbovirus belonging to the Flaviviridae family and the genus Flavivirus. Infection with ZIKV causes a mild, self-limiting febrile illness called Zika fever. However, ZIKV infection has been recently associated with microcephaly and Guillain-Barré syndrome. Vaccines for the disease are a high priority of World Health Organization. Several studies are currently being conducted to develop a vaccine against ZIKV, but until now there is no licensed ZIKV vaccine. This study used a novel immunoinformatics approach to identify potential T-cell immunogenic epitopes present in the structural and nonstructural proteins of ZIKV. Fourteen T-cell candidate epitopes were identified on ZIKV structural and nonstructural proteins: pr36-50; C61-75; C103-117; E374-382; E477-491; NS2a90-104; NS2a174-188; NS2a179-193; NS2a190-204; NS2a195-209; NS2a200-214; NS3175-189; and NS4a82-96; NS4a99-113. Among these epitopes, only E374-382 is a human leukocyte antigen (HLA) type I restricted epitope. All identified epitopes showed a low similarity with other important flaviviruses but had a high conservation rate among the ZIKV strains and a high population coverage rate. Therefore, these predicted T-cell epitopes are potential candidates targets for development of vaccines to prevent ZIKV infection.

Changes in condylar volume and joint spaces after orthognathic surgery.

The aim of this study was to evaluate the changes in condylar volume and joint spaces occurring in patients undergoing bimaxillary orthognathic surgery for the treatment of class II deformities, by means of cone beam computed tomography (CBCT). Initial and follow-up (at least 6 months) CBCT examinations of 114 condyles (57 patients) were studied retrospectively. Linear measurements of the joint space and volumetric analysis of changes in condylar volume were performed using Dolphin 3D Imaging in association with ITK-SNAP 3.0.0 segmentation software. The paired t-test and Pearson correlation coefficient were applied, and a descriptive analysis was performed. Mean condyle volumes were significantly smaller at follow-up (P=0.0125). There were significant reductions in superior and medial joint spaces in the follow-up examinations (both P<0.05). Positive correlations were found when comparing the mean changes in anterior, superior, and posterior space values between the right and left sides. No significant correlation was observed between changes in volume and joint spaces. In conclusion, there was a reduction in mean condylar volume after orthognathic surgery in class II patients. However, changes in volume for each condyle may be variable. Such changes in condylar volume may occur independently on the left and right sides, and do not correlate with changes in joint spaces.

Physiological and enzymatic alterations in sesame seeds submitted to different osmotic potentials.

With the imminence of global climate changes that affect the temperature and the rainfall uniformity, it is growing the concern about the adaptation of crops to the water deficit. Thus, the objective of this study was to evaluate alterations in physiological and enzymatic mechanisms during the germination process of sesame seeds under different water availability. To simulate the water restriction we used PEG6000, a high molecular weight molecule that does not penetrate the seed structure but allows different osmotic potentials. The treatments were -0.1, -0.2, and -0.3 MPa, and the control. Germination, first-count germination, germination velocity index, and length and dry mass of the hypocotyl and radicle were performed. The seeds were weighed before and after treatments every 3 h. After each weighing, 100 seeds were taken for analysis of the enzymes alcohol dehydrogenase (ADH), malate dehydrogenase, esterase, catalase (CAT), superoxide dismutase (SOD), isocitrate lyase (ICL), and glutamate dehydrogenase (GTDH). The statistical design was completely randomized with five replications. PEG6000 prolonged ADH activity during the beginning of germination, maintaining the anaerobic metabolism for longer. Subsequently, their activity was reduced, as well as ICL, favoring the deterioration of the seeds that take the time to germinate. Behavior was evidenced by the appearance of SOD, CAT, and GTDH isoforms after 24 h of imbibition when water restriction was imposed. Therefore, the PEG600 is efficient in simulating water deficit conditions in future scenarios of climate change, offering impotent information regarding the germination behavior of the plants under these conditions.

Characterization of amyloid in equine recurrent uveitis as AA amyloid.

Two horses with chronic uveitis and histological lesions consistent with equine recurrent uveitis (ERU) were examined. Microscopical findings in the ciliary body included deposits of amyloid lining the non-pigmented epithelium, intracytoplasmic, rod-shaped, eosinophilic inclusions and intraepithelial infiltration of T lymphocytes. Ultrastructural examination of the ciliary body of one horse confirmed the presence of abundant extracellular deposits of non-branching fibrils (9-11 nm in diameter) consistent with amyloid. Immunohistochemistry revealed strong positive labelling for AA amyloid and mass spectrometry showed the amyloid to consist primarily of serum amyloid A1 in both cases. The findings suggest that localized, intraocular AA amyloidosis may occur in horses with ERU.

Tranquilização de asininos com acepromazina associada ou não ao diazepam / Tranquilization of donkeys using acepromazine or acepromazine: diazepam

Avaliaram-se os efeitos da acepromazina isolada ou associada ao diazepam em asininos. Cinco asininos foram submetidos a dois protocolos anestésicos: os do grupo acepromazina (AC) receberam acepromazina, 0,1mg/kg/IV, e os do grupo acepromazina-diazepam (ACD), acepromazina na mesma dose e via do AC, associada ao diazepam, 0,1mg/kg/IV. Foram mensuradas as frequências cardíaca (FC) e respiratória (FR) e a temperatura retal (TR) e analisadas variáveis eletrocardiográficas, tranquilização, período de latência, início do prolapso peniano e grau de ataxia. A tranquilização iniciou-se aos 10,4±0,9 minutos nos asininos do AC e aos 4,8±1,1 nos do ACD. Ocorreu prolapso peniano aos 4,2±1,3min no AC e aos 2,7±0,4 no ACD. A FC elevou-se aos 15 e 30min no AC. Não ocorreu variação significativa nas variáveis eletrocardiográficas e na temperatura retal. A FR diminuiu no AC a partir de 60min e no ACD a partir de 30min. A distância focinho-solo reduziu-se significativamente em ambos os grupos e nos momentos a partir de 15min. Concluiu-se que a acepromazina promove tranquilização discreta, e a adição do diazepam potencializa a tranquilização, diminui o período de latência e aumenta a ataxia.

The effects of acepromazine isolated or associated with diazepam were evaluated in five donkeys were underwent in two anesthetic protocols, in the acepromazine group (AC), animals received acepromazine (0.1mg/kg/IV) and in acepromazine-diazepam group (ACD), acepromazine at the same dose and route of AC, associated with diazepam (0.1 mg/kg/IV). Heart frequency (HR), respiratory frequency (RF) and rectal temperature (RT) were measured and electrocardiographic variables analyzed, in addition to tanquilization, latency, beginning of the penile prolapse and degree of ataxia. The tanquilization began at 10.4±0.9 minutes (min) in the AC donkeys and 4.8±1.1 in ACD. Penile prolapse occurred at 4.2±1.3 minutes in AC and 2.7±0.4 in ACD. The HR increased to 15 and 30min. Electrocardiographic parameters and rectal temperature not varied significantly. RF decreased from AC in 60min and 30min from ACD. The muzzle-to-ground distance reduced significantly in both groups and at times from 15min. It was concluded that the acepromazine promotes discreet tanquilization and the adition of diazepam potentiates the tranquilization, decreases the latency period and increases ataxia caused by acepromazine.

Energy expenditure, lipid profile, oxidative stress, and cardiac energy metabolism after growth hormone treatment in obese young rats.

Obesity is rampant in modern society and growth hormone (GH) could be useful as adjunct therapy to reduce the obesity-induced cardiovascular damage. To investigate GH effects on obesity, initially 32 male Wistar rats were divided into two groups (n=16): control (C) was fed standard-chow and water and hypercaloric (H) was fed hypercaloric chow and 30% sucrose in its drinking water. After 45 days, both C and H groups were divided into two subgroups (n=8): C+PL was fed standard-chow, water and received saline subcutaneously; C+GH was fed standard-chow, water, and received 2 mg/kg/day GH subcutaneously; H+PL was fed hypercaloric diet, 30% sucrose in its drinking water, and received saline subcutaneously; and H+GH was fed hypercaloric diet, 30% sucrose in its drinking water, and received GH subcutaneously. After 75 days of total experimental period, H+PL rats were considered obese, having higher body weight, body mass index, Lee-index, and atherogenic index (AI) compared to C+PL. Obesity was accompanied by enhanced myocardial lipid hydroperoxide (LH) and lactate dehydrogenase (LDH), as well of depressed energy expenditure (RMR) and oxygen consumption(VO (2))/body weight. H+GH rats had higher fasting RMR, as well as lower AI and myocardial LH than H+PL. Comparing C+GH with C+PL, despite no effects on morphometric parameters, lipid profile, myocardial LH, and LDH activity, GH enhanced fed RMR and myocardial pyruvate dehydrogenase. In conclusion, the present study brought new insights into the GH effects on obesity related cardiovascular damage demonstrating, for the first time, that GH regulated cardiac metabolic pathways, enhanced energy expenditure and improved the lipid profile in obesity condition. Growth hormone in standard fed condition also offered promising therapeutic value enhancing pyruvate-dehydrogenase activity and glucose oxidation in cardiac tissue, thus optimizing myocardial energy metabolism.

Insulin-degrading enzyme binds to the nonglycosylated precursor of varicella-zoster virus gE protein found in the endoplasmic reticulum.

Insulin degradation enzyme (IDE) is a 110-kDa zinc metalloprotease found in the cytosol of all cells. IDE degrades insulin and a variety of small proteins including amyloid-beta. Recently, IDE has been proposed as the receptor for varicella-zoster virus (VZV) attachment. During our reassessment, some of the original studies were repeated and expanded in scope. We first confirmed that IDE antibody reduced VZV spread. For additional controls, we repeated the same experiments with herpes simplex virus (HSV)-infected cells as well as uninfected cells. There was a visible reduction in HSV spread but less than seen in the VZV system. Of greater importance, IDE antibody also inhibited the growth of uninfected cells. Second, we repeated the coprecipitation assays. We confirmed that antibodies to VZV gE (open reading frame 68) coprecipitated IDE and that anti-IDE antibody coprecipitated gE. However, the detected gE protein was not the mature 98-kDa form; rather, it was a precursor 73-kDa gE form found in the endoplasmic reticulum. Additional control experiments included VZV-infected cell cultures treated with tunicamycin to block gE glycosylation in the endoplasmic reticulum; again, the anti-IDE antibody coprecipitated a 73-kDa gE product. Finally, Orbitrap mass spectrometry analysis of a chromatographically purified gE sample revealed four cellular proteins associated with the unfolded protein response: BiP (HSPA5), HSPA8, HSPD1, and PPIA (peptidyl-propyl cis-trans isomerase). We conclude that IDE protease binds to the 73-kDa gE precursor and that this event occurs in the cytosol but not as a receptor/ligand interaction.

HIV induces both a down-regulation of IRAK-4 that impairs TLR signalling and an up-regulation of the antibiotic peptide dermcidin in monocytic cells.

HIV-infected individuals have an increased risk of invasive bacterial infections, even at early clinical stages with relatively normal CD4(+) T-cell counts. The pathogenic mechanisms behind this are not fully understood. However, an increasing number of studies indicate that HIV may impair the innate immunity to bacteria by infecting key cells of the monocyte/macrophage lineage. In this study, the effects of HIV infection on the protein profile of undifferentiated monocyte-like THP-1 cells were examined by a mass spectrometric approach based on stable isotope labelling with amino acid in cell culture (SILAC). We identified 651 proteins, of which nine proteins were down-regulated and 17 proteins were up-regulated in HIV-infected THP-1 cells as compared to uninfected controls. Most remarkably, the IL-1 receptor associated kinase 4 (IRAK-4), which is essential for virtually all TLR signalling, was suppressed, whereas the precursor for the antibiotic peptide Dermcidin was up-regulated in HIV-infected cells. Upon stimulation of either TLR2 or TLR4, the HIV-infected THP-1 cells displayed reduced TNF-alpha secretion. The HIV-induced down-regulation of IRAK-4 was reconfirmed in monocyte-derived macrophage cell cultures. These data suggests that HIV may impair the TLR signalling cascade for pathogen recognition in cells of the monocyte/macrophage lineage and thus, may reduce the ability of the innate immune system to sense invading pathogens and initiate appropriate responses.

Montelukast induced acute hepatocellular liver injury.

A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast induced hepatocellular liver injury. Liver tests began to improve and returned to normal 55 days after drug cessation. Causality of this adverse drug reaction by the Council for International Organizations of Medical Sciences or Roussel Uclaf Causality Assessment Method (CIOMS or RUCAM) and Naranjo's algorithm was 'probable'. Liver tests should be monitored in patients receiving montelukast and any early signs of liver injury should be investigated with a high index of suspicion for drug induced liver injury.

Efficacy of shoulder exercises on locoregional complications in women undergoing radiotherapy for breast cancer: clinical trial / Eficácia dos exercícios para ombro nas complicações loco-regionais em mulheres submetidas a radioterapia para câncer de mama: ensaio clínico

Objective: To investigate the effect of shoulder exercises during radiotherapy in relation to prevention of locoregional physical complications: limitation of range of motion (ROM) and functional capacity, arm circumference and scar tissue adhesion. Methods: Sixty-six women without shoulder ROM impairment following breast cancer surgery that included complete axillary dissection were allocated to one of two groups: 32 in the physical therapy group (PG) (52.7±10.2 years), who underwent an exercise program; and 34 in the control group (CG) (48±10.1years). Shoulder ROM, upper-limb circumference and functional capacity and scar tissue adhesion were evaluated at the beginning and end of radiotherapy and six months after completing radiotherapy. Results: The PG showed improvements in flexion and abduction ROM between the first and third evaluations (flexion from 164.77°±8.9° to 167.98°±9.5° and abduction from 168.56°±10.0° to 175.62°±10.2°),which was not observed in the CG (flexion from 167.06±06° to 165.16°±9.2° and abduction from 169.71° 10.1° to 169.53°±12.8°). There was a statistically significant increase in ROM in the PG in relation to the CG (flexion, p=0.02; and abduction, p=0.004). The circumference and functional capacity were similar between the groups and the frequency of scar tissue adhesion in the CG was twice that observed in the PG (48% versus 24%, p=0.04). Conclusions: These results suggest that shoulder exercises favor maintenance of flexion and abduction ROM of the shoulder and minimize the incidence of scar tissue adhesion in women undergoing radiotherapy for breast cancer treatment.

Objetivo: Verificar o efeito da realização de exercícios para o ombro durante a radioterapia na prevenção de complicações físicas locoregionais: limitação da amplitude de movimento (ADM) e da capacidade funcional, circunferência do braço e aderência cicatricial. Métodos: Sessenta e seis mulheres sem comprometimento de ADM de ombro no pós-operatório de cirurgia para câncer de mama com dissecção axilar completa foram alocadas em dois grupos, sendo 32 no grupo de fisioterapia (GF) (52,7±10,2 anos), o qual foi submetido a um programa de exercícios, e 34 no grupo controle (GC) (48±10,1 anos). A ADM do ombro, a circunferência e capacidade funcionaldos membros superiores e a aderência cicatricial foram avaliados no início e no final da radioterapia e seis meses após seu término. Resultados: O GF apresentou melhora da ADM de flexão e abdução entre a primeira e terceira avaliação (Flexão: de 164,77°±8,9° para 167,98°±9,5° e Abdução: 168,56°±10° para 175,62°±10,2°), o que não se observou no GC (Flexão: 167,06°±6° para 165,16°±9,2° e Abdução: 169,71°±10,1° para 169,53°±12,8°), demonstrando uma melhora significativa do GF em relação do GC (Flexão: p=0,02 e Abdução: p=0,004). A circunferência e a capacidade funcional foram similares entre os grupos e a frequência de aderência cicatricial no GC foi o dobro daquela observada no GF (48% e 24%, p=0,04). Conclusões: Esses resultados sugerem que exercícios para o ombro favorecem a manutenção da ADM de flexão e abdução de ombro e minimizam a incidência de aderência cicatricial em mulheres submetidas à radioterapia para tratamento por câncer de mama.

Resveratrol toxicity: effects on risk factors for atherosclerosis and hepatic oxidative stress in standard and high-fat diets.

The beneficial action of moderate wine consumption is increasingly being attributed to resveratrol (trans-3,4',5-trihydroxystilbene). To test the safety of resveratrol use as a dietary supplement, 24 male Wistar rats were initially divided into three groups: (C, n=6) was given standard chow and water; (R, n=6) received standard chow and 6 mg/l resveratrol in its drinking water (1mg/kg/day), and (HFD, n=12) received high-fat diet and water. In order to more appropriately study the effects of resveratrol on high-fat diet, after 30 days of treatments, HFD-rats were divided into two subgroups (n=6/group):(HFD) remained receiving high-fat diet and water; (HFD-R) given high-fat diet and 6 mg/l resveratrol in its drinking water (1mg/kg/day). The total experimental period was 45 days. The resveratrol dose took into account its average concentration in wine, the time variability of wine ingestion, and so of resveratrol consumption in humans. HFD-rats had hyperglycaemia, dyslipidemia, increased serum oxidized-LDL (ox-LDL) and hepatic oxidative stress. Comparing HFD-R and HFD-rats, resveratrol improved lipid profile and glucose level, enhanced superoxide dismutase, thus reducing ox-LDL and hepatic oxidative stress. Resveratrol, in standard-fed-rats reduced glutathione-antioxidant defense system and enhanced hepatic lipid hydroperoxide. In conclusion, based on the results of this single dose preliminary study with resveratrol in the drinking water of male Wistar rats for 30 days, it may be concluded that resveratrol may have beneficial effects in high-fat diets (e.g. ox-LDL, decreased serum and hepatic oxidativestress), but not in standard-fed diets (effects produced include enhanced hepatic oxidative stress). Further studies are indicated.

Cytoreduction combined with intraperitoneal hyperthermic perfusion chemotherapy in advanced/recurrent ovarian cancer patients: The experience of National Cancer Institute of Milan.

AIMS: We report the effects of cytoreductive surgery (CRS) and intraperitoneal hyperthermic perfusion (IPHP) in the treatment of advanced/recurrent epithelial ovarian cancer (EOC) on survival, morbidity and mortality. PATIENTS: Forty EOC patients were studied. Median age was 52.5 years (range: 30-68) and median follow-up 26.1 months (range: 0.3-117.6). Most patients presented advanced disease (stage III/IV). Previous systemic chemotherapy included cisplatin-based, taxol-based or taxol/platinum containing regimens. RESULTS: After the CRS, 33 patients presented no macroscopic residual disease. Five-year overall survival was 15%; the mean overall and progression-free survivals were 41.4 and 23.9 months, respectively. The morbidity, toxicity and mortality rates were 5%, 15% and 0%, respectively. CONCLUSION: Our results suggest that CRS + IPHP merits further evaluation by a formal prospective trial.

Prevalence and risk factors for bronchial asthma in Indian adults: a multicentre study.

BACKGROUND: There is limited information on field epidemiology of bronchial asthma in Indian adults. OBJECTIVES: To estimate prevalence of bronchial asthma in different regions of India and to define risk factors influencing disease prevalence. METHODS: A field study was conducted at Chandigarh, Delhi, Kanpur and Bangalore through a two stage stratified (urban/ rural) sampling and uniform methodology using a previously validated questionnaire. Asthma was diagnosed if the respondent answered affirmatively both to (a) whistling sound from chest, or chest tightness, or breathlessness in morning, and (b) having suffered from asthma, or having an attack of asthma in the past 12 months, or using bronchodilators. Besides demographic data, information on smoking habits, domestic cooking fuel used, atopic symptoms, and family history suggestive of asthma was also collected. Univariate and multivariate logistic regression modelling was performed to calculate odds ratio of various potential risk factors. RESULTS: Data from 73605 respondents (37682 men, 35923 women) were analysed. One or more respiratory symptoms were present in 4.3-10.5% subjects. Asthma was diagnosed in 2.28%, 1.69%, 2.05 and 3.47% respondents respectively at Chandigarh, Delhi, Kanpur and Bangalore, with overall prevalence of 2.38%. Female sex, advancing age, usual residence in urban area, lower socio-economic status, history suggestive of atopy, history of asthma in a first degree relative, and all forms of tobacco smoking were associated with significantly higher odds of having asthma. CONCLUSION: Prevalence estimates of asthma in adults in this study, although lower than several previously reported figures, point to a high overall national burden of disease.

Household environmental tobacco smoke exposure, respiratory symptoms and asthma in non-smoker adults: a multicentric population study from India.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) is a risk factor for childhood asthma. Its association with asthma in adults is less clear. METHODS: In a multicentric population study on asthma prevalence in adults, specific enquiries were made into childhood and adulthood exposure to household ETS, and its relationship with asthma diagnosis were analysed. RESULTS: From a total of 73605 respondents, 62109 were studied after excluding current or past smokers. Overall observed prevalence of asthma was 2.0% (men 1.5%,women 2.5%, p < 0.001). Of all asthma patients, history of ETS exposure was available in 48.6 percent. Prevalence of asthma in the ETS exposed subjects was higher compared to non-exposed individuals (2.2% vs 1.9%, p < 0.05). Multiple logistic regression analysis showed a higher risk of having asthma in persons who were exposed to ETS compared to those not exposed (odds ratio [OR] 1.22, 95% CI 1.08-1.38) after adjusting for age, gender, usual residence, exposure to biomass fuels and atopy. Stratification of ETS exposure revealed that exposure during childhood and both during childhood and adulthood were significantly associated with asthma prevalence. Exposure only in adulthood was not a significant risk factor (OR 1.13, 95% CI 0.95-1.33). Persons reporting combined environmental tobacco smoke exposure from parents during childhood and spouse during adulthood had highest risk of having asthma (OR 1.69, 95% CI 1.38-2.07). Environmental tobacco smoke exposure was also significantly associated with prevalence of respiratory symptoms such as wheezing, cough and breathlessness. CONCLUSIONS: Environmental tobacco smoke exposure during childhood is an important risk factor for asthma and respiratory symptoms in non-smoking adults.

Tobacco smoking in India: prevalence, quit-rates and respiratory morbidity.

BACKGROUND: Population prevalence of tobacco smoking especially with reference to detailed habits such as the amount smoked, the smoking forms, quit-rates and relationship with demographic variables were studied at four different centres in India along with the study on epidemiology of asthma and chronic obstructive pulmonary disease. METHODS: The study population included adults of over 15 years of age selected with two-stage stratified random sample design. A specifically designed questionnaire was used for the study. RESULTS: There were 11496 (15.6%) ever smokers in the study sample of 73605 subjects. Among 37682 males, 10756 (28.5%) were ever smokers and among 35923 females, 740 (2.1%) were ever smokers. Bidi was the commonest form of smoking, more so in the rural areas. The mean number of cigarettes/bidis smoked per day was 14 (+/- 11.5) and the mean age of starting smoking was 20.5 (+/- 20.0) years. Increasing age, low socio-economic status and rural residence were important factors associated with smoking. Vigorous anti-tobacco measures under the tobacco control programmes yielded only a quit-rate of 10 percent. Nearly 14% of ever smokers had some respiratory symptoms. CONCLUSIONS: A substantial proportion of population in India has current or past smoking habit with higher prevalence among males than females. The quit-rates have been low in spite of the various anti-tobacco measures. There is a significant respiratory morbidity associated with smoking.

A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure.

INTRODUCTION: Population prevalence of chronic obstructive pulmonary disease (COPD) and its relationship with tobacco smoking, environmental tobacco smoke (ETS) exposure and other variables were studied in adult subjects of 35 years and above at four different centres in India. Question-items for the diagnosis of COPD were included in the questionnaire used for the field study on asthma epidemiology. METHODS: Field surveys were conducted in both the urban and the rural populations at Bangalore, Chandigarh, Delhi and Kanpur with the help of a structured and validated questionnaire for diagnosis of asthma and COPD. Separate sets of questions were used for the diagnoses of the two diseases. A two-stage stratified sample design was employed where a village or an urban locality formed the first stage unit and a household formed the second stage unit. A uniform methodology was used at all the four centres and the analyses were done at the central coordinating centre--Chandigarh. Chronic obstructive pulmonary disease, defined by chronic bronchitis (CB) criteria, was diagnosed from the presence of cough and expectoration on most of the days for at least three months in a year for two consecutive years or more. RESULTS: Chronic obstructive pulmonary disease was diagnosed in 4.1% of 35295 subjects, with a male to female ratio of 1.56:1 and a smoker to nonsmoker ratio of 2.65: 1. Prevalence among bidi and cigarette smokers was 8.2% and 5.9%, respectively. Odds ratio (OR) for COPD was higher for men, elderly individuals, lower socio-economic status and urban (or mixed) residence. Environmental tobacco smoke exposure among nonsmokers had an OR of 1.4(95% CI 1.21-1.61). Combined exposure to both ETS and solid fuel combustion had higher OR than for ETS exposure alone. CONCLUSIONS: Population prevalence of COPD is very high in India with some centre to centre differences. Smoking of both bidis and cigarettes, and ETS exposure among nonsmokers, were two important risk factors at all centres. It is important to employ uniform methodology for assessment of national burden and disease-surveillance programme.

NK/T-cell lymphoma in AIDS.

A 42-year-old man diagnosed to be HIV positive and on highly active antiretroviral treatment (HAART), presented with double vision and gradual drooping of the left eyelid. He had left 3rd cranial nerve palsy and partial right lower-motor-neuron facial palsy. CT of the PNS revealed soft tissue filling the right maxillary sinus antruin. Further workup showed the mass to be an NK/T cell lymphoma.

A clinical trial of the efficacy and safety of montelukast as monotherapy in patients with chronic stable bronchial asthma.

This study is aimed to evaluate the efficacy and safety of montelukast, as monotherapy, in the treatment of chronic stable bronchial asthma in adults. This was a multicentre, open label, non-comparative, prospective, 4-week study. Eligible patients discontinued all anti-inflammatory medication (steroids, chromoglycate sodium) 2 weeks prior to starting therapy with montelukast (10 mg daily). The primary efficacy criteria were improvements in forced expiratory volume in one second (FEV1), peak exploratory flow rate (PEFR) after 4 weeks of therapy. Secondary efficacy criteria were improvement in the patients' symptoms (assessed on an ordinal scale), decrease in discomfort levels (scored on a scale of 0-100), change in peripheral eosinophil counts, decrease in total daily dose of inhaled beta2 agonist (salbutamol). A total of 148 patients, mean age (+/- SD) 40.21 +/- 13.70 years, were enrolled into the study. At the end of the study there were significant improvements in FEV1 and PEFR (29% and 28% increase respectively from baseline values, p<0.000001). The mean total daily dose of inhaled salbutamol decreased significantly from prestudy values of 461 +/- 332 microg/day to 161 +/- 207 microg/day (p<0.000001). The mean eosinophil counts fell from 5.80 +/- 4.90% (+/- SD) to 4.84 +/- 4.42% (+/- SD) (p=0.02). Symptom scores improved significantly as did subjective assessment of discomfort. A total of 29 (19.6%) adverse events were reported, all of which were of mild to moderate intensity. Monotherapy with montelukast significantly improved parameters of asthma control. It was well tolerated with no reports of serious or severe adverse events.