Realizing the label-free sensitive detection of carcinoembryogenic antigen (CEA) in blood serum via a MNC-decorated flexible immunosensor.

A label-free electrochemical immunosensor utilising nitrogen-rich mesoporous carbon (MNC) as the substrate material was developed for the sensitive quantification of carcinoembryonic antigen (CEA). The synergic interactions between MNC and AbCEA also eliminated the need for coupling agents such as EDC/NHS. The novel immunosensor demonstrated a wide detection range from 500 fM (9.04 pg mL-1) to 50 nM (1 µg mL-1) and a low detection limit (LOD) of 500 fM. Moreover, the immunosensor showed sensitivities of 12.27 mA nM-1 cm-2 and 0.066 mA nM-1 cm-2 for detecting CEA in the linear ranges 10 pM to 1 nM and 2 nM to 50 nM, respectively, while maintaining long-term storage stability of 6 weeks. Analysis of real serum sample analysis yielded highly accurate results with recovery rates ranging from 99.3% to 103.7%. Furthermore, the developed paper-based screen-printed electrode exhibited a similar detection range, suggesting its potential for use in point-of-care detection devices in future applications.

Advances and Challenges in Nanomaterial-Based Electrochemical Immunosensors for Small Cell Lung Cancer Biomarker Neuron-Specific Enolase.

Early and rapid detection of neuron-specific enolase (NSE) is highly significant, as it is putative biomarker for small-cell lung cancer as well as COVID-19. Electrochemical techniques have attracted substantial attention for the early detection of cancer biomarkers due to the important properties of simplicity, high sensitivity, specificity, low cost, and point-of-care detection. This work reviews the clinically relevant labeled and label-free electrochemical immunosensors developed so far for the analysis of NSE. The prevailing role of nanostructured materials as electrode matrices is thoroughly discussed. Subsequently, the key performances of various immunoassays are critically evaluated in terms of limit of detection, linear ranges, and incubation time for clinical translation. Electrochemical techniques coupled with screen-printed electrodes developing market level commercialization of NSE sensors is also discussed. Finally, the review concludes with the current challenges associated with available methods and provides a future outlook toward commercialization opportunities for easy detection of NSE.

Pembrolizumab-Induced Lichen Planus: A Rare Immune-Related Adverse Side Effect.

Pembrolizumab is the first anti-programmed death protein-1 agent approved by the US Food and Drug Administration. It has demonstrated efficacy in melanoma, lung cancer, and other advanced solid tumours and hematologic malignancies. Various dermatological side effects including pruritus, maculopapular rash, vitiligo, lichenoid skin reactions, psoriasis, and rarely life-threatening conditions like bullous pemphigoid, Stevens-Johnson syndrome, and drug rash with eosinophilia and systemic symptoms have been reported. We report a case of pembrolizumab-induced lichen planus in a 54-year-old female who was receiving pembrolizumab for management of lung metastasis from squamous cell carcinoma of the buccal mucosa. The lichen planus responded to acitretin and pembrolizumab was continued safely.

Electrochemical Production of Hydrogen from Hydrogen Sulfide Using Cobalt Cadmium Sulfide.

The electrocatalytic decomposition of H2S is a promising technology for H2 production as well as for targeting environmental pollution. But due to the lack of low-cost and efficient electrocatalysts, this technology for H2 production is not being explored much. Moreover, the highly toxic and copious waste H2S released from industries is rarely encountered in the scientific domain. Herein, we have designed a highly efficient electrocatalyst, i.e., CoCd(x:y)Sn, as an anode catalyst for sulfide oxidation reaction (SOR). This optimized catalyst could drive the anode reaction at an onset potential of 0.25 V vs reversible hydrogen electrode (RHE), which was 1.27 V lower than that required for the water oxidation reaction. Moreover, we have achieved 98% H2 Faradaic efficiency with remarkable stability of 120 h. Thus, this method paves a path to high-value utilization of hazardous waste H2S and demonstrates its great potential for hydrogen production and sulfur toward sustainable energy applications.

Selective Electrochemical Conversion of N2 to NH3 in Neutral Media Using B, N-Containing Carbon with a Nanotubular Morphology.

Electrochemical dinitrogen reduction (NRR) has riveted substantial attention as a greener method to synthesize ammonia (NH3) under ambient conditions. Here, B, N-containing carbon catalysts with a discrete morphology were synthesized from the metal-organic framework-ionic liquid (MOF-IL) composite for NRR in a neutral electrolyte medium (pH = 7). Morphology-dependent activity is witnessed, wherein C-BN@600 with a nanotubular morphology is able to achieve a high NH3 yield rate of 204 µg h-1 mgcat-1 and an F.E. of 16.7% with a TOF value of 0.2 h-1 at -0.2 V vs RHE. Further, a rigorous protocol is put forward for true NH3 estimation by tracing/eliminating any source of contamination in catalysts, electrolytes, or gas supply via ultraviolet-visible (UV-vis) spectroscopy, gas-purification methods, and isotope labeling experiments. Density functional theory predicts BN to be the favorable active site for N2 adsorption with a reduced energy barrier in the first reduction step and sequential stabilization of the B-N bond by an adjacent carbon atom.

Pyoderma Gangrenosum with Splenic Abscess- A Rare Association.

Pyoderma gangrenosum is a rare, chronic neutrophilic dermatosis of unknown etiology. The classical clinical feature of pyoderma gangrenosum is a pustule or plaque that rapidly progresses to a painful, necrotic ulcer with undermined violaceous margins. Pyoderma gangrenosum may be associated with underlying inflammatory bowel diseases, hematological malignancies, or rheumatologic disorders in 50-70% of the cases. The visceral involvement by pyoderma gangrenosum is rare. Sterile neutrophilic infiltrates in organs other than the skin are uncommon systemic manifestations of neutrophilic dermatoses, but have occasionally been reported. We report a case of a 38-year-old female with pyoderma gangrenosum and visceral involvement manifesting as splenic abscess.

Proton Pump Inhibitor Induced Subacute Cutaneous Lupus Erythematosus: A Case Series of 7 Patients and Brief Review of Literature.

BACKGROUND: Subacute cutaneous lupus erythematosus (SCLE) manifests with erythematous, nonscarring, annular, or papulosquamous plaques. Proton pump inhibitors (PPIs) are increasingly being incriminated in its causation, but reports of similar nature from India are lacking. AIMS: To describe the characteristics of seven patients with SCLE induced by PPIs and to review the published cases in order to provide a better perspective of the association. MATERIALS AND METHODS: We describe seven patients of PPI-induced SCLE, seen over a period of 6 years. We also review the literature for additional data on PPI-induced SCLE. The selected publications were reviewed, and relevant clinical and laboratory data were extracted. RESULTS: Of the total seven cases, there were four males and three females with a mean age of 60.2 ± 5.5 years (range 53-70 years). Nine episodes of PPI-induced SCLE were recorded in the seven patients. Of the initial episodes, esomeprazole was implicated in four, pantoprazole in two, and rabeprazole in one patient. Latency period ranged from 2 weeks to 1 year (mean 11.4 ± 16.2 weeks). Morphology was described as annular scaly plaques in six and papulosquamous in one. Antinuclear antibodies and anti-Ro antibodies were positive in all patients. Naranjo probability scale was used in all patients; two were categorized as definite and five as probable. Treatments included drug withdrawal in six patients, topical steroids in one, systemic corticosteroids in all seven, and hydroxychloroquine in one patient, used alone or in combinations. Complete remission was achieved in six cases, while one had partial remission. LIMITATION: Retrospective nature of this study and limited number of patients. CONCLUSION: PPIs can trigger SCLE.

A Clinicopathological Study of Skin Tumors from a Tertiary Care Centre in North India.

BACKGROUND: There is a huge spectrum of skin tumors which can be confused clinically with malignancies, particularly when they are pigmented or inflamed, and histopathological examination of a biopsy specimen is required to establish a definitive diagnosis and to facilitate appropriate intervention and follow up. AIM: To evaluate all skin tumors and categorize them according to their origin. METHODS: The present study was conducted over a period of 4 years (July 1, 2013 to June 31, 2017) comprising of 1.5 years prospective and 2.5 years retrospective analysis in the departments of Dermatology and Pathology, at a tertiary hospital in North India. All specimens of skin tumors were analyzed grossly and microscopically. Immunohistochemistry was done wherever possible. RESULTS: A total of 232 skin tumors were seen; of which 123 cases were benign (53.0%) and 109 cases were malignant (47.0%). The mean age of patients with benign and malignant skin tumors was 40.3 ± 19.9 and 60.8 ± 14.8 years, respectively. The most common site was face (n = 106; 45.7%) followed by limbs (n = 44; 19.0%). The male:female ratio of benign and malignant tumors was 1.01:1 and 1.31:1, respectively. Among the benign tumors, keratinocytic tumors were the commonest (n = 57; 46.3%) followed by the melanocytic tumors (n = 37; 30.1%) and appendageal tumors (n = 29; 23.6%). The most common malignant skin tumors were the keratinocytic tumors (n = 87; 79.8%) followed by 12 cases (11%) of hematolymphoid tumors and five cases (4.6%) each of melanocytic and appendageal tumors. LIMITATIONS: The lack of clinical and dermatoscopic correlation and inclusion of retrospective data are the limitations of this study. CONCLUSIONS: Skin tumors affect people of all ages. The benign tumors are seen in the younger age group as compared to malignant tumors. Face is the most common site and keratinocytic tumors are the most common skin tumors in both benign and malignant categories.

Lamotrigine-induced Systemic Lupus Erythematosus: A Diagnostic Dilemma.

Many drugs are known to cause systemic lupus erythematosus (SLE), however there are no well defined criteria for drug induced lupus erythematosus (DILE). We present a rare case of lamotrigine induced lupus presenting as acute syndrome of apoptotic pan epidermolysis (ASAP).

Dermatologic findings of vitamin B12 deficiency in infants.

BACKGROUND/OBJECTIVES: Vitamin B12 deficiency in infants is uncommonly reported from developed countries and generally lacks dermatologic manifestations. On the contrary, infantile vitamin B12 deficiency is common in India and cutaneous manifestations are a constant feature, although often overshadowed by neurologic and hematological manifestations. The aim of this study was to describe the skin changes of vitamin B12 deficiency in infants. MATERIALS AND METHODS: A retrospective chart review of vitamin B12 deficient infants for clinical and laboratory parameters was performed and data analyzed. RESULTS: Forty-three infants, 30 boys and 13 girls, aged 4 to 27 months, with vitamin B12 deficiency were identified. Skin hyperpigmentation was present in 41 infants; it was localized to the dorsa of hands and feet in 26. Fifteen infants had generalized hyperpigmentation; 10 had a reticulate pattern, and 5 had a homogeneous pattern. Brown and sparse scalp hair were present in all. Glossitis was seen in 5 infants and cheilitis in 3. Of the 32 infants who underwent laboratory investigations, 28 had anemia and 21 macrocytosis. Serum vitamin B12 was measured in 30 infants; it was low in 19. Of the 11 with normal serum vitamin B12 , 9 had received vitamin B12 before referral but had macrocytosis and low maternal serum vitamin B12 . The infants were treated with vitamin B12 . Skin pigmentation and mucosal changes resolved completely by 3-4 weeks, but hair changes were slower to reverse. CONCLUSION: Cutaneous findings are a common feature of vitamin B12 deficiency in Indian infants and resolve with treatment.

Vitamin B12 Status of Mothers of Children with Infantile Tremor Syndrome.

Retrospective chart review of 15 patients with infantile tremor syndrome in which mothers had their serum vitamin B12 measured, showed low (<200 pg/mL) serum vitamin B12 in 9 and low-normal (<200-350 pg/mL) in 6. Of the 9 mothers who had undergone complete blood counts, anemia was present in 6 and macrocytosis in 3. Vitamin B12 deficiency appears to be common in mothers of infants with infantile tremor syndrome.

Infantile tremor syndrome: A review and critical appraisal of its etiology.

Infantile tremor syndrome (ITS) is defined by the tetrad of pallor, developmental delay/regression, skin pigmentation, and brown scanty scalp hair. Involuntary movements in the form of tremors supervene in the natural course of the illness in a significant number of cases. The disorder occurs in exclusively breast-fed infants of vegetarian mothers belonging to economically deprived sections of society. Most of the children eventually recover but are frequently left with long-term cognitive and language neurodeficits. ITS continues to be seen in clinical practice, but there has been no consensus on its causation. Last comprehensive review was published in 1987 describing the ITS as a syndrome of unknown or multiple etiologies. Several important papers have been published since then. This review attempts to provide comprehensive and up-to-date information on the subject incorporating recently published studies. In the end, the issue of etiology is objectively re-examined in the light of available evidence some of which has been published in recent years.

Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review.

We studied 27 infants aged 6 to 27 months with vitamin B12 deficiency also known as "infantile tremor syndrome" in India. All were exclusively breast-fed by vegetarian mothers. Developmental delay or regression, pallor, skin hyperpigmentation, and sparse brown hair were present in all. Majority were hypotonic and involuntary movements were encountered in 18. Anemia and macrocytosis was found in 83% and 71% infants, respectively. Low serum vitamin B12 was present in 12 of 21 infants. Seven of the 9 infants with normal serum vitamin B12 had received vitamin B12 before referral. Twelve mothers had low serum vitamin B12. Cerebral atrophy was present in all the 9 infants who underwent neuroimaging. Treatment with vitamin B12 resulted in dramatic improvement in general activity and appetite within 48 to 72 hours followed by return of lost milestones. Tremors resolved in all by 3 to 4 weeks. Nutritional vitamin B12 deficiency is a treatable cause of neurologic dysfunction in infants.

Infantile tremor syndrome -- down but not out.

Retrospective chart review of 21 infants with infantile tremor syndrome for vitamin B12 deficiency showed low serum vitamin B12 levels in 8/16 (50%). Of the eight infants with normal levels, six had received vitamin B12 before referral. Macrocytosis and low maternal serum B12 was found in 12 and seven cases each. Treatment with vitamin B12 alone produced rapid recovery.