Methyl glyoxal elevation is associated with oxidative stress in rheumatoid arthritis

Methyl glyoxal (MG), a metabolic hazard plays a role in pathogenesis of different diseases. We studied the role of MG in cellular oxidative and carbonyl stress in rheumatoid arthritis (RA). 148 RA patients were divided into subgroups according to disease severity, RA factor status and age. They were acute, remission, seropositive, seronegative and JRA group. About 88 normal, young, healthy individuals were taken as control. We estimated serum level of total antioxidant status (TAS), total thiol, GSH, MG, carbonyl compounds and TBARS level of normal control and RA. The synovial fluid (SF) level of above parameters have been also evaluated in RA. Our observation suggests that MG elevation is associated with increased level of TBARS and decreased level of GSH in all RA subgroups than normal control. The elevation of MG along with declination of GSH and antioxidant status may be associated with free radical damage in RA.

Airway management of two patients with penetrating neck trauma

SUMMARY

Direct trauma to the airway is a rare injury which can lead to disastrous consequences due to compounding effect of bleeding, aspiration of blood, airway obstruction and severe sympathetic stimulation. Here we are presenting two cases of open tracheal injury in two adult males following assault with sharp weapon. Two different techniques of securing the airways were employed depending upon the severity and urgency of the situation. In the first case, orotracheal intubation helped the surgeon to repair airway around the endotracheal tube whereas in the second patient this stenting effect was absent as he was intubated through the distal cut-end of trachea in the face of airway emergency.

The role of iron chelation activity of wheat grass juice in patients with myelodysplastic syndrome

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Background: A pilot study with wheat grass juice in major thalassaemia patients was done by a group of clinicians in IPGMR, Chandigarh, India. We performed a study of 200 patients of intermediate thalassaemia with wheat grass juice and found 80% patients becoming transfusion independent. During the study in majority of the patients, serum ferritin level was significantly less as compared to pretreatment values. The aim of our study was to see the effect of wheat grass juice in reducing Ferritin level in myelodysplastic syndrome and also do the biochemical analysis of the wheat grass juice. Methods: During period from January 2003 to December 2007 we selected 20 patients of transfusion dependent myelodysplastic syndrome in the oncology department of Netaji Subhash Chandra Bose Cancer Research Institute. The age range of the patients was 42 years to 72 years (median 55 years). The fresh leaves of 5–7-day-old wheat grasss including stems were made fresh juice and had given 30 mL of juice daily to all 20 patients for continuous 6 months. Wheat grass juice was analyzed by column chromatography and found to be rich in oxalic and malic acid which might have some role in dietary absorption of iron from intestine. Beside that the wheat grass juice was found to contain two unique active ingredients with iron chelating property which was performed by deoxyribose degradation assay. We compared aqueous soluble extract of 5–7-day-old plant and dose-dependent study showed a significant iron chelating activity of crude extract in comparison to known standard iron chelator desferroxamine (DFO). The active compounds of crude extract of wheat grass may chelate catalytic iron in iron overload disorders when taking systematic dose. Result: The mean serum Ferritin level of the patients was 2,250 (range 650–4,800) before wheat grass treatment. The mean reduced to 950 (range 68–1680) (p < 0.0001). The performance status was improved from 60% to 80% (Karnofsky) after wheat grass treatment. The mean interval between transfusions was found increased. Conclusions: Wheat grass juice is an effective iron chelator and its use in reducing serum ferritin should be encouraged in myelodysplastic syndrome and other diseases where repeated blood transfusion is required.

No significant financial relationships to disclose.

Result of adolescent acute lymphoblastic leukemia protocol (MCP 841) from a developing country

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Background: Acute Lymphatic Leukemia is a curable disease in the range of 80 - 90% in developed countries by aggressive protocol like BFM, St. Judes’ but result is much less in adolescence age group (60–70%). In developing countries like ours, patients can't tolerate that aggressive protocol because of socio-economic and nutritional factors. The less aggressive protocol like MCP841 is suitable in developing countries like ours. The aim of our study was to see outcome of adolescent ALL patient with protocol MCP 841 and tolerability of the protocol in Indian-Asian population. Methods: We treated 75 children with age range 13 - 18 years (median age of 15 yrs) with MCP 841 Protocol at Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata, India, a tertiary cancer center from Eastern India during the period of April 1999 to Dec 2007. There was female preponderance in the study. Fever 48 (64.0%), lymphadenopathy 35 (46.7%), and haepatosplenomegaly 28 (37.3%) were the major clinical presentation. Eight (10.7%) patients were present with hyper leukocytosis. T-ALL phenotype was the largest group though the incidence of the C-ALL was quite high 23 (30.7%). Results: Remission induction was seen in 65 (86.7%) of the patients. In a follow-up period of 24 - 88 months (with an average of 54 months) the disease-free survival ( DFS) was 42 (56%) patients with an overall survival of 46 (61.34%) patients. The isolated bone marrow relapse was seen in majority of the cases 28 (37.34%) and the major relapse was in maintenance and first 6 months of completion of therapy. The major cause of morbidity was infection 53 (70.7%) followed metabolic complications 16 (21.34%), pancreatitis 3 (4.0%), hemorrhage 10 (13.3%), neurologic 2 (2.7%), and hepatitis 1 (1.3%). The major cause of the mortality was infection 18% (24.0% patients) followed progressive disease 9 (12.0%) and hemorrhage 2 (2.7%). As compared to our all pediatric ALL group the outcome is much less and complications are much more. Conclusions: The data of acute lymphatic leukemia in adolescent is not satisfactory as compared to other pediatric patients. They also tolerate chemotheraphy badly. Therefore there is need for modified protocol for this age group.

No significant financial relationships to disclose.

An investigation into a mass psychogenic illness at Burdwan, West Bengal

This investigation of the outbreak of mass psychogenic illness during July 2007 at three schools in Burdwan was done to observe the description of the epidemic, identify its characteristics and to study any particular factor associated with the spread of illness. Relevant data were obtained from medical and school records. All concurrent factors were considered. All the incidents happened prior to the examinations. There have been differences in presentations and final diagnosis among the schools. Intense media coverage influenced the manifestations. Poor school performance was associated with recurrence of symptoms. So understanding the academic anxiety is important to prevent such outbreaks.

Clearance of acanthosis nigricans associated with insulinoma following surgical resection

Acanthosis nigricans is said to be a marker of insulin resistance. It is known to occur in patients with insulinoma where there is marked hyperinsulinaemia. We report a case wherein the acanthosis disappeared following surgical resection of insulinoma and this strengthens the hypothesis that hyperinsulinaemia is responsible for acanthosis.

Filaggrin null mutations are associated with increased asthma exacerbations in children and young adults

BACKGROUND

Filaggrin (FLG) null mutations are important genetic predisposing factors for atopic asthma and have recently been shown to influence controller and reliever medication needs in asthmatic children. Our objective was to study the role of FLG null alleles in asthma exacerbations.

METHODS

FLG mutations R501X and 2282del4 were assayed in 1135 individuals ranging from 3 to 22 years old with asthma from Tayside and Dumfries, Scotland. Asthma exacerbations over the previous 6 months were also studied.

RESULTS

The FLG mutations were significantly associated with greater risk of exacerbations in children with asthma. Exacerbations were significant for the R501X but not the 2282del4 mutation and the combined genotype compared to the wild-type with odds ratios of 1.97 (95% CI, 1.19-3.22; P = 0.009) and 1.61 (95% CI, 1.08-2.40; P = 0.021), respectively. Individuals with FLG null alleles were more likely to require oral steroids (31.4%vs 19.5%; OR = 1.89; P = 0.021) for their exacerbations. There was also a 1.71-fold increased risk (42.6%vs 30%; P = 0.041) of school absence owing to asthma exacerbations in asthmatic individuals with FLG null mutation. On sub-group analysis, the effect of FLG mutations on asthma exacerbations is significant (P = 0.045) only for participants with relatively mild asthma controlled on inhaled steroids, with inhaled albuterol according to need.

CONCLUSION

In addition to their effect on asthma medication requirements reported previously, there is an association between the presence of FLG null mutations and the risk of asthma exacerbations in asthmatic children and young adults.

Simulations of liquid nanocylinder breakup with dissipative particle dynamics

In this work, we use a dissipative-particle-dynamics-based model for two-phase flows to simulate the breakup of liquid nanocylinders. Rayleigh's criterion for capillary breakup of inviscid liquid cylinders is shown to apply for the cases considered, in agreement with prior molecular dynamics (MD) simulations. Also, as shown previously through MD simulations, satellite drops are not observed, because of the dominant role played by thermal fluctuations which lead to a symmetric breakup of the neck joining the two main drops. The parameters varied in this study are the domain size, cylinder radius, thermal length scale, viscosity, and surface tension. The breakup time does not show the same scaling dependence as in capillary breakup of liquid cylinders at the macroscale. The time variation of the radius at the point of breakup agrees with prior theoretical predictions from expressions derived with the assumption that thermal fluctuations lead to breakup.