Evaluation of the effect of gemcitabine on cochlea by otoacoustic emission in experimental animal model

OBJECTIVES

In this study, we aimed to search whether gemcitabine - a commonly used antimetabolite type antineoplastic agent-has ototoxic effect.

STUDY DESIGN AND SETTING

An experimental animal research.

SUBJECTS AND METHODS

We evaluated the effect of gemcitabine on hearing through its possible effect on cochlea by using otoacoustic emission method on experimental rat model. For this purpose 16 healthy adult male Wistar albino rats were used and these were divided into 4 groups. The rats in the 1st, 2nd, 3rd and the 4th groups were given 40-160-240 and 320 mg/kg of intraperitoneal gemcitabine respectively. Distortion product otoacoustic emission measurements on both ears of each rat were performed before and 1 week after administration of gemcitabine. The mean of signal to noise ratio of emission values obtained from each rat before and after the drug administration were calculated.

RESULTS

Rats in the 1st group had no statistically significant difference at the emission rates before and after gemcitabine administration. A statistically significant decrease was observed in the emission rates at emission values of only 5 kHz in the 2nd group, at 4-6 kHz in the 3rd group, at 4-5-6-8 kHz in the 4th group.

CONCLUSIONS

Gemcitabine causes a decrease in otoacoustic emission values on experimental rat models at high doses and especially at high frequencies. Larger clinical and laboratory studies are needed to determine whether this decrease in emission rates are permanent and whether it has any permanent effect on hearing.  

Health needs and eHealth readiness assessment of health care organizations in Kabul and Bamyan, Afghanistan

This study assessed the need and readiness of health care institutions in Kabul and Bamyan, Afghanistan for successful implementation of information and communication technology in health care (eHealth). A mixed methods design was adopted at 2 institutions in the Aga Khan Development Network in Afghanistan: the French Medical Institute for Children in Kabul and Bamyan Provincial Hospital, Bamyan. Information for the needs assessment was obtained from interviews and focus groups and eHealth readiness was assessed using a validated survey tool. The needs of institutions in the Aga Khan Development Network in Afghanistan were categorized as follows: provision of care needs; learning needs; and information management needs. eHealth readiness on average was lower in Bamyan compared with Kabul in all areas of the readiness assessment. Other institutions in Afghanistan may benefit from adopting the model of needs and readiness assessment used for Aga Khan Development Network institutions.

FZD6 encoding the Wnt receptor frizzled 6 is mutated in autosomal-recessive nail dysplasia

BACKGROUND

Isolated nail dysplasia is rare and has been reported in only a small number of families.

OBJECTIVES

To describe and characterize two Pakistani families with an autosomal-recessive inherited nail dysplasia.

METHODS

Genome-wide linkage analysis; mutation screening of candidate genes by Sanger sequencing; cloning of FZD6 and protein analyses; immunohistochemistry.

RESULTS

We mapped this genodermatosis to chromosome 8q22.3, and identified a homozygous nonsense mutation c.1750G>T (p.E584X) in the frizzled 6 (FZD6) gene in all affected individuals. Immunohistochemical analyses in nail sections from healthy individuals revealed strong expression of FZD6 in the ventral nail matrix and a less pronounced expression of FZD6 in the nail bed.

CONCLUSIONS

FZD6 belongs to a family of proteins that serve as receptors in Wnt signalling pathways, and has been shown to act as a negative regulator of the canonical Wnt/β-catenin signalling cascade and a positive regulator of the noncanonical Wnt or planar cell polarity pathway. The present results therefore suggest that FZD6 plays a pivotal role in the growth and guidance of the nail plate in humans by acting as a molecular switch between different Wnt pathways. Previous studies have identified mutations in the RSPO4 and LMX1B components of the Wnt pathway in patients with the hypoplastic nail disorders anonychia and nail-patella syndrome, respectively. Only recently, FZD6 mutations were identified in isolated nail dysplasia. The present results emphasize the important role of the Wnt pathways in nail development and increase understanding of Wnt-mediated developmental events in general.

A misdiagnosed keratoacanthoma turned out to be a metastatic parotid carcinoma

Distinguishing keratoacanthoma from well-differentiated squamous-cell carcinoma is often difficult on account of the clinical and histopathological similarities between them. Since the outcome of treatment depends on identifying the correct diagnosis and having the correct treatment on time, it is essential to differentiate keratoacanthoma and squamous-cell carcinoma as soon and accurately as possible. A paradigmatic case is herein reported. An 85 year-old female underwent total parotidectomy and ipsilateral neck dissection due to the squamous-cell carcinoma of the parotid gland. The investigations, in order to determine whether the tumour was a metastatic or a primary one, led to a misdiagnosis. A prior skin lesion, which was excised over her left cheek one year ago in another clinic, was diagnosed as keratoacanthoma. However, the histopathological revision of the specimen revealed that the lesion was in fact a squamous-cell carcinoma. Thus the parotid tumour was accepted as metastatic squamous-cell carcinoma rather than primary squamous-cell carcinoma.

Influence of fructose concentration on myocardial infarction in senile diabetic and non-diabetic patients

BACKGROUND

Fructose intake has been increased steadily during the past two decades. Fructose, like other reducing sugars can react with proteins, which may account for aging and myocardial infarction. Fructose participates in glycation (fructation) and AGE formation some 10 times faster than glucose. This study aims to determine the fructose concentration and correlate with antioxidant status in senile diabetic and non-diabetic patients with myocardial infarction.

METHODS

The study included one hundred twenty six subjects. Out of them 31 were normal senile subjects, 33 were senile diabetic patients without myocardial infarction, 32 were senile diabetic patients with myocardial infarction and 30 were senile non-diabetic patients with myocardial infarction. The patients were selected on clinical grounds from National Institute of Cardiovascular Diseases, Karachi and Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

RESULTS

Serum fructose was significantly increased in senile diabetic patients with and without myocardial infarction and senile non-diabetic patients with myocardial infarction as compared with senile control subjects. Serum total antioxidant status was found to be significantly decreased in senile diabetic patients with and without myocardial infarction and senile non-diabetic patients with myocardial infarction as compared with senile control subjects. Fasting blood glucose, HbA (1C) and serum fructosamine were significantly increased in senile diabetic patients with or without myocardial infarction as compared with senile non-diabetic patients with myocardial infarction and senile control subjects. Negative significant correlation was observed between serum fructose and serum total antioxidant status in diabetic and non-diabetic patients with myocardial infarction. Positive significant correlation was observed between serum fructose and s-AGEs in diabetic and non-diabetic patients with myocardial infarction.

CONCLUSIONS

This study revealed that increased fructose concentration and decreased antioxidant status might have a role in the myocardial infarction.

Adult-onset Still's disease

BACKGROUND

Adult-onset Still's disease (AOSD) is a febrile disorder of unknown aetiology characterised by typical spiking fever, evanescent rash, arthralgia and leucocytosis.

METHODS

According to the diagnostic criteria of AOSD, we identified 84 patients between 1990 and 2003. The aim of this study was to analyse the characteristics of AOSD in Turkish patients who were followed-up in a tertiary referral centre.

RESULTS

Of 84 patients of AOSD, 59 (70.2%) were female, 25 (29.8%) were male. Arthralgia (96.4%), fever (95.2%), arthritis (69%), sore throat (65.5%) and typical rheumatoid rash (59.5%) were the most common findings. The mean value of laboratory findings were as follows; C-reactive protein level of 11.59 +/- 6.81 mg/dl, erythrocyte sedimentation rate (ESR) of 89.05 +/- 31 mm/h, leukocyte count of 16,234.51 +/- 7785.2/microl. Leucocytosis was present in 69 patients (84.15%). Forty-eight patients had a WBC count >or= 15,000/microl. Hypoalbuminaemia was present in 35 patients. Abnormal levels of aspartate aminotransferase and alanine aminotransferase were observed in 30 patients, whereas abnormal levels of alkaline phosphatase in 16 patients. Thirty-seven patients had an ESR value of more than 100 mm/h. Thirty-two patients had a ferritin value of more than 1000 ng/dl.

CONCLUSION

High fever, sore throat, rheumatoid rash, polyarthritis, hyperferritinaemia (>or= 1000 ng/ml), leucocytosis with a neutrophilic predominance, anaemia and hypoalbuminaemia were remarkable observations in the initial examination.