Melatonin protects against neurobehavioral and mitochondrial deficits in a chronic mouse model of Parkinson's disease

Neuronal oxidative stress and mitochondrial dysfunction have been implicated in Parkinson's disease. Melatonin is a natural antioxidant and free radical scavenger that has been shown to effectively reduce cellular oxidative stress and protect mitochondrial functions in vitro. However, whether melatonin is capable of slowing down the neurodegenerative process in animal models of Parkinson's disease remains controversial. In this research, we examined long-term melatonin treatment on striatal mitochondrial and dopaminergic functions and on animal locomotor performance in a chronic mouse model of Parkinson's disease originally established in our laboratory by gradually treating C57BL/6 mice with 10 doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (15 mg/kg, s.c.) and probenecid (250 mg/kg, i.p.) over five weeks. We report here that when the chronic Parkinsonian mice were pre-treated and continuously treated with melatonin (5 mg/kg/day, i.p.) for 18 weeks, the defects of mitochondrial respiration, ATP and antioxidant enzyme levels detected in the striatum of chronic Parkinson's mice were fully preempted. Meanwhile, the striatal dopaminergic and locomotor deficits seen in the chronic Parkinson's mice were partially and significantly forestalled. These results imply that long-term melatonin is not only mitochondrial protective but also moderately neuronal protective in the chronic Parkinson's mice. Melatonin may potentially be effective for slowing down the progression of idiopathic Parkinson's disease and for reducing oxidative stress and respiratory chain inhibition in other mitochondrial disorders.     

Dapsone-induced erythroderma with Beau's lines

A 35-year-old female with borderline lepromatous (BL) leprosy who suffered from dapsone-induced erythroderma is reported. Sudden onset of erythroderma gave rise to a temporary arrest of the function of nail matrix with the resultant Beau's lines. She rapidly recovered with omission of dapsone and therapy with systemic corticosteroids and a topical emollient. In view of the potentially fatal hypersensitivity reaction, we suggest that any patient on multidrug therapy for leprosy needs an urgent referral to a dermatologist if the patient develops a skin rash during the first two months of treatment.     

Congenital localized absence of skin associated with blistering of the skin and mucous membranes: Bart's syndrome

A newborn girl presented with a congenital localized absence of skin on both legs. At the age of eight months, blistering of the scalp, upper limbs, and oral mucous membranes occurred, which was nonscarring and recurrent. This case is reported because of its rarity.     

Water Soluble Components of ‘Osteocare’ Promote Cell Proliferation,Differentiation, and Matrix Mineralization in Human Osteoblast-Like SaOS-2 Cells

Osteocare, a herbal formulation, has been found to be very effective in bone mineralization and support of the microstructure of bone tissue. The water-soluble components of Osteocare (WSCO) induced osteogenic activity in human osteoblast-like SaOS-2 cells. The addition of WSCO (100 μg/ml) to SaOS-2 cells was effective in increasing the cell proliferation by 41.49% and DNA content by 1.9-fold. WSCO increased matrix mineralization in SaOS-2 cells by increased alkaline phosphatase levels and calcium-rich deposits as observed by Alizarin red staining. WSCO markedly increased mRNA expression for osteopontin (OPN), osteocalcin (OCN), type I collagen (Col I) in SaOS-2 cells, and it down-regulated IL-6 mRNA levels in SaOS-2 cells. The present study showed that WSCO plays an important role in osteoblastic bone formation through enhanced activities of ALP, Col I, bone matrix proteins such as OPN and OCN, down-regulation of cytokines like IL-6, as well as promoting mineralization in SaOS-2 cells.     

A pit‐fall in the estimation of rice consumption through oral questionnaire method of diet survey

Rice forms one of the most important and widely consumed cereals in the country. It is known that about 80 % of the total calones and protein consumed particularly by the rural and urban poor are derived from these sources. As such, precise estimation of rice intake by population groups has great relevance in overall assessment of nutrient intake of the community.

In diet surveys, estimates of food and nutrient consumption of individuals are usually made by verbal questionnaire (24 hour recall) method. In this method, the rice intake is assessed from amounts in vessels of cooked rice, and it is then converted to raw amount equivalents by making use of a standardised conversion table. In the present study, an attempt has been made to assess the validity of the use of such a conversion table for calculating rice intake. It was observed that this method always under estimated the consumption of rice to the extent of about 30%. The implication of this observation in estimating the nutrients intake of individuals is obvious.

An alternate approach has been suggested which overcomes the limitations of the above method. This involves working out a conversion factor at each household level, which is defined as the ratio of total raw weight of rice to total cooked volume of rice. This factor is used to convert individual intake of cooked rice (assessed in terms of vessel volumes) into the raw equivalent amounts. This approach has been tested in a field trial and found to be suitable for wider application.     

Unrecognized bladder perforation with mid‐urethral slings

Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVE

To present a series of women with late presentation of mid‐urethral synthetic slings perforating the bladder and their management, this is rare but can lead to significant morbidity with medico‐legal consequences.

PATIENTS AND METHODS

We retrospectively reviewed the case notes of nine women with urinary symptoms referred to our unit for further investigation after synthetic mid‐urethral sling placement.

RESULTS

The women presented between 8 weeks and 18 months after initial sling placement. Eight patients underwent a tension‐free vaginal tape insertion via the retropubic route and one patient had an ‘outside‐in’ obturator sling with the I‐Stop device (CL Medical, Lyon, France). The frequencies of presenting symptoms were: dysuria in six; recurrent urinary tract infection in four; frequency and urgency in four and pelvic pain in two. Seven of the nine women developed bladder calculi on the exposed sling material, all of which were visible on plain X‐ray. In six women, perforations were present at more than one site; in three urethral perforation had occurred together with an anterolateral bladder injury and in the remaining three there was bilateral bladder perforation. Initial management included cystoscopy and cystolithopaxy followed by transurethral resection (TUR) of the visible prolene mesh into the detrusor muscle. One woman required two TURs to clear all the mesh. Two women required further open surgery to remove all of the remaining mesh, both for ongoing pelvic pain that resolved after revision surgery. All the women had resolution of symptoms but all had recurrent stress urinary incontinence after tape division/excision. We used a novel technique to remove intraurethral mesh using a nasal speculum urethrally and excising the tape under direct vision, where resection proved impossible due to poor endoscopic views, with significant risk of sphincter injury.

CONCLUSIONS

The possibility of unrecognized tape perforation or erosion must be considered in women with persistent urinary symptoms, infection or pain after any form of mid‐urethral sling procedure. Bladder stones almost invariably develop if the exposed mesh has been present for >3 months. Most patients can be managed with endoscopic resection to remove all intravesical tape. Cystoscopy should remain a mandatory procedure together with any form of mid‐urethral sling placement but does not prevent unrecognized perforations in inexperienced hands.