Prevalence of Transfusion Transmitted Infections in Voluntary and Replacement Donors

The aim of the study was to find out the prevalence of transfusion transmitted infections (TTI) in voluntary and replacement donors. A total of 9599 donors were analysed for the prevalence of TTI over a period of 2 years.Of these 61.2% were voluntary donors and 38.8% were replacement donors. Prevalence of TTI in total donors was 0.6%. Prevalence of hepatitis B was highest (0.34%) followed by syphilis (0.11%), HIV&HCV (0.06%) and malaria (0.01%). Prevalence was more in male replacement donors. Extensive donor selection and screening procedures will help in improving the blood safety.     

Consumer Beware: A Systematic Assessment of Potential Bias in the Lay Electronic Media to Examine the Portrayal of “PARP” Inhibitors for Cancer Treatment

This study examined how the lay electronic media covers poly-ADP-ribose polymerase, or “PARP,” inhibitors, a class of cancer agents currently under clinical investigation. Of 771 internet links, 51 targeted the lay public. Independent review by two investigators yielded the following categorizations: 36 (71%) were “overly positive”, 15 (29%) “neutral”, and none “overly negative”. “Overly positive” articles used: (l) overstated benefit, (2) included quotations from enthusiastic scientists, and (3) discussed single or small patient subsets. They used such phrases as “the holy grail of cancer research”, “the most exciting development in cancer research in a decade or more…. it could save thousands of lives”, and “we were surprised and delighted…. it’s the kind of thing you don’t really think will happen”. Healthcare providers should be aware of the foregoing when discussing PARP inhibitors—and perhaps other novel therapies—with cancer patients.     

Unmasking of Neonatal Renovascular Hypertension by Milrinone Used for Cardiac Dysfunction

A neonate initially presented with heart failure, with severe cardiac dysfunction confirmed by echocardiography, at 3 days of age. Blood pressure at presentation was in the high normal range. It was not until there was a rapid improvement of left-ventricular function on intravenous milrinone that the infant was noted to be hypertensive on day of life 7. It is noteworthy that milrinone, a drug with vasodilator and inotropic properties, paradoxically unmasked hypertension by rapidly improving left-ventricular function. Subsequent work-up showed the etiology of hypertension to be left renal artery stenosis. We present this case to alert clinicians to the rarer causes of left-ventricular dysfunction and to point out that its etiology, i.e., hypertension, may not be apparent until there is improvement in the systolic function of the left ventricle.     

Single-stage functional reconstruction of the post-burn lower lip

Burn scar contracture of the lower face and neck is one of the most difficult subjects to solve because it produces problems with function and appearance. The lip is a part of the face that is frequently affected by burn injury. Lower lip deformity can be due to an extrinsic or intrinsic cause. Post-burn sequelae in this area results in cosmetic disfigurement and psychological trauma to patients as it is often associated with ectropion of the lower lip, severe microstomia leading to poor oral access for intubation, drooling, difficulty in eating, speaking and oral hygiene. The aim is to describe a single-stage correction to address all of these problems for a successful outcome. The technique was applied to 30 post-burn scar contractures of the lower lip. We classified the deformities of the lower lip and based on this classification the surgical procedure was executed to obtain functional improvement. At 2 months post-surgery the patient is able to demonstrate speech clarity with full functional oral range of movement. Neck release combined with vermillionectomy and comissuroplasty of the lip is a rational approach for preserving the function. A good planning of reconstructive procedures, facilitate patient recovery and optimize functional and aesthetic outcomes.     

Collagen cross-linking in thin corneas

Collagen cross-linking (CXL) has become the standard of care for progressive keratoconus, after numerous clinical studies have established its efficacy and safety in suitably selected eyes. The standard protocol is applicable in eyes which have a minimum corneal thickness of 400 μm after epithelial debridement. This prerequisite was stipulated to protect the corneal endothelium and intraocular tissues from the deleterious effect of ultraviolet-A (UVA) radiation. However, patients with keratoconus often present with corneal thickness of less than 400 μm and could have otherwise benefited from this procedure. A few modifications of the standard procedure have been suggested to benefit these patients without a compromise in safety. Transepithelial cross-linking, pachymetry-guided epithelial debridement before cross-linking, and the use of hypoosmolar riboflavin are some of the techniques that have been attempted. Although clinical data is limited at the present time, these techniques are worth considering in patients with thin corneas. Further studies are needed to scientifically establish their efficacy and safety.     

Evaluation of Micronuclei and Cytomorphometric Changes in Patients with Different Tobacco Related Habits Using Exfoliated Buccal Cells

Background: Tobacco is one of the main reasons behind the occurrence of oral cancer. Oral cancer, even though being the tenth most common cancer in the world, gets diagnosed at an advanced stage and ends up with poor prognosis. So early diagnosis is the need of the hour. Our study aimed to evaluate the genotoxic changes in patients with different tobacco habits using buccal exfoliated cells. Methods: Buccal smears were taken from smokers (30), smokeless tobacco users (30), combined tobacco users (30) and controls (30) with clinically normal oral mucosa. All the smears were stained with Papanicolaou stain and Feulgen stain and viewed under light microscope for the evaluation of mean number of micronuclei, mean micronuclei per cell, frequency of cells showing micronuclei, nuclear area, cytoplasmic area, nuclear-cytoplasmic ratio. Results: Mean number of micronuclei, mean micronuclei per cell, frequency of cells showing micronuclei, and nuclear area were significantly increased in tobacco users than controls, especially in combined tobacco users. Nuclear-cytoplasmic ratio was increased and cytoplasmic area was decreased in tobacco users than controls. Conclusion: Tobacco in any consumable form is genotoxic. Smoking and smokeless tobacco, when consumed together, synergistically causes higher genetic damage. Different tobacco habits have different deleterious effects on oral mucosa, and these effects are more pronounced when the patients have combined habits. So, detecting the genotoxic changes through exfoliative cytology can be used as a simple yet reliable marker for early detection of carcinogenesis.     

Human alpha-subunit analogs act as partial agonists to the thyroid-stimulating hormone receptor: differential effects of free and yoked subunits

The α-subunit is common to the heterodimeric glycoprotein hormones and has been highly conserved throughout vertebrate evolution. In an effort to determine if wild-type and engineered human α analogs can serve as agonists or antagonists to the human thyroid-stimulating hormone (TSH) receptor (TSHR), a potent α mutant, obtained by replacing four amino acid residues with lysine (α4K), was assayed and compared with the wild-type α-subunit. When added to CHO cells expressing TSHR, α4K, and to a very limited extent the fused homodimer, α4K-α4K, but not α, exhibited ago-nistactivity as judged by cAMP production. When yoked to TSHR to yield fusion proteins, neither α, α4K, α-α, nor α4K-α4K activated TSHR, although yoked α4K and α4K-α4K were weak inhibitors of TSH binding to TSHR. The yoked subunit-receptor complexes were, however, functional as evidenced by increased cAMP production in cells co-expressing human TSHβ and α-TSHR, α4K-TSHR, α-α-TSHR, and α4K-α4K-TSHR. These results demonstrate that agonists to TSHR can be obtained with α-subunit analogs and suggest that rational protein engineering may lead to more potent α-based derivatives. The differences found between the experimental paradigms of adding free α analogs to TSHR and covalent attachment are attributed to conformational constraints imposed by fusion of the α-subunit analog and receptor, and may suggest an important role for a free (C-terminal) α-carboxyl in the absence of the β-subunit.