Comparative study of intralesional triamcinolone alone and in combination with 5-flurourouracil for the treatment of keloid and hypertrophic scars

Background

Keloids and hypertrophic scars are benign growths of dermal collagen that can cause physical and psychological (cosmetic) problems for patients. Many modalities of treatment have been advocated for the treatment of keloids, without convincing results.

Methods

A randomised controlled trial was conducted in the Department of Surgery at Silchar Medical College and Hospital, Silchar, Assam for the period from January 2015 to June 2016. Keloids or hypertrophic scars (1cm to 5cm in size) having no history of treatment for the scars in preceding 6 months were included. The subjects were divided into two groups: Group A received intralesional triamcinolone acetonide alone and Group B received triamcinolone acetonide + 5 flourouracil. Eight injections were given at weekly interval. Scars were assessed at 4, 8 weeks during and 4 weeks after the completion of treatment on a five-point scale.

Results

50 patients were included in the study and were divided in two equal groups of 25 each. Good to excellent results were seen in 14 (56%) cases in Group A, compared to 20 (80%) in Group B (p value <0.05). Group B lesions showed better improvement than Group A lesions in pruritus, pain, tenderness, restriction of movements and cosmetic problem. Recurrence was seen in 16% and 4% in both groups respectively.

Conclusion

The combination of triamcinolone acetonide and 5 flourouracil is superior to triamcinolone acetonide alone in treatment of keloids and hypertrophied scars.

     

Impact of titanium dioxide on androgen receptors,seminal vesicles and thyroid hormones of male rats: possible protective trial with aged garlic extract

The aim of this study was to evaluate the effect of titanium dioxide (TiO₂), a widely produced and consumed pigment in various food products, on the post‐natal development of male albino rat seminal vesicle and thyroid hormones, as well as to evaluate the ameliorative effect of aged garlic extract (AGE) on TiO₂‐induced alterations. Forty male rat pups (3 weeks old) were divided into four equal groups. The 1st group received distilled water orally (control group), 2nd group was given 2 ml kg^?1 AGE, 3rd group was administered TiO₂ (5 g kg^?1 BW) day after day for 65 days, and the 4th group administered AGE 6 hr prior to TiO₂ gavage. TiO₂‐exposed rats showed nonsignificant changes in the serum testosterone, TSH, T₃ and T₄, while serum glucose showed a significant decrease. Androgen receptor (AR) mRNA expression was significantly down‐regulated and weak signal of AR immune labelling. Histopathologically, the epithelium cell lining of seminal vesicles showed focal areas of necrosis and fibrous tissue with the prominent fibrous stroma of the atrophied glands. Meanwhile, AGE supplementation ameliorated the deleterious effects of TiO₂ intoxication through protecting the tissues from oxidative stress caused by TiO₂. In summary, oral administration of TiO₂ resulted in abnormal developmental events in male rat seminal vesicle and AGE able to reduce TiO₂ toxicity.     

Melatonin attenuates 60Co γ‐ray‐induced hematopoietic,immunological and gastrointestinal injuries in C57BL/6 male mice

Protection of hematopoietic, immunological, and gastrointestinal injuries from deleterious effects of ionizing radiation is prime rational for developing radioprotector. The objective of this study, therefore, was to evaluate the radioprotective potential of melatonin against damaging effects of radiation‐induced hematopoietic, immunological, and gastrointestinal injuries in mice. C57BL/6 male mice were intraperitoneally administered with melatonin (50–150 mg/kg) 30 min prior to whole‐body radiation exposure of 5 and 7.5 Gy using ⁶⁰Co‐teletherapy unit. Thirty‐day survival against 7.5 Gy was monitored. Melatonin (100 mg/kg) pretreatment showed 100% survival against 7.5 Gy radiation dose. Melatonin pretreatment expanded femoral HPSCs, and inhibited spleenocyte DNA strands breaks and apoptosis in irradiated mice. At this time, it also protected radiation‐induced loss of T cell sub‐populations in spleen. In addition, melatonin pretreatment enhanced crypts regeneration and increased villi number and length in irradiated mice. Translocation of gut bacteria to spleen, liver and kidney were controlled in irradiated mice pretreated with melatonin. Radiation‐induced gastrointestinal DNA strand breaks, lipid peroxidation, and expression of proapoptotic‐p53, Bax, and antiapoptotic‐Bcl‐xL proteins were reversed in melatonin pretreated mice. This increase of Bcl‐xL was associated with the decrease of Bax/Bcl‐xL ratio. ABTS and DPPH radical assays revealed that melatonin treatment alleviated total antioxidant capacity in hematopoietic and gastrointestinal tissues. Present study demonstrated that melatonin pretreatment was able to prevent hematopoietic, immunological, and gastrointestinal radiation‐induced injury, therefore, overcoming lethality in mice. These results suggest potential of melatonin in developing radioprotector for protection of bone marrow, spleen, and gastrointestine in planned radiation exposure scenarios including radiotherapy. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 501–518, 2017.     

Computerized scintigraphic technique for the evaluation of adult respiratory distress syndrome: initial clinical trials

Eleven patients with suspected adult respiratory distress syndrome (ARDS) and five control patients were studied using a computerized gamma imaging and analysis technique and 99mTc-labeled human serum albumin. The heart and right lung were imaged, lung:heart ratio was plotted vs. time, and a linear regression was fitted to the data points displayed. The slope of this fit was termed the "slope index." An index value of 2 standard deviations greater than the control mean was considered positive. Radiographs from the six positive studies revealed typical diffuse air-space disease. Radiographs from two of the five negative studies demonstrated air-space consolidation. Both of these patients had elevated pulmonary capillary wedge pressure, cardiomegaly, and clinical course consistent with cardiogenic pulmonary edema. These preliminary data demonstrated a good correlation between positive slope index and clinical ARDS.     

Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning.     

N-Formylcyclomicrobuxeine - A New Alkaloid from the Leaves of Buxus papillosa

Studies on the alkaloidal constituents of the leaves of BUXUS PAPILLOSA have resulted in the isolation of a new steroidal base, (+)- N-formylcyclomicrobuxeine ( 1).     

Pulmonary nodules: detection of calcification by linear and pluridirectional movement in tomographic study

Calcification within solitary pulmonary nodules (1-2 cm range) was demonstrated by conventional tomography in a group of 20 patients. Each patient had a combined tomographic examination consisting of 15 degrees linear movement followed by 34 degrees hypocycloidal movement. Linear tomography was superior to pluridirectional tomography in 19 cases for visualization of calcium within the nodule. The results are attributed to differences in contrast sensitivity and "blur" phenomena between the two tomographic movements. This study, although comparing a specific linear movement with a specific pluridirectional movement, provides insight into the differences between tomographic techniques for a given task.     

Single-dose treatment of cholera with furazolidone or tetracycline in a double-blind randomized trial.

To evaluate single doses of 400 mg of furazolidone and 1 g of tetracycline given orally to patients with diarrhea due to Vibrio cholerae, we studied 87 adults in a randomized, double-blind, placebo-controlled trial. All patients received intravenous fluids for rehydration and no other drugs. The total volumes of stool (mean +/- standard deviation) during a 6-day period after treatment were significantly smaller in the tetracycline group (10.5 +/- 8.6 liters) than in the furazolidone group (20.9 +/- 15.9 liters) and the placebo group (19.1 +/- 10.5 liters) (P less than 0.01). The duration of diarrhea and volumes of intravenous fluids were also significantly reduced in the tetracycline group (P less than 0.05). However, there were no differences between the furazolidone and the placebo groups with regard to stool volume, intravenous fluid, and duration of diarrhea. Within 48 h of treatment, tetracycline significantly reduced the number of patients with positive stool cultures for V. cholerae (37%) compared with furazolidone treatment (96%) and the placebo (97%) (P less than 0.001). Although the tetracycline group had a significantly higher incidence (61%) of bacteriologic relapse (negative stool cultures on days 2 and 3, followed by positive cultures afterward) compared with that in the furazolidone group (40%) and the placebo group (33%), this was not associated with clinical relapse. There were no differences between the furazolidone and placebo groups with regard to any of the bacteriologic responses examined. These data indicate that a single dose of 1 g of tetracycline is effective in the treatment of cholera, but it is asymptomatic bacteriologic relapse. A single dose of 400 mg of furazolidone is not therapeutically effective in cholera.