Bendamustine in combination with thalidomide and dexamethasone is a viable salvage option in myeloma relapsed and/or refractory to bortezomib and lenalidomide

Treatment options are limited in myeloma relapsed or refractory to both bortezomib and lenalidomide (double-relapsed/refractory multiple myeloma; DRMM). Bendamustine is an antitumour agent that has efficacy in relapsed myeloma. We retrospectively analysed data from 30 DRMM patients who received a combination of bendamustine, thalidomide and dexamethasone (BTD) in 28-day treatment cycles. Bendamustine was administered with a cumulative dose of up to 200 mg/m². Thalidomide (50–150 mg) was given daily as tolerated, and dexamethasone was given at an equivalent dose of up to 160 mg per cycle. A median of 5 (2–9) treatment cycles were administered per patient. Twenty-six patients (87 %) achieved stable disease or better. At a median follow-up time of 12.1 (2.3–21.5) months, median (95 % CI) progression-free survival and overall survival were 4.0 (2.6–5.3) months and 7.2 (5.2–9.2) months, respectively. The most common grade 3–4 adverse events were haematological: anaemia (n?=?8, 34.8 %), neutropenia (n?=?16, 69.6 %) and thrombocytopenia (n?=?10, 43.5 %). Non-haematological toxicities included pain (n?=?3, 13.0 %), infection (n?=?7, 30.4 %) and sensory neuropathy (n?=?1, 4.3 %). We propose that BTD is a viable salvage treatment option for DRMM patients.     

A Challenge in Diagnosis and Management: Uterine Torsion in Childhood

BackgroundUterine torsion is a rare event, which mostly reported in females with a gravid uterus and is exceptionally rare in children.CaseA 9-year-old girl presented with 3 days of intermittent lower abdominal pain. Ultrasound revealed an ovarian mass, but laparotomy revealed an ischemic enlarged ovary and uterus rotated 180°. No reperfusion occurred after 60 minutes. A subtotal hysterectomy and right salpingoophorectomy were thus performed.ConclusionUterine and adnexal torsion presents with symptoms similar to those of adnexal torsion. Delays in diagnosis and referral continue to be an issue, resulting in suboptimal outcomes. Uterine torsion, although exceedingly rare in childhood, appears to occur only in the setting of ovarian masses, which provide the impetus for the rotational force to the elongated cervix of the prepubertal uterus.     

In vitro antibacterial activity of the metal oxide nanoparticles against urinary tract infectious bacterial pathogens

ObjectiveTo investigate the antibacterial properties of the five metal oxide nanoparticles viz., Al₂O₃, Fe₂O₃, CeO₂, ZrO₂ and MgO against urinary tract infectious pathogens viz., Pseudomonas sp., Enterobacter sp., Klebsiella sp., Escherichia coli (E. coli), Proteus morganii (P. morganii) and Staphylococcus aureus (S. aureus).MethodsThe antibacterial activity of the five different nanoparticles was assessed by well diffusion method. Different concentrations of the nanoparticles were analyzed by minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) techniques. Finally, the potential nanoparticle Al₂O₃ which showed maximum antibacterial sensitivity was also subjected for the time kill assay method.ResultsAmong the nanoparticles, Al₂O₃ nanoparticle showed maximum sensitivity (16.00±0.21) mm against E. coli. None of the nanoparticles showed activity against Pseudomonas sp. The MIC results also revealed that, the Al₂O₃ nanoparticle showed maximum inhibition at the concentration of 5 μg/mL against E. coli, followed by 10 μg/mL against Klebsiella sp. and P. morganii, respectively. Moreover, the time kill assay revealed that, the bacterial growth was maximum inhibited at the concentration of 5 μg/mL from the 2nd h.ConclusionsIt can be concluded from the present findings that, the Al₂O₃ nanoparticle can be used as an alternative antibacterial agent for the urinary bacterial diseases after completing successful clinical trials.