Cerebral venous sinus thrombosis in a tertiary care setting in India

Sir, We read with interest the article on cerebral venous sinus thrombosis(CVST) in your journal.¹ CVST is reported to be commoner indeveloping countries, and has been linked to pregnancy, multiparityand infection.^2,3 Developments in imaging, immunology and geneticshave provided valuable information about risk factors and clinicalspectrum of CVST. We report our experience of CVST,     

Sequential therapy versus standard triple-drug therapy for Helicobacter pylori eradication: A randomized study

Background

Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. A sequential treatment schedule has been reported to be effective, but studies published to date were performed in Italy. We undertook this study to determine whether these results could be replicated in India.

Methods

A randomized, open-labeled, prospective controlled trial comparing sequential vs. standard triple-drug therapy was carried out at Lokmanya Tilak Municipal General Hospital, Mumbai. Two hundred and thirty-one patients with dyspepsia were randomized to a 10-day sequential regimen (40 mg of pantoprazole, 1 g of amoxicillin, each administered twice daily for the first 5 days, followed by 40 mg of pantoprazole, 500 mg of clarithromycin, and 500 mg of tinidazole, each administered twice daily for the remaining 5 days) or to standard 14-day therapy (40 mg of pantoprazole, 500 mg of clarithromycin, and 1 g of amoxicillin, each administered twice daily).

Results

The eradication rate achieved with the sequential regimen was significantly greater than that obtained with the triple therapy. Per-protocol eradication rate of sequential therapy was 92.4 % (95 % CI 85.8–96.1 %) vs. 81.8 % (95 % CI 73.9–87.8 %) (p?=?0.027) for standard drug therapy. Intention-to-treat eradication rates were 88.2 % (95 % CI 80.9–93.0 %) vs. 79.1 % (95 % CI 71.1–85.4 %), p?=?0.029, respectively. The incidence of major and minor side effects between therapy groups was not significantly different (14.6 % in the triple therapy group vs. 23.5 % in sequential group, p?=?0.12). Follow up was incomplete in 3.3 % and 4.7 % patients in standard and sequential therapy groups, respectively. Sequential therapy includes one additional antibiotic (tinidazole) that is not contained in standard therapy.

Conclusions

Sequential therapy was significantly better than standard therapy for eradicating H. pylori infection.     

Spatial tuning of negative and positive Poisson's ratio in a multi-layer scaffold

While elastic modulus is tunable in tissue engineering scaffolds, it is substantially more challenging to tune the Poisson's ratio of scaffolds. In certain biological applications, scaffolds with a tunable Poisson's ratio may be more suitable for emulating the behavior of native tissue mechanics. Here, we design and fabricate a scaffold, which exhibits simultaneous negative and positive Poisson's ratio behavior. Custom-made digital micro-mirror device stereolithography was used to fabricate single- and multiple-layer scaffolds using polyethylene glycol-based biomaterial. These scaffolds are composed of pore structures having special geometries, and deformation mechanisms, which can be tuned to exhibit both negative Poisson's ratio (NPR) and positive Poisson's ratio (PPR) behavior in a side-to-side or top-to-bottom configuration. Strain measurement results demonstrate that analytical deformation models and simulations accurately predict the Poisson's ratios of both the NPR and PPR regions. This hybrid Poisson's ratio property can be imparted to any photocurable material, and potentially be applicable in a variety of biomedical applications.     

Diabetic retinopathy grade as a predictive marker of severity of cardiovascular disease and mortality: DIVERSE Study Group

International Journal of Diabetes in Developing Countries - Patients with diabetic retinopathy (DR) are more likely to have subclinical cardiovascular disease. Objective of this study was to assess...     

Impact of Venous Collaterals on Clinical Outcomes in Paget–Schroetter Syndrome

Purpose

To characterize the degree of venous collateralization before and after endovascular therapy and determine the effect of collateralization on success of thrombolysis and rate of repeat intervention in patients with Paget–Schroetter syndrome.

Melanoma brain metastases: Biological basis and novel therapeutic strategies

The development of brain metastases is the deadliest complication of advanced melanoma and has long been associated with a dismal prognosis. The recent years have seen incredible progress in the development of therapies for melanoma brain metastases (MBM), with both targeted therapies (the BRAF-MEK inhibitor combination) and immune checkpoint inhibitors (the anti-CTLA-4, anti-PD-1 combination) showing impressive levels of activity. Despite this, durations of response for these therapies remain lower at intracranial sites of metastasis compared to extracranial metastases and it has been suggested that there are unique features of the brain microenvironment that contribute to therapeutic escape. In this review, we outline the latest research into the biology and pathophysiology of melanoma brain metastasis development and progression. We then discuss the current status of clinical trial that are open to patients with MBM and end by describing the ongoing challenges for the field.     

Effect of Aromatase Inhibitor Therapy on Sleep and Activity Patterns in Early-stage Breast Cancer

Introduction

Adherence to aromatase inhibitor (AI) therapy is poor, often because of treatment-emergent side effects, including musculoskeletal symptoms, fatigue, and insomnia. In the present analysis, we examined the sleep patterns and daytime function both objectively using actigraphy and subjectively using validated questionnaires in women initiating AI therapy.

Efficacy of two dose measles vaccination in a community setting

OBJECTIVE: To compare the efficacy of two dose and single dose measles vaccination in a community setting. DESIGN: Two community ICDS blocks with populations of 8990 and 8550 children below 12 years of age were selected. Block A had 1560 children between 9 mo to 1 year of age and Block B had 1380 children between the age of 9 mo to 1 year. METHODS: All eligible children between 9 mo to 1 year of age were given measles vaccination in October 1994. Only the children in Group A were given a second dose of measles (as MMR) in April 1995; six months after the first dose. A survey was undertaken from January 1996 to April 1996 to clinically evaluate the number of cases of measles in both these blocks. RESULTS: In Block A 3 children developed measles, whereas in Block B, there were 16 cases of measles (p < 0.01). All other parameters in both groups, e.g., cold chain maintenance were similar. CONCLUSION: This study supports the superiority of two dose measles vaccination given at an interval of 6 months over a single dose measles in a community setting.