Effect of Azelastine Nasal Spray on Histamine-and Allergen-Induced Skin Wheal Response in Patients with Allergic Rhinitis

Effect of azelastine nasal spray on histamine-and allergen-induced skin test response in patients suffering with allergic rhinitis was evaluated. Baseline cutaneous response to histamine and 18 common allergen extracts were recorded by skin prick tests on 10 patients. The patients were then advised to take azelastine nasal spray (1 spray per nostril, twice daily; 0.28 mg/dose). This pediatric dose is reported to be effective also in adults (age ≥ 12 years) with improved tolerability as compared with usually recommended adult dose of 2 sprays per nostril twice daily. Skin tests were repeated 2 and 6 hours after single dose, as well as after 6 days of continuous treatment. We did not find any significant difference in skin wheal response with single dose and 6 days' treatment of azelastine nasal spray (p > 0.05). It is concluded that diagnostic allergen skin tests may be performed on patients undergoing azelastine nasal spray treatment (0.28 mg/dose, twice a day) during their symptomatic period.     

Liposomal formulation of curcumin attenuates seizures in different experimental models of epilepsy in mice

Contemporary research indicates promising anticonvulsant effect of curcumin. However, its poor oral bioavailability is a major hindrance toward its pharmacological action. Thus, this study was carried out to evaluate the acute effect of liposome‐entrapped curcumin on increasing current electroshock seizures (ICES) test, pentylenetetrazole (PTZ)‐induced seizures, and status epilepticus in mice. Liposome‐entrapped curcumin in doses 25 and 50 mg/kg demonstrated significant increase in seizure threshold current and latency to myoclonic and generalized seizures in ICES test and PTZ‐induced seizures, respectively. Similarly, liposomal‐entrapped curcumin also increased the latency to the onset and decreased the duration of seizures during status epilepticus in mice. To conclude, liposomal‐entrapped curcumin possesses anticonvulsant activity against status epilepticus in mice.     

Metastatic Differentiated Thyroid Carcinoma: ClinicopathologicalProfile and Outcome in an Iodine Deficient Area

Reports on metastatic differentiated carcinoma in endemic goiter regions are scarce. The aim of this study was to look into the clinicopathological profile and outcome of patients with metastatic differentiated thyroid carcinoma (DTC) of endemic origin. This was a retrospective study of 28 cases of metastatic DTC out of a total of 140 DTC patients managed between 1990 and June 1999. Demographic data, clinicopathological profile, operative and radioiodine ablation therapy details, and follow-up findings were noted. The overall incidence of distant metastases in our series was 20%. Mean age was 48.5 +/- 12.8 years (32.1%patients were < 45 years). Most metastases were detected synchronously (85.7%) and were multiple, with the skeletal system being the commonly affected site. Out of 22 cases having skeletal metastases, 6 patients were young (< 45 years). Though most patients with skeletal metastases had follicular carcinoma (FTC), 4 cases had papillary thyroid cancer (PTC). Near total or total thyroidectomy was done in 26 cases. Sixteen patients required regional lymph node dissection. Resection of metastases was performed in 9 cases.Histopathological diagnosis was PTC, FTC, and poorly differentiated carcinoma in 32.1%, 50.0%, and 17.9% of cases, respectively. Most patients had good symptomatic palliation following administration of I131 therapy. In 17.9% of cases there were locoregional recurrences. There was an overall 28.6% mortality. Two patients expired in the perioperative period. Six others died in follow-up (all within 3-9 months). In contrast to iodine sufficient regions, the incidence of metastases was high; the majority of cases had synchronous, symptomatic skeletal metastases. Skeletal metastases were not infrequent even in cases of PTC and in young patients. One-third of the cases were young. Though survival was poor despite aggressive management, significant symptomatic palliation could be achieved in most cases.     

Outcome analysis of pelvic ring fractures

Background:

The behavior of pelvic ring fractures in the long run has been very sparsely studied. The purpose of this study is to assess the long-term outcome of pelvic ring fractures.

Materials and Methods:

A total of 24 patients with pelvic ring fractures, not involving the acetabulum, were followed up for an average duration of 33 months (range 24–49 months). The clinicoradiological assessment was done using the pelvic scoring system adapted from Cole et al. Parameters assessed included sacroiliac (SI) joint involvement and, among SI joint injuries, the presence of a fracture disruption and the degree of displacement.

Results:

Pain and limp were present in 13 patients (54.2%) each and residual working disability in 9 patients (37.5%). The overall Cole''s pelvic score was 31.3 ± 7.02 of a total score of 40. The average pelvic score in patients with SI disruption was 29.2 ± 6.75; much lower than patients without SI disruption with an average score of 34.9 ± 6.25 reaching statistical significance. The pelvic score among patients with a displacement ≤10 mm was 33.0 ± 3.92 and with a displacement >10 mm 25.88 ± 7.14. The difference was statistically significant.

Conclusions:

Pelvic ring injuries can lead to long term problems significantly. The involvement of the SI joint affects the long-term outcome adversely, more so if the residual displacement is >10 mm. The pelvic scoring system is comprehensive and depicts subtle differences in the outcome, which the individual parameters of the assessment fail to show.     

Determination of hand and palm area as a ratio of body surface area in Indian population

Background:

Accurate estimation of body surface area (BSA) burn is important. In small and patchy burns, the patient''s hand is used to estimate percentage of burn which is traditionally considered as 1%. There is discrepancy about what percentage of TBSA is constituted by the palm and hand. Therefore, this study was designed to determine correctly the TBSA represented by the palmar surface of the entire hand and palm in the Indian population.

Material and Methods:

300 healthy adult (male and female) and 300 healthy children (male and female) were included in the study. TBSA was calculated using DuBois formula and hand and palm surface area was calculated using hand tracing on plain paper. The hand/palm percentage of BSA (ratio) was determined by dividing hand/palm surface area by total BSA.

Results:

The mean hand and palm ratio for adults was 0.92% and 0.50%, respectively. The mean hand and palm ratio in children was 1.06% and 0.632%, respectively.

Conclusion:

The hand area (palm plus digits) is more closely represented to 1% of TBSA in Indian population.     

Calpeptin provides functional neuroprotection to rat retinal ganglion cells following Ca2+ influx

Apoptosis of retinal ganglion cells (RGCs) impairs vision in glaucoma patients. RGCs are also degenerated in multiple sclerosis (MS), resulting in loss of visual perception in MS patients. We examined the involvement of calpain and caspase cascades in apoptosis of the rat retinal ganglion cell line RGC-5 following 24 h of exposure to 250 nM ionomycin (IMN) or 300 units/ml interferon-gamma (IFN-gamma) and then evaluated functional neuroprotection with 2 microM calpeptin (CP, a calpain-specific inhibitor). Morphological and biochemical features of apoptosis were detected in RGC-5 cells following exposure to IMN or IFN-gamma. Fura-2 assay determined significant increases in intracellular free [Ca2+] following exposure to IMN or IFN-gamma. Pretreatment with CP for 1 h prevented Ca2+ influx, proteolytic activities, and apoptosis in RGC-5 cells. Western blot analyses showed an increase in activities of calpain and caspase-12, upregulation of Bax:Bcl-2 ratio, release of cytochrome c from mitochondria, and increase in caspase-9 and caspase-3 activities during apoptosis. Increased caspase-3 activity was also confirmed by a colorimetric assay. Activation of caspase-8 and cleavage of Bid to tBid in RGC-5 cells following exposure to IFN-gamma indicated co-operation between extrinsic and intrinsic pathways of apoptosis. Patch-clamp recordings showed that pretreatment with CP attenuated apoptosis and maintained normal whole-cell membrane potential, indicating functional neuroprotection. Taken together, our results demonstrated that Ca2+ overload could be responsible for activation of calpain and caspase cascades leading to apoptotic death of RGC-5 cells and CP provided functional neuroprotection.