Cutaneous tuberculosis

Tuberculosis continues to be a significant health problem in developing countries. Although cutaneous tuberculosis is uncommon, disseminating skin involvement may still be seen, especially patients from rural areas. A case is reported of disseminated tuberculosis presenting with different clinical forms of cutaneous lesions, pulmonary and liver involvement in an immunocompetent patient.     

One-year follow up results of Smoking Cessation Outpatient Clinic

In this study we investigated the five-year-results of our smoking cessation outpatient clinic retrospectively. Out of 839 subjects admitted to our clinic during this time period 634 of them completed the one-year follow up period. 318 (50.2%) of these subjects were male and 316 (49.8%) of them were female. Subjects were divided into two groups. While one group received nicotine patch therapy, education and motivation the other group received just education and motivation. Mean age was 43.5 +/- 12 years. Nicotine patch therapy administered to 297 subjects and smoking cessation rates in this group were 46.8% at 15th day and 33.6% at the end of first year. The other group had smoking cessation rates of 11.8% at 15th day and 10.9% at the end of one year. Out of 185 subjects who did not smoke at the end of 15th day 98 of them were also not smoking at the end of one year. 449 subjects were smoking at the end of 15th day and just 26 (5.7%) of them gave up smoking at the end of first year. Therapy compliance was 82.2% at the 15th day and 23.2% at 12th week. Most frequent side effects were local skin reactions (13.8%) due to nicotine patches, irritability and nervousness (8.5%) and concentration difficulties (7.4%). In this retrospective analysis we concluded that nicotine replacement therapy in conjunction with education and motivation may be an effective method for helping individuals in giving up smoking. We also observed that smoking situation in first 15 days is a good predictor of long-term success.     

Graphene quantum dots: Synthesis,characterization, cell viability,genotoxicity for biomedical applications

We report the synthesis and applications of a novel N-doped graphene quantum dots (GQDs) using hydrothermal reaction between citric acid and p-aminophenol. The synthesized N-doped GQDs have been characterized physico-chemically and evaluated its antioxidant, antimicrobial, DNA binding and cleavage activities. siRNA loading studies were performed and their effects on cells were evaluated. Obtained results indicate that monodisperse solution of N-doped GQDs has been obtained with particles size ca. ～10.9 ± 1.3 nm. UV–Vis spectroscopy studies of the interactions between the N-doped GQDs and calf thymus DNA (CT-DNA) showed that the compound interact with CT-DNA via both intercalative and electrostatic binding. The DNA cleavage study showed that the N-doped GQDs cleaved DNA without any external agents. The antioxidant activity of N-doped GQDS was very active when compared to BHT. As the concentration of the compound increased, the antioxidant activity also increased. Cell viability assay demonstrated that the Ndoped GQDs showed cell viability (70%) when the concentration reached 200 μg/mL for A549 and also MDA-MB-231, 150 μg/mL for NIH-3T3 cell lines at 24 h incubation. N-doped GQDs were coated with Eudragit RS 100 and EphA2-siRNA was loaded. As a result of the studies on these formulations, it was concluded that there may be significant effects on A549 cells. The microscopy results revealed that N-doped GQDs was quickly internalized into the cell. Our novel N-doped-GQDs with siRNA are candidate for in situ tumor suppression via DNA and mRNA breakage.     

Parotid elastography: a potential alternative to replace labial biopsy in classification of patients with primary Sjögren’s syndrome?

Clinical Rheumatology - There has been a substantial improvement in classifying patients with primary Sjögren’s syndrome (pSS), with the new 2016 ACR/EULAR classification criteria. It...     

Retroanastomotic hernia after Moynihan's gastroenterostomy

Retroanastomotic hernias after gastroenterostomieseither antecolic or retrocolic-are extremely rare but are associated with high mortality rates due to delayed identification which precludes immediate surgical re-duction. In this report, we present a 77-year-old man with retroanastomotic herniation of the efferent loop segments that occurred 14 years after a Moynihan's gastroenterostomy.     

A case of thrombocytopenia associated with the use of hydroxychloroquine following open heart surgery

INTRODUCTION

Thrombocytopenia is a common problem occurring in patients and drug-induced thrombocytopenia is a significant cause of thrombocytopenia.

PRESENTATION OF CASE

We present an unusual case of thrombocytopenia that was considered to be associated with the use of hydroxychloroquine in the late term following open heart surgery.

DISCUSSION

The drug-induced thrombocytopenia, mechanical destruction of the platelets, and hemodilution are common causes of low platelet count. Although drug-induced immune thrombocytopenia has a mild clinical course in most cases (in this case it has severe clinical course), some patients may experience life-threatening hemorrhages. The decision to discontinue the drug that is deemed to be responsible from the drug-induced thrombocytopenia (DITP) relies on the clinical condition of the patient. The diagnosis is mostly established by discontinuation, exclusion, and correlation because the tests performed to detect drug-dependent antibodies (DDAbs) for the diagnosis of DITP are time-consuming, and these tests are also not commonly available. The authors of the current study diagnosed DITP by discontinuation of the drug. We suggest that the use of hydroxychloroquine could be severe thrombocytopenia occurring after open heart surgery.

CONCLUSION

The medication history must be carefully reviewed in patients presenting with thrombocytopenia, and if the medications could cause thrombocytopenia must be discontinued.