The Noscapine Chronicle: A Pharmaco‐Historic Biography of the Opiate Alkaloid Family and its Clinical Applications

Given its manifold potential therapeutic applications and amenability to modification, noscapine is a veritable “Renaissance drug” worthy of commemoration. Perhaps the only facet of noscapine's profile more astounding than its versatility is its virtual lack of side effects and addictive properties, which distinguishes it from other denizens of Papaver somniferum. This review intimately chronicles the rich intellectual and pharmacological history behind the noscapine family of compounds, the length of whose arms was revealed over decades of patient scholarship and experimentation. We discuss the intriguing story of this family of nontoxic alkaloids, from noscapine's purification from opium at the turn of the 19th century in Paris to the recent torrent of rationally designed analogs with tremendous anticancer potential. In between, noscapine's unique pharmacology; impact on cellular signaling pathways, the mitotic spindle, and centrosome clustering; use as an antimalarial drug and cough suppressant; and exceptional potential as a treatment for polycystic ovarian syndrome, strokes, and diverse malignancies are catalogued. Seminal experiments involving some of its more promising analogs, such as amino‐noscapine, 9‐nitronoscapine, 9‐bromonoscapine, and reduced bromonoscapine, are also detailed. Finally, the bright future of these oftentimes even more exceptional derivatives is described, rounding out a portrait of a truly remarkable family of compounds.     

Efficacy of Autogenous Split Thickness Calvarial Graft in the Management of Residual Cranial Defect

Introduction

The patients with cranial deformity suffer from headache, dizziness, irritability, loss of concentration, depression, anxiety, intolerance to noise and vibration and neuromotor weakness. It is therefore essential to restore the calvarium.

Material and Method

This study was conducted in the Department of Oral and Maxillofacial Surgery, Armed Forces Medical College, Pune between Oct 2010 and Mar 2012. The study population was selected from the outpatient department and from the referred cases. The aim was to study the uptake of split thickness calvarial graft in the management of residual cranial defect. After applying the inclusion and exclusion criterions, ten cases were selected with residual cranial deformity, operated for cranioplasty using split thickness calvarial graft and evaluated.

Conclusion

It was concluded that cranioplasty using autogenous split thickness calvarial graft for restoring cranial defects is a useful technique and this procedure allows the surgeon to reconstruct a moderate-to-large cranial defect, without breaching the inner cortical plate.     

An unusual case of phenotype switch between AML FAB subtypes

Phenotypic switch between any leukemia subtypes is of concern to a treating physician and more so, in acute myelocytic leukemia (AML) as the mechanisms for switch and subsequent chemotherapy regimen to be used remain unclear. AML‐non‐M3 from AML‐M3 subtype needs special mention as this has been unheard off.     

Lactose Intolerance and Other Disaccharidase Deficiency

Intolerance to foods which contain lactose can cause a range of intestinal and systemic symptoms. These symptoms are caused by Lactase deficiency which is encoded by a single gene (LCT) of ≈ 50 kb located on chromosome 2q21. In some food items, lactose has been missed because of “hidden” lactose due to inadequately labeled, confusing diagnosis of lactose intolerance based on dietary restriction of dairy foods. Two polymorphisms, C/T13910 and G/A22018, linked to hypolactasia, correlate with breath hydrogen and symptoms after lactose. The key in the management of lactose intolerance is the dietary removal of lactose. Patients diagnosed as lactose intolerant must be advised of “risk” foods, inadequately labeled, including processed meats, bread, cake mixes, soft drinks, and lagers. This review highlights the types, symptoms and management of lactose intolerance and also highlights differences from milk allergy which closely mimics the symptoms of lactose intolerance.     

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.