Electrical stimulation of the substantia nigra does not increase tail-flick latency in the rat

The effect of electrical stimulation at multiple sites in the midbrain was investigated in rats lightly anesthetized with barbiturate. The application of monopolar electrical stimulation to the substantia nigra (SN) or the adjacent cerebral peduncle failed to produce an elevation in tail-flick latency (TFL) in response to the application of noxious radiant heat. However, the same intensity of stimulation when applied to an area dorsal to the SN led to an elevation in TFL. This effect was not due to current spread to dopaminergic neurons in the zona compacta compartment of the SN because administration of cis-flupenthixol failed to block the effect. We conclude that, contrary to previous suggestions, discrete electrical stimulation of the SN itself does not give rise to a state of antinociception.     

Clinical Evaluation of an Indigenous Paclitaxel-Eluting Stent in De NovoCoronary Artery Stenosis

BACKGROUND, Drug-eluting stents have enabled considerable reduction in restenosis in patients subjected to angioplasty. However, in view of high cost of drug-eluting stents, efforts to develop medicated stents at reduced cost using alternative polymers in Indian setting are imperative. Hence a multi-center study was undertaken to evaluate the safety and efficacy of the indigenously developed paclitaxel-eluting RELEASE-T stent. METHODS, The study included 100 patients (male:86, Female:14) who were undergoing angioplasty for various indications at four centres viz. Delhi, Hyderabad, Pune and Warangal. The age range was 29 - 76 years; 37 patients were diabetic. All patients were pre-treated with aspirin 150-325 mg plus clopidogrel 75 mg daily four days before procedure or clopidogrel alone. Aspirin was continued indefinitely. RESULTS, Direct stenting ws done in majority of patients. One patient, in whom stent could not be delivered, received only baloon angioplasty. Sixty-four patients had stenting of left anterior descending artery. The stent diameter ranged from 2.5 to 3.5 mm, and the length, 15 to 20 mm. All patients were followed up at 1,3 and 6 months. There was two deaths: one had subacute thrombosis on both stents, and the other (who was HIV positive) had sudden cardiac death. The 6-month rate of major adverse cardiac events was 4% and target lesion revascularization rate ws 2%. CONCLUSION, This ulti-locational study brings out that the use of indigenously developed paclitaxel-eluting stent is safe and clinically efficacious.     

IL6 -174 G/C promoter polymorphism influences susceptibility to mucosal but not localized cutaneous leishmaniasis in Brazil

BACKGROUND: Mucosal leishmaniasis (ML) is associated with exaggerated tumor necrosis factor- alpha and interferon- gamma responses and tissue destruction. ML follows localized cutaneous leishmaniasis (CL) caused by Leishmania braziliensis infection. Interleukin (IL)-6 down-regulates T helper (Th) cell type 1 differentiation and drives Th2 cell differentiation. The IL6 -174 G/C polymorphism is associated with proinflammatory diseases and IL-6 regulation. METHODS: The -174 G/C polymorphism was genotyped in population samples and families with CL and ML from Brazil. Genotype frequencies were compared among patients with ML, patients with CL, and 2 control groups by logistic regression and family-based association test (FBAT) analysis. IL-6 levels were measured in macrophages. RESULTS: The C allele was more common in patients with ML than in patients with CL (odds ratio [OR], 2.55 [95% confidence interval {CI}, 1.32-4.91]; P=.005), than in patients who were leishmanin skin-test positive (OR, 2.23 [95% CI, 1.23-4.05]; P=.009), and than in neighborhood control subjects (OR, 2.47 [95% CI, 1.24-4.90]; P=.01). FBAT analysis confirmed an association between allele C and ML under both additive (z=4.295; P=.000017) and dominant (z=4.325; P=.000015) models. Significantly lower levels of IL-6 were measured in unstimulated macrophages from CC individuals than from GG individuals (P=.003) as well as after stimulation with soluble leishmania antigen (P=.009). CONCLUSIONS: IL-6 may regulate type 1 proinflammatory responses, putting individuals with low macrophage IL-6 levels at increased risk for ML.     

Soft drinks and dental health: a review of the current literature

In recent years there has been increased interest in the role of commercial soft drinks in dental diseases namely as dental caries and erosion. The objective of this paper has been to review the past and current literature to determine the present knowledge on this subject. The literature related to dental caries, erosion, drinks, soft drinks and fruit juices was reviewed. The literature shows efforts have been taken to modify soft drinks by either adding or deleting certain components so as to reduce their harmful effects on teeth. A rational protocol to encourage the sensible use of drinks and the modification of drinks to render them less harmful would be advisable.     

Systemic methotrexate: An effective alternative to surgery for management of unruptured ectopic pregnancy

Background

Medical management of an unruptured ectopic pregnancy with intramuscular methotrexate is a common and cost-effective alternative to surgery. Early diagnosis and timely institution of methotrexate has resulted in a dramatic decline in the morbidity, mortality and financial burden associated with ectopic pregnancy. The objective of our study was to evaluate the efficacy of medical management in a series of patients with unruptured ectopic pregnancy meeting the strict inclusion criteria.

Methods

Multiple dose methotrexate regimen was utilized for the management of the cases. Parenteral methotrexate 1 mg/kg was administered on Day 1, Day 3, Day 5 and Day 7 whereas rescue dose of injection leucovorin 0.1 mg/kg was given on Day 2, Day 4, Day 6 and Day 8. Monitoring for the resolution of the ectopic was carried out with β-hCG, done on Day 1, Day 3, Day 5, and Day 7. Any value showing a decline of >15% of the baseline value led to the termination of treatment and only surveillance was carried out. If the decrease was <15%, treatment was continued.

Results

Total 43 patients with ectopic pregnancy were diagnosed over a period of 1 year, conceived during infertility evaluation and treatment. 11 cases went directly for surgery whereas 32 were subjected to medical treatment. 75% of the patients got successfully treated and rest 25% required surgery following failed medical management.

Conclusions

Methotrexate therapy is a safe and effective alternative for the management of unruptured ectopic pregnancies with minimal or no side-effects and associated advantage of avoiding invasive surgery.     

Loss of DLC1 is an independent prognostic factor in patients with oral squamous cell carcinoma

Deleted in liver cancer (DLC1), a Rho GTPase-activating protein, was observed to be differentially expressed in oral squamous cell carcinoma in comparison with normal tissues using tissue proteomics. In the current study, we investigated the clinical significance of loss of DLC1 expression in different stages of development of oral squamous cell carcinoma to determine its potential as a biomarker for oral dysplasia and prognosis of oral squamous cell carcinoma. Immunohistochemical analysis of DLC1 expression was carried out in oral squamous cell carcinoma patients (n=214), dysplasia (n=51), hyperplastic squamous mucosa (n=45), and histologically normal oral tissues (n=80), and correlated with clinicopathological parameters and disease prognosis over 91 months for oral squamous cell carcinomas. Loss of DLC1 expression was observed in oral squamous cell carcinoma (64%), oral dysplasia (31%), hyperplastic squamous mucosa (22%), and normal mucosa (16%). Significant loss of DLC1 expression was observed in oral squamous cell carcinomas as compared with dysplasia (P<0.001, odds ratio=3.8, 95% CI=2.0-7.3), suggesting it may be an important event involved in cancer progression. Among oral squamous cell carcinomas, the loss of DLC1 expression was significantly associated with poor prognosis (P=0.021, hazards ratio (HR)=1.8, 95% CI=1.1-2.9). Multivariate analysis revealed loss of DLC1 (P=0.023, HR=2.1, 95% CI=1.2-3.9) and histopathological grade (P=0.015, HR=1.7, 95% CI=1.1-2.7) to be independent predictors for disease-free survival in oral squamous cell carcinoma patients in comparison with known prognostic factors, viz. tumor stage, nodal status, and overall stage. Loss of DLC1 expression emerged as an important biomarker for predicting patients diagnosed with oral dysplasia at high risk of transformation upon future validation in longitudinal studies. Loss of DLC1 expression is a poor prognostic marker for oral squamous cell carcinoma patients.     

Embryo reduction: our experience

Background

The transvaginal ultrasound-guided embryo reduction technique is a feasible option for the prevention and management of the medical and obstetric risks associated with high-order multiple pregnancy resulting from assisted reproductive treatment.

Method

Multifoetal pregnancy reduction was carried out in 51 in vitro fertilisation pregnancies (IVF) and one intrauterine quintuplet pregnancy resulting from intrauterine insemination (IUI) using transvaginal approach under ultrasonographic guidance.

Results

Of the 52 embryo reduction procedures, 48 (92%) were performed between the seventh and eighth weeks of gestation, three between eighth and ninth weeks and one in the 10th week of gestation. Forty-nine patients (94%) underwent reduction from triplets to twins, two from quadruplet to twins, and one from quintuplet to twin pregnancy. The average time required for the embryo reduction was 5.0±0.5 minutes per sac in early gestation (6th-9th weeks), increasing to 8.5 minutes per sac for later procedures, due to technical difficulties brought about by increased embryo size and mobility. All embryo reduction procedures were successfully performed in a single session.

Conclusion

Transvaginal ultrasound guided embryo reduction technique performed between seventh and eighth-weeks of gestation is an effective and safe procedure for embryo reduction.