Orbital and adnexal amyloidosis: Thirty years experience at a tertiary eye care center

Purpose:The aim of this work was to study the clinical presentation, management and outcomes of orbital and adnexal amyloidosis.Methods:This retrospective analysis included all the patients diagnosed with orbital and adnexal amyloidosis between January 1990 and December 2019. Positive staining with Congo Red and apple-green birefringence on polarized light microscopy established the diagnosis. Data analyzed included demographic profile, varied presentations, management, and outcome.Results:Thirty-three eyes of 26 patients were included. The male:female ratio was 1:1. The mean age of the study population was 42.6 ± 16 years. The median duration of symptoms was two years. Unilateral involvement was seen in 19 eyes (right = 11, left = 8). The most common presenting feature was acquired ptosis. Eyelid was the most commonly affected site followed by orbit and conjunctiva. Two patients had systemic involvement in the form of multiple myeloma and lymphoplasmacytic lymphoma. Complete excision was done in seven (26.9%) cases while 19 (73.1%) cases underwent debulking. Three patients underwent ptosis surgery. The median duration of follow-up was 1.5 years. Three cases had recurrence and underwent repeat surgery.Conclusion:Orbit and adnexa is a rare site for amyloidosis. It is usually localized; however it can occur as a part of systemic amyloidosis. Eyelid is the most common site of involvement and patients usually present as eyelid mass or ptosis. Complete excision is difficult and most of the patients usually undergo debulking surgery. All patients should undergo screening for systemic amyloidosis     

The behavioral performance tests of Mucuna pruriens gold nanoparticles in the 1-methyl 4-phenyl-1,2,3,6-tetrahydropyridine treated mouse model of Parkinsonism

ObjectiveThe present investigation is aimed to carry out the behavioural changes of the Mucuna pruriens extract (MPE) and Mucuna pruriens Goldnanoparticles (MPGNPs) against MPTP-induced neurotoxicity.MethodsMPGNPs prepared from the methanolic extract of Mucuna pruriens seeds using Chloroauricchloride (HAuCl₄). The seed powder has been found to show the anti-parkinsonian effects. Mice were induced with 10 mg/kg of MPTP, four injections i.p., at 1 h intervals within 24 h. MPE was administered at the dose 200 mg/kg (i.p) and MPGNPs was administered at different doses of 500 μg/kg, 5, 10 and 20 mg/kg (i.p) in different groups once a day for seven days and the dose on the first day was given 30 min prior to first MPTP injection.ResultsThe behavioural changes were studied using the rotarod test, hang test and narrow beam test. MPE and MPGNPs significantly (P < 0.05) improved the behavioural activities.ConclusionsMPGNPs possesses significant behavioural activity than MPE against MPTP induced neurotoxicity.     

Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients

INTRODUCTION

Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.

METHODS

In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients’ perception of the exercise programme was also determined using self-reported questionnaires.

RESULTS

Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).

CONCLUSION

Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.     

Levels and determinants of malnutrition among India's urban poor women: An analysis of Demographic Health Surveys 2006 and 2016

A quarter of 400 million urban Indian residents are poor. Urban poor women are as undernourished as or worse than rural women but urban averages mask this disparity. We present the spectrum of malnutrition and their determinants for more than 26,000 urban women who gave birth within 5 years from the last two rounds of Demographic Health Survey 2006 and 2016. Among urban mothers in the lowest quartile by wealth index (urban poor), 12.8% (95% CI [11.3%, 14.5%]) were short or with height < 145 cm; 20.6% (95% CI [19%, 22.3%]) were thin or with body mass index < 18.5 kg/m²; 57.4% (95% CI [55.5%, 59.3%]) had any anaemia (haemoglobin < 12 g/dL), whereas 32.4% (95% CI [30.5%, 34.3%]) had moderate to severe anaemia; and 21.1% (95% CI [19.3%, 23%]) were obese (body mass index ≥ 25 kg/m²). Decadal gains were significant for thinness reduction (17p.p.) but obesity increased by 12 p.p. Belonging to a tribal household increased odds of thinness by 1.5 (95% CI [1.06, 2.18]) times among urban poor mothers compared with other socially vulnerable groups. Secondary education reduced odds of thinness (0.61; 95% CI [0.48, 0.77]) and higher education of short stature (0.41; 95% CI [0.18, 0.940]). Consuming milk/milk products, pulses/beans/eggs/meats, and dark green leafy vegetables daily reduced the odds of short stature (0.52; 95% CI [0.35, 0.78]) and thinness (0.72; 95% CI [0.54, 0.98]). Urban poor mothers should be screened for nutritional risks due to the high prevalence of all forms of malnutrition and counselled or treated as per risk.     

Attenuation of renal ischemia-reperfusion injury with selectin inhibition in a rabbit model

BACKGROUND: The selectin glycoproteins are involved in the pathogenesis of renal ischemia-reperfusion injury. We investigated the ability of glycyrrhizin, a known selectin inhibitor, to attenuate renal ischemia-reperfusion injury. METHODS: Eighteen New Zealand white rabbits underwent midline laparotomy with renal artery cross-clamping. After 30 minutes of reperfusion, group 1 (control, n = 10) animals received a saline infusion, while group 2 (GLY, n = 8) animals received a glycyrrhizin infusion. Renal function was compared between the two groups after 72 hours of reperfusion. A t test was utilized, with alpha set at P<0.05. RESULTS: Group 1 and group 2 animals had similar baseline renal function. However, after 72 hours of reperfusion, group 1 animals had a significantly higher mean blood urea nitrogen creatinine ratio than group 2 animals (P<0.01), indicating preserved renal function in rabbits treated with glycyrrhizin. CONCLUSIONS: Selectin blockade using glycyrrhizin attenuates renal ischemia-reperfusion injury when given 30 minutes after the onset of reperfusion in a rabbit model.     

Combination Treatment of Withalongolide a Triacetate with Cisplatin Induces Apoptosis by Targeting Translational Initiation,Migration, and Epithelial to Mesenchymal Transition in Head and Neck Squamous Cell Carcinoma

Treatment regimens for head and neck squamous cell carcinoma (HNSCC) typically include cisplatin and radiotherapy and are limited by toxicities. We have identified naturally derived withalongolide A triacetate (WGA-TA) from Physalis longifolia as a lead compound for targeting HNSCC. We hypothesized that combining WGA-TA with cisplatin may allow for lower, less toxic cisplatin doses. HNSCC cell lines were treated with WGA-TA and cisplatin. After treatment with the drugs, the cell viability was determined by MTS assay. The combination index was calculated using CompuSyn. The expression of proteins involved in the targeting of translational initiation complex, epithelial to mesenchymal transition (EMT), and apoptosis were measured by western blot. Invasion and migration were measured using the Boyden-chamber assay. Treatment of MDA-1986 and UMSCC-22B cell lines with either WGA-TA or cisplatin alone for 72 h resulted in a dose dependent decrease in cell viability. Cisplatin in combination with WGA-TA resulted in significant synergistic cell death starting from 1.25 μM cisplatin. Combination treatment with WGA-TA resulted in lower cisplatin dosing while maintaining the downregulation of translational initiation complex proteins, the induction of apoptosis, and the blockade of migration, invasion, and EMT transition. These results suggest that combining a low concentration of cisplatin with WGA-TA may provide a safer, more effective therapeutic option for HNSCC that warrants translational validation.     

Effect of Ti Content on the Microstructure and High-Temperature Creep Property of Cast Fe-Ni-Based Alloys with High-Al Content

The cast Fe-Ni-based austenitic heat-resistant alloys with 4.5 wt% Al and varying Ti content were developed for high-temperature application. With increase in Ti content, strength of model alloys increased gradually at 700 °C and 750 °C. At 750 °C, alloys with 35Ni–(2~4)Ti composition showed a significant increase in creep rupture life compared to 30Ni–1Ti alloy, attributed to the increase in γ’-Ni₃(Al,Ti) precipitates due to higher Ni and Ti content. Among the 35Ni–(2~4)Ti alloys, increasing Ti content from 2 to 4 wt% gradually increased the creep rupture life in the as-cast condition. The creep rupture life was improved after solution annealing treatment, however, the beneficial effect of higher Ti content was not evident for 35Ni–(2~4)Ti alloys. After solution annealing, interdendritic phases were partially dissolved, but coarse B2-NiAl phases were formed. The size and amount of coarse B2-NiAl phases increased with Ti content. In the creep-tested specimens, creep void nucleation and crack propagation were observed along the coarse B2-NiAl phases, especially for high-Ti alloys. Therefore, the beneficial effect of the increase in γ’-Ni₃(Al,Ti) precipitates for high-Ti alloys on creep property was limited due to the detrimental effect of the presence of coarse B2-NiAl phases.