Subclinical atherosclerosis and endothelial dysfunction in young South-Asian patients with systemic lupus erythematosus

Patients with systemic lupus erythematosus (SLE), especially Asian Indians, are at increased risk of developing premature atherosclerosis. To find out the prevalence and predictors of carotid intima-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD). Endothelial dysfunction was assessed by FMD in brachial artery and IMT was measured in common carotid artery in SLE patients and healthy controls. Sixty SLE patients (mean age 31 ± 9 years) and 38 healthy controls (mean age 34 ± 6 years) were included. The IMT was higher in SLE patients as compared to controls (0.49 ± 0.08 mm vs. 0.39 ± 0.05 mm, p < 0.0001). SLE and damage were independent predictors of abnormal IMT. FMD was impaired in SLE patients compared to controls (9.97% vs. 18.97%, p < 0.00001). None of the classical cardiovascular risk factors were predictors of FMD or abnormal IMT. Indian patients with SLE have higher prevalence of subclinical atherosclerosis and endothelial dysfunction. Presence of damage was associated with abnormal IMT in SLE patients.     

Is CT scan a predictor of instability in recurrent dislocation shoulder?

Purpose: Glenoid bone defect and the defect on the posterior-superior surface of the humerus “HillSachs lesion” are the commonly seen bony lesions in patients with recurrent dislocation shoulder. Computed tomography (CT) scan is considered as the best option in assessing the bony defects in the recurrent dislocation shoulder. The aim of this study was to assess the clinical and radiological corelation in the patients with recurrent dislocation shoulder. Methods: Forty-four patients of recurrent dislocation shoulder who were evaluated between January 2015 and December 2017 at a tertiary care center, clinically and radiologically using CT scan and meeting the inclusion criteria, were included. The correlation between the clinical history of the number of dislocations and the bone loss using CT scan was evaluated. Two sided statistical tests were performed at a significance level of a = 0.05. The analysis was conducted using IBM SPSS STATISTICS (version 22.0). Results: All the patients were male with mean age of 25.95 (SD ± 4.2) years were evaluated. Twenty-four patients sustained injury in sporting activities while 20 patients sustained injury in training. There were an average of 4.68 (SD ± 3.1, range 2-15, median 3) episodes of dislocation. Forty-one patients had the glenoid bone loss while 40 had the Hill-Sachs lesions. The mean glenoid width defect was 10.80% (range 0-27%) while the mean Hill-Sachs defect was 14.27 mm (range 0-26.6 mm). The mean area of bone loss of the glenoid surface was 10.81% (range 0-22.4%). The lesions were on track in 34 patients and off track in 10 patients. Conclusions: CT scan of the shoulder joint is an effective method for assessing the amount of bone loss. The number of dislocations are correlated significantly with off-track lesions and the amount of bone loss on the glenoid and Hill-Sachs lesion. The glenoid width bone loss of more than 9.80% or Hill-Sachs defect of more than 14.80 mm are the critical defects after which the frequency of dislocations increases.     

Bell’s Palsy

Thirty four patients of Bell’s Palsy have been studied over a period of one and half years. Various aetiological factors, diagnostic tests and therapy have been reviewed.     

Concentration and pump power-mediated color tunability,optical heating and temperature sensing via TCLs of red emission in an Er3+/Yb3+/Li+ co-doped ZnGa2O4 phosphor

Intense red upconversion luminescence was observed in the Er³⁺/Yb³⁺/Li⁺ co-doped ZnGa₂O₄ phosphor synthesized through the solid state reaction method for the first time. The structural characterization showed a large crystalline nature and an increase in the particle size via Li⁺ doping. The absorption spectra showed a large number of peaks in the UV-vis-NIR regions due to the Er³⁺ and Yb³⁺ ions. The Er³⁺/Yb³⁺ co-doped ZnGa₂O₄ phosphor exhibited green, red and NIR upconversion emissions on excitation with 980 nm radiation. The intensity of the red emission was relatively larger than that of the other emissions. The luminescence intensity versus pump power measurements revealed the number of required photons for these emissions. The phosphor showed very interesting color tunability as a function of Er³⁺ ion concentration and incident pump power. The luminescence intensity of the Er³⁺/Yb³⁺ co-doped phosphor was enhanced more than two times via Li⁺ doping. The enhancement in the luminescence intensity was proposed to be due to the increase in the crystallinity and particle size of the phosphor. The lifetimes of the ⁴S_3/2 and ⁴F_9/2 levels also increased in the presence of Li⁺ ions. The variation in the fluorescence intensity ratio (FIR) of the thermally coupled levels (TCLs) of the red emission with incident pump power offered effective optical heating in the phosphor. The temperature-induced FIR using TCLs of red emission exhibited a larger value of temperature sensing sensitivity in the presence of Li⁺ ions, which was up to 14 × 10⁻⁴ K⁻¹. Thus, the Er³⁺/Yb³⁺/Li⁺ co-doped ZnGa₂O₄ phosphor may be used in photonic, optical heating, and temperature sensing devices.

The Er³⁺/Yb³⁺/Li⁺ co-doped ZnGa₂O₄ phosphor gives intense red upconversion photoluminescence, color tunability with Er³⁺ ion concentration and incident pump power, R/G ratio, induced optical heating and temperature sensing characteristics.     

In silico study of naphtha [1, 2-d] thiazol-2-amine with adenosine A2A receptor and its role in antagonism of haloperidol-induced motor impairments in mice

Loss of dopaminergic nigrostriatal neurons in the substantia nigra leads to Parkinson's disease (PD). Adenosine A_2A receptors (A_2ARs) have been anticipated as novel therapeutic target for PD. A_2ARs potentiate locomotor behavior and are predominantly expressed in striatum. Naphtha [1, 2-d] thiazol-2-amine (NATA), a tricyclic thiazole have been studied as new anti-Parkinsonian compound. AutoDock analysis and pharmacophore study of NATA with known A_2AR antagonists explicit its efficacy as a possible adenosine receptor antagonist. In vivo pharmacology of NATA showed reduction of haloperidol (HAL)-induced motor impairments in Swiss albino male mice. Relatively elevated levels of dopamine in NATA pre-treated mice are suggestive of its possible role as neuromodulator in PD.     

Longitudinal Patterns in Survival, Comorbidity, Healthcare Utilization and Quality of Care among Older Women Following Breast Cancer Diagnosis

OBJECTIVES

To compare longitudinal patterns of health care utilization and quality of care for other health conditions between breast cancer-surviving older women and a matched cohort without breast cancer.

DESIGN

Prospective five-year longitudinal comparison of cases and matched controls.

SUBJECTS

Newly identified breast cancer patients recruited during 1997–1999 from four geographic regions (Los Angeles, CA; Minnesota; North Carolina; and Rhode Island; N = 422) were matched by age, race, baseline comorbidity and zip code location with up to four non-breast-cancer controls (N = 1,656).

OUTCOMES

Survival; numbers of hospitalized days and physician visits; total inpatient and outpatient Medicare payments; guideline monitoring for patients with cardiovascular disease and diabetes, and bone density testing and colorectal cancer screening.

RESULTS

Five-year survival was similar for cases and controls (80% and 82%, respectively; p = 0.18). In the first follow-up year, comorbidity burden and health care utilization were higher for cases (p < 0.01), with most differences diminishing over time. However, the number of physician visits was higher for cases (p < 0.01) in every year, driven partly by more cancer and surgical specialist visits. Cases and controls adhered similarly to recommended bone density testing, and monitoring of cardiovascular disease and diabetes; adherence to recommended colorectal cancer screening was better among cases.

CONCLUSION

Breast cancer survivors’ health care utilization and disease burden return to pre-diagnosis levels after one year, yet their greater use of outpatient care persists at least five years. Quality of care for other chronic health problems is similar for cases and controls.KEY WORDS: survival, case-control, inpatient care, outpatient care, costs, preventive careDemographics and therapeutic progress in the United States are increasing the number of older cancer survivors. About 182,500 women were diagnosed with breast cancer in 2008, almost half occurring in women aged 65 or older. At five years, 89% remain alive;¹ of over 2.6 million breast cancer survivors in the United States, more than half are ≥65 years old.² Both the prevalence and absolute numbers of breast cancer survivors will grow, because aging is the most important risk factor for breast cancer;³ gains in life expectancy and advances in detection and treatment will place more women at risk for breast cancer, and breast cancer survivorship.Comorbidities also increase with age, for those with cancer and others.^4–7 Across most cancer types, older cancer patients report significantly more comorbidity and poorer physical health than non-cancer patients of the same age.^6–8 Since hypertension, heart conditions, arthritis, and diabetes are common in older breast cancer survivors,⁷ the Institute of Medicine has emphasized quality follow-up care for this cohort.^9,10Although follow-up care is essential in cancer survivorship,^11–15 studies comparing the quality of care for cancer survivors to those without cancer are conflicting. A longitudinal study of patients with diabetes showed similar quality of diabetes care for patients with and without cancer.¹⁶ Other studies have found that older cancer survivors receive similar, or less follow-up care than controls, or that the type of primary and cancer-related care varies by provider type.^9,11–14 Finally, a SEER-Medicare study of older breast cancer survivors found them receiving more preventative services than non-cancer patients.¹⁷ The inconsistent results may be due to different study populations (e.g. source, age, and type of cancer) and/or the kinds of follow-up care examined.To answer whether overall healthcare utilization and quality of follow-up care for other conditions differs for older women with and without breast cancer, we conducted a multi-site study of women ≥65-years of age with breast cancer and age-, morbidity-, and geography-matched controls. We compared differences in survival and quality of follow-up care over five years.     

“Juvenile alveolar rhabdomyosarcoma of mandible”

Rhabdomyomatous tumours are the malignant neoplasms of complex composition and deriva-tion. Three varities of Rhabdomyosarcoma are described. These are -1. Pleomorphic 2. Embryonal 3. Alveolar Juvenile Alveolar Rhabdomyosarcoma usually affects extremities and less commonly trunk, or-bit, soft tissues of the face (Cheek), Neck and oral cavity including the tongue and palate. A case of Juvenile Alveolar Rhabdomyosarcoma of Mandible is being reported. Relevant literature is reviewed.     

Antihyperglycemic activity, antihyperlipedemic activity, haematological effects and histopathological analysis of Sapindus mukorossi Gaerten fruits in streptozotocin induced diabetic rats

ObjectiveTo investigate the antihyperglycemic and antihyperlipidemic properties of hydroalcoholic extract of fruits of Sapindus mukorossi Gaerten and its beneficial effect on haematological parameters with histopathological analysis in streptozotocin induced diabetic rats.MethodsSapindus mukorossi fruits extract (250 and 500 mg/kg body weight) and standard drug glybenclamide (0.5 mg/kg body weight) were administered to diabetic rats. Effect of extract on hyperglycemia, hyperlipidemia and hematological parameters was studied in diabetic rats. Histopathological changes in diabetic rat pancreas were also observed after extract and glybenclamide treatment.ResultsDaily oral administration of Sapindus mukorossi fruits extract (250 and 500 mg/kg body weight) and glybenclamide for 20 days showed beneficial effects on blood glucose level (P<0.01) and lipid level. The extract has a favorable effect on the histopathological changes of the pancreas in streptozotocin induced diabetes.ConclusionThese findings reveal that the hydroalcoholic extract of Sapindus mukorossi fruits extract possesses antihyperglycemic and antihyperlipidemic properties. In addition, the extract can prevent various complications of diabetes and improve some haematological parameters.