Visual outcome in macular retinoblastoma treated with primary chemotherapy

In this prospective clinical study, we treated 8 patients (8 eyes, 11 tumors) of macular retinoblastoma with chemotherapy alone, with the aim of avoiding visual loss because of retinal damage by radiation or adjuvant therapy and to assess their final visual outcome. The mean basal dimension of the tumor was 5.0 +/- 2.6 mm and the mean height was 2.9 +/- 1.3 mm. The fovea was involved in 4 patients (50%) and foveal detachment was present in 3 patients (37.5%). All the patients required less than 6 cycles for tumor control. Four patients (50%) obtained visual acuities ranging from 20/25 to 20/200. Two patients (25%) could gain visual acuity of 20/20. The mean follow-up of patients was 3.24 +/- 0.9 years (range 2-5). No patient developed recurrence or metastatic disease. In conclusion, recent trends for ocular salvage have favored chemoreduction followed by focal therapy for the treatment of retinoblastoma. This study supports the consideration of chemotherapy alone as the primary treatment in eyes with macular retinoblastomas, under close supervision, with satisfactory visual outcome.     

Topical cyclosporine A 0.5% as a possible new treatment for superior limbic keratoconjunctivitis

PURPOSE: To report the early success of the use of topical cyclosporine A 0.5% drops to treat Theodore's superior limbic keratoconjunctivitis (SLK). DESIGN: A retrospective noncomparative case series. PARTICIPANTS: Five patients diagnosed with SLK. INTERVENTION: All five patients were treated with topical cyclosporine A 0.5% drops as primary or adjunctive therapy after treatment failure in some of prednisolone acetate 1% drops and topical silver nitrate 0.5% application. Topical cyclosporine A 0.5% drops were used four times a day in both eyes. MAIN OUTCOME MEASURES: Resolution of symptoms (foreign body sensation and irritation) and signs (rose bengal staining, tarsal papillary reaction, and injection). RESULTS: All five patients had long-term (6 months to 3 years) improvement of irritation and foreign body sensation, as well as improvement of injection and filamentary keratitis. Aside from burning on instillation, there were no complications related to this therapy. CONCLUSIONS: Topical cyclosporine A 0.5% is helpful as primary or adjunctive therapy for SLK. It may also be used as a maintenance drug to prevent recurrence. Further study may delineate the specific role and treatment parameters for the use of topical cyclosporine A 0.5% in the treatment of SLK.     

New sesquiterpenes from Pluchea arabica

Two new sesquiterpenes, godotol A (1) and godotol B (2), were isolated from Pluchea arabica. Their structures were determined by analysis of NMR data. The absolute configurations of 1 and 2 were established by Mosher ester methodology. The godotols displayed weak activity against bacteria and the brine shrimp larvae. They were also inactive in the DPPH antioxidant assay.     

Evaluation of carboxymethyl guar films for the formulation of transdermal therapeutic systems

Carboxymethyl guar (CMGS), an anionic semisynthetic guar gum derivative was evaluated for its suitability of use in transdermal drug-delivery systems. Terbutaline sulfate (TS) was used as a model drug. The diffusion of terbutaline sulfate from CMGS solution was relatively slower at pH 5 than at pH 10. It is most likely that the interaction between CMGS and terbutaline sulfate at pH 5 is physical, involving static interaction. The ability of such interactions in modifying the release kinetics of drug from the CMGS transdermal films was studied. The release was exponential from pH 5 formulations whereas the release rate followed zero or Higuchian order from pH 10 formulations. However, the diffusion kinetics of both pH 5 and pH 10 formulations followed zero order across human cadaver epidermis. Such an interaction was also found to alter the pharmacokinetic parameters of the drug. The steady-state concentration of TS was relatively consistent and the bioavailability was approximately 50% higher in pH 5 formulations than pH 10. The elimination rate constant/half-life was significantly different between pH 5 and pH 10 formulations.     

Household tobacco and alcohol use, and child health: an exploratory study from India

The study uses data from the National Family Health Survey-II, a nationally representative survey from India of 92,486 households, to investigate the association between household tobacco and alcohol use, and child health. The study findings show that children from households that use tobacco or alcohol were less likely to be immunized, more likely to have acute respiratory tract infection, more likely to be malnourished, and more likely to die before first birthday, even after controlling for other socio-economic and demographic characteristics. Policies and programs for child survival may also need to incorporate strategies to control household tobacco and alcohol use in addition to other ongoing interventions.     

Synthesis and antiinflammatory activity of heterocyclic indole derivatives

Chalcones of indole 1-5 and their corresponding products; pyrazolines 6-10 and azo compounds 11-15 were synthesised and evaluated for their antiinflammatory activity against carrageenan induced oedema in albino rats at a dose of 50 mg x kg(-1) oral. The structure of compounds was confirmed by IR, (1)H-NMR and mass spectral data. All the compounds of this series showed promising antiinflammatory activity. The most active compound of this series is 3-[1-acetyl-5-(p-hydroxyphenyl)-2-pyrazolin-3-yl]indole (7) was found to be most potent, which has shown higher percent of inhibition of oedema, lower ulcerogenic liability and acute toxicity than the standard drug phenylbutazone.