A retrospective analysis of cannabis use in a cohort of mentally ill patients in Sri Lanka and its implications on policy development

Background  

Several epidemiological studies have shown that cannabis; the most widely used illegal drug in the world, is associated with schizophrenia spectrum disorders (SSD).     

Cardiopulmonary resuscitation service in a general hospital in Britain

The experience of a cardiopulmonary resuscitation programme in a small general hospital is reported. Twenty-five resuscitation attempts were made in 22 patients. The initial success rate was 52% and 32% of patients survived over 24 h and 18% were discharged alive. These figures compared favourably with the experience reported from major teaching hospitals. This study demonstrates the feasibility of a satisfactory cardiopulmonary resuscitation programme with limited equipment and personnel. Some aspects of the organization and maintenance of such a cardiopulmonary resuscitation programme, with emphasis on training medical and nursing personnel, are discussed.     

Transitional cell carcinoma of the nasal passages: Dramatic response to chemotherapy

Transitional cell carcinoma of the nasal passages and sinuses is an uncommon tumor of the head and neck, for which the efficacy of chemotherapy has not been previously reported. A dramatic and complete tumor response to chemotherapy with cis-platinum, methotrexate, and bleomycin is described in a patient with advanced proptosis due to extensive local recurrence of transitional cell carcinoma. Relevant literature on this rare histologic type of head and neck cancer has been reviewed.     

The aggregation of pig articular chondrocyte and synthesis of extracellular matrix by a lactose-modified chitosan

A reductive amination reaction (N-alkylation) obtained exploiting the aldheyde group of lactose and the amino group of the glucosamine residues of chitosan (d.a. 89%) afforded a highly soluble engineered polysaccharide (chitlac) for a potential application in the repair of the articular cartilage. Chitosan derivatives with 9% and 64% of side chain groups introduced have been prepared and characterized by means of potentiometric titration, (1)H-NMR and intrinsic viscosity. Both polymers, with respect to the unmodified chitosan, induce cell aggregation when in contact with a primary culture of pig chondrocytes, leading to the formation of nodules of considerable dimensions (up to 0.5-1 mm in diameter). The nodules obtained from chondrocytes treated with chitlac with the higher degree of substitution have been studied by means of optical and electron microscopy (SEM, TEM) and the production of glycosaminoglycans (GAGs) and collagen has been measured by means of colorimetric assays. The chondro-specificity of GAG and collagen was determined by RT-PCR. The results show that the lactose-modified chitosan is non-toxic and stimulates the production of aggrecan and type II collagen.     

Direct identification of Pseudomonas aeruginosa from blood culture bottles by PCR-enzyme linked immunosorbent assay using oprI gene specific primers

A PCR-enzyme-linked immunosorbent assay (PCR-ELISA) was developed for direct identification of Pseudomonas aeruginosa from positive BACTEC blood culture bottles. PCR primers were designed to target a 249 bp sequence of the oprI gene in P. aeruginosa. Biotin-labeled probe (PA3) targeted to the species-specific motif were hybridized to the digoxigenin-labeled amplified products from P. aeruginosa and captured on streptavidin-coated microtiter plates. The specificity of the assay using the PA3 probe was investigated with a range of microorganisms, which are commonly isolated from blood culture bottles serving as negative controls. The PCR-ELISA assay was shown to be highly specific for the identification of P. aeruginosa and was 10-fold more sensitive than an agarose gel-based detection method using the same pair of primers, with a detection limit at 10 fg of template. The PCR-ELISA assay developed in this study is 100% sensitive and 100% specific as it correctly identified all 73 positive and 42 negative controls as well as 25 double blind clinical samples. It significantly reduces the time needed for the identification of P. aeruginosa from positive BACTEC blood cultures bottles from 2-3 days to 6-8h.     

Epratuzumab with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy in patients with previously untreated diffuse large B-cell lymphoma

Approximately 60% of patients with diffuse large B-cell non-Hodgkin lymphoma (DLBCL) are curable with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemoimmunotherapy. Epratuzumab (E) is an unlabeled anti-CD22 monoclonal antibody with efficacy in relapsed DLBCL. This phase 2 trial tested the safety and efficacy of combining E with R-CHOP (ER-CHOP) in untreated DLBCL. A secondary aim was to assess the efficacy of interim positron emission tomography (PET) to predict outcome in DLBCL. Standard R-CHOP with the addition of E 360 mg/m(2) intravenously was administered for 6 cycles. A total of 107 patients were enrolled in the study. Toxicity was similar to standard R-CHOP. Overall response rate in the 81 eligible patients was 96% (74% CR/CRu) by computed tomography scan and 88% by PET. By intention to treat analysis, at a median follow-up of 43 months, the event-free survival (EFS) and overall survival (OS) at 3 years in all 107 patients were 70% and 80%, respectively. Interim PET was not associated with EFS or OS. Comparison with a cohort of 215 patients who were treated with R-CHOP showed an improved EFS in the ER-CHOP patients. ER-CHOP is well tolerated and results appear promising as a combination therapy. This study was registered at www.clinicaltrials.gov as #NCT00301821.     

Utilization of Boxes for Pesticide Storage in Sri Lanka

Pesticide self-poisoning is now considered one of the two most common methods of suicide worldwide. Encouraging safe storage of pesticides is one particular approach aimed at reducing pesticide self-poisoning. CropLife Sri Lanka (the local association of pesticide manufacturers), with the aid of the Department of Agriculture, distributed lockable in-house pesticide storage boxes free of charge to a farming community in a rural district of Sri Lanka. Padlocks were not provided with the boxes. These storage boxes were distributed to the farmers without prior education. The authors carried out a cross-sectional follow-up survey to assess the usage of boxes at 7 months after distribution. In an inspection of a sample of 239 box recipients’ households, 142 households stored pesticides in the provided box at the time of survey. Among them, only 42 (42/142, 29.65%) households had locked the box; the remaining households (100/142, 70.4%) had not locked the box. A simple hand over of in-house pesticide storage boxes without awareness/education results in poor use of boxes. Additionally, providing in-house storage boxes may encourage farmers to store pesticides in and around houses and, if they are not locked, may lead to unplanned adverse effects.     

Radically Accessing D–A Type Ambipolar Copolymeric Materials with Intrinsic Electrical Conductivity and Visible–Near Infrared Absorption Via Electro‐Copolymerization

Thienothiadiazole‐bisthiophene (TTDT₂) and diketopyrrolo–pyrrole–bisthiophene (DPPT₂) are successfully electro‐copolymerized with terthiophene (T₃) as an initiator and linker at low oxidative potentials. AC impedance analysis, absorption spectroscopy, and elemental composition via SEM‐EDX support the formation of donor–acceptor (D–A) type alternating block copolymers, poly(T₃‐TTDT₂), and poly(T₃‐DPPT₂). Unique optical properties that span into the near infrared‐II(>1000 nm) region and inherent electrical conductivity at the p‐type regime, n‐type regime, and in between the two regimes (i.e., typical insulator region) are observed. This study showcases the advantages of electro‐polymerization toward tailoring of next generation opto‐electronic materials.     

Do Targeted Bans of Insecticides to Prevent Deaths from Self-Poisoning Result in Reduced Agricultural Output?

BACKGROUND: The pesticides monocrotophos, methamidophos, and endosulfan were a very common cause of severe poisoning in Sri Lanka during the 1980s and early 1990s, before they were banned in 1995 and 1998. Now, the most commonly used insecticides are the less toxic World Health Organization Class II organophosphorus pesticides and carbamates. These bans were followed by a large reduction in both fatal poisonings and suicide in Sri Lanka. OBJECTIVE: We aimed to see if these bans adversely affected agricultural production or costs. METHODS: We used data from the World Resources Institute to compare the yields of the main crop groups in Sri Lanka with those from surrounding South Asian countries for 1980-2005. We also examined data from the Sri Lankan Department of Census and Statistics to examine the yields of 13 specific vegetable crops and rice for 1990-2003, along with the costs of rice production. RESULTS: We found no drop in productivity in the years after the main bans were instituted (1995, 1998). We observed substantial annual fluctuation in estimated yields in all data sources, but these did not coincide with the bans and were no larger than the fluctuations in other countries. Also, there was no sudden change in costs of rice production coinciding with bans. CONCLUSIONS: Countries aiming to apply restrictions to reduce deaths from pesticide poisoning should evaluate agricultural needs and develop a plan that encourages substitution of less toxic pesticides. If farmers have an affordable alternative for pest control for each crop, there is no obvious adverse effect on agricultural output.