Haploidentical Hematopoietic Stem Cell Transplantation in Leukemia’s: Experience from a Cancer Center in India

There has been a surge in haploidentical hematopoietic stem cell transplantation (HSCT) in India recently. However, there is a paucity of data on haploidentical HSCT from India. The report is an analysis of data of haploidentical HSCT performed at our center. Analysis of patients with acute leukemia or chronic myeloid leukemia who underwent haploidentical HSCT during 2014–2019 was performed. The graft versus host disease (GVHD) prophylaxis was post-transplant Cyclophosphamide with Mycophenolate-mofetil and Cyclosporine. All patients were transfused peripheral blood stem cells from donors. Overall survival (OS) was calculated using the Kaplan–Meier method. Twenty-one patients underwent haploidentical HSCT. Fourteen-patients were males. The median age of patients was 15 years. Fludarabine with total body irradiation was the most common conditioning regimen (n = 15, 71.4%). The median duration for neutrophil and platelet engraftment was 14 days. Cumulative incidence of acute and chronic GVHD was 19%, and 38% respectively. The median follow-up was 26 months and the two-year OS was 38%. Twelve (57%) patients died during the study period, 8 patients (38%) died from transplant-related mortality (TRM), and 4 from disease relapse. Sepsis was the cause of death in six of the eight TRM. Nine out of 21 patients (42.8%) are leukemia-free on follow-up. Haploidentical HSCT is a promising modality of treatment in patients who have no suitable matched donors. Though the TRM remains high, good disease control was achieved in 42.8% of patients. Multi-drug resistant bacterial infection remains a challenge in performing haploidentical HSCT in developing countries.     

A modified olanzapine-based anti-emetic regimen for the control of nausea and vomiting in patients receiving weekly cisplatin

International Journal of Clinical Pharmacy - Background There is limited data on specific antiemetic protocols for control of chemotherapy-induced nausea/vomiting (CINV) caused by weekly cisplatin...     

High Recovery of Functional Islets Stored at Low and Ultralow Temperatures

BACKGROUND: Poor recovery of islets upon cryopreservation is the main hurdle in islet banking. Pancreatic islets have a poor antioxidative defense mechanism, and exposure of islets to low temperature leads to oxidative stress. AIM: We aimed to investigate whether known compounds such as metformin, γ aminobutyric acid (GABA), docosahexanoic acid (DHA), or eicosapentaenoic acid (EPA) alone or in combination are capable of reducing oxidative stress for better islet recovery upon storage at suboptimal temperatures. METHODS: Islets isolated from mouse pancreas were stored at low temperature (4°C) for 15 days and at ultralow temperature (-196°C) for 30 days with or without additives. After revival from cold storage, islets were assessed by using three methods: (1) specificity by dithizone (DTZ), (2) viability by fluorescein diacetate/propidium iodide (FDA/PI) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetra-zolium bromide (MTT) assay, and (3) functionality by glucose-stimulated insulin secretion (GSIS). The oxidative status of the islets stored at suboptimal temperatures was determined by both intracellular free radical release (fluorometric analysis) and lipid peroxidation (enzymatic determination). RESULTS: Supplementation with additives led to an improvement in islet survival upon storage at suboptimal temperatures, without depletion of insulin secretory activity, which was comparable to that of controls. The additives acted as cryoprotectants and antioxidants as revealed by high recovery of viable islets and reduction in total reactive oxygen species (ROS) and malonidealdehyde (MDA), respectively. CONCLUSIONS: Our results demonstrate for the first time that supplementation with EPA, DHA, and metformin may lead to higher islet recovery from -196°C storage, enabling proper islet banking.     

Identification of Polybacterial Communities in Patients with Postoperative,Posttraumatic, and Endogenous Endophthalmitis through 16S rRNA Gene Libraries

Endophthalmitis is a potential vision-threatening complication following surgical procedures (postoperative endophthalmitis [POE]), trauma (posttraumatic endophthalmitis [PTE]), and bacteremic seeding of the eye from a distant infection site (endogenous endophthalmitis [EE]). Several studies have revealed the polybacterial characteristics of endophthalmitis, which make the administration of antibiotics to treat the disease challenging. However, until now, the polybacterial communities of POE, PTE, and EE have not been precisely studied. Hence, the present study was designed to identify the bacterial community of endophthalmitis through 16S rRNA gene libraries. Of the 40 intraocular samples tested, 30 libraries were constructed with bacterial nested-PCR-positive samples. The obtained recombinant clones were screened through amplified rRNA gene restriction analysis (ARDRA) to identify unique clones. The multiple types of ARDRA patterns (P = 0.345) and diverse bacterial sequences (P = 0.277) within the libraries revealed the polybacterial nature of infection in POE, PTE, and EE. Moreover, to the best of our knowledge, this is the first report on polybacterial infection in EE. Gram-positive bacteria, including Bacillus spp. (n = 19), Streptococcus spp. (n = 18), Staphylococcus spp. (n = 6), Exiguobacterium spp. (n = 3), Gemella spp. (n = 2), Enterococcus spp. (n = 2), a Lysinibacillus sp. (n = 1), a Clostridium sp. (n = 1), and a Nocardia sp. (n = 1), and Gram-negative bacteria, including Serratia spp. (n = 18), Pseudomonas spp. (n = 10), Enterobacter spp. (n = 8), Acinetobacter spp. (n = 3), Pantoea spp. (n = 3), a Haemophilus sp. (n = 1), and a Massilia sp. (n = 1), were identified. Interestingly, among them, 10 bacterial species were not previously reported to be associated with endophthalmitis or other ocular infections. Besides, the presence of 4 unidentifiable clones suggests the possibility of novel organisms that might cause eye infections. Therefore, it is recommended that, in addition to the polybacterial nature of POE, PTE, and EE infections, the spectrum of the pathogenic bacterial community identified in this work should be considered while administering antibiotic therapy in suspected endophthalmitis cases.     

The rapid response and high sensitivity of a ruthenium-doped copper ferrite thin film (Ru–CuFe2O4) sensor

A sensor displaying a rapid response and high sensitivity was developed by following a simple route. Ionic defects in this sensor were explored using X-ray diffraction analysis. In general, such defects arise from a mismatch of ionic radii, which actually improves the sensing performance. SEM and TEM images of the currently produced particles demonstrated negligible agglomeration, which greatly enhanced the flow of water molecules through the particles. The current sensor showed a rapid response to changes in humidity. Its sensing performance was classified into three different ranges of humidity. Of these humidity ranges, the sensor showed the highest sensitivity (8.84 MΩ per %RH) at low relative humidity (10–20% RH). Furthermore, the sensitivity fall off as the RH was increased from 20 to 99%. The sensor showed a rapid response time of 20 s. Also, the sensor showed 92.98% reproducibility and few effects of aging.

A sensor displaying a rapid response and high sensitivity was developed by following a simple route.     

Hydrothermal synthesis of cobalt telluride nanorods for a high performance hybrid asymmetric supercapacitor

Cobalt telluride nanostructured materials have demonstrated various applications, particularly in energy generation and storage. A high temperature and reducing atmosphere are required for the preparation of cobalt telluride-based materials, which makes this a difficult and expensive process. The development of a facile route for producing the desirable nanostructure of cobalt telluride remains a great challenge. We demonstrated a simple hydrothermal method for preparing cobalt telluride nanorods (CoTe NRs) and telluride nanorods (Te NRs) for supercapacitor applications. The morphology of CoTe NRs and Te NRs was analyzed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The prepared CoTe NR electrode material exhibited a high specific capacity of 170 C g⁻¹ at a current density of 0.5 A g⁻¹ with an exceptional cyclic stability. The asymmetric supercapacitor was assembled using CoTe NRs and orange peel-derived activated carbon (OPAA-700) as a positive and negative electrode, respectively. The fabricated device delivered a high energy density of 40.7 W h kg⁻¹ with a power density of 800 W kg⁻¹ at 1 A g⁻¹ current density. When the current density was increased to 30 A g⁻¹, the fabricated device delivered a high power density of 22.5 kW kg⁻¹ with an energy density of 16.3 W h kg⁻¹. The fabricated asymmetric supercapacitor displayed a good cyclic stability performance for 10 000 cycles at a high current density of 30 A g⁻¹ and retained 85% of its initial capacity for after 10 000 cycles. The prepared materials indicate their applicability for high performance energy storage devices.

A one-step hydrothermal derived cobalt telluride nanorods and activated carbon-based hybrid asymmetric supercapacitor delivered a high energy (40.7 W h kg⁻¹) and power density (22.5 kW kg⁻¹) with an electrochemical stability of 85% for 10000 cycles.     

Laparoscopic Ablative and Reconstructive Surgeries in Genitourinary Tuberculosis

Background and Objectives:

Laparoscopy is the present standard of care for urologic diseases. Laparoscopy in renal tuberculosis (genitourinary tuberculosis) is difficult because of inflammation and fibrosis associated with the disease. We present the outcome of our experience of laparoscopy in genitourinary tuberculosis, both ablative and reconstructive.

Methods:

The detailed data of patients with genitourinary tuberculosis who underwent laparoscopic surgeries between January 2011 and September 2012 were reviewed. Indications, type of surgery, duration, blood loss, intraoperative problems, postoperative outcomes, and follow-up details were noted.

Results:

Overall, 7 laparoscopic procedures were performed: 5 nephrectomies, 1 ureteric reimplantation with psoas hitch, and 1 combined nephrectomy and laparoscopy-assisted Mainz II pouch reconstruction. The mean operative time was 192 minutes for nephrectomy, 210 minutes for ureteric reimplantation, and 480 minutes for nephrectomy with Mainz II pouch reconstruction. There were no conversions to open surgery. The mean amount of blood loss was 70 mL for the nephrectomies, 100 mL for ureteric reimplantation, and 200 mL for nephrectomy with Mainz II pouch reconstruction. In 5 of 6 patients who underwent nephrectomy, there was severe perinephric and peripelvic fibrosis posing difficulty in dissection. However, the renal vessels could be controlled individually. The mean postoperative hospital stay was 3 days for the nephrectomies, 5 days for the ureteric reimplantation, and 10 days for the nephrectomy with Mainz II pouch reconstruction. In all cases the recovery was uneventful.

Conclusions:

Laparoscopy, though technically more demanding, is a feasible and safe option for ablative and complex reconstructive procedures in genitourinary tuberculosis. It offers the benefits of minimally invasive surgery. The difficulty with this procedure is mostly because of peripelvic and perinephric fibrosis, whereas the lower ureter and bladder are relatively easier to dissect.