Propofol and priapism

Propofol-induced priapism in a 25-year-old male confirmed by rechallenge is reported for its rarity and to create awareness among practitioners, because propofol is used frequently in India for the induction and maintenance of anesthesia or sedation. The probable mechanisms are highlighted. Because propofol causes low-flow priapism, early alleviation is essential to minimize and/or avert the long-term complications.     

Interleukin-10 as an indicator of chronic course of oral candidiasis in diabetics: an in vitro study

The importance of host defense against candidiasis and the role of cell-mediated immunity in host defense have been the subject of many studies. Increased expression of virulence factors in Candida isolates from diabetes mellitus (DM) patients with oropharyngeal candidiasis (OPC) has also been reported. To study the difference in T helper type 2 (Th2) and T helper type 1 (Th1) responses and neutrophil respiratory burst response, as a parameter of acute phase and adaptive immune responses, respectively, by using Candida isolates from lesions of oropharyngeal candidiasis (OPC) in DM patients compared to oral Candida isolates from healthy carriers. Analytical experimental laboratory-based study: (a) yeast identification and speciation was done. (b) Peripheral blood mononuclear cells (PBMCs) and neutrophils, obtained from healthy volunteers, were stimulated with oral Candida isolates of DM patients and healthy carriers (controls). Thereafter, cytokine analysis and neutrophil respiratory burst response analysis were done. IL-10 release was uniformly low at all concentrations of Candida albicans antigen isolated from healthy controls as compared to when C. albicans isolated from DM patients was used as antigenic stimulus. Mean INF-_γ concentration was highest when C. albicans, isolated from healthy carriers was used as antigenic stimulus for PBMCs. There was no significant difference in neutrophil respiratory burst response among study and control groups. The observations highlight a significant IL-10 dominance, which may be an indicator of the inclination of host immune system toward a chronic progressive disease condition, indicating the pathogenic potential of select Candida strains.     

Tumor necrosis factor (TNF)-α −308G/A (rs1800629) polymorphism distribution in North India and its association with pemphigus: Case–control study and meta-analysis

Pemphigus is an autoimmune blistering disorder of skin and/or mucosal surfaces characterized by intraepithelial lesions and immunoglobulin-G autoantibodies against desmogleins (proteins critical in cell-to-cell adhesion). Genetic, immunological, hormonal, and environmental factors are known to contribute to its etiology. Tumor necrosis factor-alpha (TNF-α) which plays a key role in pathogenesis of many infectious and inflammatory diseases has been found in high levels in lesional skin and sera of pemphigus patients. However, studies on association of single nucleotide polymorphism (SNP) in promoter region of TNF-α at position ?308 affecting G to A transition with pemphigus has been scarce. This study was conducted to evaluate the TNF-α ?308G/A SNP distribution in North Indian cohort, and to define the association between the TNF-α ?308G/A SNP distribution and pemphigus, globally, by means of meta-analysis. TNF-α ?308G/A SNP in pemphigus patients was investigated by cytokine genotyping using genomic DNA by PCR with sequence-specific primers. Meta-analysis of the data, including four previously published studies from other populations, was performed to generate a meaningful relationship. The results of our case–control study indicate non-significant differences between patients and controls in TNF-α ?308G/A SNP. The meta-analysis also revealed that TNF-α ?308G/A SNP is not associated with pemphigus risk in population at large; however, it may be contributing towards autoimmune phenomenon in pemphigus by being a part of its multi-factorial etiology. This study provides evidence that the TNF-α ?308G/A polymorphism is not associated with overall pemphigus susceptibility. Nevertheless, further studies on specific ethnicity and pemphigus variants are necessary to validate the findings.