Acute calcific periarthritis of acromioclavicular joint: A case report.

Key Clinical Message: It is of utmost importance to be aware of acute calcific periarthritis, as it may confuse the clinicians leading to misdiagnosis. Furthermore, patients may be subjected to various diagnostic and invasive procedures due to a lack of familiarity with this condition. Abstract: Deposition of hydroxyapatite crystals in the para-articular soft tissues is a well-known condition, often involving the shoulder joint. However, the deposition of calcium salts in the para-articular soft tissue of acromioclavicular joint has rarely been described. We report a case of a 55-year-old otherwise healthy man, presented with acute onset of pain and restriction of movement of left shoulder, who was diagnosed based on radiographic findings with calcific periarthritis of the acromioclavicular joint. As suggested by the literatures, he was managed conservatively, and no reoccurrence was reported after the episode.

PTEN-AKT pathway attenuates apoptosis and adverse remodeling in ponatinib-induced skeletal muscle toxicity following BMP-7 treatment.

Tyrosine kinase inhibitors (TKIs) including ponatinib are commonly used to treat cancer patients. Unfortunately, TKIs induce cardiac as well as skeletal muscle dysfunction as a side effect. Therefore, detailed mechanistic studies are required to understand its pathogenesis and to develop a therapeutic treatment. The current study was undertaken to examine whether ponatinib induces apoptosis and apoptotic mechanisms both in vitro and in vivo models and furthermore to test the potential of bone morphogenetic protein 7 (BMP-7) as a possible treatment option for its attenuation. Sol8 cells, a mouse myogenic cell line was exposed to ponatinib to generate an apoptotic cell culture model and were subsequently treated with BMP-7 to understand its protective effects. For the in vivo model, C57BL/6J mice were administered with ponatinib to understand apoptosis, cell signaling apoptotic mechanisms, and adverse muscle remodeling and its attenuation with BMP-7. TUNEL staining, immunohistochemistry (IHC), and real-time polymerase chain reaction (RT-PCR) methods were used. Our data show significantly (p < 0.05) increased TUNEL staining, caspase-3, BAX/Bcl2 ratio in the in vitro model. Furthermore, our in vivo muscle data show ponatinib-induced muscle myopathy, and loss in muscle function. The observed muscle myopathy was associated with increased apoptosis, caspase-3 staining, and BAX/Bcl-2 ratio as confirmed with IHC and RT-PCR. Furthermore, our data show a significant (p < 0.05) increase in the involvement of cell signaling apoptotic regulator protein PTEN and a decrease in cell survival protein AKT. These results suggest that increased apoptosis following ponatinib treatment showed an increase in skeletal muscle remodeling, sarcopenia, and fibrosis. Furthermore, BMP-7 treatment significantly (p < 0.05) attenuated ponatinib-induced apoptosis, BAX/Bcl2 ratio, decreased PTEN, and increased cell survival protein AKT, decreased adverse muscle remodeling, and improved muscle function. Overall, we provide evidence that ponatinib-induces apoptosis leading to sarcopenia and muscle myopathy with decreased function which was attenuated by BMP-7.

Behcet's disease in an adult male from Nepal: A case report.

This case report highlights considering Behcet's disease as a diagnosis in orogenital ulcers and uveitis, although its prevalence is unknown in Nepal due to underreporting. Also, collaboration for patient care among relevant specialties is required.

Prevalence, Risk Factors and Outcome of Pregnancy induced Hypertension in Nepal: A Meta-Analysis of Prevalence Studies.

BACKGROUND: Pregnancy induced hypertension is a major cause of global maternal mortality and morbidity. This review was conducted to fulfill the objective of evaluating the status of pregnancy induced hypertension in Nepal. METHODS: The protocol for this review was registered in PROSPERO (CRD42020211210). Pubmed, Embase, Google Scholar, Scopus and Pubmed Central were searched using appropriate keywords for relevant studies. Data analysis was performed using Comprehensive Meta-Analysis Software version 3. Forest plot was used to visualize the prevalence and risk factors of Pregnancy induced hypertension. Random effect model was used and the level of heterogeneity was high. Joanna Briggins Institute bias assessment tool was used for the analysis of bias in the included studies. RESULTS: Twenty studies were included in the review. The pooled prevalence of pre-eclampsia and eclampsia were 2.6% (95% CI, 1.2%-5.3%) and 0.5% (95% CI, 0.2%-1.1%) respectively. The majority of cases were young women and had not complete or unbooked antenatal visits. Cesarean delivery was the most common mode of deliveries in 50% of deliveries (proportion, 0.50; 95% CI, 0.40-0.60) among patients with PIH followed by vaginal deliveries in 43.1% (proportion, 0.431; 95% CI, 0.336-0.532); and rest 6.9% were vacuum/forceps assisted deliveries (proportion, 0.069; 95% CI, 0.050-0.093). Common maternal complications were abruption in 6.56% of Pregnancy induced hypertension cases, rest were pulmonary embolism, renal injury. CONCLUSIONS: The prevalence of pre-eclampsia and eclampsia in Nepal were 2.6% and 0.5%. Younger woman and women with poor antenatal checkups had increased risk of Pregnancy induced hypertension. Cesarean delivery was the most common route of delivery and common maternal complications were abruption placenta, pulmonary embolism, renal injury etc. Keywords: Eclampsia; hypertension; maternal mortality; Nepal; pre-eclampsia; pregnancy-induced.

Temporary reduction in air pollution due to anthropogenic activity switch-off during COVID-19 lockdown in northern parts of India.

Due to fast and deadly spread of corona virus (COVID-19), the Government of India implemented lockdown in the entire country from 25 April 2020. So, we studied the differences in the air quality index (AQI) of Delhi (DTU, Okhla and Patparganj), Haryana (Jind, Palwal and Hisar) and Uttar Pradesh (Agra, Kanpur and Greater Noida) from 17 February 2020 to 4 May 2020. The AQI was calculated by combination of individual sub-indices of seven pollutants, namely PM2.5, PM10, NO2, NH3, SO2, CO and O3, collected from the Central Pollution Control Board website. The AQI has improved by up to 30-46.67% after lockdown. The AQI slope values - 1.87, - 1.70 and - 1.35 were reported for Delhi, - 1.11, - 1.31 and - 1.04 were observed for Haryana and - 1.48, - 1.79 and - 1.78 were found for Uttar Pradesh (UP), which may be attributed to limited access of transportation and industrial facilities due to lockdown. The ozone (O3) concentration was high at Delhi because of lesser greenery as compared to UP and Haryana, which provides higher atmospheric temperature favourable for O3 formation. The air mass back trajectory (AMBT) analysis reveals the contribution of air mass from Europe, Africa and Gulf countries as well as local emissions from Indo-Gangetic Plain, Madhya Pradesh and Maharashtra states of India.

Dendrimer entrapped microsponge gel of dithranol for effective topical treatment.

Dithranol is one of the important topical agents for the treatment of psoriasis, a chronic inflammatory skin disease with aberrant differentiation of keratinocytes. However, its application is troublesome and inconvenient because of its associated side effects, including staining, burning sensation, irritation, and necrotizing effect on the diseased cells as well as on the normal cells. The purpose of the current investigation was to explore the potential of poly(amido) amine (PAMAM) dendrimers in the topical delivery of dithranol through a novel microsponge based gel. Generation-4 (G4) dendrimers were incorporated into the microsponge based gel formulation by quasi-emulsion solvent diffusion method with varying concentration of polymers, and evaluated for the morphology of the formulation, encapsulation efficiency and skin irritation potential. Percentage yield of the formulation was found to be 66.28%, whereas encapsulation efficiency was ranged between 71.33% to 49.21%, and an average particle size was ranged between 28 ± 1.12 µm to 130 ± 1.01 µm. Surface morphology of developed microsponge was confirmed by scanning electron microscopy, revealed micro-porous nature. The optimized microsponge formulation was found to be stable and recorded non-irritant during cutaneous application of the experimental animals. Further, the pharmacokinetic outcomes of study were showed prolong penetration of the drug through the skin, equivalent to the marketed formulation of dithranol. Therefore, it could be conferred that the microsponge formulation of the PAMAM entrapped dithranol can produce prolonged efficacy without producing toxicities to the skin, and thus can effectively be projected in the treatment of diseases like psoriasis.

Prospects, challenges and need for regulation of nanotechnology with special reference to India.

To meet the challenges of food security in a sustainable way, technological intervention in agriculture is of prime importance. With the existing conventional technologies supporting high yield, better crop production and protection, the emphasis is now on use of nanotechnology. Exploring new applications of nanotechnology has gained momentum in recent years and has shown acceptance in sectors like food, medicine, chemistry etc. As compared to other sectors, the accepted role in agriculture can still be considered on the marginal side in terms of nanotechnology application. Nanotechnology offers a potential to open large scope of novel application in the fields of biotechnology and agricultural industries due to unique physicochemical properties. Nanoparticles can be used in herbicides, nano-pesticide, nano-fertilizers, or genes, which target specific cellular organelles in plant to release their content. It can potentially play an instrumental role in minimizing the application losses of agrochemicals due to their more stable emulsion, higher coverage on leaf surface, precision application, etc. Understanding that the conventional and macro-technologies in agriculture do not ensure sustainable food security and environmentally safe methods; the researchers are now inclined for more précised nanotechnology based applications. There is still a huge untapped potential of nanomaterials to be used a future technology in agriculture which remains to be explored. Besides offering potential benefits, there are high concerns about the potential challenges associated with nanoparticles. To address the safety concerns about nanoparticles, it is important that a strong regulation system should be developed. Presently, very few countries have started focusing on keeping nanoregulation on their agenda. It is very important for agricultural and biodiverse country like India to set up norms of use nanoregulation and bring nanotechnology on the safe technology net.