Predictors of the severity of oral submucous fibrosis among gutka consumers: a regression analysis.

Oral submucous fibrosis (OSMF) is an insidious chronic disease of the oral mucosa that is characterised by severely limited mouth opening, blanching of the oral mucosa, and a burning sensation in the oral cavity. Consumption of betel nut and/or gutka are the known risk factors. We undertook this study to correlate the frequency and duration of gutka intake with the severity of OSMF and to determine the predictors of severe OSMF (mouth opening <20mm). A cross sectional study was conducted on 300 participants (who were known gutka chewers) selected at the Baqai Dental College and Fatima Hospital, Karachi, Pakistan. Participants' medical and dental histories were recorded. Informed consent was obtained, and clinical oral examination was done. Information regarding the extent of mouth opening, chewing habits, frequency and duration of gutka intake, the site of placing gutka, duration of chewing, and whether they swallowed or spat out the gutka were collected. A standardised questionnaire was used to document the findings. Binary logistic regression was applied using the severity of OSMF (mouth opening <20mm) as an outcome variable. Out of 300 participants, 172 (57.3%) were males; mean (SD) age of the sample was 38.2 (12.3) years. A total of 156 (52%) participants had the habit of chewing gutka, of which 213 (71%) had clinical stage I OSMF, 75 (25%) had stage II, and 12 (4%) had stage III. As per functional staging, 18 (6%) subjects had mouth opening <20mm. Nearly 144 (48%) participants were consuming other forms of tobacco in addition to the gutka. Patients with palpable bands = 232 (77.3%), ulcerative lesions = 212 (70.7%), altered taste sensation = 210 (70%) and altered hunger = 252 (85.7%) were common findings. The duration of gutka intake was found to be positively correlated with the severity of OSMF; however; its frequency was not. Among intraoral findings, the presence of red and white lesions inside the mouth was the most significant predictor of the severity of OSMF.

Implementing mhGAP training to strengthen existing services for an internally displaced population in Pakistan.

BACKGROUND: In 2014, over a million people were internally displaced after the launch of a military operation in North Waziristan, a tribal region on Pakistan's side of the Durand Line. Despite security concerns and restrictions, a collaborative mental health and psychosocial support initiative was undertaken in the district of Bannu. Monthly mental health camps were conducted for a period of 6 months by a multidisciplinary mental health team. The initiative also helped to assess mental health needs and plan training for primary care staff to strengthen existing resources. METHODS: As part of this initiative, Mental Health Gap Action Programme (mhGAP) training was conducted for physicians and psychosocial staff in the affected district. This marked the first instance of implementing these guidelines in Pakistan following a humanitarian crisis. This paper describes the training process including the adaptation of the mhGAP curriculum, training of trainers, training workshops for primary care staff and an analysis of results of pre- and post-testing of their knowledge about common mental disorders using a 25-item questionnaire. RESULTS: The gaps in knowledge of primary care physicians in recognizing and managing common mental disorders were clearly identified. The mean pre- and post-test scores of the participants were 15.43, 62% (p value 0.000, s.d. 4.05) and 19.48, 78% (p value 0.000, s.d. 3.13) respectively, which showed significant improvement. CONCLUSIONS: Despite the challenges of a humanitarian crisis, mhGAP guidelines can be successfully implemented to train primary care physicians in in low- and middle-income countries such as Pakistan. However, the dearth of primary care resources can hinder the complete integration of mental health services into primary healthcare.

Cadmium bound to metal rich granules and exoskeleton from Gammarus pulex causes increased gut lipid peroxidation in zebrafish following single dietary exposure.

There has been a growing interest in establishing how the sub-cellular distribution of metals in macro-invertebrate prey affects metal trophic bioavailability and toxicity. In this study, the crustacean Gammarus pulex was exposed to 300mugCdl(-1) spiked with (109)Cd for 13 days, from which the two principal metal containing sub-cellular fractions, the metallothionein-like protein (MTLP) and the metal rich granule and exoskeleton (MRG+exo) were isolated. These fractions were produced at equal metal content, incorporated into gelatin and fed to zebrafish as a single meal; assimilation efficiency (AE), carcass and gut tissue metal concentrations and gut lipid peroxidative damage measured as malondialdehyde (MDA) were assessed. The AE of cadmium bound to the MTLP fraction was 32.1+/-5.6% which was significantly greater than the AE of MRG+exo bound Cd, 13.0+/-2.1% (p<0.05). Of the metal retained by the fish at 72h post-feeding, 94% of MTLP-Cd had been incorporated into the carcass, whereas a significant proportion (46%) of MRG+exo-Cd, although assimilated, appeared to remain associated with intestinal tissue. However, this did not translate into a gut tissue concentration difference with 6.8+/-1.2ngCdg(-1) in fish fed MTLP-Cd compared to 9.5+/-1.4ngCdg(-1) in fish fed MRG+exo fraction. Both feeds led to significantly increased MDA levels compared to the control group (gelatin only feed), but MRG+exo feed caused significantly more oxidative damage than the MTLP feed (p<0.01). Thus, MTLP-Cd is more bioavailable than the cadmium bound to granules and exoskeleton, but it was the latter fraction, largely considered as having limited bioavailability, that appeared to exert a greater localised oxidative injury to the digestive tract of zebrafish.

Honey: nutritional and medicinal value.

Honey is not only used as nutrition but also used in wound healing and as an alternative treatment for clinical conditions ranging from gastrointestinal tract (GIT) problems to ophthalmic conditions. We did the literature search and found interesting facts about the nutritional and medicinal value of honey. No wonder, it is a good source of nutrition, the results of the studies prove that it also helps in wound healing. On burns, it has an initial soothing and later rapid healing effects. It has been used as wound barrier against tumour implantation in laparoscopic oncological surgery. No infection has been reported from the application of honey to open wounds. It has a potential therapeutic role in the treatment of gingivitis and periodontal disease. Based on these facts, the use of honey in the surgical wards is highly recommended and patients about to undergo surgery should ask their surgeons if they could apply honey to their wounds postoperation.

Purification and characterization of a high-molecular-weight form of recombinant human interleukin-2.

During purification of recombinant Interleukin-2 (rIL-2) by reversed-phase HPLC, early fractions are discarded due to the presence of an unidentified form of rIL-2. A procedure has been developed to isolate and purify this unidentified form of rIL-2. The purification process involves two chromatography steps and utilizes a Bakerbond Carboxy-Sulfon (CS) column under two different conditions. This material, designated as a high-molecular-weight form of rIL-2 (HMWrIL-2), exhibits lower mobility during SDS-PAGE and has a pI which is approximately one unit less than that of rIL-2, but has similar bioactivity to rIL-2. Structural analysis through enzymatic cleavage, HPLC peptide mapping, mass spectrometry, sequencing, and amino acid composition revealed that the difference between these two proteins is a C-terminal extension of 11 amino acids. This extension could be the result of a nonstandard translation event.

Extraction of rIL-2 inclusion bodies from Escherichia coli using cross-flow filtration.

A cross-flow membrane filtration process was developed for the recovery of rIL-2 inclusion bodies from homogenized Escherichia coli. The membrane extraction process was comprised of a two-step diafiltration followed by an extraction with 7 M GuHCl and a 40-fold dilution of the solubilized inclusion bodies into 0.01 M Tris-HCl, 0.035 M NaCl, pH 7.9. The first diafiltration was with a 0.03 M Tris-HCl, 5 mM ethylenediaminetetraacetic acid (EDTA), pH 8, followed by a diafiltration with 1.75 M GuHCl. All of the insoluble rIL-2 was retained behind the membrane, whereas a GuHCl wash solubilized approximately 15% of the rIL-2. The membrane process increased the yield of rIL-2 in the diluted extract by threefold as compared to a similar centrifuge process with a significant increase in purity as determined by reverse-phase high-performance liquid chromatography (HPLC). (c) 1994 John Wiley & Sons, Inc.

The use of proteolysis and direct N-terminal sequence analysis to study human interleukin-2/receptor interaction on solid support.

An immobilized interleukin-2 receptor which is capable of binding interleukin-2 and suitable for direct N-terminal sequence analysis was employed to study interleukin-2/receptor interactions. Sensitive tryptic sites on the immobilized receptor and its interleukin-2 complex were identified by sequence analyses and compared. The results have revealed that the N-terminal region of interleukin-2 is not involved in receptor binding and the peptide segment covering residues 36-39 in the receptor is probably near or involved in the interleukin-2 binding site. The rapidity and simplicity make this solid phase sequence approach a good method for analyzing interleukin-2/receptor interaction and may be suitable for studying other protein-ligand interactions.

Phosphorylation of human interleukin-2 (IL-2).

Human interleukin-2 (IL-2) is a lymphokine which is capable of activating lymphocytes and supporting the long-term in vitro growth of activated T cell clones. Recombinant human IL-2, expressed in either E. coli or cos cells, was shown to be phosphorylated by protein kinase C. Phosphorylated IL-2 synthesized in E. coli was analyzed by SDS-PAGE, reverse phase HPLC, and tryptic peptide mapping. The phosphorylated tryptic peptide was identified as the N-terminal fragment containing a single phosphorylation site at the serine residue at position 7. There was no difference in biological activity between non-phosphorylated and phosphorylated IL-2, as determined by a T cell growth assay. Although the physiological role of phosphorylation of IL-2 is unclear, IL-2 can be labeled with [gamma-32P] ATP and protein kinase C to a high specific radioactivity, and the synthesis of biologically active 32p-labeled IL-2 may be useful for receptor-binding studies of the cells containing low level of phosphoprotein phosphotases.

Structural characterization of human interferon gamma. Heterogeneity of the carboxyl terminus.

Natural human interferon gamma(IFN-gamma) was purified from the conditioned medium of peripheral blood leukocytes using selective silica gel adsorption and antibody-affinity chromatography. SDS-PAGE and Western blot analysis demonstrated three major species with molecular masses of 25 kDa, 20 kDa and 17 kDa. Structural analysis of this natural IFN-gamma preparation demonstrated a pyroglutamate residue at the amino terminus and a heterogeneous carboxyl terminus. The longest and most predominant polypeptide was 138 amino acids in length, which is five residues shorter than the sequence predicted from the cDNA. The presence of multiple-carboxyl-terminal forms indicated possible proteolytic processing during induction or protein purification. Limited proteolytic digestion of full-length recombinant IFN-gamma with endoproteinase Lys-C and trypsin revealed that the carboxyl-terminal 15 residues could be released under conditions in which the core portion of the polypeptide chain remained intact. Thus, the heterogeneity of natural IFN-gamma may be explained by partial proteolytic degradation of the molecule and differences in the degree of glycosylation as previously reported [Rinderknecht, E., O'Conner, B. H. & Rodriguez, H. (1984) J. Biol. Chem. 259, 6790-6797].

Characteristics of Mevatron 77 15-MV photon beam.

The characteristics of 15-MV photon beam of Mevatron 77 have been examined with respect to clinical parameters. Some of the characteristics of this 15-MV photon beam are different from those of similar machines used in radiotherapy. The tissue-maximum ratio values have been determined experimentally for SAD 100 cm and percentage depth dose values have been determined from tissue-maximum ratio data. It is found that the experimentally determined PDD values for SSD 80, 100, and 120 cm are within +/- 1% of the calculated data. The scatter-maximum ratio data have been calculated from the experimentally determined zero area attenuation coefficient and tissue-maximum ratio data and are presented as function of depth and radii of circular fields. The relative dose factors have been determined both for square and rectangular fields. The relative dose factor for rectangular fields depends on the two pairs of jaws differently and the maximum difference is about 1.5%. The flatness and symmetry are within the specifications set by the manufacturer.

Isocitrate lyase from flax : terminal residues, composition, active site, and catalysis.

The cleavage of D(s)-isocitrate catalyzed by isocitrate lyase from Linum usitatissimum results in the ordered release of succinate and glyoxylate. The glyoxylate analog 3-bromopyruvate irreversibly inactivates the flax enzyme in a process exhibiting saturation kinetics and protection by glyoxylate or isocitrate or the competitive inhibitor l-tartrate. Succinate provides considerably less protection. Results with 3-bromopyruvate suggest that this reagent modifies plant and prokaryotic isocitrate lyases differently. Treatment of the tetrameric 264,000-dalton flax enzyme with carboxypeptidase A results in a release of one histidine/subunit which is concordant with loss of activity. The only N-terminal residue is methionine. Treatment of flax enzyme with diethylpyrocarbonate at pH 6.5 selectively modifies two histidines per 67,000-dalton subunit. The reaction of one histidine residue is abolished by the binding of l-tartrate and the modification of one is coincident with inactivation. The carboxy-terminal and active-site modifications establish that one histidine residue/monomer is essential in the flax enzyme and considerably extend information heretofore available only for fungal and bacterial isocitrate lyase.

Enzyme Profiles in Seedling Development and the Effect of Itaconate, an Isocitrate Lyase-directed Reagent.

Changes in levels of isocitrate lyase, malate synthase, and catalase have been investigated during germination of flax (Linum usitatissimum L.) in the presence and absence of itaconate. Germination was accompanied by a rapid increase in these enzymes during the first 3 days. The presence of 38 millimolar itaconate inhibited the incidence of seed germination and the growth of embryo axes as well as the appearance of isocitrate lyase but did not alter the levels of malate synthase, catalase, or NADP(+)-isocitrate dehydrogenase. The specific activity for the latter enzyme was constant throughout germination. Oxalate or succinate, each at 38 millimolar, had no effect upon germination of flax seeds. Itaconate did not inhibit the activities of malate synthase, catalase, or NADP(+)-isocitrate dehydrogenase in vitro but was a potent noncompetitive inhibitor of isocitrate lyase (K(i):17 micromolar at 30 C, pH 7.6). Itaconate (at 38 millimolar) did not alter the appearance of malate synthase but reduced the incidence of germination, onset of germination, and growth of the embryo axis as well as the specific activity of isocitrate lyase in seedlings of Zea mays, Vigna glabra, Glycine hispida, Vigna sinensis, Trigonella foenumgraecum, Lens culinaris, and Medicago sativa. The incidence and onset of germination of wheat seeds were unaltered by the same concentration of itaconate but seedlings did not contain isocitrate lyase or malate synthase. The data suggest that itaconate may be isocitrate lyase-directed in inhibiting the germination of fatty seeds.

Dosimetric reliability of thermoluminescent phosphors (TLD-too).

The dosimetric reliability of TLD-100 has been studied in view of the fact that these TLDs are extensively used for patient dosimetry in the case of irregular fields and where patient's contour creates special problems. TLDs have also been used in intercavitary dosimetry (e.g. esophagus and rectum) and in some cases of dosimetric comparison of radiation output. However, it appears that these TLDs are unsuitable for most practical dosimetry due to poor reproducibility and system error. It is found that the same TLD-chip gives widely divergent readings for the same exposure even when correction for the system error is made. The composite uncertainty under the best experimental conditions is about +/-3.5%.