Effect of titanium dioxide nanocoating on the colour stability of room temperature vulcanizing maxillofacial silicone-an invitro study.

OBJECTIVE: The aim of this in vitro study was to evaluate the effect of an oxide nanocoating to prevent colour degradation of maxillofacial silicone elastomers following accelerated ageing. MATERIAL AND METHODS: Specimens (N = 40) of specified dimensions were fabricated in Factor II room temperature vulcanizing (RTV) silicone and processed according to the manufacturer's instructions. Two groups were classified with 20 specimens each. Specimens in the first group were coated with titanium dioxide (TiO2) by atomic layer deposition technology. The colour stability test was conducted with a UV-VIS spectrometer (Schimadzu) for both titanium dioxide nanocoated and uncoated specimen groups after subjecting them to accelerated ageing. It was analysed using the CIE L*a*b method. RESULTS: The average colour change was highest for uncoated specimens (2.868), and the average colour change for titanium dioxide-coated specimens was significantly low (1.774). The average colour change of uncoated specimens (2.868) was close to the acceptable threshold value (3), and that of coated specimens (1.774) was far below the acceptable threshold (3). CONCLUSIONS: The colour change that occurred in titanium dioxide nanocoated specimens following accelerated ageing was significantly lower than that in the uncoated group, showing that the TiO2 nanocoating was effective in reducing the colour degradation of silicone elastomers. CLINICAL RELEVANCE: Maxillofacial prostheses fabricated from silicone elastomers go through undesirable colour degradation over time. The development of a scientific technique that retards the colour deterioration of silicone prostheses would be of great clinical significance.

Paraquat Poisoning: A Retrospective Study of 55 Patients From a Tertiary Care Center in Southern India.

BACKGROUND: In India the data on paraquat (PQ) poisoning are limited to case reports and small case series. Hence, this study was carried out to understand the clinical features and outcomes of PQ poisoning. We also briefly report the relevant Indian studies on PQ poisoning. MATERIALS AND METHODS: This was a retrospective case record-based study of PQ poisoning victims admitted over a period of 5 years. RESULTS: Of the 55 patients included in this study, the in-hospital mortality rate was 72.7%. Acute kidney injury was the most common manifestation. The use of cyclophosphamide did not affect the clinical outcome. Hemoperfusion (HP) was not done for any patient. Pulmonary edema and acute tubular necrosis were the most common histopathological findings. CONCLUSION: In India, this is one of the most comprehensive studies of PQ toxicity. Hence, we hope that this information would be of use to clinicians who deal with PQ poisoning. HOW TO CITE THIS ARTICLE: Ravichandran R, Amalnath D, Shaha KK, Srinivas BH. Paraquat Poisoning: A Retrospective Study of 55 Patients from a Tertiary Care Center in Southern India. Indian J Crit Care Med 2020;24(3):155-159.

Vitamin K1 prevents diabetic cataract by inhibiting lens aldose reductase 2 (ALR2) activity.

This study investigated the potential of vitamin K1 as a novel lens aldose reductase inhibitor in a streptozotocin-induced diabetic cataract model. A single, intraperitoneal injection of streptozotocin (STZ) (35 mg/kg) resulted in hyperglycemia, activation of lens aldose reductase 2 (ALR2) and accumulation of sorbitol in eye lens which could have contributed to diabetic cataract formation. However, when diabetic rats were treated with vitamin K1 (5 mg/kg, sc, twice a week) it resulted in lowering of blood glucose and inhibition of lens aldose reductase activity because of which there was a corresponding decrease in lens sorbitol accumulation. These results suggest that vitamin K1 is a potent inhibitor of lens aldose reductase enzyme and we made an attempt to understand the nature of this inhibition using crude lens homogenate as well as recombinant human aldose reductase enzyme. Our results from protein docking and spectrofluorimetric analyses clearly show that vitamin K1 is a potent inhibitor of ALR2 and this inhibition is primarily mediated by the blockage of DL-glyceraldehyde binding to ALR2. At the same time docking also suggests that vitamin K1 overlaps at the NADPH binding site of ALR2, which probably shows that vitamin K1 could possibly bind both these sites in the enzyme. Another deduction that we can derive from the experiments performed with pure protein is that ALR2 has three levels of affinity, first for NADPH, second for vitamin K1 and third for the substrate DL-glyceraldehyde. This was evident based on the dose-dependency experiments performed with both NADPH and DL-glyceraldehyde. Overall, our study shows the potential of vitamin K1 as an ALR2 inhibitor which primarily blocks enzyme activity by inhibiting substrate interaction of the enzyme. Further structural studies are needed to fully comprehend the exact nature of binding and inhibition of ALR2 by vitamin K1 that could open up possibilities of its therapeutic application.

Evaluation of positional accuracy in multiple implants using four different splinting materials: An in vitro study.

BACKGROUND: Prosthesis misfit plays an important role in complications such as occlusal and abutment screw loosening and fracture in implant restorations. Reproducing the intraoral relationship of implants through impression procedures is the first step in achieving an accurate, passively fitting prosthesis to ensure maximum accuracy. Hence, splinting of multiple implants with most accurate material may be a valid option. CONTEXT: The results of splinting multiple implants are always inconsistent, and there is limited literature available to compare the accuracy of impression techniques as well as materials. In such situation, more and more studies have to be done to prove the efficacy and accuracy of each splinting materials. AIM: The aim of the study was to evaluate the positional accuracy in multiple implants using acrylic resin, pattern resin, flowable composite, and bite registration paste. SUBJECTS AND METHODS: An acrylic resin model was fabricated into which four implant analogs placed. The copings attached were splinted with dental floss onto which acrylic resin was added, which was sectioned and rewelded (Group A). Similarly, pattern resin, flowable composite, and bite registration material were added which were considered as Group B, C, and D, respectively. Impressions were made in vinyl polysiloxane and analogs were attached. The casts retrieved from each group were analysed for the positional accuracy of implants. STATISTICAL ANALYSIS: One-way ANOVA was done to analyze the significant difference between the four implant analogs of each group with the master model. The confidence interval was also calculated to assess the accuracy. RESULTS: It was observed that all materials are equally effective for the accurate reproduction of implant positions. There was no significant difference between the centroids of implant analogues of master model and the mean of interimplant distance 1 and 2, 1 and 4, 3 and 4 and 2 and 4 in each group. The P-values were >0.05. The accuracy of splinting materials were analysed and it showed that splinting with flowable composite (Group C) as well as bite registration paste were in par with the conventionally used materials like pattern resin and acrylic resin. CONCLUSIONS: Results showed that flowable composite as well as bite registration material can be recommended as splinting material of choice for multiple implant cases, as these exhibited similar results like other groups (pattern resin and acrylic resin) which are conventionally used.

A comparative evaluation of the marginal adaptation of a thermoplastic resin, a light cured wax and an inlay casting wax on stone dies: An in vitro study.

BACKGROUND: Different pattern materials do not produce copings with satisfactory, marginal accuracy when used on stone dies at varying time intervals. PURPOSE: The purpose of this study was to evaluate and compare the vertical marginal accuracy of patterns formed from three materials, namely, thermoplastic resin, light cured wax and inlay casting wax at three-time intervals of 1, 12, and 24 h. METHODOLOGY: A master die (zirconia abutment mimicking a prepared permanent maxillary central incisor) and metal sleeve (direct metal laser sintering crown #11) were fabricated. A total of 30 stone dies were obtained from the master die. Ten patterns were made each from the three materials and stored off the die at room temperature. The vertical marginal gaps were measured using digital microscope at 1, 12, and 24 h after reseating with gentle finger pressure. RESULTS: The results revealed a significant statistical difference in the marginal adaptation of three materials at all the three-time intervals. Light cured wax was found to be most accurate at all time intervals, followed by thermoplastic resin and inlay casting wax. Furthermore, there was a significant difference between all pairs of materials. The change in vertical marginal gap from 1 to 24 h between thermoplastic resin and light cured wax was not statistically significant. CONCLUSION: The marginal adaptation of all the three materials used, was well within the acceptable range of 25-70 µm. The resin pattern materials studied revealed significantly less dimensional change than inlay casting wax on storage at 1, 12, and 24 h time intervals. They may be employed in situations where high precision and delayed investing is expected.

Prosthetic rehabilitation in neurosurgical cranioplasty.

The defects of the skull cause mechanical vulnerability of the brain, esthetic disfigurement, and transmission of vibrations and pulsation of the brain. Subsequent cranioplasty may be required to compensate for the defect and to alleviate various signs and symptoms. When long-term outcome of biomaterial use in pediatric cases is limited, alloplastic cranioplasty in adults are supported by several large case series. This case report narrates cranioplasty using titanium alloplastic implant material.

MAGE-TRIM28 complex promotes the Warburg effect and hepatocellular carcinoma progression by targeting FBP1 for degradation.

Hepatocellular carcinoma (HCC) is one of the leading cause of cancer death in the world. Fructose-1,6-biphosphatase (FBP1), a rate-limiting enzyme in gluconeogenesis, has been identified recently as a tumor suppressor in HCC and other cancer types. In this study, we demonstrated that the tripartite motif-containing protein 28 (TRIM28) binds directly to and promotes FBP1 for ubiquitination and degradation. MAGE-A3 and MAGE-C2, which are known to be overexpressed in HCC, can enhance TRIM28-dependent degradation of FBP1 by forming ubiquitin ligase complexes with TRIM28. We further showed that expression of TRIM28 increased glucose consumption and lactate production by promoting FBP1 degradation in HCC cells and that FBP1 is a key mediator of TRIM28-induced HCC growth in culture and in mice. Moreover, we demonstrated that FBP1 and TRIM28 protein levels inversely correlated in HCC patient specimens. Finally, we showed that the proteasome inhibitor bortezomib mitigated the Warburg effect by inhibiting FBP1 degradation in HCC. Collectively, our findings not only identify oncogenic MAGE-TRIM28 complex-mediated proteasome degradation of FBP1 as a key mechanism underlying downregulation of FBP1 proteins in HCC, but also reveal that MAGE-TRIM28-regulated reprogramming of cancer cell metabolism and HCC tumorigenesis is mediated, at least in part, through FBP1 degradation.

Correction: Functionalised type-I collagen as a hydrogel building block for bio-orthogonal tissue engineering applications.

Correction for 'Functionalised type-I collagen as a hydrogel building block for bio-orthogonal tissue engineering applications' by R. Ravichandran et al., J. Mater. Chem. B, 2016, 4, 318-326.

Coloured cornea replacements with anti-infective properties: expanding the safe use of silver nanoparticles in regenerative medicine.

Despite the broad anti-microbial and anti-inflammatory properties of silver nanoparticles (AgNPs), their use in bioengineered corneal replacements or bandage contact lenses has been hindered due to their intense yellow coloration. In this communication, we report the development of a new strategy to pre-stabilize and incorporate AgNPs with different colours into collagen matrices for fabrication of corneal implants and lenses, and assessed their in vitro and in vivo activity.

Functionalised type-I collagen as a hydrogel building block for bio-orthogonal tissue engineering applications.

In this study, we derivatized type I collagen without altering its triple helical conformation to allow for facile hydrogel formation via the Michael addition of thiols to methacrylates without the addition of other crosslinking agents. This method provides the flexibility needed for the fabrication of injectable hydrogels or pre-fabricated implantable scaffolds, using the same components by tuning the modulus from Pa to kPa. Enzymatic degradability of the hydrogels can also be easily fine-tuned by variation of the ratio and the type of the cross-linking component. The structural morphology reveals a lamellar structure mimicking native collagen fibrils. The versatility of this material is demonstrated by its use as a pre-fabricated substrate for culturing human corneal epithelial cells and as an injectable hydrogel for 3-D encapsulation of cardiac progenitor cells.

Purification and characterization of an extracellular uricase from a new isolate of Sphingobacterium thalpophilum (VITPCB5).

An extracellular uricase producing bacterium (VITPCB5) was isolated from soil of the duck farm near Chidambaram, Tamilnadu, India and it was identified based on its 16S rRNA as Sphingobacterium thalpophilum. Uric acid was used as an effective inducer. The enzyme kinetics was studied using uric acid as a substrate. The Km and Vmax for the enzyme was found to be 0.28mM and 0.92µM/minml, respectively. Maximum uricase production was observed when lactose was used as a carbon source. Among the nitrogen sources tested, urea gave the maximum uricase production. The enzyme was successfully purified using a weak cation exchange convective interaction media carboxy methyl (CIM-CM) monolith column with a recovery of 79.7%±0.1 and 14.2±1.8-fold purification. The optimal reaction temperature of the enzyme was observed between 25 and 45°C. The pH optimum of the enzyme was 8.0. The enzyme activity was enhanced by copper and partially inhibited by calcium, iron, zinc and nickel ions. Treatment with ethylene diamine tetraacetic acid completely inhibited the enzyme activity. The in-gel trypsin digested peptides of 48-kDa uricase when analyzed using mass spectrometry, gave 32% sequence coverage with the uricase (30-kDa) from Cyberlindnera jadinii.

Modified technique of continuous ambulatory peritoneal dialysis catheter insertion in the pediatric population.

OBJECTIVES: To assess whether placement of a superficial cuff deeper to the external oblique aponeurosis reduces cuff extrusion and exit site infection in peritoneal catheter insertion in children. MATERIAL AND METHODS: In 2013, a total of fourteen children underwent open continuous ambulatory peritoneal dialysis catheter insertion using Tenckhoff double cuffed catheters. The initial eight patients underwent a conventional technique and developed exit site infection and cuff extrusion. In six other patients, the technique was modified by placing the superficial cuff deeper to the external oblique aponeurosis. RESULTS: In the former group, three patients developed cuff extrusion, whilst none developed it in the latter, modified group. CONCLUSION: Continuous ambulatory peritoneal dialysis catheter insertion in children is associated with superficial cuff extrusion as a complication. It can be prevented by placing the cuff deeper to the external oblique aponeurosis instead of placing it in the conventional subcutaneous plane. In early experiences with this innovative technique, results have been promising. Randomized controlled trials can thus be undertaken to strengthen this finding.

Antioxidant study of quercetin and their metal complex and determination of stability constant by spectrophotometry method.

Quercetin found chelate cadmium ions, scavenge free radicals produced by cadmium. Hence new complex, quercetin with cadmium was synthesised, and the synthesised complex structures were determined by UV-vis spectrophotometry, infrared spectroscopy, thermogravimetry and differential thermal analysis techniques (UV-vis, IR, TGA and DTA). The equilibrium stability constants of quercetin-cadmium complex were determined by Job's method. The determined stability constant value of quercetin-cadminum complex at pH 4.4 is 2.27×10(6) and at pH 7.4 is 7.80×10(6). It was found that the quercetin and cadmium ion form 1:1 complex in both pH 4.4 and pH 7.4. The structure of the compounds was elucidated on the basis of obtained results. Furthermore, the antioxidant activity of the free quercetin and quercetin-cadmium complexes were determined by DPPH and ABTS assays.

An overview of radioactive waste disposal procedures of a nuclear medicine department.

Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the I-131 solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP) of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of I-131 much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented.

Estimation of effective half life of clearance of radioactive Iodine (I) in patients treated for hyperthyroidism and carcinoma thyroid.

BACKGROUND: In medical applications of radioisotopes, for calculations of whole body doses and radiation safety applications, there is a need to estimate radioactive body burden. Local recommendations in Oman stipulate the need for hospitalization of patients treated for radioactive-iodine ((131) I) with activities above 400 MBq. MATERIALS #ENTITYSTARTX00026; METHODS: A study of body burden estimation from sequentially measured exposure rates from patients treated for carcinoma thyroid and hyperthyroidism was undertaken. A digital auto-ranging beta gamma survey instrument calibrated for measurement of exposure rates is used in this study. RESULTS: The mean measured exposure rates at 1 m in µSv/h immediately after administration and at 24 h intervals are used for estimation of effective half time of clearance of administered activity. For patients with post-operative thyroid carcinoma, the variation of body burden with time post-administration indicated tri-exponential clearance pattern, with T(½eff) values 14.4 h, 22 h, and 41.3 h. For patients treated for thyrotoxicosis, the body burden showed slow delayed clearance with a T(½eff) - 111.4 h, and exposure rates did not show appreciable fall off after 48 h.

Simple technique for fabrication of shielding blocks for total body irradiation at extended treatment distances.

Techniques are being standardized in our department for total body irradiation (TBI) with six MV photons in linear accelerator for preconditioning to bone marrow transplantation (BMT). Individualized shields with low melting point alloy are to be fabricated for shielding critical organs such as lungs, kidneys etc. A method to mount diminished dimension of shields in a tray at 3.75m is designed in the department for a teletreatment distance of four meters with magna field with A simulator image taken with the patient's midplane (MP) at one meter distance is used to mark the dimensions of lung, scaled down by a factor of 3.75/4.0. These lung dimensions are reprinted from the digital simulator image for making the shield. The methodology of the technique using digitized minification in radiography is the first of its kind to be used for shield cutting in magna field radiotherapy.

Extrapolation chamber mounted on perspex for calibration of high energy photon and electron beams from a clinical linear accelerator.

The objective of the present study is to establish radiation standards for absorbed doses, for clinical high energy linear accelerator beams. In the nonavailability of a cobalt-60 beam for arriving at Nd, water values for thimble chambers, we investigated the efficacy of perspex mounted extrapolation chamber (EC) used earlier for low energy x-rays and beta dosimetry. Extrapolation chamber with facility for achieving variable electrode separations 10.5mm to 0.5mm using micrometer screw was used for calibrations. Photon beams 6 MV and 15 MV and electron beams 6 MeV and 15 MeV from Varian Clinac linacs were calibrated. Absorbed Dose estimates to Perspex were converted into dose to solid water for comparison with FC 65 ionisation chamber measurements in water. Measurements made during the period December 2006 to June 2008 are considered for evaluation. Uncorrected ionization readings of EC for all the radiation beams over the entire period were within 2% showing the consistency of measurements. Absorbed doses estimated by EC were in good agreement with in-water calibrations within 2% for photons and electron beams. The present results suggest that extrapolation chambers can be considered as an independent measuring system for absorbed dose in addition to Farmer type ion chambers. In the absence of standard beam quality (Co-60 radiations as reference Quality for Nd,water) the possibility of keeping EC as Primary Standards for absorbed dose calibrations in high energy radiation beams from linacs should be explored. As there are neither Standard Laboratories nor SSDL available in our country, we look forward to keep EC as Local Standard for hospital chamber calibrations. We are also participating in the IAEA mailed TLD intercomparison programme for quality audit of existing status of radiation dosimetry in high energy linac beams. The performance of EC has to be confirmed with cobalt-60 beams by a separate study, as linacs are susceptible for minor variations in dose output on different days.