The importance of topical steroids after adhesiolysis in erosive lichen planus and graft versus host disease.

The aim of this study was to assess the efficacy of a postoperative steroid regimen in maintaining vulvovaginal architecture and vaginal patency following surgical adhesiolysis in severe erosive lichen planus (ELP) and genital graft versus host disease (GVHD). Sixteen women applied potent topical steroids to the vulva and vagina from 48 hours after surgery. Sexual and urinary function and vulvovaginal anatomy were assessed at 6 weeks, 6, 12 and 24 months. All of the patients had failed sexual function due to vaginal stenosis. Eleven patients were unable to have cervical smears and three had associated haematocolpos. Vaginal adhesiolysis achieving complete patency occurred in all patients with stenosis. Fifteen (93.7%) patients were compliant with the regimen. After two years, 12 (75%) patients had maintained complete vaginal patency. Four patients (25%) developed vaginal restenosis. This study demonstrates that the potent topical steroids used post-operatively are very effective in maintaining vaginal patency and function. Impact statement What is already known on this subject? Potent topical steroids are the first line treatment for ELP and GVHD and have been reported to be helpful after surgery to release adhesions. What do the results of this study add? Topical steroids used immediately after surgical adhesiolysis in patients with vulvo-vaginal lichen planus and graft-versus-host disease improves the outcomes and maintains function, which can give a prolonged benefit. What are the implications of these findings for clinical practice and/or further research? The use of potent topical steroids should be considered as routine practice after surgery in erosive inflammatory disease to control inflammation and improve the long term outcomes for these patients.

Electronic and thermoelectric properties of Zn and Se double substituted tetrahedrite.

The influence of Zn and Se double substitution on the electronic and thermoelectric properties of tetrahedrite was investigated in this study. The samples Cu11Zn1Sb4S13-xSex (x = 0.25, 0.5, 0.75, 1, and 2) were prepared via solid state synthesis followed by field assisted sintering. The density functional theory (DFT) results showed that Se substitution introduces additional bands near the Fermi level (EF), with lower effective mass compared to Zn (only) substituted sample Cu11Zn1Sb4S13. Consequently, the electrical resistivity decreased with the increase in Se content which is attributed to the enhanced charge carrier mobility caused by the more dispersive Se states as indicated by DFT results. But the Seebeck coefficient was invariant with x, due to the enhancement of the density of states (DOS) at EF. The overall effect was an increase in power factor of the Cu11Zn1Sb4S13-xSex samples compared to Cu11Zn1Sb4S13. The Zn2+ substitution at the Cu1+ tetrahedral site resulted in a decrease of the carrier thermal conductivity due to the decrease in charge carrier concentration. Whereas Se substitution resulted in the decrease of lattice thermal conductivity due to additional phonon scattering caused by the S-Se mass difference. Simultaneous optimization of the power factor and thermal conductivity could thus be achieved via double substitution at Cu and S sites. A maximum thermoelectric figure of merit (zT) of 0.86 at 673 K was exhibited by the Cu11Zn1Sb4S12.75Se0.25 sample due to its relatively high power factor among the samples (0.9 mW m-1 K-2 at 673 K) coupled with very low total thermal conductivity (0.67 W m-1 K-1 at 673 K).

Quantum Fluctuations in Quasi-One-Dimensional Dipolar Bose-Einstein Condensates.

Recent experiments have revealed that beyond-mean-field corrections are much more relevant in weakly interacting dipolar condensates than in their nondipolar counterparts. We show that in quasi-one-dimensional geometries quantum corrections in dipolar and nondipolar condensates are strikingly different due to the peculiar momentum dependence of the dipolar interactions. The energy correction of the condensate presents not only a modified density dependence, but it may even change from attractive to repulsive at a critical density due to the surprising role played by the transversal directions. The anomalous quantum correction translates into a strongly modified physics for quantum-stabilized droplets and dipolar solitons. Moreover, and for similar reasons, quantum corrections of three-body correlations, and hence of three-body losses, are strongly modified by the dipolar interactions. This intriguing physics can be readily probed in current experiments with magnetic atoms.

Peripheral T-cell lymphomas in a large US multicenter cohort: prognostication in the modern era including impact of frontline therapy.

BACKGROUND: Optimal frontline therapy for peripheral T-cell lymphoma (PTCL) in the modern era remains unclear. PATIENTS AND METHODS: We examined patient characteristics, treatment, and outcomes among 341 newly diagnosed PTCL patients from 2000 to 2011. Outcome was compared with a matched cohort of diffuse large B-cell lymphoma (DLBCL) patients, and prognostic factors were assessed using univariate and multivariate analyses. RESULTS: PTCL subtypes included PTCL, not otherwise specified (PTCL-NOS) (31%), anaplastic large T-cell lymphoma (ALCL) (26%), angioimmunoblastic T-cell lymphoma (23%), NK/T-cell lymphoma (7%), acute T-cell leukemia/lymphoma (6%), and other (7%). Median age was 62 years (range 18-95 years), and 74% had stage III-IV disease. Twenty-three (7%) patients received only palliative care whereas 318 received chemotherapy: CHOP-like regimens (70%), hyperCVAD/MA (6%), or other (18%). Thirty-three patients (10%) underwent stem-cell transplantation (SCT) in first remission. The overall response rate was 73% (61% complete); 24% had primary refractory disease. With 39-month median follow-up, 3-year progression-free survival (PFS) and overall survival (OS) were 32% and 52%. PFS and OS for PTCL patients were significantly inferior to matched patients with DLBCL. On multivariate analysis, stage I-II disease was the only significant pretreatment prognostic factor [PFS: hazard ratio (HR) 0.54, 95% confidence interval (CI) 0.34-0.85, P = 0.007; OS: HR 0.42, 95% CI 0.22-0.78, P = 0.006]. ALK positivity in ALCL was prognostic on univariate analysis, but lost significance on multivariate analysis. The most dominant prognostic factor was response to initial therapy (complete response versus other), including adjustment for stage and SCT [PFS: HR 0.19, 95% CI 0.14-0.28, P < 0.0001; OS: HR 0.26, 95% CI 0.17-0.40, P < 0.0001]. No overall survival difference was observed based on choice of upfront regimen or SCT in first remission. CONCLUSIONS: This analysis identifies early-stage disease and initial treatment response as dominant prognostic factors in PTCL. No clear benefit was observed for patients undergoing consolidative SCT. Novel therapeutic approaches for PTCL are critically needed.

Methylmercury-induced inhibition of paraoxonase-1 (PON1)-implications for cardiovascular risk.

Methylmercury (MeHg) has been associated with increased risk for cardiovascular disease in some but not all epidemiology studies. These inconsistent results may stem from the fact that exposure typically occurs in the context of fish consumption, which is also associated with cardioprotective factors such as omega-3 fatty acids. Mechanistic information may help to understand whether MeHg represents a risk to cardiovascular health. MeHg is a pro-oxidant that inactivates protein sulfhydryls. These biochemical effects may diminish critical antioxidant defense mechanism(s) involved in protecting against atherosclerosis. One such defense mechanism is paraoxonase-1 (PON1), an enzyme present on high-density lipoproteins and that prevents the oxidation of blood lipids and their deposition in vascular endothelium. PON1 is potentially useful as a clinical biomarker of cardiovascular risk, as well as a critical enzyme in the detoxification of certain organophosphate oxons. MeHg and other metals are known to inhibit PON1 activity in vitro. MeHg is associated with lowered serum PON1 activity in a fish-eating population. The implications of lowering PON1 are evaluated by predicting the shift in PON1 population distribution induced by various doses of MeHg. An MeHg dose of 0.3 µg/kg/d is estimated to decrease the population average PON1 level by 6.1% and to increase population risk of acute cardiovascular events by 9.7%. This evaluation provides a plausible mechanism for MeHg-induced cardiovascular risk and suggests means to quantify the risk. This case study exemplifies the use of upstream disease biomarkers to evaluate the additive effect of chemical toxicity with background disease processes in assessing human risk.

Serum zinc and magnesium level in newly diagnosed type-2 diabetic subjects.

This cross sectional study aimed to determine serum levels of zinc and magnesium in 80 newly diagnosed type 2 diabetic (Group I) and 80 healthy non-diabetic subjects (Group II). Diabetic patients without any complications were studied. It was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the out patient Department of Endocrinology of Mymensingh Medical College, Bangabandhu Sheikh Mujib Medical University and BIRDEM Hospital, Dhaka during the period from July 2008 to June 2009. A total of 160 subjects aged 55-65 years were enrolled for this study. Of them 80 were newly diagnosed type 2 diabetic (Group I) and 80 were apparently healthy non-diabetic (Group II) subjects. For both case and control, persons having no current medication, intercurrent illness, macro or microvascular complications and history of renal failure were selected. Atomic Absorption Spectrophotometer (AAS) was used to estimate the serum levels of zinc and magnesium. The Plasma zinc (72.07±6.84µg/dl) and magnesium (1.86±0.17mg/dl) significantly decreased in type 2 diabetic patients when compared with control (76.59±6.10µg/dl, 1.99±0.17mg/dl). It is concluded that type 2 diabetes mellitus can result in changes in zinc and magnesium levels. As the present study sample was small so it is difficult to draw any definite conclusion. However, the estimation and supplementation of both zinc and magnesium may be suggested in those cases.

Hierarchically Porous, Biphasic, and C-Doped TiO2 for Solar Photocatalytic Degradation of Dyes and Selective Oxidation of Benzyl Alcohol.

Macroporous TiO2 monoliths were synthesized by self-sustained combustion reactions of molded pellets made up of a mixture of TiCl4 as a precursor, urea as a fuel, ammonium nitrate as an oxidizer, and starch as a binder. The porous TiO2 monoliths were found to be a heterostructure of anatase and rutile phases, in addition to being doped with carbon. Variation in the amount of starch yielded porous monoliths of different anatase-rutile ratios (increasing rutile component from 0 to 40%) but comparable Brunauer-Emmett-Teller (BET) surface area (∼30 m2 g-1). The porous monoliths obtained, where the TiCl4/starch mass ratio was 2.17, exhibit exceptional photocatalytic activity in the degradation of dyes (methylene blue and methyl orange) and selective oxidation of benzyl alcohol to benzaldehyde under natural sunlight. The synergistic combination of high surface area, porous network, lowered band gap due to heterostructured anatase-rutile polymorphs, and the presence of doped carbon renders the macroporous TiO2 an efficient photocatalyst.

Predictors of no-reflow phenomenon following percutaneous coronary intervention for ST-segment elevation myocardial infarction.

OBJECTIVES: No reflow during percutaneous coronary intervention (PCI) is a complex issue with serious outcomes. Multiple studies have studied predictors of no-reflow during primary PCI, but data on patients with the late presentation is sparse, which constitutes the majority of patients in peripheral centers. This study aimed to determine predictors of no-reflow during PCI in patients with ST-segment elevation myocardial infarction (STEMI) in 7 days. METHODS: It was a single-center prospective case-control study performed at a tertiary care center and included 958 patients with STEMI who underwent PCI within 7 days of symptom onset. Baseline and angiographic data of patients undergoing PCI were recorded and patients divided into reflow and no-reflow group. RESULTS: Of 958 who underwent PCI, 182 (18.9%) showed no-reflow by myocardial blush grade (MBG)<2. No-reflow group had a higher mean age (66.46±10.71 vs. 61.36±9.94 years), lower systolic blood pressure (SBP) on admission (100.61±26.66 vs. 112.23±24.35, P<0.0001), a higher level of peak Troponin I level (9.37±2.81 vs. 7.66±3.11ng/dL, P<0.0001), low left ventricular ejection fraction (36.71±3.89 vs. 39.58±4.28% respectively P<0.0001). Among angiographic data and procedural features, multivariable logistic regression analysis identified that advanced age, reperfusion time>6hours, SBP<100mmHg on admission, functional status of Killip class for heart failure≥3, lower EF (≤35%), low initial myocardial blush grade (≤1) before PCI, long target lesion length, larger reference diameter of vessel (>3.5mm) and high thrombus burden on angiography were found to be independent predictors of no-reflow (P<0.05). CONCLUSION: No-reflow phenomenon after PCI for STEMI is complex and multifactorial and can be identified by simple clinical, angiographic, and procedural features. Preprocedural characters of the lesion and early perfusion decides the fate of the outcome.

Three-dimensional roton excitations and supersolid formation in Rydberg-excited Bose-Einstein condensates.

We study the behavior of a Bose-Einstein condensate in which atoms are weakly coupled to a highly excited Rydberg state. Since the latter have very strong van der Waals interactions, this coupling induces effective, nonlocal interactions between the dressed ground state atoms, which, opposed to dipolar interactions, are isotropically repulsive. Yet, one finds partial attraction in momentum space, giving rise to a roton-maxon excitation spectrum and a transition to a supersolid state in three-dimensional condensates. A detailed analysis of decoherence and loss mechanisms suggests that these phenomena are observable with current experimental capabilities.

Critical behavior and magnetocaloric effect across the magnetic transition in Mn1+xFe4-xSi3.

The nature of the magnetic transition, critical scaling of magnetization, and magnetocaloric effect in Mn1+xFe4-xSi3 (x = 0 to 1) are studied in detail. Our measurements show no thermal hysteresis across the magnetic transition for the parent compound which is in contrast with the previous report and corroborate the second order nature of the transition. The magnetic transition could be tuned continuously from 328 K to 212 K with Mn substitution at the Fe site. The Mn substitution leads to a linear increase in the unit cell volume and a slight reduction in the effective moment. A detailed critical analysis of the magnetization data for x = 0.0 and 0.2 is performed in the critical regime using the modified Arrott plots, Kouvel-Fisher plot, universal curve scaling, and scaling analysis of magnetocaloric effect. The magnetization isotherms follow modified Arrott plots with critical exponent (ß [Formula: see text] 0.308, γ [Formula: see text] 1.448, and δ [Formula: see text] 5.64) for the parent compound (x = 0.0) and (ß [Formula: see text] 0.304, γ [Formula: see text] 1.445, and δ [Formula: see text] 5.64) for x = 0.2. The Kouvel-Fisher and universal scaling plots of the magnetization isotherms further confirm the reliability of our critical analysis and values of the exponents. These values of the critical exponents are found to be same for both the parent and doped samples which do not fall under any of the standard universality classes. The exchange interaction decays as J(r) ~ r-3.41 following the renormalization group theory and the observed critical exponents correspond to lattice dimensionality d = 2, spin dimensionality n = 1, and the range of interaction σ = 1.41. This value of σ(<2) indicates long-range interaction between magnetic spins. A reasonable magnetocaloric effect ΔSm [Formula: see text] -6.67 J/Kg-K and -5.84 J/Kg-K for x = 0.0 and 0.2 compounds, respectively, with a huge relative cooling power (RCP ~ 700 J/Kg) for 9 T magnetic field change is observed. The universal scaling of magnetocaloric effect further mimics the second order character of the magnetic transition. The obtained critical exponents from the critical analysis of magnetocaloric effect agree with the values deduced from the magnetic isotherm analysis.

Interactions of bacterial polysaccharides with cationic dyes: physicochemical studies.

Capsular polysaccharides (SPS) are an integral component of gram-negative bacteria, and also have potential use as vaccine. In this paper, interactions of SPS isolated from Klebsiella strains K20 and K51 with cationic dyes pinacyanol chloride (PCYN) and acridine orange (AO) were studied by absorbance and fluorescence measurements. Both the polysaccharides having glucuronic acid as the potential anionic site induced strong metachromasy (blue shift approximately 100 nm) in the PCYN. The spectral changes were studied at different polymer/dye molar ratios (P/D = 0-40). A complete reversal of metachromasy was observed upon addition of co-solvents, suggesting the breakaway of dye molecules from the biopolymer matrix. Binding constant, changes in free energy, enthalpy and entropy of the dye polymer complex were also computed from the spectral data at different temperatures to reveal the nature of the interaction. Quenching of fluorescence of AO by the polymers and the incorporated mechanisms were also explored.

Miltefosine Induced Reduced Male Fertility Capacity after Treatment of Post Kala-azar Dermal Leishmaniasis, Bangladesh.

Post Kala-azar Dermal Leishmaniasis (PKDL) is the sequel of visceral leishmaniasis in Indian subcontinent and may appear among patients with or without previous history of visceral leishmaniasis (VL). The aim of the study is to understand the male reproductive safety profile of miltefosine used for the treatment of Post Kala-azar Dermal Leishmaniasis (PKDL) in Bangladesh. From January 2017 to March 2017, an exploratory study was carried out on male fertility capacity in Bangladesh among male patients above 14 years old with PKDL treated with miltefosine. Twenty nine male patients were included to observe the effect of miltefosine on reproductive health. All PKDL patients had history of visceral leishmaniasis (VL) in different time periods. Among them three (10.3%) patients were unable to ejaculate semen. In semen analysis, 3 patients (10.3%) were found azoospermia (sperm count & motility- 0, viscosity- good, pH- 7 to 8), microscopically there was presence of RBC (5-15/HPF), WBC (8-15/HPF). Another 3 patients (10.3%) were found oligospermia (sperm count- 4.2 to 15.3 million/ml, motility- 20 to 50%, viscosity- good, pH- 6 to 9, RBC- 4 to 15/HPF, WBC- 4 to 15/HPF). The study documented some important findings in evaluating male infertility and selection of drug regimens in treating PKDL patients with miltefosine for 12 weeks.

Preparation and characterization of an anionic dye-polycation molecular films by electrostatic layer-by-layer adsorption process.

This communication reports the formation and characterization of self-assembled films of a low molecular weight anionic dye amaranth and polycation poly(allylamine hydrochloride) (PAH) by electrostatic alternating layer-by-layer (LBL) adsorption. It was observed that there was almost no material loss occurred during adsorption process. The UV-vis absorption and fluorescence spectra of amaranth solution reveal that with the increase in amaranth concentration in solution, the aggregated species starts to dominate over the monomeric species. New aggregated band at 600 nm was observed in amaranth-PAH mixture solution absorption spectrum. A new broad low intense band at the longer wavelength region, in the amaranth-PAH mixture solution fluorescence spectrum was observed due to the closer association of amaranth molecule while tagged into the polymer backbone of PAH and consequent formation of aggregates. The broad band system in the 650-750 nm region in the fluorescence spectra of different layered LBL films changes in intensity distribution among various bands within itself, with changing layer number and at 10 bilayer LBL films the longer wavelength band at 710 nm becomes prominent. Existence of dimeric or higher order n-meric species in the LBL films was confirmed by excitation spectroscopic studies. Almost 45 min was required to complete the interaction between amaranth and PAH molecules in the one-bilayer LBL film.

Embolized Guidewire into Central Aorta: A Nightmare in the Pediatric Intensive Care Unit.

A 4-month-old preterm, critically ill infant weighing 3.8 kg was admitted to our pediatric intensive care unit with congestive cardiac failure due to a large ventricular septal defect and its sequelae. During an attempt to insert a central line into the right subclavian vein at bedside, the guidewire inadvertently entered the subclavian artery and embolized distally. After multiple failed retrieval attempts, including surgical femoral cut-down to retrieve the wire, it was removed finally by fluoroscopic-guided percutaneous catheterization with the help of a cardiac bioptome and a gooseneck snare utilizing a novel maneuver.

Biomethanation of water hyacinth biomass.

The aim of this study was to test practical solutions to improve biogas yield during the anaerobic digestion of water hyacinth (WH) biomass. Increasing the WH (whole plant) solid content to ∼40% through sun drying (6 h), and its subsequent digestion increased biogas yield by 14% with a higher biogas methane (75%) content. Ensilation of dried WH (40% moisture) was found effective for its preservation to ensure its continuous availability even during offseasons, but the biogas yield from six months ensilated biomass was 20% less compared with fresh WH. Co-digestion of WH with waste activated sludge and food waste revealed ∼150 and ∼400 ml biogas/g VS respectively against ∼140 ml/g VS of WH alone. The practical approaches tested in this study like pre-treatment, preservation, and co-digestion of WH found to be effective to make its bio methanation more feasible.

Improvement in abduction of the shoulder after reconstructive soft-tissue procedures in obstetric brachial plexus palsy.

Residual muscle weakness in obstetric brachial plexus palsy results in soft-tissue contractures which limit the functional range of movement and lead to progressive glenoid dysplasia and joint instability. We describe the results of surgical treatment in 98 patients (mean age 2.5 years, 0.5 to 9.0) for the correction of active abduction of the shoulder. The patients underwent transfer of the latissimus dorsi and teres major muscles, release of contractures of subscapularis pectoralis major and minor, and axillary nerve decompression and neurolysis (the modified Quad procedure). The transferred muscles were sutured to the teres minor muscle, not to a point of bony insertion. The mean pre-operative active abduction was 45 degrees (20 degrees to 90 degrees ). At a mean follow-up of 4.8 years (2.0 to 8.7), the mean active abduction was 162 degrees (100 degrees to 180 degrees ) while 77 (78.6%) of the patients had active abduction of 160 degrees or more. No decline in abduction was noted among the 29 patients (29.6%) followed up for six years or more. This procedure involving release of the contracted internal rotators of the shoulder combined with decompression and neurolysis of the axillary nerve greatly improves active abduction in young patients with muscle imbalance secondary to obstetric brachial plexus palsy.

Surgical correction of the medial rotation contracture in obstetric brachial plexus palsy.

The medial rotation contracture caused by weak external rotation secondary to obstetric brachial plexus injury leads to deformation of the bones of the shoulder. Scapular hypoplasia, elevation and rotation deformity are accompanied by progressive dislocation of the humeral head. Between February and August 2005, 44 children underwent a new surgical procedure called the 'triangle tilt' operation to correct this bony shoulder deformity. Surgical levelling of the distal acromioclavicular triangle combined with tightening of the posterior glenohumeral capsule (capsulorrhaphy) improved shoulder function and corrected the glenohumeral axis in these patients. The posture of the arm at rest was improved and active external rotation increased by a mean of 53 degrees (0 degrees to 115 degrees ) in the 40 children who were followed up for more than one year. There was a mean improvement of 4.9 points (1.7 to 8.3) of the Mallet shoulder function score after surgical correction of the bony deformity.