Sinecatechins ointment as a potential novel treatment for usual type vulval intraepithelial neoplasia: a single-centre double-blind randomised control study.

OBJECTIVE: To compare the safety and efficacy of 10% sinecatechins (Veregen® ) ointment against placebo in the treatment of usual type vulvar intraepithelial neoplasia (uVIN). DESIGN: A Phase II double-blind randomised control trial. SETTING: A tertiary gynaecological oncology referral centre. POPULATION: All women diagnosed with primary and recurrent uVIN. METHODS: Eligible patients were randomised 1:1 to receive either sinecatechins or placebo ointment (applied three times daily for 16 weeks) and were followed up at 2, 4, 8, 16, 32 and 52 weeks. MAIN OUTCOME MEASURES: The primary outcome measure, recorded at 16 and 32 weeks, was histological response (HR). Secondary outcome measures included clinical (CR) response, toxicity, quality of life and pain scores. RESULTS: There was no observed difference in HR between the two arms. However, of the 26 patients who were randomised, all 13 patients who received sinecatechins showed either complete (n = 5) or partial (n = 8) CR, when best CR was evaluated. In placebo group, three patients had complete CR, two had partial CR, six had stable disease and two were lost to follow up. Patients in the sinecatechins group showed a statistically significant improvement in best observed CR as compared with the placebo group (P = 0.002). There was no difference in toxicity reported in either group. CONCLUSION: Although we did not observe a difference in HR between the two treatment arms, we found that 10% sinecatechins application is safe and shows promise in inducing clinical resolution of uVIN lesions and symptom improvement, thus warranting further investigation in a larger multicentre study. TWEETABLE ABSTRACT: A randomised control study indicating that sinecatechins ointment may be a novel treatment for uVIN.

Biological synergy of greener gold nanoparticles by using Coleus aromaticus leaf extract.

Greener nanotechnology plays an important role in developing alternative and effective treatment strategies for various diseases. Biological synthesis of metal nanoparticles (MNPs) has known to possess suitable alternatives than the existing chemical methods. Greener synthesis of MNPs by using plant extracts has become an emerging field due to their safe, eco-friendly and non-toxic nature that are suitable for synergistic biological activities. Hence, the greener method is chosen by the present study. In the present study, the greener synthesis of gold nanoparticles (AuNPs) was successfully done by using Coleus aromaticus leaf extract at three different temperatures (30 °C, 60 °C and 100 °C). The formation of AuNPs was initially monitored by visual observation and then characterized with the help of diverse techniques like UV-Vis spectroscopy (UV-Vis), X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, Scanning Electron Microscopy (SEM), High Resolution-Transmission Electron Microscopy (HR-TEM) and dynamic light scattering (DLS). Surface plasmon resonance (SPR) peak and crystalline nature of AuNPs were obtained by UV-Vis and XRD spectroscopies respectively. FT-IR analysis shows the different characteristic functional groups in turn responsible for the bio-reduction of gold ions by using leaf extract. The formations of different nano-sized AuNPs with their different morphologies were observed by SEM and HR-TEM analyses. Surface charge and stability of the AuNPs were measured by zeta potential and DLS respectively. The synthesized AuNPs coated with cotton fabric was analyzed by UV-Diffuse Reflectance Spectroscopy (UV-DRS), which revealed excellent UV protection against UV radiation. The AuNPs coated cotton fabric exhibited remarkable antibacterial sensitivity against Staphylococcus epidermidis and Escherichia coli. Further, the synthesized AuNPs showed significant cytotoxicity against human liver cancer (HepG2) cell line. The findings of this study revealed that, AuNPs synthesized using Coleus aromaticus leaf extract could be an alternative, safe, and effective source of UV protection, antibacterial and anticancer agents.

Surgery for Blue Rubber Bleb Nevus Syndrome-a Case Report.

Blue rubber bleb nevus syndrome (BRBNS) is a rare disease characterised by multiple venous malformations and haemangioma in the skin and visceral organs. The lesion often involves the cutaneous and gastrointestinal tract. Most common visceral organ affected is the GIT. Most predominant region involved in the GIT is small bowel. However, vascular lesions can occur anywhere from oral mucosa to anal canal. GIT bleed is relatively slow, resulting in minor, chronic and occult blood loss. The syndrome in the GIT may also present with severe complications such as rupture, volvulus, intussusceptions and even death. Cutaneous malformations are usually asymptomatic and do not require treatment. The treatment of GIT lesions is determined by the extent of intestinal involvement and severity of the disease. Most patients respond to supportive therapy such as iron supplementation and blood transfusion. Surgical resection, endoscopic sclerosis and laser photocoagulation have been proposed for more significant haemorrhage and severe complications. Here, we present a case of BRBNS in a 13-year-old girl involving the GIT especially the large bowel, presenting with the complaints of bleeding per rectum and iron deficiency anaemia. Initially, endoscopic sclerotherapy was performed, but to no response. Hence, proceeded with surgical resection.

Assessment of adulteration in raw herbal trade of important medicinal plants of India using DNA barcoding.

A number of studies have shown that there could be widespread substitution and/or adulteration (hereafter referred to as substitution) in raw herbal trade of medicinal plants. Substitution could potentially endanger the health and safety of the consumers. In this study, the extent of adulteration in raw herbal trade of 30 important medicinal plants in South India was analyzed. Biological reference material (BRM) consisting of taxonomically authenticated samples of each of the 30 species along with 14 other co-occurring and congeneric allied species that are likely to be used in adulteration was established. DNA barcode signatures of 124 BRM using two candidate regions, nr-ITS and psbA-trnH were identified. A total of 203 herbal trade samples representing the 30 medicinal plant species were collected from 34 locations in South India. Using the DNA barcode sequences of the BRM as reference, the analysis indicated that the substitution ranged from 20 to 100%. Overall, approximately 12% of the market samples were adulterated. Considering the potential health hazard that such adulteration can cause, the need for a national regulatory framework that can authenticate and regulate raw herbal trade in the country is discussed.