Changes in olfaction & quality of life following standard medical therapy in patients with intermittent & persistent allergic rhinitis.

Background & objectives: Allergic rhinitis (AR) is an inflammatory disease prevalent worldwide which can affect both olfaction and quality of life (QoL). The objective of the present study was to assess olfaction and QoL changes in patients with AR before and after medical therapy. Methods: Adult participants (>18 yr) with AR were recruited for this study. These patients prospectively underwent olfaction testing using the modified Connecticut Chemosensory Clinical Research Centre Test and QoL assessment using Rhinoconjunctivitis QoL Questionnaire (RQLQ) before and after standard medical therapy with topical steroids and/antihistaminics. Results: Of the 150 patients recruited, 72 per cent had intermittent AR. The symptom of hyposmia was present in 34 patients (22.7%) and was more prevalent in patients with moderate-to-severe type of AR (P<0.001). However, olfaction testing revealed hyposmia/anosmia in 44 patients (29.3%). Mean composite olfaction scores were significantly higher in patients with mild AR compared to moderate/severe AR (P=0.026). The pre-therapy mean composite olfaction score in the 34 patients with olfaction disturbances was 3.1 standard deviation (±1.06 SD). Following therapy, the mean composite olfaction score rose to 4.3 (±1.34 SD) and this change was found to be significant (P<0.001). Mean pre-therapy RQLQ scores were 2.87 (0.06-5.33) overall. Significant improvement was also found in RQLQ scores following therapy (P<0.001). Mean RQLQ scores were significantly lower in those with moderate-to-severe AR (P<0.001) as well as those with intermittent AR (P=0.004). Nine patients had persistently high RQLQ scores after medical therapy. Interpretation & conclusions: Both olfaction and QoL showed significant improvement after medical therapy in Indian adults with AR. In those patients who do not improve, other causes must be sought for the persistent symptoms.

ZFTA (Zinc Finger Translocation Associated) Fusion in Supratentorial Ependymomas: Low Prevalence in South Asians and No Correlation with Survival.

BACKGROUND: Supratentorial ependymomas (STEs) are an aggressive group of ependymomas, topographically distinct from their posterior fossa and spinal counterparts. Zinc finger translocation associated (ZFTA) fusion-positive cases have been reported to account for the majority of STEs, although data on its association with poorer outcomes are inconsistent. MATERIALS AND METHODS: We assessed the prevalence of the ZFTA fusion by reverse-transcription polymerase chain reaction and fluorescence in situ hybridization in a cohort of 61 patients (68 samples) with STE. Our primary outcome was to determine the role of the ZFTA fusion on progression-free and overall survival of patients with STE. Our secondary objectives were to assess the impact of ZFTA fusion on nuclear factor (NF)-kB pathway signaling via surrogate markers of this pathway, namely COX-2, CCND1, and L1 cell adhesion molecule. RESULTS: ZFTA fusion was noted in 21.3% of STEs in our cohort. The presence of this rearrangement did not significantly impact the progression-free or overall survival of patients with STEs and was not associated with upregulation of markers of the NF-kB pathway. Only gross total resection was significantly associated with better progression-free survival. CONCLUSIONS: In contradiction to previous reports from across the world, the ZFTA fusion is far less prevalent among our population. It does not appear to drive NF-kB signaling or significantly affect outcomes. Gross total resection must be attempted in all cases of STE and adjuvant radiation and/or chemotherapy employed when gross total resection is not achieved.

Effect of potassium channel modulators on toxicity of Cleistanthus collinus.

The study was conducted to determine the effects of boiled extract of Cleistanthus collinus on rats by observing ECG changes and electrolyte levels in serum and urine. Influence of minoxidil and glibenclamide on Cleistanthus collinus induced toxicity was determined. ED50 for arrhythmia, changes in contractility and heart rate were recorded using the isolated frog heart. Cleistanthus at low doses caused transient tachycardia and increase in contractility and at high dose caused arrhythmia and cardiac arrest in rat. LD50 was found to be 1690 mg/kg. Minoxidil potentiated cardiac toxicity, whereas glibenclamide did not produce any significant change. High concentration of potassium in Cleistanthus extract hindered comparison of its levels. There was excretion of sodium even in the presence of hyponatraemia. Cleistanthus at low dose caused transient tachycardia and increase in contractility and at high dose caused arrhythmia and cardiac arrest in isolated frog heart. ED50 for arrhythmia was found to be 1406 mg/kg. Acute toxicity was mainly due to depressive cardiac activity of Cleistanthus. It also caused renal failure. Potassium channel modulators did not have important role in acute cardiac toxicity treatment. Probably in chronic toxicity, electrolyte level changes are involved and potassium channel modulators might have a role.