Syphilis: Is it Back with a Bang?

Background: Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC). Aim: To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center. Materials and Methods: Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed. Results: Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common. Conclusion: India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence.

Design and in vitro evaluation of chlorpheniramine maleate from different eudragit based matrix patches: Effect of platicizer and chemical enhancers

The release and permeation studies were carried out for developing transdermal therapeutic systems with chlorpheniramine maleate (CPM). The patches were prepared with eudragit RS-100 and RL-100 with/without polyvinyl pyrrolidone (PVP) and dibutyl phthalate (DBP) in different compositions. Thickness, tensile strength, drug content, moisture content and water absorption studies of the patches were measured. In vitro release/permeation of CPM was studied in modified Keshary-Chien diffusion cell. Chemical enhancers like l-menthol, oleic acid and phospholipon80 were added to compare the release pattern of the drug. The percent release of the drug from matrix patch increased with increase of PVP & DBP but the tensile strength decreased with the increase of DBP & PVP. Experimental release/permeation data of different formulations of the matrix systems are reported. Also the drug-polymer interaction was investigated by ATR-FTIR studies. The discussion was correlated the efficient matrix dispersion patch from suitable eudragit polymers for transdermal antihistamine applications in film device industry(AU)

Diet-induced hypermethylation at agouti viable yellow is not inherited transgenerationally through the female.

The effects of nonmutagenic environmental exposures can sometimes be transmitted for several generations, suggesting transgenerational inheritance of induced epigenetic variation. Methyl donor supplementation of female mice during pregnancy induces CpG hypermethylation at the agouti viable yellow (A(vy)) allele in A(vy)/a offspring. Epigenetic inheritance occurs at A(vy); when passed through the female germ line, A(vy) epigenotype is not completely "reset." We therefore tested whether diet-induced epigenetic alterations at A(vy) are inherited transgenerationally. Female A(vy)/a mice were weaned onto either control (n=6) or a methyl-supplemented diet (n=5). These F0 dams were mated with a/a males. All F1 and F2 A(vy)/a females were weaned onto the same diet as their mothers, then mated with a/a males. F1, F2, and F3 A(vy)/a offspring were classified for coat color, an indicator of A(vy) methylation. In total, 62 F1, 98 F2, and 209 F3 A(vy)/a mice were studied. As expected, average A(vy)/a coat color was darker in the supplemented group (P<0.01). However, there was no cumulative effect of supplementation across successive generations. These results suggest that, in the female germ line, diet-induced A(vy) hypermethylation occurs in the absence of additional epigenetic modifications that normally confer transgenerational epigenetic inheritance at the locus.

Maternal methyl supplements increase offspring DNA methylation at Axin Fused.

Transient environmental exposures during mammalian development can permanently alter gene expression and metabolism by influencing the establishment of epigenetic gene regulatory mechanisms. The genomic characteristics that confer such epigenetic plasticity upon specific loci, however, have not been characterized. Methyl donor supplementation of female mice before and during pregnancy permanently increases DNA methylation at the viable yellow agouti (A(vy)) metastable epiallele in the offspring. The current study tested whether another murine metastable epiallele, axin fused (Axin(Fu)), similarly exhibits epigenetic plasticity to maternal diet. We found that methyl donor supplementation of female mice before and during pregnancy increased DNA methylation at Axin(Fu) and thereby reduced by half the incidence of tail kinking in Axin(Fu)/+ offspring. The hypermethylation was tail-specific, suggesting a mid-gestation effect. Our results indicate that stochastic establishment of epigenotype at metastable epialleles is, in general, labile to methyl donor nutrition, and such influences are not limited to early embryonic development.