Chloroquine-Induced Psychosis: A Case Report.

The use of antimalarial drugs for prophylaxis is a widespread practice while traveling to underdeveloped nations, particularly those with a high malaria prevalence. Chloroquine is still one of the most commonly recommended antimalarials, either alone or in combination with others, for prophylaxis. However, its increased use over the past few decades has been associated with many adverse effects, including headaches, dizziness, vomiting, and diarrhea, as well as neuropsychiatric symptoms such as psychosis. Here, we discuss the case of a 30-year-old Asian man who, after starting a 500-milligram (mg) prophylactic dosage of chloroquine per week, developed psychotic symptoms. This case highlights the need to use chloroquine and other antimalarials with care, especially when beginning as a prophylactic measure with the lowest suggested dosage.

Magnesium-zinc scaffold loaded with tetracycline for tissue engineering application: In vitro cell biology and antibacterial activity assessment.

Recently, porous magnesium and its alloys are receiving great consideration as biocompatible and biodegradable scaffolds for bone tissue engineering application. However, they presented poor antibacterial performance and corrosion resistance which limited their clinical applications. In this study, Mg-Zn (MZ) scaffold containing different concentrations of tetracycline (MZ-xTC, x = 1, 5 and 10%) were fabricated by space holder technique to meet the desirable antibacterial activity and corrosion resistance properties. The MZ-TC contains total porosity of 63-65% with pore sizes in the range of 600-800 µm in order to accommodate bone cells. The MZ scaffold presented higher compressive strength and corrosion resistance compared to pure Mg scaffold. However, tetracycline incorporation has less significant effect on the mechanical and corrosion properties of the scaffolds. Moreover, MZ-xTC scaffolds drug release profiles show an initial immediate release which is followed by more stable release patterns. The bioactivity test reveals that the MZ-xTC scaffolds are capable of developing the formation of HA layers in simulated body fluid (SBF). Next, Staphylococcus aureus and Escherichia coli bacteria were utilized to assess the antimicrobial activity of the MZ-xTC scaffolds. The findings indicate that those scaffolds that incorporate a high level concentration of tetracycline are tougher against bacterial organization than MZ scaffolds. However, the MTT assay demonstrates that the MZ scaffolds containing 1 to 5% tetracycline are more effective to sustain cell viability, whereas MZ-10TC shows some toxicity. The alkaline phosphatase (ALP) activity of the MZ-(1-5)TC was considerably higher than that of MZ-10TC on the 3 and 7 days, implying higher osteoblastic differentiation. All the findings suggest that the MZ-xTC scaffolds containing 1 to 5% tetracycline is a promising candidate for bone tissue healing due to excellent antibacterial activity and biocompatibility.

In-vitro biocompatibility, bioactivity, and mechanical strength of PMMA-PCL polymer containing fluorapatite and graphene oxide bone cements.

In this study, a bone cement consisting of poly methyl methacrylate (PMMA)-poly caprolactone (PCL)-fluorapatite (FA)-graphene oxide (GO) was synthesized as bone filler for application in orthopedic surgeries. The FA and GO particulates were homogenously distributed in the PMMA-PCL polymer matrix and no defects and agglomeration were found in the PMMA-PCL/FA/GO bone cement. The in-vitro bioactivity result exhibited that addition of FA and GO to the polymer cement (PMMA-PCL) improved the apatite formation ability on the surface of polymer. The results also showed that addition of FA to the polymer bone cement escalated the compressive strength and elastic modulus while reducing elongation to 8 ±â€¯2%. However, after addition of GO into the PMMA-PCL/FA bone cement, both compressive strength and elongation considerably increased to 101 ±â€¯5 MPa and 35 ±â€¯6%, respectively. Furthermore, tensile tests exhibited that inclusion of GO was favorable in improving the tensile modulus, UTS and elongation of the PMMA-PCL/FA bone cement. The cytotoxicity test pointed out that MG63 osteoblast cells viability increased to 279 ±â€¯15% after addition of FA and GO to the PMMA-PCL polymer bone cement. The DAPI (4',6-diamidino-2-phenylindole) staining demonstrated better spreading and attachment of MG63 cells on PMMA-PCL/FA/GO surface compared to the PMMA-PCL bone cements. These results confirm the suitable mechanical properties and favorable bioactivity along with high cells viability of PMMA-PCL/FA/GO bone cement, indicating its potentials for orthopedic applications.

Effect of Ta Additions on the Microstructure, Damping, and Shape Memory Behaviour of Prealloyed Cu-Al-Ni Shape Memory Alloys.

The influence of Ta additions on the microstructure and properties of Cu-Al-Ni shape memory alloys was investigated in this paper. The addition of Ta significantly affects the green and porosity densities; the minimum percentage of porosity was observed with the modified prealloyed Cu-Al-Ni-2.0 wt.% Ta. The phase transformation temperatures were shifted towards the highest values after Ta was added. Based on the damping capacity results, the alloy of Cu-Al-Ni-3.0 wt.% Ta has very high internal friction with the maximum equivalent internal friction value twice as high as that of the prealloyed Cu-Al-Ni SMA. Moreover, the prealloyed Cu-Al-Ni SMAs with the addition of 2.0 wt.% Ta exhibited the highest shape recovery ratio in the first cycle (i.e., 100% recovery), and when the number of cycles is increased, this ratio tends to decrease. On the other hand, the modified alloys with 1.0 and 3.0 wt.% Ta implied a linear increment in the shape recovery ratio with increasing number of cycles. Polarization tests in NaCl solution showed that the corrosion resistance of Cu-Al-Ni-Ta SMA improved with escalating Ta concentration as shown by lower corrosion current densities, higher corrosion potential, and formation of stable passive film.

Fabrication of biodegradable Zn-Al-Mg alloy: Mechanical properties, corrosion behavior, cytotoxicity and antibacterial activities.

In this work, binary Zn-0.5Al and ternary Zn-0.5Al-xMg alloys with various Mg contents were investigated as biodegradable materials for implant applications. Compared with Zn-0.5Al (single phase), Zn-0.5Al-xMg alloys consisted of the α-Zn and Mg2(Zn, Al)11 with a fine lamellar structure. The results also revealed that ternary Zn-Al-Mg alloys presented higher micro-hardness value, tensile strength and corrosion resistance compared to the binary Zn-Al alloy. In addition, the tensile strength and corrosion resistance increased with increasing the Mg content in ternary alloys. The immersion tests also indicated that the corrosion rates in the following order Zn-0.5Al-0.5Mg

Corrosion and bioactivity performance of graphene oxide coating on TiNb shape memory alloys in simulated body fluid.

In the present work, the microstructure, corrosion, and bioactivity of graphene oxide (GO) coating on the laser-modified and -unmodified surfaces of TiNb shape memory alloys (SMAs) were investigated. The surface morphology and chemical composition was examined using field emission scanning electron microscopy (FE-SEM) and X-ray diffraction (XRD). The surface modification was carried out via a femtosecond laser with the aim to increase the surface roughness, and thus increase the adhesion property. FE-SEM analysis of the laser-treated Ti-30at.% Nb revealed the increase in surface roughness and oxygen/nitrogen containing groups on the Ti-30at.% Nb surface after being surface modified via a femtosecond laser. Furthermore, the thickness of GO was increased from 35µm to 45µm after the surface was modified. Potentiodynamic polarisation and electrochemical impedance spectroscopy studies revealed that both the GO and laser/GO-coated samples exhibited higher corrosion resistance than that of the uncoated TiNb SMA sample. However, the laser/GO-coated sample presented the highest corrosion resistance in SBF at 37°C. In addition, during soaking in the simulated body fluid (SBF), both the GO and laser/GO coating improved the formation of apatite layer. Based on the bioactivity results, the GO coating exhibited a remarkable antibacterial activity against gram-negative bacteria compared with the uncoated. In conclusion, the present results indicate that Ti-30at.% Nb SMAs may be promising alternatives to NiTi for certain biomedical applications.

Deposition of nanostructured fluorine-doped hydroxyapatite-polycaprolactone duplex coating to enhance the mechanical properties and corrosion resistance of Mg alloy for biomedical applications.

The present study addressed the synthesis of a bi-layered nanostructured fluorine-doped hydroxyapatite (nFHA)/polycaprolactone (PCL) coating on Mg-2Zn-3Ce alloy via a combination of electrodeposition (ED) and dip-coating methods. The nFHA/PCL composite coating is composed of a thick (70-80 µm) and porous layer of PCL that uniformly covered the thin nFHA film (8-10 µm) with nanoneedle-like microstructure and crystallite size of around 70-90 nm. Electrochemical measurements showed that the nFHA/PCL composite coating presented a high corrosion resistance (R(p)=2.9×10(3) kΩ cm(2)) and provided sufficient protection for a Mg substrate against galvanic corrosion. The mechanical integrity of the nFHA/PCL composite coatings immersed in SBF for 10 days showed higher compressive strength (34% higher) compared with the uncoated samples, indicating that composite coatings can delay the loss of compressive strength of the Mg alloy. The nFHA/PCL coating indicted better bonding strength (6.9 MPa) compared to PCL coating (2.2 MPa). Immersion tests showed that nFHA/PCL composite-coated alloy experienced much milder corrosion attack and more nucleation sites for apatite compared with the PCL coated and uncoated samples. The bi-layered nFHA/PCL coating can be a good alternative method for the control of corrosion degradation of biodegradable Mg alloy for implant applications.

Degradation behavior of biodegradable Fe35Mn alloy stents.

This article reports a degradation study that was done on stent prototypes made of biodegradable Fe35Mn alloy in a simulated human coronary arterial condition. The stent degradation was observed for a short-term period from 0.5 to 168 h, which simulates the early period of stenting procedure. Potentiodynamic polarization and electrochemical impedance spectroscopy were used to quantify degradation rate and surface property of the stents. Results showed that signs of degradation were visible on both crimped and expanded stents after 1 h of test, mostly located on the stent's curvatures. The degradation rate of stent was higher compared to that of the original alloy, indicating the surface altering effect of stent fabrication processing to degradation. A single oxide layer was formed and detected as a porous structure with capacitive behavior. Expanded stents exhibited lower polarization resistance compared to the nonexpanded ones, indicating the cold work effect of expansion procedure to degradation.

Perinatal mortality and morbidity in rural West-Java, Indonesia. Part II: The results of a longitudinal survey on pregnant women.

The main objective of this prospective survey is to obtain more information on the natural history of pregnancy and its outcome, including low birth weights, and of the factors closely associated with it. During the survey period the birth rate was 40 per thousand and the perinatal death rate 48 per thousand. The main causes of neonatal deaths are infections (predominantly tetanus) and hypoxia/birth asphyxia. Perinatal mortality is significantly associated with the following risk factors: age of mother less than 20 years; birth interval shorter than 18 months, twins, and breech presentation. The incidence of low birth weight is 14.7%. Statistically significant associations have been found between low birth weight and several risk factors.

PIP: Traditional birth attendants made 5 home visits to each pregnant woman in Ujung-Berung area of rural West Java in Indonesia between September 1978-February 1980 to determine the natural history of pregnancy and its outcome and the factors associated with the different outcomes. They performed 87% of the deliveries. 4 mothers died (1.7% of all live births). The birth rate was 40% and 2335 infants were born. The perinatal mortality rate stood at 44.5. The percentage of fetal deaths was 13.7% (32) and of early neonatal deaths was 31.2% (72). The leading cause of early neonatal death was infection (50.2%) and tetanus neonatorum contributed to mortality in 79% of these cases (case fatality rate 100%). In the early neonatal period, the tetanus specific perinatal mortality was 17%. Further it stood at a high of 9.5/1000 live births due to low tetanus immunization coverage. Intrauterine hypoxia and birth asphyxia contributed the most to perinatal deaths (57.8%) followed by infections (23.6%). Twin births posed 4.14 times the risk of perinatal mortality than did singleton births (p.05). The single most significant risk factor for perinatal mortality, however, was breech delivery (relative risk [RR] 5.7; p.05). Mother's age 20 years (RR 1.28) and birth interval between 6-17 months (2.76) comprised the only other 2 significant risk factors (p.05). 14.7% of the infants weighed 2500 g. For low birth weight (LBW) infants, twin births posed the greatest risk to mortality (RR 5.65) followed by complications before delivery (RR 3.7), breech birth (RR 2.3), and 1st birth (RR 2.06) [all significant at p.05]. LBW infants had a high percentage of illnesses during the neonatal period (30.2%). Overall morbidity during this time stood at 16.9%.

Brucellosis in man. I. Serological diagnosis.

50 Blood samples were collected from in-patients with febrile splenomegaly suspected to be Malta fever, in Sharkia fever hospitals; Egypt. The samples were subjected to serological tests (tube agglutination, Widal & Coombs) for diagnosis of brucellosis. The results of tube agglutination (TAT) revealed that 5 (10%) were positive; the titre ranging from 1/80-1/320, 3 doubtful (1/40) and 42 negative (1/20, 1/10 and no agglutination). Results of the Coombs test on negative and doubtful of TAT showed that out of 45 patients; 3 (6.66%) were positive; the titre ranging from 1/80-1/160, one doubtful and 41 negative. Coombs test improved the titre of one positive case of TAT from 1/320-1/640. Results of serological tests (TAT & Coombs) for MALTA fever were 8 (16%); the titre ranging from 1/80-1/640, one doubtful (1/40) and 41 negative. Results of the Widal test to detect Enteric fever in the way of differential diagnosis were 7 (14%) positive out of 50 patients examined; the titre ranging from 1/80-1/160. Five of them agglutinated typhoid (O&M) suspensions. One of the sera agglutinated paratyphi A (H) suspension, the remaining one serum agglutinated paratyphi. B(H) suspension and none of the sera agglutinated paratyphi. C(H) suspension. All the positive Coombs and negative Widal cases were obtained against typhoid (O) suspension and none against any of the (H) suspensions; Coombs test was positive in two (4.65) of 43 patients negative to Widal; no improvement of titre in the positive Widal. Results of Widal & Coombs to detect Enterica were 9 (18%) positive and 41 negative.

Brucellosis in man--II. Isolation of the causative organisms with special reference to blood picture and urine constituents.

Blood and urine samples were collected from 50 patients with febrile splenomegaly suspected to be Malta fever in Sharkia fever hospitals, Egypt. Blood samples were subjected to isolation of Brucellae; blood counts and erythrocyte sedimentation rate. Urine analysis. Four strains of brucella were isolated. Two of these isolated first from the 50 patients and typed as Br. melitensis Biotype I and the others were recovered secondly and thirdly from serologically positive patients and typed as Br. abortus Biotype I. All the strains from positive serology, titre ranging from 1/160-1/640. Br. melitensis is more readily isolated from the blood than Br. abortus. Blood picture of serologically positive Malta fever showed three patients with mild leukopenia; two with relative lymphocytosis; two with secondary anaemia and three with accelerated erythrocyte sedimentation rate. Urine analysis revealed five patients with albuminuria.