Skin tumorigenic potential of benzanthrone: prevention by ascorbic acid.

Benzanthrone (BA) exposed occupational workers have been found to exhibit toxicological manifestations in the skin, thus it is quite likely that long term exposure may lead to skin tumorigenicity. Thus, attempts were made to elucidate the tumor initiating and promoting potentials of pure (PBA) and commercial benzanthrone (CBA). Additionally, the preventive role of ascorbic acid (AsA) was also assessed. PBA showed tumor initiating activity while CBA demonstrated tumor initiating as well as promoting activities in two-stage mouse skin tumor protocol. Further, prior treatment of AsA to PBA and CBA followed by twice weekly application of 12-o-tetradecanoyl phorbal myristate acetate (TPA) resulted into delayed onset of tumor formation and similarly single application of 7,12-dimethylbenz [α] anthracene (DMBA) followed by twice weekly application of AsA and CBA showed an increase in the latency period. Thus, AsA showed a protective effect against CBA promoted skin tumor. Furthermore, the topical application of CBA significantly increased the levels of xenobiotic enzymes. The animals topically treated with AsA along with topical application of CBA, restored all the impairment observed in enzyme activities. Thus, this study suggested that AsA can be useful in preventing PBA and CBA induced skin tumorigenicity.

Anterior neck lipoma with anterior mediastinal extention - a rare case report.

Lipomas are the most common benign mesenchymal tumour. Thirteen percent of lipomas are seen in head and neck region. Anterior neck lipoma is a rare one. Anterior neck lipoma with mediastinal extension is extremely rare. We are presenting a case of 52 years old male reported to Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim with complains of swelling in left side of neck for last 18 months along with occasional history of dyspnoea. Physical examination, ultrasound, computed tomography and fine needle aspiration cytology are in favor of lipoma. Due to its location up to the anterior mediastinum, the surgery could not be done in this hospital and patient was referred to higher center having cardiothoracic surgical back up.

Usage pattern of synthetic food colours in different states of India and exposure assessment through commodities preferentially consumed by children.

Exposure studies in children are emphasized nowadays given children's higher consumption vulnerability. The present study generated national-level data covering 16 major states of India on the usage pattern of colours and it identified food commodities through which a particular colour has the scope to exceed ADI limits. Out of the total analysed samples, 87.8% contained permitted colours, of which only 48% adhered to the prescribed limit of 100 mg kg(-1). The majority of candyfloss, sugar toys, beverages, mouth fresheners, ice candy and bakery product samples exceeded the prescribed limit. Non-permitted colours were mostly prevalent in candyfloss and sugar toy samples. Though sunset yellow FCF (SSYFCF) and tartrazine were the two most popular colours, many samples used a blend of two or more colours. The blend of SSYFCF and tartrazine exceeded the prescribed limit by a factor of 37 in one sample, and the median and 95th percentile levels of this blend were 4.5- and 25.7-fold, respectively. The exposure assessment showed that the intake of erythrosine exceeded the ADI limits by two to six times at average levels of detected colours, whereas at the 95th percentile level both SSYFCF and erythrosine exceeded the respective ADI limits by three- to 12-fold in all five age groups. Thus, the uniform prescribed limit of synthetic colours at 100 mg kg(-1) under Indian rules needs to be reviewed and should be governed by consumption profiles of the food commodities to check the unnecessary exposure of excessive colours to those vulnerable in the population that may pose a health risk.

Usage pattern and exposure assessment of food colours in different age groups of consumers in the State of Uttar Pradesh, India.

The present study aims to investigate the nature and levels of colours in food items and to undertake risk assessment vis-a-vis intake among different age groups of consumers in the State of Uttar Pradesh, India. A total of 478 edible foodstuffs were analysed, and of six permitted colours, Sunset Yellow FCF (SSYFCF) and Tartrazine were most popular, and two non-permitted colours, namely Metanil Yellow and Rhodamine B, were encountered. The study showed a marked improvement in the trend of use of non-permitted colours over previous surveys, with 90% foods now resorting to approved food colours. However, 59% of foods employing permitted colours exceeded the maximum allowable limit, with average quantities crossing the threshold of 100 mg kg(-1) in most food commodities. The intake of SSYFCF exceeded the acceptable daily intake (ADI) for children and adolescents by 88% and 39%, respectively, and was statistically significant when analysed by error bars and distribution curves. In adults, SSYFCF saturated 59% of the ADI. For Carmoisine, Tartrazine and Ponceau 4R, saturation of ADI ranged from 27.4% to 90.3% in children and adolescents and from 10.8% to 47.6% in adult subjects. These results indicate that children and adolescents are more vulnerable to higher intakes of food colours compared with the adult population. Allowing a uniform level of all colours in foods under Indian rules, notwithstanding wide variations of 250-fold in their allocated ADIs, could be one reason for the higher intake and hence only technological need-based levels of individual colours are desired to be prescribed.

Justifying the need to prescribe limits for toxic metal contaminants in food-grade silver foils.

The use of silver foils in various food preparations is a common practice in Middle Eastern and South East Asian countries. The FAO/WHO Joint Expert Committee on Food Additives (JECFA) has included silver in the list of food additives, but specifications were not prepared. Indian food legislation has included food-grade silver foil and laid down a purity requirement of 99.9%. This leaves an unspecified margin of 0.1% or 1000 microg g(-1) for contaminants. Therefore, a study to investigate the levels of metallic contaminants in food-grade silver foil was undertaken. Of 178 foils analysed, 161 (90%) contained silver, whilst 10% were fraudulently made up of aluminium. In the case of silver foils, 46% of the samples adhered to the desired purity requirement of 99.9%, while 54% had a lower silver content. Copper was present in 86.3% of the silver foils, while chromium, nickel and lead contamination was found in over 54% of samples. Cadmium levels were detected in 28% of the silver foils and manganese was present in 6.8% of samples. In silver foils showing metal contaminants, average levels were found for nickel (487 microg g(-1)), lead (301 microg g(-1)), copper (324 microg g(-1)), chromium (83 microg g(-1)), cadmium (97 microg g(-1)) and manganese (43 microg g(-1)), which being appreciable justify the need to prescribe limits for some metals in food-grade silver foil as well as for silver powder used in confectioneries and medicinal preparations. The work reported here should encourage manufacturers to use high-purity raw materials and take suitable precautions to reduce unwarranted exposure of consumers to toxic metal contaminants.

Xanthogranulomatous cholecystitis.

Twelve cases of xanthogranulomatous cholecystitis are reported. The clinical presentation was similar to chronic cholecystitis. All patients had associated gallstones. The diagnosis was achieved at histopathological examination of the resected gall bladders and none had any focus of malignancy. Cholecystectomy was curative.

Preoperative autologous plateletpheresis in patients undergoing open heart surgery.

Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB). It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP) can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP) harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I) in which one unit of whole blood was withdrawn, and PRP group (Group II) where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p<0.001) and required 38.5% less homologous blood and blood products (p<0.05), in the postoperative period. Haemoglobin levels on day zero (day of operation) and day three were statistically not different between the two groups. We conclude that autologous plateletpheresis is a better method of blood conservation in terms of better haemostasis, and less requirement of blood and blood products in the postoperative period as compared with the autologous whole blood donation. This technique can be especially useful in the above-mentioned categories of patients.

Toxic Interaction of Lathyrus sativus and Manganese in Guinea Pig Intestine.

The combined effects on the intestinal cells of guinea pigs following feeding them with lathyrus and manganese (Mn) for 90 days were studied in this investigation. Guinea pigs given Mn (4 ppm of their diets) for 90 days showed no change in either intestinal bioconstituents or marker enzymes, with the exception of gamma-glutamyl transpeptidase (GGT) and quinone reductase (QR). Exposure to a diet of 80% lathyrus only resulted in significant (p <. 05) inhibition of intestinal alkaline phosphatase (ALP), sucrase, GGT, QR, and glutathione-s-transferase (GST) along with significant (p <. 05) depletion of total hexose and phospholipids. Animals given lathyrus and Mn showed a significant (p <. 05) decrease in intestinal ALP, Ca +2 Mg +2 -ATPase, sucrase, GGT, GST, and QR along with significant (p <. 05) depletion in total hexose and phospholipids and concomitant enhancement in cholesterol when compared to controls. The data clearly indicate that combined treatment with lathyrus and Mn potentiates intestinal toxicity more than does Mn or lathyrus alone.

Dermal toxicity due to industrial chemicals.

The dermal toxicity due to industrial chemicals is well recognised. They may be the cause of skin irritation and skin sensitization. Some of the chemicals may result in dermal reactions such as changes in skinfold thickness, cellular degeneration and necrosis. The absorption through the skin may also cause penetration of chemicals into the organism causing systemic effects.

Toxicity of argemone oil: effect on hsp70 expression and tissue damage in transgenic Drosophila melanogaster (hsp70-lacZ) Bg9.

The effect of argemone oil on hsp70 expression and tissue damage was investigated by studying beta-galactosidase activity, Western blotting and hybridization, and trypan blue staining in the larval tissues of transgenic Drosophila melanogaster (hsp70-lacZ)Bg9. Different concentrations of argemone oil were mixed with food and third-instar larvae were allowed to feed on them for different time intervals (2, 4, 24, and 48 h). Argemone oil was found to induce hsp70 even in the lowest concentration of the adulterant while maximum tissue damage was observed in the higher two treatment groups. Malpighian tubules and midgut tissue reflected maximum damage as evidenced by both high beta-galactosidase activity and trypan blue staining in these tissues. A prior temperature shock treatment to the larvae was enough to protect the larvae from argemone oil-induced tissue damage as evidenced by little or no trypan blue staining. The present study suggests the cytotoxic potential of argemone oil and further strengthens the evidence for the use of hsp70 as a biomarker in risk assessment.

A COMPARATIVE STUDY OF CHEST RADIOGRAPHIC FEATURES BETWEEN HIV SEROPOSITIVE AND HIV SERONEGATIVE PATIENTS OF PULMONARY TUBERCULOSIS.

Chest radiographic appearance of pulmonary tuberculosis (TB) in Human Immunodeficiency Virus (HIV) positive patients was reviewed. A study group of 50 HIV +ve cases and a control group of 100 HIV -ve cases were analysed. The chest radiographs of HIV seropositive group showed significantly higher incidence of thoracic lymphadenopathy (36% vs 8%, P<.001), pleural effusion (28% vs 10%, P<.01) and miliary pattern (12% vs 2%, P<.05) as compared to the seronegative group. Cavitation was less common in the seropositive group (8% vs 35%, P<.001) than the seronegative group. Upper zone involvement was significantly less common in the study group (38% vs 77%, P<.001) as compared to the control group.

Role of biological antioxidants in benzanthrone toxicity.

Previous studies indicate that benzanthrone, an anthraquinone dye intermediate, caused significant depletion of ascorbic acid (AsA). In this investigation the effect of benzanthrone on the status of different forms of AsA and other bio-antioxidants such as glutathione (GSH) was studied. Oral administration of benzanthrone (50, 125 or 250 mg/kg body weight) resulted in a significant increase of urinary AsA levels with a concomitant decrease in the urinary dehydroascorbic acid (DHA) content in both rats and guinea-pigs. Benzanthrone caused a dose-dependent decrease in hepatic, adrenal and serum AsA levels with a subsequent increase in DHA and diketogulonic acid (DKA) levels in both rats and guinea-pigs. Following benzanthrone treatment, rats showed an increase in the scorbutic index (to 1.01-1.21) of the liver, adrenal glands and serum compared to controls (0.12-0.24). The scorbutic indices of liver, adrenal glands and serum were also substantially increased (to 3.61-11.20) in benzanthrone-treated guinea-pigs compared to controls (0.16-0.38). Single oral administration of benzanthrone to guinea-pigs caused a dose-dependent depletion of GSH in liver (15-51%), adrenal glands (27-64%) and serum (32-86%). Furthermore, the depletion of GSH by benzanthrone in rats was of a lesser degree. This suggests that continued exposure of guinea-pigs to benzanthrone may lead to scurvy-type changes in this animal species but not to the same extent in rats, since the latter has the enzymatic capacity to synthesise AsA. Therefore, it can be hypothesised that benzanthrone per se, or its metabolites, interact with reduced GSH thereby causing its depletion. Furthermore, in order to replenish the depleted GSH levels, AsA might be oxidized to DHA and hence the decrease in AsA with the simultaneous increase in DHA was observed.

Quantitative determination of aflatoxin B1-oxime by column liquid chromatography with ultraviolet detection.

Liquid chromatography was used for the quantification of aflatoxin B1-oxime (AFB1-oxime). The yield of AFB1-oxime in the reaction mixture was 89%, while after purification on silica gel it was 72%. LC analysis of the reaction mixture after silica gel fractionation revealed a retention time of 0.84 min for AFB1-oxime, 8.42 min for AFB1, 1.21 min for unknown 1 and 1.61 min for unknown 2. UV-visible analysis of the reaction mixture after silica gel fractionation showed a lambda(max) of 269 and 361 nm for AFB1-oxime, 263 and 360 nm for AFB1, 273 nm for unknown 1 and 275 nm for unknown 2. Excitation and emission wavelengths were found to be 269 and 368/438 nm for AFB1-oxime, 359/424 nm for AFB1, 270 and 367/450 nm for unknown 1 and 273 and 416/447 nm for unknown 2. The method may find versatile application in monitoring reactions for the preparation of oximes of various analytes for the synthesis of their immunogens.

Evaluation of dermal irritancy potential of benzanthrone-derived dye analogs: structure activity relationship.

The twelve structural analogs of benzanthrone-derived dyes of commercial use were screened for their dermal irritation potential response using the Draize occlusive patch test. The test dyes, dissolved in DMSO as vehicle, were topically applied on the skin of the male Druckery rats (160 +/- 10 g) according to the OECD protocol. The potential dermal hazard was assessed in terms of the primary cutaneous irritation (PCI) index and irritancy. Irritancy was evaluated according to the AFNOR scale. In terms of irritancy, the twelve benzanthrone dyes qualified as moderately irritant (3.0-5.0) according to the above scale. In decreasing order, PCI index of the various dyes was: Navy Blue R (4.5); Jade Green XBN (4.25); 16, 17-dihydroxydibenzanthrone (3.84); Black NB (3.75), Jade Green 2G (3. 75); 3-bromobenzanthrone (3.58); Brilliant Purple 4R (3.58); Olive D (3.50); Dark Blue 2R (3.41); Olive Green B (3.33); isodibenzanthrone (3.33), and benzanthrone (3.16). These results indicate that benzanthrone-derived dyes/dye intermediates caused dermal toxicity which appears to be influenced by the number of carbonyl and amino-anthraquinone groups as well as by the presence of functional groups like halogen, nitro, hydroxy and methoxy in the parent molecule, benzanthrone.

Intracystic tetracycline therapy for hypofunctioning cystic thyroid nodules.

OBJECTIVES: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine deficient region. There are reports of resolution of recurrent thyroid cysts with tetracycline instillation. Hence we conducted a study in 20 patients with hypofunctioning benign cystic thyroid nodules to document response to intracystic instillation of tetracycline as a primary modality of treatment. METHODS: Twenty patients were thoroughly investigated for the presence of malignancy clinically, radiologically and cytologically. One milliliter of tetracycline was instilled under ultrasonographic guidance. Response to therapy was assessed clinically and ultrasonographically at one, three, six and 12 months. RESULTS: Study group comprised of five male and 15 female patients with mean age 30 +/- 8 years. Initial mean volume of nodules was 15 +/- 7 ml (6 to 27 ml), which was decreased to 3 +/- 3 ml at one month, 2 +/- 3 ml at three months, and 1 +/- 2 ml at six months. Maximum number of patients (75%) responded within three months, however two patients required reaspiration and reinstallation of tetracycline. Ultrasonography revealed fibrotic scar as thick wall with internal echodensities in six patients (30%) six month after sclerotherapy. There was high rate of patient satisfaction, as cosmetically tetracycline did not leave any scar, which was unavoidable with surgery. Six patients (30%) reported mild pain after injection, and one patient developed redness at the site of injection. CONCLUSIONS: Intracystic tetracycline sclerotherapy is highly effective as primary mode of treatment in hypofunctioning benign cystic thyroid nodule in selected group of patients not at high risk of malignancy.

FOLLICULAR MONITORING: COMPARISON OF TRANSABDOMINAL AND TRANSVAGINAL SONOGRAPHY.

Transabdominal sonography (TAS) and Transvaginal sonography (TVS) were compared for follicular monitoring in 73 patients of infertility. These patients were referred for follicular monitoring in normal and stimulated cycles from infertility clinic. Patient compliance and acceptance was excellent for TVS technique as compared to TAS technique. The overall resolution of ovarian and follicular anatomy was much better in TVS. With TAS only 35.6% had good visualisation of follicles as compared to 80.8% (p<0.05) in TVS. TVS offered advantage of much better detection rate of smaller follicles (<10mm) and higher accuracy in assessing number of follicles.

VASCULAR EMBOLOTHERAPY-HOW MUCH HAS BEEN ACHIEVED?

Emergency and elective embolotherapy of various systemic arteries in 64 patients was carried out at a tertiary centre of Armed Forces. Specific indications were haemoptysis (n=43), preoperative (n=18), haematuria (n=1), epistaxis (n=1) and chemoembolization (n=1). The procedures were performed with gelfoam pellets (n=46), gelfoam pellets and absolute alcohol (n=1), polyvinyl alcohol particles (PVA) (n=14), steel coils (n=2) and Adriamycin-in-oil emulsion (n=1). Embolotherapy resulted in complete haemostasis in 37 (82.2%) out of 45 cases of haemorrhage. In eight cases (17.8%), it resulted in significant improvement. Complete haemostasis was achieved in both cases of haematuria and epistaxis. Pre-operative embolotherapy resulted in considerable reduction of peroperative blood loss in all the cases. Chemoembolization of Hepatocellular carcinoma resulted in partial regression of the tumour. The purpose of this study was to assess the efficacy, safety and reliability of vascular embolotherapy for control of life threatening haemorrhage and preoperative reduction of lesions.

TRANSVAGINAL SALINE INFUSION SONOHYSTEROGRAPHY: INITIAL RESULTS.

Transvaginal sonohysterography was carried out with dynamic instillation of normal saline in the uterine cavity in fourteen infertile patients. Sonohysterography was found to be simple, accurate and specific in delineating endometrial cavity lesions like polyp, submucosal myoma, intrauterine synechiae and endometrial hyperplasia.