Prevalence of leptospira in acute hepatitis syndrome and assessment of IL-8 and TNF-alpha level in leptospiral hepatitis.

To study the prevalence of leptospira in acute hepatitis syndrome and to assess interleukin (IL)-8 and tumour necrosis factor (TNF)-alpha levels in the pathogenesis of hepatitis due to leptospiral infection. Two hundred and forty-seven consecutive cases with symptoms of acute hepatitis and 30 healthy controls were enrolled in the study and detailed clinical history was elicited from them. Enzyme-linked immunosorbent assays (ELISAs) for HAV, HBV, HCV and HEV were performed to rule out common viral aetiology of hepatitis. IgM antibodies to leptospira were detected by ELISA. IL-8 and TNF-alpha levels were estimated in leptospira-positive cases and healthy controls by ELISA. Out of 247 cases of acute hepatitis, 46 (18.62%) were observed to be positive for IgM antibodies for leptospira. The mean age of these patients was 31.99 ± 0.28 years (25 males and 21 females; M/F ratio: 1.19:1). The mean ALT, AST and ASP were raised in the majority of patients. IL-8 was found to be elevated (130.81 pg/ml) in a large majority of cases 41/46, 89.1% (P < 0.001). Patients with more severe symptoms were associated with higher levels of IL-8. One mortality was observed due to leptospira. Unpredictably, TNF-alpha level was largely suppressed (45.63 pg/ml) in most of the leptospira-positive patients in comparison with healthy controls. Leptospira-induced hepatitis should be actively looked for in patients negative for A-E viral hepatitis. IL-8 appears to play an important role in the pathogenesis of leptospiral hepatitis. High TNF-alpha should alert clinicians for aggressive in hospital management of patients.

A rare case of extra-nasopharyngeal angiofibroma of the septum in a female child.

BACKGROUND: Extra-nasopharyngeal angiofibroma is a rare but distinct clinical entity, different from juvenile angiofibroma. METHODS: This clinical record elucidates the only case of extra-nasopharyngeal angiofibroma arising from the septum in a female child, who presented with epistaxis. RESULTS: The histopathological diagnosis was confirmed by immunohistochemistry, and the case was managed surgically with no recurrence. CONCLUSION: In a female paediatric patient presenting with epistaxis, extra-nasopharyngeal angiofibroma (of the inferior turbinate) is a rare albeit important differential diagnosis, as it challenges the hormonal theory of angiofibroma aetiopathogenesis.

Fabrication and characterization of chitosan, polyvinylpyrrolidone, and cellulose nanowhiskers nanocomposite films for wound healing drug delivery application.

This study describes the preparation of composite film using chitosan (CS) and polyvinylpyrrolidone (PVP) with incorporated cellulose nanowhiskers (CNWs) for drug delivery application. CNWs were prepared by acid hydrolysis of cellulose with sulfuric acid. Field emission scanning electron microscopy studies revealed nanofibrous morphology of CNWs with 20-30 nm diameter and 200-250 nm in length. X-ray powder diffraction analysis confirmed highly crystalline nature of CNWs with 92.81% crystallinity. Incorporation of CNWs enhanced the thermal and mechanical properties of films. Fourier transform infrared spectroscopy data showed physical interactions between polymer-polymer and polymer-drug. Films prepared with CNWs showed improved swelling behavior which resulted in sustained drug release from polymeric matrix. In vitro curcumin release data were fitted with two-step release model; Step 1 as desorption from the outer surface of the film, and Step 2 as diffusion from within the film and subsequent desorption. The release kinetics confirmed biphasic release profile with different release rates along with diffusion controlled curcumin release. Prepared films showed high biocompatibility with excellent antibacterial activities. Overall, the performed studies confirmed CS-PVP-CNWs based release system can as a potential candidate for wound dressing applications with sustained drug release. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2391-2404, 2017.

Chlamydia trachomatis infection & female infertility.

BACKGROUND & OBJECTIVES: Chlamydia trachomatis is a well recognized sexually transmitted pathogen. Besides its potential to produce genital tract infection, C. trachomatis is increasingly being associated with long-term complications like infertility. The present study was undertaken to assess the role of C. trachomatis in female infertility as such data are lacking. METHODS: Women of primary and secondary infertility (n=110) and 30 healthy term pregnant women as control group were enrolled in the study. Detailed clinical history of each patient was recorded. Hysterosalpingography was performed in all patients. Endocervical swabs were collected for culture on cycloheximide treated McCoy cell line and for antigen detection by ELISA. RESULTS: C. trachomatis was detected in 31 (28.1%) of the 110 infertile women while one (3.3%) in control group was positive for C. trachomatis (P<0.01). Cell culture alone identified 25 (22.72%) patients suffering from chlamydial infection while C. trachomatis antigen was detected by ELISA in 18 (16.37%) patients. The one control case was positive for Chlamydia antigen by ELISA and not by cell culture. Chlamydial positivity was seen in 20 of the 74 (27%) women with primary infertility and in 11 of the 36 (30.6%) with secondary infertility. Of the 58 asymptomatic women, 21(36.2%) had chlamydia infection while among the 52 symptomatic cases 10 (19.2%) were infected; 38 per cent women with chlamydial infection also had tubal occlusion. INTERPRETATION & CONCLUSION: A significantly high rate of C. trachomatis infection was found in infertile women and more so in asymptomatic females and in secondary infertility cases. Lack of symptoms make clinical diagnosis of chlamydial infection difficult. Screening of infertile women for C. trachomatis is therefore recommended so far early therapeutic interventions.

Microdetermination of oxprenolol hydrochloride and metoprolol tartrate with ammonium metavanadate.

A micro method has been developed for the determination of oxprenolol hydrochloride and metoprolol tartrate in pure form and in pharmaceutical preparations, with vanadium(V) in acidic medium.

Milligram determination of aromatic amines and phenols with N-bromosuccinimide.

A simple and rapid method has been developed for the determination of milligram amounts of aromatic amines and phenols. An aliquot containing 2-4 mg of sample is dissolved in a mixture of hydrochloric and acetic acids and allowed to react with N-bromo-succinimide, the excess of which is determined iodometrically after the reaction is over. The reaction time varies from 1-10 min and the absolute error generally is negative, ranging from -1 to -4%.

Milligram determination of primary amides.

An accurate and selective milligram procedure for the determination of primary amides is described. About 3-4 mg of sample are hydrolysed with a concentrated solution of sodium hydroxide and the resulting ammonia is distilled into dilute sulphuric acid. The ammonium sulphate thus obtained is converted into ammonium iodide by passing it through hydroxide- and iodide-form resins. This iodide is oxidised to iodate with bromine, then titrated iodometrically. Determinations carried out on a number of primary amides, ureas and thioureas show a deviation of about 0.3% from full recovery of the compounds.

A direct titrimetric method for the microdetermination of some phenothiazine derivatives in pharmaceutical preparations.

A micro method has been developed for the determination of some phenothiazine derivatives in pure form and in pharmaceutical preparations, 1-5 mg of sample being titrated directly with 0.02M N-bromosuccinimide, with Methyl Red as indicator. The error does not exceed +/-1%.

Hydatid cyst of the orbit with papilloedema.

A rare case of Hydatid cyst of the orbit causing, unilateral axial proptosis is reported. The presence of gross unilateral papilloedema misled us to the character of the cystic swelling causing axial proptosis.

Effect of pregnancy associated hypertension on immunoglobulin levels in newborns.

In a prospective study of 124 neonates born to mothers with normal pregnancy and pregnancy associated hypertension (PAH), serum IgG, IgA and IgM were estimated by single radial immunodiffusion technique. Significantly low levels of IgG were found in mothers having PAH, as compared to normal pregnancy (p less than 0.001), whereas IgA and IgM showed no difference in the two groups. There was no statistical difference in maternal and cord blood IgG in either the control or study group. IgG was significantly higher (p less than 0.001) in cord blood of babies born by vaginal route as compared to forceps (via vaginal route) or cesarean section. IgA and IgM levels did not vary with mode of delivery.

Controlled trial of hypo-osmalar versus World Health Organization oral rehydration solution.

OBJECTIVE: To compare the safety and efficacy of a hyposmolar oral rehydration solution (H-ORS) (245 mmol/liter) with the World Health Organization oral rehydration solution (WHO ORS) in cholera and acute non-cholera diarrhea. DESIGN: Controlled clinical trial. SETTING: Diarrhea training and treatment unit. METHODS: Thirty-five culture proven cholera and 135 acute non-cholera diarrheal patients randomly received H-ORS or WHO-ORS. Intake and output were measured every 4 hours. RESULTS: Analysis of the total cases revealed rehydration phase (p=0.048, 95% CI 0.64-0.99) and overall (p=0.046, 95% CI 0.70-0.99) frequency of stools to be significantly less in the H-ORS group. In the severely malnourished, the rehydration phase (p=0.032, 95% CI 0.55-97), maintenance phase (p=0.035, 95% CI 0.51-0.97) and overall (p=0.011; 0.95% CI 0.55-0.93) stool frequency were significantly decreased in the H-ORS group. The amount of ORS consumed in the maintenance phase of the cholera cases was significantly (p=0.04, 95% CI 0.44-0.98) less in the H-ORS group. All other parameters, despite showing a decreasing trend, were statistically comparable in the cholera, non-cholera and total cases. The amount of intravenous fluid needed was significantly more in the noncholera and total cases on H-ORS. In the non-breastfed cases, under two years of age, the total duration of diarrhea was significantly decreased (p=0.03; 95% CI 11.07-11.45) but the need for intravenous fluids significantly increased (p=0.02; 95% CI 109.8-112.1) in the H-ORS group. The proportion of children vomiting, the weight gain, urine passed in 24 hours, serum sodium, caloric intake and failure rate were comparable. CONCLUSIONS: H-ORS is as safe and effective as the WHO-ORS and may have some additional benefits in malnourished children.