Glycosylated fibronectin point-of-care test for diagnosis of pre-eclampsia in a low-resource setting: a prospective Southeast Asian population study.

OBJECTIVE: To determine the performance of a glycosylated fibronectin (GlyFn) point-of-care (POC) test for pre-eclampsia (PE) in a large Southeast Asian cohort (India) in comparison to previously described biomarkers. DESIGN: A total of 798 pregnant women at ≥20 weeks of gestation were enrolled in a prospective case-control study. Study participants included 469 normotensive women with urinary mg protein/mmol creatinine ratio <0.3, 135 with PE (hypertension with urinary mg protein/mmol creatinine ratio ≥0.3) and 194 with gestational hypertension (hypertension with urinary mg protein/mmol creatinine ratio <0.3). METHODS: GlyFn levels were determined using a POC device and PIGF, sFlt-1 and PAPPA2 levels were determined by immunoassay. Performance was assessed using logistic regression modelling and receiver-operating characteristic (ROC) curves. Classification performance and positive and negative predictive values are reported at specific thresholds. RESULTS: Increased levels of GlyFn, soluble fms-like tyrosine kinase-1 (sFlt-1) and pregnancy-associated placental protein A2 (PAPPA2), and decreased levels of placental growth factor (PlGF) were significantly associated (P < 0.01) with clinically defined PE. Area under the ROC (AUROC) values with 95% confidence intervals were: GlyFn, 0.99 (0.98-0.99); PlGF, 0.96 (0.94-0.98); sFlt-1, 0.86 (0.83-0.89); and PAPPA2, 0.96 (0.94-0.97). Of subjects with GH, 48% were positive for more than two PE biomarkers, and 70% of these delivered preterm. CONCLUSIONS: The Lumella™ GlyFn POC test has been validated in a low/middle-income country setting for PE diagnosis and may be a useful adjunctive tool for early identification, appropriate triage, and improved outcomes. TWEETABLE ABSTRACT: The Lumella™ point-of-care test had excellent performance in diagnosing PE in a large Southeast Asian cohort.

Polypyrrole/zeolite composite - A nanoadsorbent for reactive dyes removal from synthetic solution.

Synthetic dyes are among the common pollutants in the ecosystem. In the present study, polypyrrole/zeolite (PPy/Ze) nanocomposite was prepared and subsequently assessed for the removal of Reactive blue (RB) and Reactive red (RR) from synthetic solution. The polymeric PPy/Ze composite was synthesized by chemical oxidation of pyrrole in the presence of zeolite. Electron microscopic images (transmission and scanning) indicate that PPy/Ze nanocomposite was spherical in shape with an average size of 40-80 nm. The characteristic pyrrole and zeolite Fourier transform infrared spectrum peaks (1542 cm-1, 1463 cm-1, 1156 cm-1, 1054 cm-1, 879 cm-1 and 756 cm-1) in the nanocomposite confirmed zeolite integration with polypyrrole. Experimental variables such as PPy/Ze nanocomposite dose, initial RB and RR concentration, reaction temperature and pH were optimized. The PPy/Ze nanocomposite adsorbed 86.2% of RB and 88.3% of RR from synthetic solution at optimal conditions (pH 9, initial RR or RB concentration, 75 mg/l; PPy/Ze dose, 1.8 g/l; and temperature, 50 °C). Freundlich isotherm model and pseudo-second-order kinetics showed better fit for both RB and RR removal from synthetic solution. X-ray diffractogram confirmed the amorphous nature of PPy/Ze nanocomposite and that it was not altered even after dye adsorption. Adsorption-desorption studies showed that the composite has satisfactory adsorption potential for four cycles. The results show that the PPy/Ze nanocomposite could be used for the removal of dyes from wastewaters.

Significance of conducting polyaniline based composites for the removal of dyes and heavy metals from aqueous solution and wastewaters - A review.

Dyes and heavy metals pollution have become a major environmental concern worldwide. Various methods, such as advanced oxidation, biodegradation, precipitation, flocculation, ultra filtration, ion-exchange, electro-chemical degradation and coagulation, have been proposed for the removal of dyes and heavy metals from contaminated wastewater. Of these methods, adsorption and detoxification are considered as the most promising and economically viable. Polyaniline-based composites, a material prepared by combining polyaniline with one or more similar or disimilar materials, have been reported as good adsorbents to remove and detoxify different groups of pollutants due to their unique physical and chemical properties. In the last decade, several studies have reported the effective adsorption (∼95%) of dyes and heavy metals onto polyaniline based composites. Furthermore, some polyaniline -composites reduced the adsorbed heavy metals into less toxic state. This review compiles the application of different polyaniline composites for adsorption and/or detoxifcation of dyes and heavy metals and documents composite preparation methods, morphology and properties of the composites, and mechanism of dyes and heavy metals adsorption. Based on the avilabile literature, this review suggests that more studies are warranted to understand the influence of various conditions and experimental variables on dyes and heavy metals removal from wastewater and/or aqueous solution.

Biosynthesis of Cr(III) nanoparticles from electroplating wastewater using chromium-resistant Bacillus subtilis and its cytotoxicity and antibacterial activity.

The aim of this study was to synthesize and characterize Cr(III) nanoparticles using wastewater from electroplating industries and chromium-resistant Bacillus subtilis. Formation of Cr(III) nanoparticles was confirmed by UV-visible (UV-Vis) spectroscopy at 300 nm. The size of the nanoparticles varied from 4 to 50 nm and energy dispersive spectroscopy profile shows strong Cr peak approximately at 4.45 and 5.2 keV. The nanoparticles inhibited the growth of pathogenic bacteria Staphylococcus aureus and Escherichia coli. The cytotoxic effect of the synthesized Cr(III) nanoparticle was studied using HEK 293 cells, and the cell viability was found to decrease with increasing concentration of Cr(III) nanoparticles.

Follicular infundibulum tumour presenting as cutaneous horn.

Tumour of follicular infundibulum is an organoid tumour with a plate like growth attached to the epidermis with connection from the follicular epithelium. We are reporting such a case unusually presenting as cutaneous horn.

Eccrine poroma.

Eccrine poroma is a benign tumour, usually found over palms and soles. A 35-year-old lady presented with a raised nodule of 0.75 cm over the right palm. On excision biopsy it showed tumour masses consisting anastomosing bands with ductal lumina lined by an eosinophilic cuticle. A diagnosis of eccrine poroma was made. Due to paucity of reports in Indian literature we are reporting this case.

Atypical fibroxanthoma in tuberous sclerosis.

Atypical fibroxanthoma is not an uncommon condition occurring in elderly on the sun exposed areas. We report a case of atypical fibroxanthoma in a patient with tuberous sclerosis. The lesion was excised surgically. There was no evidence of any metastasis.

Cutaneous B-cell lymphoma.

Primary cutaneous B-cell lymphoma is associated with poor prognosis. But with low grade pathology it may have a good prognosis. A 32-year-old man presented with hyperpigmented patches over chest which on biopsy showed perivascular infiltrate and was treated as vasculitis. After 8 months he came again with multiple nodules and plaques with ulceration. Biopsy of the plaque showed evidence of B-cell lymphoma. With chemotherapy the patient died after 6 months. Retrospective study of the earliest biopsy showed atypical lymphoid cells. This emphasizes the importance of the dermatopathological interpretation at the earliest stage.

Acantholytic dyskeratotic epidermal naevus.

A 43-year old male presented with unilateral warty papular eruptions of 20 years duration, involving the left side of trunk, left upper and lower limbs. There were also whitish macules intermingled with them. Histological features were compatible with Darier's disease. There was no evidence of any family history or palmar pits and nail changes typical of Darier's disease. We are reporting this case as acantholytic dyskeratotic epidermal naevus representing a mosaic form of Darier's disease.

Waardenburg's syndrome.

Three children in a family of five presented with heterochromia iridis, lateral displacement of inner canthi and varying degrees of sensorineural deafness. All the 3 showed iris atrophy. The father of the children had only heterochromia iridis. A diagnosis of Waardenburg's syndrome Type I was made in the children with the father probably representing a forme fruste of the condition.

Atypical dyskeratosis congenita.

Dyskeratosis congenita is a syndrome characterised mainly by pigmentation and atrophy of skin, nail dystrophy and oral leucoplakia. We report a patient who had features consistent with this syndrome including skin atrophy and pigmentation, oral leucoplakia, oesophageal stricture, but with normal finger and toe nails. Even though many variants have been described in the literature sparing of the nails as in our patient is extremely uncommon.

Malignant blue nevus.

Blue nevus represents an aberrant collection of functioning benign dermal melanocytes. Its malignant degeneration is rare and is regarded as a form of malignant melanoma. We report a case of 35-year old male with this rare condition whose primary lesion over left foot ulcerated and patient later succumbed to multiple metastases.

Darier's disease with warty dyskeratoma and basal cell epithelioma.

A 48-year old man with warty dirty papules over the seborrhoeic areas, also had a nodule with a central keratotic crater over the right cheek. Biopsy of this nodule revealed features of Darier's disease, warty dyskeratoma and basal cell epithelioma. Even though Darier's disease and warty dyskeratoma are considered as a distinct entities, the presence in the same lesion emphasizes the need for further studies on this association.

Mutilating acral keratoderma.

A 15-year-old male, born of non-consanguineous marriage started developing thickening of skin of sole of the both feet at the age of 7 which progressed to involve whole of both feet by 11th year. Patient later developed painful autoamputation of little toes of both feet due to pseudoainhum. Involvement of the palms was limited to a localised area over palmar aspect of right middle finger and was non-progressive. No other family member was affected. This may represent a variant of Vohwinkel's syndrome or the rarer form of acral keratoderma.

Tuberous sclerosis.

Although tuberous sclerosis has been described with a diagnostic triad, it is not present consistently in all cases. Variety of skin manifestations were reported in tuberous sclerosis. This studay was undertaken to assess the frequency of various skin changes in tuberous sclerosis. Ten consecutive cases of tuberous sclerosis were studied. Angiofibroma was the commonest cutaneous manifestation. Atypical fibroxanthoma, dermatofibroma and neurofibroma were also noticed as interesting associations.

Aggressive infantile fibromatosis.

An 8-month-old infant presented with 2 ulcerated indurated plaques in the right lower limb. The lesions grew rapidly initially but for the last 2 months, they have been stationary. Biopsy showed proliferation of fusiform fibroblasts some of which were arranged in whorls. The clinical picture and the histopathology suggested the diagnosis of an aggressive infantile fibromatosis. This is one of the types of juvenile fibromatoses, a group of tumours characterised by fibrous tissue proliferation present at birth or acquired early in childhood.

Monomorphic cutaneous metastases with different primaries.

Telangiectatic type of secondary cutaneous metastases is described with primary malignancies in different organs in a female and in a male. The clinical and histopathological features of the secondary metastases are described along with the features of the primaries manifesting as adenocarcinoma of breast in the former and squamous cell carcinoma in the larynx in the latter.

Atypical gorlin's syndrome.

A 21-year-old woman presented with complaints of skin lesions on her face, palms and soles. On examination, 8 to 10 well-defined, pigmented nodules with raised and pearly borders were seen on the face. Multiple pits were present on the palms and soles. Biopsy of both lesions revealed the presence of basal cell epitheliomas. The patient also gave history of removal of a keratocyst of mandible 10 years back. The case was diagnosed as Gorlin's syndrome. It is atypical due to the low number of basal cell epitheliomas, the occurrence of only a single odontogenic cyst and the absence of other features usually associated with this condition.

Epidermolysis bullosa pruriginosa.

Epidermolysis bullosa pruriginosa is a recently described variant of epidermolysis bullosa dystrophica. It is characterised by pruritic nodular prurigo like lesions, milia and with a histopathology of a subepidermal blister. We report 3 cases of this new variant.

Interface dermatitis in a patient with AIDS.

Interface dermatitis is a histological reaction pattern which is seen in a number of conditions. One of the recent associations of the histology is in Acquired Immune Deficiency Syndrome. There are differentiating factors between interface dermatitis occurring in AIDS and those occurring in other conditions. These are discussed in detail.