A Study of Management of Primary Chalazion in Adults by Intralesional Injection of Triamcinolone Acetonide

Introduction A chalazion is a common non-effective granuloma of the meibomian glands of eyelids. They are commonly found on the tarsal conjunctival surface and the eyelid margins. It may be ignored by the patients until it reaches a considerable size. Recently the use of intralesional corticosteroids has shown promising results. We in the present study tried to evaluate the outcomes of intralesional triamcinolone acetonide injection in the management of Chalazion. Methods The current study was carried on Patients with chalazion attending Ophthalmology OPD of Rajiv Gandhi Institute of Medical Sciences, [RIMS], Adilabad. Successive patients with small multiple marginal chalazia were included. Patients were selected based on the amenability of treatment with intralesional triamcinolone acetonide injections. A chalazion is a common non-infective granuloma of the meibomian glands of eyelids. They are commonly found on the tarsal conjunctival surface and the eyelid margins. It may be ignored by the patients until it reaches a considerable size. Recently the use of intralesional corticosteroids has shown promising results. We in the present study tried to evaluate the outcomes of intralesional triamcinolone acetonide injection in the management of Chalazion. Results Group I with very small-sized chalazia< 5 mm out of n=22 included in Group I resolution after one week following treatment was found in 72.72%. Resolution following repeated injection after one week was found in 18.18%. In group II (chalazia size 5-7 mm) out of n=28 cases, 46.24% resolved after first injection and 39.28% cases resolved after the second injection and no resolution was found in 14.28% cases after one month. Conclusion Patients with small chalazia who are not amenable to incision and curettage intralesional triamcinolone acetonide injection appear to be a better option. Intralesional triamcinolone acetonide injections were found to be effective in resolving acute and sub-acute chalazia of soft to firm consistency irrespective of their duration.

Dose selection of Incobotulinumtoxin A for the treatment of spasticity and sialorrhea in cerebral palsy: results of a retrospective multicenter study

Introduction. In patients with infantile cerebral palsy (CP), botulinum therapy is used to treat both muscle tone disorders and sialorrhea. Therefore, it is logical to use one preparation of botulinum toxin type A to treat spasticity and sialorrhea in one injection procedure. The aim of the work is to conduct a retrospective analysis of data from 15 centres that treat patients with cerebral palsy and use the botulinum therapy method to determine the optimal doses of IncobotulinumtoxinA (IBTA) for the treatment of spasticity and chronic sialorrhea in real clinical practice. Materials and methods. The treatment results of 389 children with cerebral palsy (including 211 (54.2%) boys) with IBTA were analyzed. The majority were children with bilateral forms of cerebral palsy - 312 (80.2%). The average age of the patients was 5.27 ± 3.71 years, the average weight of the patients was 18.8 ± 10.9 kg. Results. The total dose of IBTA in the group of 389 patients with cerebral palsy for the treatment of spasticity was 163.74 ± 80.65 U (25-550; 95% CI 155.7-171.7) and 10.4 ± 5.4 U/kg body weight (1,25-29.7; 95% CI 9.8-10.9). The total dose of IBTA in the group of patients with cerebral palsy with simultaneous treatment of spasticity and chronic sialorrhea (n = 16) was significantly higher: 267.18 ± 124.57 U (115-570; 95% CI 200.8-333.6) and 13, 0 ± 7.1 U/kg (5.8-24.6; 95% CI 9.2-16.8). In the lower extremities, the most frequent target muscles were the gastrocnemius (55.0% of cases; 95% CI 49.9-60.0) and semitendinosus / semimembranous muscle (46.3% of cases; 95% CI 41.2-51.4 ), and in the upper limbs - pronator teres (48.6% of cases; 95% CI 43.5-53.7) and biceps brachii (28.8% of cases; 95% CI 24.3-33.6). Limitations of the study. The limitations of our work are the use of an open retrospective study format, a relatively small sample of patients with chronic sialorrhea, the absence of long-term follow-up of patients and the results of repeated IBTA injections. Conclusion. If it is necessary to use botulinum therapy for the treatment of spasticity and sialorrhea in a child with CP, it is optimal to use the product IncobotulinumtoxinA, which will allow correction of two pathological manifestations in one procedure and can shorten the intervals between repeated injection cycles.

The Class I HDAC Inhibitor, MS-275, Prevents Oxaliplatin-Induced Chronic Neuropathy and Potentiates Its Antiproliferative Activity in Mice

Oxaliplatin, the first-line chemotherapeutic agent against colorectal cancer (CRC), induces peripheral neuropathies, which can lead to dose limitation and treatment discontinuation. Downregulation of potassium channels, which involves histone deacetylase (HDAC) activity, has been identified as an important tuner of acute oxaliplatin-induced hypersensitivity. MS-275, a class I histone deacetylase inhibitor (HDACi), prevents acute oxaliplatin-induced peripheral neuropathy (OIPN). Moreover, MS-275 exerts anti-tumor activity in several types of cancers, including CRC. We thus hypothesized that MS-275 could exert both a preventive effect against OIPN and potentially a synergistic effect combined with oxaliplatin against CRC development. We first used RNAseq to assess transcriptional changes occurring in DRG neurons from mice treated by repeated injection of oxaliplatin. Moreover, we assessed the effects of MS-275 on chronic oxaliplatin-induced peripheral neuropathy development in vivo on APCMin/+ mice and on cancer progression when combined with oxaliplatin, both in vivo on APCMin/+ mice and in a mouse model of an orthotopic allograft of the CT26 cell line as well as in vitro in T84 and HT29 human CRC cell lines. We found 741 differentially expressed genes (DEGs) between oxaliplatin- and vehicle-treated animals. While acute OIPN is known as a channelopathy involving HDAC activity, chronic OIPN exerts weak ion channel transcriptional changes and no HDAC expression changes in peripheral neurons from OIPN mice. However, MS-275 prevents the development of sensory neuropathic symptoms induced by repeated oxaliplatin administration in APCMin/+ mice. Moreover, combined with oxaliplatin, MS-275 also exerts synergistic antiproliferative and increased survival effects in CT26-bearing mice. Consistently, combined drug associations exert synergic apoptotic and cell death effects in both T84 and HT29 human CRC cell lines. Our results strongly suggest combining oxaliplatin and MS-275 administration in CRC patients in order to potentiate the antiproliferative action of chemotherapy, while preventing its neurotoxic effect.

Repeated exposure with short-term behavioral stress resolves pre-existing stress-induced depressive-like behavior in mice

Chronic stress induces adaptive changes in the brain via the cumulative action of glucocorticoids, which is associated with mood disorders. Here we show that repeated daily five-minute restraint resolves pre-existing stress-induced depressive-like behavior in mice. Repeated injection of glucocorticoids in low doses mimics the anti-depressive effects of short-term stress. Repeated exposure to short-term stress and injection of glucocorticoids activate neurons in largely overlapping regions of the brain, as shown by c-Fos staining, and reverse distinct stress-induced gene expression profiles. Chemogenetic inhibition of neurons in the prelimbic cortex projecting to the nucleus accumbens, basolateral amygdala, or bed nucleus of the stria terminalis results in anti-depressive effects similarly to short-term stress exposure, while only inhibition of neurons in the prelimbic cortex projecting to the bed nucleus of the stria terminalis rescues defective glucocorticoid release. In summary, we show that short-term stress can reverse adaptively altered stress gains and resolve stress-induced depressive-like behavior.

Risk Factors and Treatment of Postpartum Anestrus in Cattle: The Case of Zebu

This literature review reports on risk factors for postpartum anoestrus in zebus and their potential treatments. Prolonged postpartum anestrus is one of the major factors limiting reproductive efficiency in cattle, particularly in Bos indicus cows in tropical regions, as it prevents a calving interval of 365 days from being achieved. During anestrus, ovulation does not occur despite ovarian follicular development, as the growing follicles do not reach maturity. This period is very variable and depends on various factors whose importance is relative or, on the contrary, essential. Some are specific to the animal (breastfeeding or food); others relate more to its social environment, season sanitary conditions. Several hormonal treatments have been used to induce ovulation and cyclicity in postpartum cows. Generally speaking, given the inconsistency of the effects or even their lack of practicability, treatments using a single or repeated injection of a gonadotropin-releasing hormone (GnRH) have been gradually abandoned in favour of progestagens. These are administered for 8 to 12 days on a continuous basis in the form of a subcutaneous implant (Crestar®), a vaginal coil (PRID®) or a CIDR. A prostaglandin injection is given two days before the implant is removed. The addition of an ECG treatment at the time of device removal, which increased plasma progesterone concentrations and pregnancy rates in anestrous postpartum suckled Bos indicus cows, may be useful to improve reproductive performance. This improvement requires a better understanding of the effect of different risk factors on the recovery of postpartum cyclicity.

Endoscopic submucosal dissection: How to be more efficient?

Endoscopic submucosal dissection (ESD) allows an “en bloc” resection with safety margins (R0 resection) regardless of the size of the lesion. However, while R0 brings a real benefit for the patient, it is not considered sufficient by many experts to justify the technical difficulties and the longer procedure time compared to piecemeal mucosectomy. The aims of this review are to provide several technical and strategical tips to help you save time and become comfortable during ESD procedures. ESD is divided into several intertwined phases: injection, incision, access to the submucosae, and submucosal dissection itself. During injection there are some mistakes that should not be made: a superficial injection, or on the contrary, a too deep injection. A good needle and good injection technique are mandatory. Some techniques, such as repeated injection or prolonged lifting solution, can help maintain the lift. After this step, mucosal incision can be made, taking care to have a good margin to allow an R0 resection. Starting the mucosal incision from a small point allows calibration of the depth of the incision and then obtaining a nice incision. Trimming is also very important to widen submucosal access. Then comes the submucosal dissection itself. Strategies such as the tunnel strategy or the pocket creation method can help to facilitate dissection, but more importantly, traction systems have become unavoidable, especially in the stomach and colon. Most common complications are bleeding and perforation, and they usually can be managed endoscopically.

Number of Times Recycled and Its Effect on the Recyclability, Fluidity and Tensile Properties of Polypropylene Injection Molded Parts

The ease with which modern plastics can be injection molded makes them very suitable for the production of many different products and, today, plastics are often used as substitutes for metal. Polypropylene (PP) is one of the most widely used thermoplastics globally since it is very useful, cost-effective and flexible for molding. However, the amount of harm to the environment caused by plastic waste has become phenomenal and the recycling of plastics has become a serious aspect of environmental protection. PP, as the most commonly used plastic material, was selected for use in this study. It has a melt flow index of 15 g/min and its recyclability, fluidity, and physical properties, as well as manufacturing conditions, were explored in relation to the number of times the material could be recycled (TR). A cavity pressure sensor was used to measure the viscosity index of the recycled plastic after multiple cycles of plasticizing and injection, part molding, scrap-recycling, and crushing. A paperclip-shaped test specimen was used to determine PP fluidity and crystallinity of specimens with different TRs. Tensile tests were used to detect differences in the tensile strength between specimens made from Raw-PP and recycled PP. The results showed that PP that had been recycled several times had a higher melt flow index, material fluidity, melting peak area, crystallinity, crystallization rate, and crystallization temperature. Repeated injection and recycling of the material had reduced the length of the molecular chains and broadened the molecular weight distribution. This improved the fluidity and increased crystallinity. The increase in fluidity made cavity filling easier, reducing the cavity pressure as well as the viscosity index. The results of this study showed that the recycling of the PP could improve the physical properties of the products to a degree and also went some way to further the benefits of a circular economy. The recycling of injection-molded PP material can be added to renewable energy technologies and used in environmental impact assessment.

THE INFLUENCE OF MEHCANICAL RECYCLING ON THE MECHANICAL AND THERMAL PROPERTIES OF THERMOTROPIC LIQUID CRYSTALLINE POLYMER AND GLASS FIBER REINFORCED POLYPROPLYENE

In this work, TLCP and GF reinforced PP have been recycled and TLCP/PP demonstrates superior recyclability over GF/PP due to the generation of fibrils during mold filling steps. The fiber shortening has a major impact on mechanical properties of GF/PP, which is induced by repeated injection molding and grinding. The thermal properties of TLCP/PP and GF/PP have been analyzed by DSC. The results show that injection molding and grinding does not impact the glass transition temperature, melting temperature and crystallinity of recycled composites.In continuation of this work, the influence of mechanical recycling on rheological, thermal stability and thermo-mechanical properties will be analyzed in order to gain full understanding about the impact of recycling on the various properties of TLCP and GF composites.

The Decrease In The Anxiolytic Effect of Morphine After Repeated Use of The Drug In Rats is Associated With Inflammatory Cytokine Signaling Pathways In The Prefrontal Cortex

We aim to examine anxiety-like behaviors and expression of specific genes complicated in neuroinflammation in the prefrontal cortex (PFC) after repeated use of morphine. A group of male Wistar rats received injections of morphine (10 mg/kg) twice a day for eight days while a control group received saline (1 ml/kg) instead of morphine. On days 1 and 8, anxiety-like behaviors were evaluated using a light/dark box test. On day 8, opioid dependence was confirmed by measuring the behavioral expression of morphine withdrawal precipitated with naloxone. Expression of neuroinflammation genes were also evaluated at mRNA levels in the PFC on day 8. The results revealed that morphine induced anxiolytic-like effects on day 1, which significantly decreased after the repeated injection of the drug on day 8. The results also revealed that repeated morphine injection significantly increased the mRNA level of Il1, Tnfα, and Il6 but decreased Il1r and Tnfr while increased Il6r in the PFC. The gene expression results also revealed a significant decrease in Tlr1 but not in Tlr4 in the PFC of morphine-dependent rats. Although Erk1 expression had no significant alteration but p38 increased and Jnk3 decreased significantly in the PFC in morphine-dependent rats. Creb and Nfkb significantly increased but Fos expression decreased. Let-7c, mir-133b, and mir-365 also significantly increased in the PFC in morphine-dependent rats. We conclude that the alteration in neuroinflammatory pathways at gene expression level in the PFC may party underlie neuroadaptive changes leading to the decrease in anxiolytic effect of morphine in dependent rats.