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Renal Adverse Reaction Secondary to Check-point Inhibitors in Metastatic Renal Cancer

Published on: 17th May, 2024

Immune Checkpoint Inhibitors (PCIs,) are monoclonal antibodies directed against immune checkpoint regulatory molecules. These antibodies inhibit T-cell activation and prolong survival in patients with different types of cancer. However, they can produce adverse effects related to the immune response such as renal damage.We present the clinical case of a 75-year-old man with a personal history of Chronic Kidney Disease (CKD) and metastatic renal cancer with lung, bone, and mediastinal involvement. He started treatment with immunotherapy with Nivolumab-Ipilimumab. Then, after 4 cycles of immunotherapy, the patient was admitted to the Urology Department for an adverse reaction to immunotherapy with the development of nephritis and toxic hepatitis. Despite treatment with methylprednisolone, he evolved poorly, and a palliative approach was finally decided.The incidence of acute renal failure attributed to PCIs is estimated at 2% - 3%, being grade I-II in most cases. Among the renal complications associated with PCIs, acute interstitial nephritis is the most predominant with an incidence of 80% - 90% of cases. In addition, an increased risk is observed in patients with intermediate or poor risk metastatic renal cancer.Despite their fundamental role in metastatic renal cancer, we must take into account the potential for renal failure as an adverse effect of PCIs, especially in patients with previous CKD.
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Radiological evaluation of a Chondromyxoid Fibroma

Published on: 27th July, 2017

OCLC Number/Unique Identifier: 7286423061

Chondromyxoid fibroma (CMF) is a very rare benign cartilaginous tumor representing less than 0.5% of all bone tumors while also being the rarest cartilaginous bone tumor. Common locations of occurrence include the metaphysial region of the proximal tibia and distal femur. We report a case of a 10-year-old female affected by a CMF of the left lower tibia. The radiological features demonstrated by X-ray and magnetic resonance imaging (MRI) are discussed.
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Navigation in the land of Scarcity

Published on: 28th December, 2018

OCLC Number/Unique Identifier: 7964862527

Delivering health care is a complex task that marginalized a portion of the population intentionally or unintentionally. Discrepancy in health care providing to the intended patients is sometimes accompanied by unintended collateral damage to the bystanders who desperately needing our help and assistance.
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Recurrent Mucoepidermoid Carcinoma of Parotid with Facial Tics - Report of an unusual case

Published on: 16th June, 2017

OCLC Number/Unique Identifier: 7317651487

We report an interesting case of a 21 year old male who presented with recurrent mucoepidermoid carcinoma of parotid with facial nerve involvement as facial tics. Intraoperatively, the tumour was noted to be firm, irregular and adherent to the underlying structures. The patient underwent extended total parotidectomy, division of buccal branch of facial nerve, selective neck dissection with cervical local rotational flap repair and post-operative radiotherapy. This presentation of Mucoepidermoid carcinoma with involvement of facial nerve as facial tics is one of the rare unique reported cases.
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Potter Syndrome: A case study

Published on: 31st August, 2017

OCLC Number/Unique Identifier: 7286353788

Potter syndrome (PS) is a term used to describe a typical physical appearance, which is the result of dramatically decreased amniotic fluid volume secondary to renal diseases such as bilateral renal agenesis (BRA). Other causes are abstraction of the urinary tract, autosomal recessive polycystic kidney disease (ARPKD), autosomal dominant polycystic kidney disease (ADPKD) and renal hypoplasia. In 1946, Dr Edith Potter characterized this prenatal renal failure/renal agenesis and the resulting physical characteristics of the fetus/infant that result from oligohydramnios as well as the complete absence of amniotic fluid (anhydramnios). Oligohydramnios and anhydramnios can also be due to the result of leakage of amniotic fluid from rupturing of the amniotic membranes. The case reported below, concerns of stillborn boy with potter syndrome.
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Near Complete Response to 177Lu-PSMA-DKFZ-617 Therapy in a Patient with Metastatic Castration Resistant Prostate Cancer

Published on: 5th November, 2017

OCLC Number/Unique Identifier: 7286424598

Prostate specific membrane antigen, a type II transmembrane protein is an excellent target for the radionuclide therapy in advanced prostate cancer patients due to its high expression in the prostate cancer cells. We present the case of a 69-year old man with advanced metastatic castration resistant prostate cancer. In view of rising serum PSA levels despite hormonal and chemotherapy, we decided to perform a 68Ga-PSMA-HBED-CC PET/CT scan (prostate specific membrane antigen). It revealed intense radiotracer uptake in the prostate, lymph nodes and multiple skeletal sites. Five cycles of 177Lu-PSMA-DKFZ-617 radioligand therapy were administered in the patient followed by an intrim 68Ga-PSMA-HBED-CC PET/CT. Intrim 68Ga-PSMA-HBED-CC PET/CT scan demonstrated a near complete remission of disease with a corresponding decrease in the sPSA levels. During the follow-up duration of 12 months, the patient did not develop haematological, kidney and liver toxicity during the course of treatment and follow-up. 177Lu-PSMA-DKFZ-617 is a promising therapeutic option in metastatic castration resistant prostate cancer (mCRPC) patients.
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Investigate the Effect of Coating Concentration and Coating Thickness on the Anti-microbial Properties of Polycarbonate Sheet

Published on: 29th May, 2024

This paper investigates the effect of coating concentration (ppm), and coating thickness (µm) on the anti-microbial properties of polycarbonate sheets using a variety of anti-microbial agents (Cu-infused Mg(OH)2, Mg(OH)2, Cu(OH)2, MgO, CuCl2.2H2O, and ZnO). In addition, a complete analysis was performed for all agents to rank the best agent in terms of the highest anti-microbial performance against E. coli K-12 MG1655 in two time intervals (4 and 24 hours). The coating concentration (ppm) was found to be a significant factor in the anti-microbial characteristics for Cu-infused Mg(OH)2, Mg(OH)2, Cu(OH)2, MgO, CuCl2.2H2O, and ZnO (p = 0.004, p < 0.0001, p < 0.0001, p = 0.0297, p = 0.0011, and p = 0.0130 respectively). The coating thickness (µm), on the other hand, was found to be a major contributor to the anti-microbial properties of Cu-infused Mg(OH)2, Mg(OH)2, Cu(OH)2, MgO, and CuCl2.2H2O (p < 0.0001, p = 0.0004, p = 0.0011, p = 0.0310, and p < 0.0001 respectively). The analysis determined that the coating did not influence the anti-microbial properties of ZnO. The interaction between the coating concentration (ppm), and the coating thickness (µm) was found to be a significant factor for Cu-infused Mg(OH)2, Cu(OH)2, MgO, CuCl2.2H2O, and ZnO (p < 0.0001, p = 0.0001, p = 0.0004, p < 0.0001, and p < 0.0001 respectively), however, this was not a significant factor for Mg(OH)2.Highlights•    The anti-microbial activity of the inorganic material is dependent on the particle shape and size.•    Particles with sharp edges will provide additional physical injuries to the microorganisms.•    Smaller particle size will provide higher surface area therefore better interaction with microorganisms.•    The coating concentration and coating thickness will be crucial to the anti-microbial activity.•    The thermal embossing techniques demonstrate good adhesion to the surface.
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The management of Irvine-Gass Syndrome in a patient using Inhaler Steroid

Published on: 7th February, 2018

OCLC Number/Unique Identifier: 7355942124

Irvine-Gass syndrome, is one of the most common causes of painless decrease in vision following even uneventful cataract surgery. It usually responds well to medical therapy, but, there are no widely acceptedconsensus on the efficacy of various therapeutic options for the treatment of Irvine-Gass syndrome. The patient presenting in this case report, has systemic hypertension and chronic obstructive pulmonary disease and he use oral anti-hypertension medication and inhaler steroid. He diagnosed as Irvine-Gass syndrome due to presence of decrease in visual acuity and macular edema with hyporeflective cystic intraretinal spaces in optical coherence tomography (OCT) since4th weekcontrol visitfollowing uneventful cataract surgery. After the responsiveness of several medications including topical steroid and non-steroidal anti-inflammatory drugs and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), intravitreal sustained-release dexamethasone implant was applied. The visual acuity improved to 0.00 logMAR at 1st month after intravitreal dexamethasone therapy and consecutive OCT images showed complete resolution of macular edema with a normalization of the foveal profile.The visual acuity and foveal architecture remained stable in 2-year follow-up period and additional treatment was not needed. To the best of our knowledge, this is the first reportthatmentions the increment of visual acuity after a single dexamethasone implant, even though it did not response anti-VEGF combined with topical steroid and non-steroidal anti-inflammatory drugs. 
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Update on the Use of Mesenchymal Stem Cells and their Products in Hematopoietic Stem Cell Transplantation

Published on: 29th November, 2023

Graft Versus Host Disease (GVHD) is a major limitation to the success of allogeneic Hematopoietic Stem Cell Transplantation (HSCT) as Steroid-Refractory (SR) acute GVHD carries poor prognosis due to the absence of an efficacious second-line therapy. Mesenchymal Stem Cells (MSCs) which have immunosuppressive, immunomodulatory, and regenerative properties may become a highly effective therapeutic modality for SR-GVHD in the near future. MSCs have already been approved to treat childhood SR-GVHD in Japan, and they have been conditionally licensed in New Zealand and Canada. It is expected that MSCs will be approved for the treatment of SR-GVHD in adults in Europe, North America, and other parts of the world within a few years. Utilization of the recently introduced techniques including the use of MSC products such as exosomes and Extracellular Vesicles (ECVs) instead of the parent MSCs, robotic manufacturing technology, and genetic engineering of MSCs will ultimately overcome the remaining obstacles facing the widespread utilization of MSCs and their products as therapeutics not only in HSCT but also in other medical fields. The aim of this review is to provide an update on the remarkable progress achieved in the use of MSCs and their products in the field of HSCT.
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Agro-morphological Growth Response of Acha (FONIO) (Digitaria exilis and Digitaria iburua [Kippist] Stapf.) Exposed to Colchicine: Germination, Plant Height and Leaf Number

Published on: 30th May, 2024

Acha (Fonio) Digitaria sp. is a valuable cereal crop widely cultivated in several African countries. The genetic improvement of Acha through induced mutagenesis has gained attention for enhancing desirable traits. Colchicine, a mitotic inhibitor, is commonly used to induce polyploidy, which can lead to alterations in plant characteristics. This study aimed to investigate the effects of colchicine treatment on germination, plant height, and leaf count of two Acha species. Seeds from two Digitaria species, Digitaria exilis, and Digitaria iburua, were subjected to colchicine treatment using different concentrations (0.05, 0.10, 0.15, and 0.20g/dL). The control group was treated with distilled water. Germination rates were assessed by measuring the percentage of seeds that successfully sprouted. Plant height and leaf number were measured at maturity and analyzed using ANOVA on SPSS Version 26. The results indicated that colchicine treatment significantly affected germination, plant height, and leaf number in both Digitaria species. Germination rates varied depending on the concentration, with lower germination observed at higher concentrations (70.70% and 74.3% for 0.20g/dL treatment in both species). In terms of plant height, colchicine-treated Acha plants exhibited significant differences compared to the control group. The majority of treated plants showed increased growth (57.00 cm to 60.70 cm in D. exilis and 114.10 to 122.40 cm in D. iburua) compared to the control. Variability in plant height was observed among the treated plants, suggesting that colchicine-induced polyploidy had varying effects on height across different genotypes. Similarly, the number of leaves was affected by colchicine treatment. Treated plants exhibited an increase in leaf number (56.70 to 60.7 for D exilis and 32.60 to 36.30 for D. iburua), compared to the control group (49.7 and 29.7 respectively). This variability suggests that colchicine-induced polyploidy may have influenced leaf development and growth patterns in Acha. Colchicine treatment had significant effects on germination, plant height, and leaf count in both varieties of Acha. The results suggest that colchicine-induced polyploidy can alter these plant characteristics. These findings provide insights into the potential use of colchicine treatment for inducing desirable traits in Acha through polyploidization, which may have implications for crop improvement and breeding programs. Further research is warranted to explore the underlying mechanisms and assess the impact of these alterations on overall agronomic performance and yield potential.
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