Gatha S. Rao

Is Kikuchi–Fujimoto disease a manifestation of systemic lupus erythematosus?

A 32‐year‐old woman presented with fever and swelling in the axillae of 2 months’ duration, and erythema of the face, fluid‐filled lesions on the trunk, oral ulcers, crusting of the lips, and redness and watering of the eyes for 3 days. The patient was initially diagnosed with tuberculous lymphadenitis and was given antituberculous treatment. One month later, she developed the present complaints (see below). The patient was photosensitive. There was no joint pain or Raynaud’s phenomenon. She had experienced three intrauterine deaths in the past with no live births.

Protective effect of an aphrodisiac herb Tribulus terrestris Linn on cadmium-induced testicular damage

Aim: The aim of the present study was to investigate whether Tribulus terrestris Linn (TT) could protect the cadmium (Cd)-induced testicular tissue peroxidation in rats and to explore the underlying mechanism of the same. Materials and Methods: In vitro and in vivo studies were conducted to know the protective effect of ethanolic extract of TT (eTT) in Cd toxicity. In in vitro studies, total antioxidant and ferrous metal ion chelating activity of TT was studied. In vivo studies were conducted in rats. A total of 40 Wistar strain adult male rats were divided into four groups. Group 1 served as control, while group 2 to 4 received CdCl2 (3 mg/kg b. wt. s/c once a week). In addition to Cd, group 3 and 4 rats also received eTT (5 mg/kg b.wt. daily as oral gavage) and α-tocopherol (75 mg/kg daily by oral gavage), respectively. At the end of 6th week, all the rats were sacrificed and the separated testes were weighted and processed for estimation of tissue peroxidation markers, antioxidant markers, functional markers, and Cd concentration. The testes were also subjected to histopathological screening. Results: In in vitro studies, the percentage of metal ion chelating activity of 50 μg/ml of eTT and α-tocopherol were 2.76 and 9.39, respectively, and the antioxidant capacity of eTT was equivalent to 0.063 μg of α-tocopherol/μg of eTT. In in vivo studies, administration of Cd significantly reduced the absolute and relative testicular weight, antioxidant markers such as superoxide dismutase and glutathione, and functional markers such as LDH and ALP, along with significant increase in peroxidation markers such as malondialdehyde and protein carbonyls in testicular tissue. Testes of Cd only-treated group showed histological insults like necrotic changes in seminiferous tubules and interstitium, shrunken tubules with desquamated basal lamina, vacuolization and destruction of sertoli cells, and degenerating Leydig cells. This group also had higher Cd levels in testicular tissue. Co-treatment with eTT and α-tocopherol significantly reduced the Cd burden in the testes along with reversal of the Cd-induced changes. Conclusions: eTT exhibited protective effect against Cd-induced testicular damage. The protective effect appears to be mediated through inhibition of testicular tissue peroxidation by antioxidant and metal chelator activity and also, may be indirectly by stimulating the testosterone production from Leydig cells.

Prevention of cadmium bioaccumulation by herbal adaptogens.

Objectives: To evaluate the effect of various herbal adaptogens such as shade-dried powders of Withania somnifera, Ocimum sanctum, Asperagus recemosus, Andrographis paniculata, Asphaltum panjabinum (Shilajith), Gymnema sylvestre, Spirulina platensis, and Panex ginseng on cadmium (Cd)-induced oxidative stress and its accumulation in broiler chicken. Materials and Methods: A total of 80 male broiler chicks of day old age were randomly assigned to 10 equal groups. Group 1 birds were fed with basal diet throughout the experiment (1–42 days). Group 2–10 chicks were fed with basal diet containing cadmium at 100 ppm from day 1 to day 28 (4 weeks). From 29th to 42nd day (2 weeks), basal diet alone was fed to group 2 chicks which acted as toxic control and group 3–10 birds were fed with feed containing 0.1% powder of W. somnifera, O. sanctum, Aspe. recemosus, An. paniculata, Asph. panjabinum (Shilajith), G. sylvestre, S. platensis, and P. ginseng, respectively. Body weight gain, levels of non-enzymatic antioxidants such as reduced glutathione (GSH), lipid peroxidation markers such as thiobarbituric acid reacting substances (TBARS), liver functional markers such as serum alanine transaminase (ALT), kidney functional markers such as blood urea nitrogen (BUN) and serum creatinine and concentration of cadmium in liver and kidney were investigated. Results: Body weight gains were significantly decreased in birds of groups 2–10 compared to group 1 at the end of 4th week. Supplementation of various medicinal herbs in feed after 4th week significantly improved the body weight gain compared to that in group 2 chicks. The increase in TBARS and decrease in GSH concentrations of liver and kidney tissues in cadmium intoxicated birds were significantly reversed by the above-said herbs. The liver and kidney functional markers were also restored to normal levels. Highest concentration of cadmium was found accumulated in kidney, followed by liver in birds of group 2. Herbal supplementation in groups 3–10 prevented Cd bioaccumulation which was most evident in liver, followed by kidney. Conclusions: Administration of herbal adaptogens at the rate of 0.1% in feed significantly prevented the bioaccumulation of Cd and reversed the Cd-induced oxidative tissue damage.

Proteus syndrome with gingival hyperplasia

A 12-year-old female presented with enlargement of the right side of the lower lip, cheek and lower gum since the age of 3 years and asymptomatic skin lesions on the back, swellings on the left side of the scalp and enlargement of the left lower limb since the age of 6 months. There was no family history of similar disorder. The patient is of Indian origin. There was no history of epilepsy, mental retardation or consanguinity. The patient had not taken any drug before the onset of the complaints. There was no pain or bleeding from the gums. On clinical examination, she had hyperplasia of the right side of the lower gum (Fig. 1), right lower lip and cheek. There was no macroglossia. Non-tender, freely movable subcutaneous masses and bony swellings were present on the left parieto-occipital region. Hyperpigmented plaques with a rough surface were seen on the back (Fig. 2). The left shoulder was at a higher level than the right. Hemi-hypertrophy of the left lower limb was present. Hands and feet were normal. Radiological examination of the left parieto-occipital region revealed exostosis (Fig. 3), whereas that of the cervicodorsal spine showed scoliosis (Fig. 4). Orthopantomography revealed malocclusion and enlargement of the alveolus. Histopathologic examination of the skin biopsy specimen showed mild hyperkeratosis, papillomatosis of the flat and broad type with acanthosis (epidermal nevi) (Fig. 5). Gingival biopsy revealed fibromatosis gingivae. Ultrasonography of the pelvis and abdomen was normal. Discussion