Partha Sardar

Surface tunability of nanoparticles in modulating platelet functions

Metallic nanoparticles are attractive candidates as MRI contrast agents and mediators for drug delivery, diagnostics, and therapy. Direct contact and exposure to blood circulation is common in many such applications. The consequent thrombotic response may therefore be important to study. The main objective of the present work was to study how platelet functions were changed in the presence of different nano-surface or surface capping, which may provide a measure for the safety of a nanoparticle, and also assess the use of such nanoparticles in platelet modulation. Aggregometry, ATP release reaction, flow cytometry and immune-blotting studies were performed to study platelet response to different nano-particles (iron oxide, gold and silver). For each nanoparticle surface conjugation (capping) was varied. It was found that citric acid functionalized iron oxide nanoparticles have anti-platelet activity, with a decrease in aggregation, tyrosine phosphorylation level, and granule release. On the other hand in other cases (e.g. gold nanoparticles) pro-aggregatory response was observed in the presence of nanoparticles and, in some cases, the nanoparticles behaved neutrally (e.g. for starch-coated iron oxide nanoparticles). Therefore, nanoparticles can induce antiplatelet or a pro-aggregatory response, or remain neutral depending on surface capping. A related observation is that antiplatelet drugs can be made more potent by nanoparticle conjugation.

Prevalence of Paediatric HIV Infection in Eastern India-First report

Prevalence of pediatric HIV has not been well characterized. We evaluate the prevalence, risks and contributing factors to the spread of HIV in India. This manuscript aims to describe prevalence of Pediatric HIV infection in Eastern India. We want to provide data on burden of HIV positive children visiting a tertiary care center located in the city of Kolkata, East India. Data is provided for routes of HIV exposure and occupational background and HIV status of the parents of infected children. Background: Various studies in India have documented high prevalence of HIV infection in children. Nearly 20 million babies are born each year and the number of infected babies could be >50,000 per year. According to Solomon S et al in India the prevalence of HIV among pregnant women varies widely from state to state and figures range from 0.5% to as high as 4.7% as in Namakkal, a small village in Tamilnadu. Objective: To determine and characterize the prevalence of pediatric HIV/AIDS in India Methods: This is a two year retrospective review of patients from the (with 100 beds) pediatric outpatient unit of the Medical college and Hospital, Kokata, was undertaken to determine the prevalence of pediatric HIV/AIDS in Kokata (or in North India). Results: 3,669 pediatric patients were admitted to the hospital, 437(11.9%) tested positive for HIV, 234 were males, while 203 were females (m:f=1.15:1). Children under the age of five years accounted for 81.7% of the HIV positive children. Mother-to-child transmission occurred in 73.7% of cases was the major route of transmission of HIV. Two other common routes included the use of blood/blood products (21 patients), hairdressing implements due to punctures in 4.8% each, while sexual abuse/sex activities were the probable route in 3.8% others. Most mothers of HIV children were either housewives (45.3%), or petty traders, trade that is conducted on a small scale (10.4%). Conclusion: The prevalence of pediatric HIV/AIDS was high in Eastern india. The most common mode of transmission was mother to child. Programs to work on education of prevention of this mode of transmission should be implemented by proper detection of disease in mothers,adequate counselling and administration of HAART to prevent mother to child transmission of AIDS.

Multiple Sclerosis like Demyelination in Early HIV Infection-A Rare Presentation: Case Report and Literature Review

A 35 year-old male presented with left sided weakness for past 3 months, along with progressive deterioration in higher mental faculties, vision and audition. Clinical and investigational information suggested the diagnosis of an acute demyelination involving various areas of the brain. He was seropisitive for HIV and had good cellular immunity at the time of our assessment. We present this case to highlight the association of Multiple Sclerosis (MS) with HIV, either during seroconversion or early during course of this infection.

Therapeutic effects of nandrolone and testosterone in adult male HIV patients with AIDS wasting syndrome (AWS): a randomized, double-blind, placebo-controlled trial.

Abstract Purpose: We aimed to compare therapeutic effects of intramuscular (IM) nandrolone decanoate and IM testosterone enanthate in male HIV patients with AIDS wasting syndrome (AWS) with placebo control. Methods: In this randomized, double-blind, placebo-controlled, 12-week trial, 104 patients with AWS who satisfied our inclusion criteria were randomly allotted in a 2:2:1 ratio to the 3 intervention groups: nandrolone, testosterone, and placebo. We administered 150 mg nandrolone and 250 mg testosterone (both IM, biweekly). The primary outcome measure was a comparison of absolute change in weight at 12 weeks between the nandrolone decanoate, testosterone, and placebo groups. Results: Intent-to-treat analysis was done. The nandrolone group recorded maximum mean increase in weight (3.20 kg; post hoc P < .01 compared to placebo). Body mass index (BMI) of subjects in the nandrolone group had a significantly greater increase (mean = 1.28) compared to both testosterone (post hoc P < .05) and placebo (post hoc P < .01). Waist circumference and triceps skinfold thickness of patients on nandrolone showed similar results. Nandrolone also ensured a better quality of life. Patients with low testosterone level (<3 ng/mL) benefited immensely from nandrolone therapy, which increased their weight and BMI significantly compared to placebo (P < .05). Conclusion: Our trial demonstrates the superior therapeutic effects of nandrolone in male AWS patients, including the androgen deficient.

Pancytopenia with hemophagocytic syndrome associated with histoplasmosis in acquired immunodeficiency syndrome: description of 2 case studies and literature review.

Two cases of haemophagocytic syndrome (HPS) due to histoplasmosis in patients with the acquired immunodeficiency syndrome (AIDS) are described in our case studies. Both the patients presented with pancytopenia and the bone marrow aspirate showed features suggestive of haemophagocytosis and the presence of intracellular inclusions were compatible with Histoplasma capsulatum. Haemophagocytic syndrome due to disseminated histoplasmosis should be included in the differential diagnosis of pancytopenia in patients with AIDS, though it is a rare clinical entity.

Platelet responsiveness to yohimbine hydrochloride and MRS2179 in the context of the interaction between collagen and epinephrine in acute coronary syndrome

Acute coronary syndrome (ACS) covers a spectrum of clinical conditions ranging from unstable angina, Non-ST segment elevation myocardial infarction (NSTEMI), or ST segment elevation myocardial infarction (STEMI). This study encompasses patients with acute coronary syndrome, who were receiving the dual antiplatelet therapy of aspirin and clopidogrel. The focus of the study was to gain insight into the role of selective P2Y1 antagonism using MRS2179 in such cases as well as its effects, if any, on collagen-epinephrine interaction. All the cases showed greater potency of inhibition of the interaction when yohimbine hydrochloride (YH), a blocker of alpha2A-adrenoreceptor, was used compared to MRS2179, a P2Y1 antagonist, although there was variability in responsiveness to the antiplatelet drugs. These findings indicate that alpha2A-adrenoreceptors of platelets in this group play a major role in precipitating the interactive effect of collagen and epinephrine. The dose-response effect as studied by platelet aggregometry showed that the required molar concentration to block the interactive effect in the case of YH was less than that of MRS2179. Hence, it is postulated that although there may be an impairment of collagen-induced aggregation by MRS2179, the interactive effect of collagen-epinephrine may not be impaired by MRS2179 as efficaciously as YH.

Non tuberculous mycobacteria and toxoplasma co-infection of the central nervous system in a patient with AIDS

New-onset seizures are frequent manifestations in patients infected with Human Immunodeficiency Virus (HIV). We describe the clinical and radiological findings in an 25yr old AIDS patient presenting with new onset seizures as the primary manifestation of cerebral toxoplasmosis and Non Tuberculous Mycobacterial [NTM] co-infection. Cranial computed tomography showed a subtle ventricular dilatation whereas magnetic resonance imaging disclosed prominent temporal horn. Toxoplasma tachyzoites and rapidly growing mycobacteria were recovered from CSF. Seizures were complex partial in nature and refractory to antiepileptic therapy.

Gastric adenocarcinoma associated with lymphangitis carcinomatosa, adrenal metastasis with ectopic ACTH syndrome and malignant common bile duct stricture.

Ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) commonly occurs secondary to neuroendocrine tumours and small cell carcinoma of lung. EAS has also been reported in association with gastric carcinoids. But, the occurrence of EAS secondary to gastric adenocarcinoma has rarely been reported. A 45-year-old male patient from Bangladesh presented with abdominal pain, jaundice and hyperpigmentation. Extensive work-up revealed poorly differentiating mucin-secreting adenocarcinoma of stomach with lymphangitis carcinomatosa of lung, bilateral adrenal metastasis and malignant common bile duct (CBD) stricture. Laboratory reports were suggestive for ectopic ACTH production. Most of these features are very rare in adenocarcinoma of stomach, and all these rare events occurring in a single patient is probably the rarest.