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Little is known about the post heart transplantation management of extra cardiac manifestations in patients with hereditary transthyretin amyloid cardiomyopathy (hATTR‐CM) in the new era of disease modifying treatment for ATTR amyloidosis. This is a retrospective study of all patients with hATTR‐CM associated with the Val142Ile variant who underwent heart transplantation (HT) from January 2014 to February 2022. All 10 patients with the Val142Ile mutation were successfully transplanted, with a 1 year survival post heart transplantation (HT) of 90%, comparable to an age, sex, and race matched cohort of patients transplanted for non‐amyloid indications. However, 4 (40%) of these patients developed progressive extracardiac manifestations requiring initiation of TTR silencer therapy with the small interfering RNA (siRNA) drug patisiran, which was well tolerated with no significant side effects in this population. We recommend formal neurologic evaluation and assessment of extracardiac manifestations annually as part of routine post‐transplant care, and disease modifying therapy, aimed at TTR stabilization or silencing, should be initiated in the context of previously untreated extracardiac manifestations or evidence of subclinical neuropathy to prevent progression. [ABSTRACT FROM AUTHOR]

Background: Tephrosia purpurea (TP), commonly known as wild indigo, is traditionally used in treatment of splenomegaly. It is an important ingredient of various Ayurvedic medicines used in treatment of liver diseases. Objectives: Thus, the study was undertaken to investigate the hepatoprotective efficacy of ethanolic extract of TP against Aflatoxin B1 (AFB1) induced liver injury. Materials and Methods: The ethanolic extract of TP was prepared by Soxhlet extraction method. Presence of polyphenols and antioxidant potential were assessed. The antiproliferative activity of extract was tested on HepG2 cells using MTT assay. For in vivo studies female Wistar rats were randomly divided into 6 groups with 6 animals in each. The entire regime was of 33 days. AFB1 was administered at 200 µg/kg dose and TP was administered at three different doses (100, 200 and 300 mg/kg). 24 hr after last treatment the animals were euthanised and liver and blood samples were collected. Results: 45.77± 2.53 µg/ml IC50 of extract was seen on HepG2 cells. A significant elevation in serum transaminases, triglycerides (TG) and LPO was seen after AFB1 intoxication. Whereas decline in activities of GSH, SOD, CAT, G6Pase and ATPase were observed. Treatment with different doses of TP restored its activities towards normal indices. Maximum recovery was seen with 300 mg/kg dose of TP. Conclusion: It may be concluded that TP possess hepatoprotective efficacy against AFB1 induced oxidative injury and it may prove to be of clinical use after further studies. [ABSTRACT FROM AUTHOR]

Background Pyogenic granuloma ( PG) is a benign vascular tumor that can be treated by cautery (chemical or thermal), laser, excision, curettage, sclerotherapy, and cryotherapy. Topical timolol is emerging as a non-invasive modality for the treatment of PGs. Methods We recruited a series of 10 patients with PG, who received treatment with 0.5% timolol maleate ophthalmic solution applied 4 times a day, 2 drops per dose. No other medication, topical or systemic, was given. Pulse rate, blood pressure, and blood glucose were monitored at baseline and weekly thereafter for the duration of treatment. ECG was done at baseline. The efficacy of the treatment was evaluated by considering a complete response, a partial response, and no response. Results Of 10 patients, four showed complete response within 3-24 days, with no recurrence at 3-month follow-up. Three patients each showed partial or no response. No local or systemic side effects were reported in any of the patients. Conclusions The response of PGs to β blockers seems to be variable. Although topical timolol has the advantage of minimal adverse events, ease of administration, and better cosmetic outcomes, it's efficacy in PG may not be universal unlike in infantile hemangiomas. Topical timolol may be a treatment option in young children, incapacitated elderly, and over delicate areas like face, nails, and gums where invasive modalities are not desirable. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 28-year-old man who was presented to a hospital for slow-growing nodules on his abdomen which revealed to be a cutaneous epithelioid angiomatous nodule. The patient then underwent histopathology which shows hyperkeratotic and acanthotic epidermis. The article also discusses the risk factors of developing cutaneous epithelioid angiomatous nodule and hemangioma and its treatment.

Leukoplakia of larynx has remained a debatable topic in laryngeal pathology for decades as per classification, histology and treatment is concerned. Smoking and alcohol are the major causes and there is sufficient evidence implicating gastroesophageal reflux and human papilloma virus in its pathogenesis. A wide range of therapeutic strategies are available for different grades of dysplasia. Despite this, a significant proportion of patients progress to carcinoma for which the patients with dysplasia need to be kept in regular follow-up. [ABSTRACT FROM AUTHOR]

Depigmentation therapy in vitiligo is an option in those with extensive vitiligo who have failed to respond to medical therapy and have obvious cosmetic disfigurement due to intervening patchy pigmented areas. Various aspects of this therapy such as the cost, treatment time, course, permanency of depigmentation, side effects, and the possibility of repigmentation should first be discussed with the patient. At present, there is no ideal depigmenting therapy available, but many agents in the market have been in use for many years. Monobenzyl ether of hydroquinone (MBEH) is the mainstay and Food and Drug Administration (FDA) approved in USA but takes many months to depigment and is associated with local side effects and risk of repigmentation. Other agents which are also used are 4-methoxy phenol and 88% phenol. Physical therapies for depigmentation include Q-switched ruby and alexandrite lasers and cryotherapy. Second-line agents which can be explored for depigmentation include imatinib mesylate, imiquimod, and diphencyprone. Many possible experimental agents are being explored like various phenol derivatives, melanoma vaccines, interferon gamma, busulfan, etc. A major lacuna still exists in this area and a lot more research is desirable to give satisfactory cosmesis to these patients with extensive vitiligo. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on the effectiveness of isotretinoin drug for treatment of keratosis follicularis spinulosa decalvans skin disease. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding a 65-year-old male patient with Muir-Torre syndrome (MTS) and was treated with the combination of interferon (IFN-alpha2a) with retinoids (isotretinoin).

Background: Primary osseous hemangiomas of the facial skeleton mimic malignancy. Their location in maxillary sinus, especially in infants is extremely rare. Case characteristics: 1- month-old full term boy with maxillary swelling. Observations: Biopsy from oral route revealed hemangioma showing vascular channels lined by endothelial cells. Patient improved on oral steroids. Message: Hemangiomas should be considered as one of the differential diagnosis of unilateral maxillary swelling in infants. Steroids may serve as the primary mode of treatment as opposed to tumor excision. [ABSTRACT FROM AUTHOR]

The article describes the case of a 50-year-old lady diagnosed with contact dermatitis who presented with a large, well-defined patch of non-scarring alopecia, with normal biopsy and no underlying psychiatric illness. She was diagnosed with trichotillomania based on her report of irresistible urge to pull her hair and an intense but short-lasting relief after doing so. The article discusses trichotillomania and the possible association with stress in unusual presentation, like in older persons.

Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated with VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen. [Copyright &y& Elsevier]

Glibenclamide is an anti-diabetic drug with water insolubility and compressibility. The pure drug (Glibenclamide) was converted into spherical crystal agglomerates via the spherical crystallization technique using dichloromethane-water-chloroform solvent system. The various parameters optimized were type, amount and mode of addition of bridging liquid, temperature and agitation speed to get maximum amount of spherical crystals. These were characterized for micromeritic properties (particle size and shape, flow ability), pack ability (bulk density), wet ability (contact angle) and compressibility. It was revealed from the study that spherical agglomerates exhibited improved flow ability, wet ability and compaction behavior. [ABSTRACT FROM AUTHOR]