A comparative in vitro study on the cerumenolytic effect of docusate sodium versus 2.5%sodium bicarbonate using UVevisible absorption spectroscopy

Objective:To compare cerumenolytic effects of docusate sodium and of 2.5%sodium bicarbonate-In vitro study;observe characteristics of the solution,using ultravioletevisible(UV/Vis)spectroscopy,and measurement of cholesterol levels.Methods:Samples of human cerumen were mixed to form a relatively homogenous paste.Samples of about 500mg were weighed and packed at the bottom of the test tubes.To each tube was added 1.5 ml of either docusate sodium or 2.5%sodium bicarbonate.Tubes were incubated at 36.4C in a water bath for 15,30 or 60 min.Following incubation,the supernatant solution was pipetted into a cuvette.The cerumenolytic efficacy was defined as the absorbance(recorded at 350 nm and 400 nm)of the solutions.Results were the average of three replicates.A cholesterol level of each sample was then determined to confirm the result.Results:Turbidity was much greater in tubes containing 2.5%sodium bicarbonate,indicating dissolution of cerumen.Mean difference of absorbance values measured at 350 nm and 400 nm after 15,30,60 min digestions were 1.93[95%CI 1.49e2.38,p-value<0.001]and 1.81[95%CI 1.21e2.41,p-value<0.001],respectively.Furthermore,levels of cholesterol were greater in tubes containing 2.5%sodium bicarbonate solution after digestion than in tubes containing docusate sodium;11 mg/dl[95%CI 1.47e24.14,pvalue?0.083]Conclusion:Both spectrophotometric and cholesterol level assessments suggest that 2.5%sodium bicarbonate has a higher cerumenolytic effect than docusate sodium.In other words,cerumen can be dissolved in 2.5%sodium bicarbonate much better than docusate sodium in a time-dependent manner.

Diagnosis and Treatment of Anaplastic Thyroid Carcinoma

Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low;about 2% - 5% of thyroid cancer. The peak age incidence is 60 - 70 years and it is more common in females (55% - 77% of all patients). In recent years, the incidence has declined;however, it may be higher in areas of endemic goiter. ATC may occur with a coexisting carcinoma and may represent transformation of a well-differentiated thyroid cancer. Patients typically present with a rapidly growing anterior neck mass and aggressive symptoms. The most reliable tool in detecting thyroid malignancies is fine-needle aspiration cytology (FNAC). Sensitivity of FNAC for thyroid malignancy ranged from 61% to 97.7%. Fine-needle aspiration can diagnose ATC by the demonstration of spindled or giant cells, bizarre neoplastic cells that may be multinucleated, or atypical cells with high mitotic activity. A syncytial pattern is the predominant cellular pattern of anaplastic thyroid carcinoma. Other laboratory tests, including tumor markers (cytokeratin, vimentin, and carcinoembryogenic antigen) are helpful in diagnosis and follow-up of the patients. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the recommended treatment and it seems to have slightly improved outcomes. The prognosis is not as bad in younger patients with smaller tumors. The most common cause of death is lung metastasis. The mean survival time is less than 6 months from the time of diagnosis. The prompt diagnosis and aggressive treatment are essential modality to achieve optimal outcomes.