To Access the Role of Serum Procalcitonin in Predicting the Severity of Acute Pancreatitis.

Background Acute Pancreatitis remains a common disorder with devastating consequences in severe form of disease. In this study we assessed serum procalcitonin for early prediction of severity of acute pancreatitis and compared it with multiple scoring systems and biomarkers. Objective This is a prospective comparative study in which 125 patients with diagnosis of acute pancreatitis were enrolled. All blood samples and imaging studies were obtained within 24-72 hours of admission and the severity was predicted. Method This is a prospective comparative study in which 125 patients with diagnosis of acute pancreatitis were enrolled. All blood samples and imaging studies were obtained within 24-72 hours of admission and the severity was predicted. Result Acute pancreatitis was graded severe in 54 patients and mild in 71 patients as per the Atlanta criteria. Receiver operating characteristic curve showed the area under curve of serum procalcitonin was higher (area under curve: 0.887, Confidence interval: 0.825-0.948) compared to computed tomography severity index scoring system (Area under curve: 0.841, Confidence interval: 0.771-0.911), Ranson's score (Area under curve: 0.796, Confidence interval: 0.715-0.876) and C-reactive protein (Area under curve: 0.717, Confidence interval: 0.628-0.8.7) in predicting the severity of acute pancreatitis. The best cut-off value of serum procalcitonin to predict severe acute pancreatitis was 0.9 ng/ml with 92.6% sensitivity, 80.3% specificity. The accuracy of serum procalcitonin (85.6%) was better than computed tomography severity index score (73.6 %), Ranson's score (76.8%) and C-reactive protein (64.8%). Conclusion Multifactorial scoring systems are complex and hard to use in clinical basis. Serum procalcitonin can be used as a promising single biomarker, easily done in all setup with better accuracy. And it is comparable to computed tomography severity index and Ranson's scores in earlier prediction of severity of acute pancreatitis.

Embelin modulates metabolic endotoxemia and associated obesity in high fat diet fed C57BL/6 mice.

The present study was designed to investigate the effect of embelin in metabolic endotoxemia (ME) mediated inflammation and associated obesity in high fat diet (HFD)-fed C57BL/6 mice. The molecular docking of embelin confirms its binding with the toll-like receptor-4 (TLR-4). In vivo study, mice were treated with HFD for 8 weeks to induce ME mediated inflammation and associated obesity. Further, mice were treated with embelin (50 and 100 mg/kg/day, p.o.) and orlistat (10 mg/kg/day, p.o.) from 5th to 8th week along with HFD to improve associated changes. After 8 weeks, mice were euthanized and assessed for body weight, body mass index (BMI), fat pad weights (mesenteric, retroperitoneal, and epididymal), intestinal permeability, TLR-4, tumor necrosis factor-α, interleukin-6, lipopolysaccharide, and serum lipid levels followed by histopathological analysis of liver and adipose tissues. Embelin significantly decreased the body weight, BMI, serum lipid levels, ME, and inflammation manifested by above parameters. Further, results of histopathological study showed that embelin restored the vacuolization, inflammation, one side shifting of nucleus in liver tissue, and decreased adipocyte cells size in adipose tissue in HFD-fed mice. Thus, our findings provide the strong evidence first time that embelin could modulate ME, mediate inflammation, and consequently reduce body weight gain, BMI, and serum lipid levels in HFD-fed mice.

Guggulsterone, a farnesoid X receptor antagonist lowers plasma trimethylamine-N-oxide levels: An evidence from in vitro and in vivo studies.

The current study investigated the role of guggulsterone (GS), a farnesoid X receptor antagonist, in the choline metabolism and its trimethylamine (TMA)/flavin monooxygenases/trimethylamine-N-oxide (TMAO) inhibiting potential in a series of in vitro and in vivo studies as determined by high-performance liquid chromatography (HPLC), mass spectroscopy (MS), and liquid chromatography (LC)-MS techniques. Atherosclerosis (AS) was successfully induced in a group of experimental animals fed with 2% choline diet for 6 weeks. Serum lipid profiles such as total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol were measured. Pro-inflammatory cytokines levels, markers for a hepatic injury, and oxidative stress markers were assessed. Interestingly, GS reduced the level of TMA/TMAO in both in vitro and in vivo studies as demonstrated by the peaks obtained from HPLC, MS, and LC-MS. Furthermore, GS exhibited cardioprotective and antihyperlipidemic effects as evidenced by the attenuation of levels of several serum lipid profiles and different atherogenic risk predictor indexes. GS also prevented hepatic injury by successfully restoring the levels of hepatic injury biomarkers to normal. Similarly, GS inhibited the production of pro-inflammatory cytokines levels, as well as GS, enhanced antioxidant capacity, and reduced lipid peroxidation. Histopathological study of aortic sections demonstrated that GS maintained the normal architecture in AS-induced rats. On the basis of results obtained from current investigation, we suggest that GS might have a great therapeutic potential for the treatment of AS.

Beneficial effect of Embelia ribes ethanolic extract on blood pressure and glycosylated hemoglobin in streptozotocin-induced diabetes in rats.

Embelia ribes (common name, Vidanga) is extensively used in traditional system of medicine for treatment of various disorders. It is described in Ayurveda, as a powerful anthelmintic, antifertility and antihyperlipidemic agent. The present study was undertaken to investigate modulatory effect of 6 weeks' chronic oral administration of E. ribes ethanolic extract on diabetes mellitus induced by a diabetogen, streptozotocin (STZ) with special reference to changes in glucose levels, glycated haemoglobin status and cardiac toxicity. STZ treatment (40 mg/kg iv) resulted in significant increase in blood glucose levels, glycated haemoglobin levels, heart rate (HR) and systolic blood pressure (SBP). Oral administration of E. ribes ethanolic extract in dose of 100 mg/kg and 200 mg/kg significantly reduced the levels of blood glucose, glycated haemoglobin, heart rate (HR) and systolic blood pressure (SBP) in animals when compared with diabetic rats.

Protective role of curcumin in myocardial oxidative damage induced by isoproterenol in rats.

This study was designed to investigate the effect of oral curcumin pretreatment (200 mg/kg) on isoproterenol-induced myocardial injury in rats. Isoproterenol (85 mg/kg, s.c., in two divided doses at 24 h intervals) administration induced a statistically significant increase (P < 0.01) in serum lactate dehydrogenase, creatine kinase, aspartate transaminase, and alanine transaminase activities and significant increase (P < 0.01) in myocardial lipid peroxides levels as compared to vehicle control rats. Furthermore, significant depletion (P < 0.01) of myocardial endogenous antioxidants viz. superoxide dismutase, catalase, and tissue glutathione levels were also found in the pathogenic control group, that is, isoproterenol only treated animals. Curcumin (200 mg/kg) pretreatment for 20 days in isoproterenol treated rats significantly lowered (P < 0.01) the serum lactate dehydrogenase, creatine kinase, aspartate transaminase, alanine transaminase, and myocardial lipid peroxides levels and increased the levels of myocardial endogenous antioxidants (superoxide dismutase, catalase, and tissue glutathione) as compared to pathogenic control rats. Furthermore, histological examination of rat's heart section confirmed myocardial injury with isoproterenol administration and near normal pattern with curcumin pretreatment. The results of our study provide clear evidence that the curcumin pretreatment enhances the antioxidant defense against isoproterenol-induced oxidative myocardial injury in rats and exhibit cardioprotective property.

Ethanolic Zingiber officinale R. extract pretreatment alleviates isoproterenol-induced oxidative myocardial necrosis in rats.

Ethanolic Z. officinale (ZO) extract (200 mg/kg) pretreatment for 20 days in isoproterenol (ISO)-treated rats significantly increased the levels of endogenous myocardial antioxidants (catalase, superoxide dismutase and tissue glutathione), decreased the levels of serum marker enzymes (lactate dehydrogenase, creatine kinase, aspartate transaminase and alanine transaminase) and increased myocardial lipid peroxides. Histological examination of rat's heart section confirmed myocardial injury with ISO administration and near normal pattern with ethanolic ZO extract pretreatment. The results of the present study, for the first time, provide clear evidence that the ethanolic ZO extract pretreatment enhances the antioxidant defense against ISO-induced oxidative myocardial injury in rats and exhibit cardioprotective property.

Fenugreek Seed Extract Prevents Fat Deposition in Monosodium Glutamate (MSG)-Obese Rats.

AIM: To evaluate the preventive effects of an aqueous extract of Trigonella foenum-graecum seeds (AqE-TFG) on fat deposition and dyslipidemia in monosodium glutamate (MSG)-obese rats. METHODS: Neonatal male Wistar rats were injected with MSG (4 g/kg b. w., subcutaneously) from day 2 to 14 after birth, on alternate days. From day 43 to 70, MSG treated rats were administered orally with AqE-TFG (0.5 and 1.0 g/kg b. w.). The anthropometric and biochemical parameters were analyzed on day 71. RESULTS: Treatment with AqE-TFG produced significant (P < 0.05 or P < 0.01) reduction in body weight gain, Lee's index, white adipose tissue (WAT) weights, adiposity index, blood glucose, serum insulin, leptin, lipids (low density lipoprotein cholesterol and very low density lipoprotein cholesterol), cardiac risk indexes (atherogenic index and coronary risk index), and homeostatic model assessment index. AqE-TFG treatment restored the activities of liver and epididymal WAT lipogenic enzymes (fatty acid synthetase and glucose-6-phosphate dehydrogenase) towards normal levels. Histological studies of liver also supported the experimental findings. CONCLUSION: These findings demonstrated the preventive effect of AqE-TFG on fat deposition and dyslipidemia possibly by improvement in glucose and lipid metabolism, enhancement of insulin sensitivity and down regulation of lipogenic enzymes.

The protective action of ethanolic ginger (Zingiber officinale) extract in cholesterol fed rabbits.

The effects of ethanolic extract of ginger (200 mg/kg, p.o.) were studied in cholesterol fed rabbits. The marked rise in serum and tissue cholesterol, serum triglycerides, serum lipoproteins and phospholipids that followed 10 weeks of cholesterol feeding, was significantly reduced by the ethanolic ginger extract and results were compared with gemfibrozil, a standard orally effective hypolipidaemic drug. The severity of aortic atherosclerosis as judged by gross grading was more marked in pathogenic, i.e. the hypercholesterolemic group, while animals receiving ginger extract along with cholesterol showed a lower degree of atherosclerosis. The results indicate that ginger is definitely an antihyperlipidaemic agent.

Communication in rural health care: tea shops as a Channel.

PIP: An exploratory study was conducted to determine the potential of tea shops in rural areas of Delhi, India as a channel of communication for introducing information on community based health programs. Data were collected from 10 tea shops situated in or around 5 villages under the area covered by the Rural Health Training Center, Najafgarh, New Delhi, India. In all the 5 villages there were a total number of 22 shops, of which 7 were what might be termed "general shops," 5 vegetable shops, and the remainder tea shops. Of the 10 tea shops, only 1 was located within a village. 6 were at the outskirts of the villages near bus stops and the remaining 3 were situated outside the villages at busy road crossings or bus junctions. During morning hours usually people in service or villagers going out of the villages frequented the tea shops or assembled near them to wait for the buses. A large proportion of afternoon customers were farmers. During the evening hours villagers return from their place of work and while passing through the tea shops they informally pass on new information. This new information, or part of it, is interpreted, discussed, and commented upon by the shopkeepers and villagers who happen to be present. Both informal and formal leaders visited tea shops, but the higher the sphere of influence of such leaders, the shorter was the duration of their stay at the shops. A wide range of topics was discussed. Villagers were involved in sharing information, expressing opinions, and debating issues. The communication behavior of the shopkeepers was found to be an important factor in initiating such discussions. The information the shopkeeper provided influenced to a conaisderable extent the nature and direction of such discussions. The development activities of the community development block were discussed at tea shops, but no such discussion of health programs ever occurred at such places during the study period. On the basis of available information, it is difficult to infer whether formal educational programs can be organized effectvely at tea shops. The constraints to such an effort are likely to be 2-fold: it may be perceived as a deterrent to the normal functioning of tea shops by the owners and some of the customers; and villagers may not be able to spare sufficient time to participate in such formal instructional programs. As such shops are visited by a considerable number of villagers, attempts can be made to expose them to various health programs being carried out in the area with an imaginative use of simple and attractive visual aids which can be dipslayed in and around such shops.^ieng

Vital aspects of nursing: the family planning component.

PIP: 3 basic conditions are needed to accelerate the adoption of India's family planning program: social approval for the program; knowledge about family planning; and availability of services. The program is likely to succeed if an intensive drive is made to establish effective communication with people in order to create in them a recognition of the value of a small family. Nursing personnel form a vital component of the health team that has to shoulder major responsibilities in creating the above basic conditions in the country. Their knowledge, skills and devotion bring them close to the patients and communities under circumstances where most of their advice is welcomed. This, along with the nature of their tasks, can help nurses to help the families in accepting the family planning program. As educators nurses will need to integrate an educational component in their daily activities and to utilize various interactional situations to inform couples about the advantages of planned parenthood, available methods for spacing and limitation, motivate them to accept a contraceptive method, to remove doubts and fears about family planning methods, and to make people aware of the maternal and child health (MCH) component of the program. It is essential for a nurse to judge the effectiveness of her instruction. She can accomplish this by observing and studying the reactions and actions of her audience. Nurses also have a role in planning special aspects of the family planning program. As program planners, nurses must draw inferences from the collected data and apply these in developing a feasible and effective program for their respective areas. Nurses can play an important role in determining training needs of volunteers and in developing and imparting training. Every nurse functions to some degree in a supervisory capacity. In the family planning program the role of a nurse includes the supervision of auxiliary nurse midwives, traditional birth attendants, family planning depot holders, and others who are involved in the program in both clinic and community situations. In clinical settings nurses can assist in arranging clinics to follow procedures for prescribing clinical methods, in the maintenance of equipment, distribution of medicine, and preparation of case cards. In the rural areas nurses can aid in the development of an efficient supply line in the community. Nurses can also play an important role in the maintenance of family planning records.^ieng

Abortion practices in the rural areas around Najafgarh.

PIP: The findings of a study conducted in the rural areas around Jajaigarh, Delhi to collect information about different indigenous preparations, practices and rituals which the rural population maintain have abortion-inducing effects are presented. The resource persons interviewed include indigenous midwives, private medical practitioners, old women of the villages, teachers and barbers. Also contacted were maternity and child health workers. The 9 abortion-inducing practices reported are described. Some of the techniques have been recorded and some have some scientific basis causing abortion. For example, the administration of quinine is known to cause abortion. No scientific evidence is available to substantiate the efficacy of some of the methods, yet the resource persons providing the information were absolutely confident regarding their favorite methods. The resource persons were known to practice their favorite methods successfully.^ieng

Anti-obesity effect of Gymnema sylvestre extract on high fat diet-induced obesity in Wistar rats.

Gymnema sylvestre R. BR. (Asclepiadaceae) has been used frequently in traditional Indian folk medicine for the treatment of diabetes. Study was performed in high fat diet (HFD)-induced obesity in murine model. Obesity was induced by oral feeding of HFD for 28 days. The anti obesity effect of water soluble fraction of Gymnema sylvestre extract (120 mg/kg, p.o. for 21 days) in HFD fed rats was evaluated by the measurement of body weight gain, food intake, hemodynamic changes (systolic, diastolic, mean blood pressure and heart rate), serum lipid profiles (triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol), leptin, insulin, glucose, apolipoproteins A1 and B, lactate dehydrogenase (LDH) and antioxidant enzymes such as reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S transferase (GST), superoxide dismutase (SOD) and catalase (CAT) levels in liver tissues. Organs and visceral fat pad weight were measured. Histopathological studies were also carried out. Water soluble fraction of G. sylvestre ethanolic extract and rimonabant significantly reduced serum lipids, leptin, insulin, glucose, apolipoprotein B and LDH levels while it significantly increased the HDL-cholesterol, apolipoprotein A1 and antioxidant enzymes levels in liver tissue as compared to the HFD fed rats. Histopathological studies of tissues showed no pathological changes. The results of this study show that water soluble fraction of G. sylvestre extract possess antiobesity effect.

α-Pinene Rich Volatile Constituents of Cupressus torulosa D. Don from Uttarakhand Himalaya.

The aim of the present study was to investigate the various chemical components present in the volatile oil of the leaf of Cupressus torulosa and to find variation of essential oil components among the populations. Twenty-two, 17 and 20 compounds were identified with 95.45, 95.45 and 91.45% in Kalsi, Joshimath and Jeharikhal, respectively were identified by gas chromatography-mass spectrometry and quantify by gas chromatography and flame ionization detector (GC-FID). The major compound identified was α-pinene in all the populations and it varied between 30.30 and 34.26%. Results of the study stated that α-pinene, δ- 3-carene, limonene and sabinene components were detected in high concentration, thus competent for use in related industries and as a favourite ornamental aromatic tree.