IMPPAT: A curated database of Indian Medicinal Plants, Phytochemistry And Therapeutics.

Phytochemicals of medicinal plants encompass a diverse chemical space for drug discovery. India is rich with a flora of indigenous medicinal plants that have been used for centuries in traditional Indian medicine to treat human maladies. A comprehensive online database on the phytochemistry of Indian medicinal plants will enable computational approaches towards natural product based drug discovery. In this direction, we present, IMPPAT, a manually curated database of 1742 Indian Medicinal Plants, 9596 Phytochemicals, And 1124 Therapeutic uses spanning 27074 plant-phytochemical associations and 11514 plant-therapeutic associations. Notably, the curation effort led to a non-redundant in silico library of 9596 phytochemicals with standard chemical identifiers and structure information. Using cheminformatic approaches, we have computed the physicochemical, ADMET (absorption, distribution, metabolism, excretion, toxicity) and drug-likeliness properties of the IMPPAT phytochemicals. We show that the stereochemical complexity and shape complexity of IMPPAT phytochemicals differ from libraries of commercial compounds or diversity-oriented synthesis compounds while being similar to other libraries of natural products. Within IMPPAT, we have filtered a subset of 960 potential druggable phytochemicals, of which majority have no significant similarity to existing FDA approved drugs, and thus, rendering them as good candidates for prospective drugs. IMPPAT database is openly accessible at: https://cb.imsc.res.in/imppat .

Asterixis induced by gabapentin.

We report the case of a patient with postherpetic neuralgia who developed asterixis while being treated with gabapentin. We discuss the possible mechanism of asterixis in this patient.

Pathological laughter following intravenous sodium valproate.

BACKGROUND: Pathological laughter can be a sign of epilepsy, psychiatric illness, effect of toxins or psychotropic drugs or of structural brain disease. METHOD: Case Studies. RESULT: Two patients developed inappropriate uncontrollable laughter following intravenous sodium valproate for treatment of epilepsy. CONCLUSION: Pathological laughter can be a side effect of intravenous sodium valproate.

Rotatory seizures of frontal lobe origin.

We report a patient with true rotatory seizures. The CT scan showed a right frontal calcified lesion and the EEG showed focal epileptiform discharges over the right frontal region. The seizures responded well to phenytoin therapy.

Eating epilepsy.

The clinical and EEG profiles of 13 cases of eating epilepsy are described. Temporal lobe epilepsy (TLE) formed the seizure type in 12 cases. In all but one case, the seizures were precipitated only by eating a heavy meal. In ten cases EEG showed interictal seizure discharges. EEG recordings were obtained from 12 patients during and after eating. In two patients clinical attacks (TLE) could be induced by eating in the laboratory. There was a good response to conventional anticonvulsants in only 3 cases. Alteration of eating habits helped in controlling reflex seizures in 2 cases. Various mechanisms of reflex precipitation of seizures by eating are discussed.

Cerebral infarction in juvenile rheumatoid arthritis.

Cerebral involvement associated with juvenile rheumatoid arthritis is rare. It is not influenced by treatment and the presentation can be varied. We describe a case of cerebral infarction secondary to vasculitis in a child with juvenile rheumatoid arthritis.

Clinical and radiological features of juvenile onset olivopontocerebellar atrophy.

Olivopontocerebellar atrophy (OPCA) is uncommon in childhood. We encountered 17 consecutive patients with clinical and radiological features of OPCA with a juvenile onset (mean onset age 8.2 years). These patients were heterogenous on clinical and genetic profiles, but formed three major groups. The largest group consisted of eight patients with OPCA and pigmentary retinal degeneration. The other major groups seen were OPCAs with peripheral neuropathy and OPCA with pyramidal features. Other clinical features seen were extrapyramidal signs and lower cranial nerve palsies. The CT scan showed varying degrees of cerebellar and pontine atrophy. A more precise resolution of the underlying cause of these disorders requires characterization at the genetic and molecular level and awaits further study.

Fibromuscular dysplasia of cephalic and renal arteries.

A case of fibromuscular dysplasia of the cephalic arteries and the renal artery in a male of 18 years is reported. Unusual features with reference to reported cases in the literature are discussed.

Childhood deafness in Malaysia.

One hundred and fifty-five children with childhood deafness were examined over a period of 4 years in order to assess the aetiology of hearing disorder. In 21 (13%) children, deafness was a sequel of meningitis. Perinatal pathology accounted for 34 (22%) cases. The aetiology of deafness was unknown in 44 (28.4%) children. The percentage of unknown causes can be reduced if the deafness is detected early. Hearing loss was diagnosed only in 30 (19%) children by the age of 2 years. The early detection of deafness can be achieved by screening the high risk infants and educating the general practitioners and health assistants.

Evoked potentials and Doppler vascular studies in hydranencephaly.

A study of brainstem auditory evoked potentials, electro-encephalography and doppler vascular scans were conducted in an infant with hydranencephaly. The abnormalities detected were consistent with the gross cerebral cortical anomaly in hydranencephaly.

Clinical profile of Carpal Tunnel Syndrome in Oman.

OBJECTIVE: Carpal Tunnel Syndrome is the most common entrapment neuropathy with a reported incidence of 7 to 16% of the general population in Western studies. Since this has not been well studied in the Arabian peninsula, we studied 100 patients with Carpal Tunnel Syndrome. METHODS: We studied 100 Omani patients with Carpal Tunnel Syndrome in our clinic. After clinical evaluation the diagnosis was confirmed by motor and sensory nerve conduction studies of the median and ulnar nerves. RESULTS: There were 15 males and 85 females. No systemic cause was identified in the majority of the patients. Involvement was unilateral in 23 patients and bilateral in 77 patients. CONCLUSION: Carpel Tunnel Syndrome is common in Oman and can be easily diagnosed by clinical examination and nerve conduction studies. We found that the sensory symptoms often transgressed the median nerve distribution and tended to be bilateral for both sexes, with predominance for females.

Hypernatremic metabolic myopathy due to hypothalamic dysfunction.

We report a patient with muscle weakness secondary to elevated serum sodium level. The cause of the elevated sodium level and the mechanism involved in producing muscle weakness are discussed.

Reversible parasympathetic dysautonomia following stinging attributed to the box jelly fish (Chironex fleckeri).

Following a box jelly fish sting, a 52 year old Chinese fisherman developed acute abdominal distension, inability to pass urine and failure of erection. Examination revealed gaseous abdominal distension and a distended urinary bladder. Absence of lachrimation and absence of changes in the R-R interval in the ECG during breathing and carotid sinus massage gave further evidence of parasympathetic dysautonomia. The patient made a complete recovery. The case highlights the occurrence of reversible parasympathetic dysautonomia following box jelly fish sting.

The blink reflex and somatosensory evoked potential in optic neuritis in south India.

Optic Neuritis (ON) proceeds to multiple sclerosis (MS) in a considerable number of patients. The blink reflex (BR) and somatosensory evoked potential (SSEP) are useful non-invasive tests that can detect silent lesions in the central nervous system in patients with clinically suspect MS. In the present study, the BR and SSEP were done in 20 healthy controls and 20 patients with ON. Abnormalities of the SSEP were seen in 20%, and of the BR in 30% of the patients with ON. On combining the results of SSEP and BR studies, 45% of the ON patients were seen to have abnormalities. Over a short period of follow-up, 2 of the 20 ON patients developed clinical MS and both of them had had abnormalities of the BR. These findings suggest that ON proceeding to MS in India may be more common than suspected at present.