Pharmaceutico-Analytical Study of Vishatinduka Taila

Vishatinduka Tailam is mentioned in context of Vataroga nidhanalakshana chikitshaadhyana of Basavarajiyam text for the treatment of Sarvangasandhiasthigatavata, Amlavata, Sula, Anulomanavayu, Sthambha, Dhanurvata, Kaphajavikaras, severe painful condition of the body, etc., It is prepared with ingredients like Vishatinduka, Jambira, Aranala, Tilataila and Erandataila. It is an attempt made to validate the pharmaceutical and analytical parameters of Vishatinduka taila. Three batches of Vishatindukataila were prepared. Pharmaceutical study of batches and its standardization was done. It took five days for preparation of each batch due to presence of Aranala. Intermittent cooling was done. At the end of Taila preparation, mustard brown coloured oil was obtained and strong odour present. All Sneha siddhi lakhanas were observed and the loss was approximately 10% in all the three batches of Taila. To establish standards of Vishatinduka Taila, physicochemical and chromatographical methods were performed. The results found are acid value 12.344mg/KOH/g, peroxide value 5Meq/kg, Density 0.932g/cm3, Specific gravity 0.932, pH 4.5+/_0.3, Loss on drying 0%, Refractive index 73.5+/_0.2% brix, saponification value 112.22mg KOH/1g and Total fatty matter 95.4%. Physicochemical test was done in first and second month also results obtained. In HPTLC evaluation variable number of spots are visualized. It showed the presence of four phytoconstituents.

A comparison of results by sequential and concurrent chemo radiotherapy in locally advanced carcinoma esophagus.

Aim: Many Trials using sequential and concurrent chemo radiotherapy have been done so far and has established the role of concurrent chemo radiotherapy in treatment of inoperable carcinoma esophagus. In this study, we have compared the results of concurrent chemo radiotherapy with sequential chemo radiotherapy. We have treated inoperable carcinoma esophagus in both the settings and present here the comparison of results in the two settings. Materials and Methods: There were 26 patients of carcinoma esophagus in sequential and 31 in concurrent chemo radiotherapy arm. In sequential arm methotrexate and Cisplatin followed by radiotherapy was given whereas in concurrent arm, Cisplatin was given once weekly along with radiotherapy. Results: The 2 year survival was 38% in sequential and35.5% in the concurrent setting and the median survival was 19.5 and 18 months respectively in the two arms.The toxicities in both the arms were comparable. P value of 0.4774 with confidence interval of 95% was obtained, which is not significant. Dysphagia was improved earlier in sequential than in the concurrent arm. Conclusion: As the results and toxicities in both the arms are almost similar with better symptom control, so larger randomized trials are required to assess the response and the use of methotrexate in sequential chemo radiotherapy can be further explored.

Importance of Ananda kanda in the history of Indian alchemy.

Rasa Săstra is an important branch of Ayurvĕda developed for achieving therapeutic benefits from mineral materials. Ananda kanda is one of this subject text which gives an elaborate description of this subject. Dĕhavada concept of Rasa Săstra has been described elaborately along with Lŏha vada in this text. This book serves an important reference text. This book serves an important reference text for students and scholars of Rasa Săstra for teaching and training practical purposes.

Acute intermittent porphyria: an unusual cause of malignant hypertension.

Hypertension is a rare complication of acute intermittent porphyria (AIP) and is related to the sympathetic over-activity seen in this condition. We report a patient with AIP with malignant hypertension that recurred with a subsequent episode. Mechanisms of hypertension and renal damage are discussed.

Visceral leishmaniasis: a rare cause of post-transplant fever and pancytopenia.

Despite the endemic distribution of visceral leishmaniasis in certain parts of our country, there are only a few reports of this infection in renal transplant recipients. We report one renal transplant recipient from non-endemic area with visceral leishmaniasis and graft dysfunction that responded to treatment with stibogluconate. The infection should be considered in the differential diagnosis of a febrile transplant recipient with pancytopenia and allograft dysfunction.

Acute pneumonitis with pulmonary hemorrhage an uncommon and potentially fatal complication of systemic lupus erythematosus: a case report.

Acute pneumonitis with diffuse alveolar haemorrhage is potentially fatal. When it occurs in a patient of systemic lupus erythematosus, the primary disease itself may be responsible for it; rather than any complicating infection or metabolic/physiological derangement. Diagnosis of primary pulmonary involvement by systemic lupus erythematosus can only be made on open lung biopsy coupled with immunofluorescent and/or ultrastructural studies. Early diagnosis of acute pulmonary complications in systemic lupus erythematosus patients is essential as specific management is reported to improve the chances of recovery.

Lupus nephritis in children.

Systemic lupus erythematosus (SLE) is an autoimmune disease with varied clinical manifestations. Children and adolescents comprise one-fourth of affected patients with SLE and 40-80% of them have renal involvement. Lupus nephritis (LN) may present with mild urinary abnormalities or fulminant acute nephritis and renal failure. Diffuse proliferative glomerulonephritis (WHO class IV) is the predominant histological presentation in children and more common in boys than girls. This probably is one of the main reasons for the high mortality reported in the initial studies. Early diagnosis and aggressive treatment have led to improvement prognosis in these children. Cytotoxic therapy including intravenous cyclophosphamide has a definite role in the management WHO class IV and occasionally class III lupus nephritis. Prolonged steroid and cytotoxic therapy may lead to significant toxicity.

Quantitative enzymuria following aorto-renal angiography.

Quantitative estimation of urinary enzymes has been advocated as a more sensitive marker than conventional renal function tests to assess radio-contrast media induced nephrotoxicity. We studied 27 subjects with normal renal functions who underwent abdominal aortography for varied indications. Among these, 8 also required selective renal arteriography and 3 underwent arch aortography in addition. Sodium iothalamate was used as a radio-contrast medium and the average amount injected was 73 ml (45 to 120 ml) per subject. Standard renal function assessment including urinalysis, 24 hour urinary protein excretion, creatinine clearance done both before and after aortography did not show any significant alteration. Urinary excretion of tubular enzymes including leucine aminopeptidase (LAP), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT) and maltase (MAL) was estimated before and 2, 24 and 48 hours after aortography. All enzymes showed a significant rise at 2 hours. Urinary excretion of LAP, ALP and GGT peaked at 24 hours after aortography without a further change in MAL levels. Enzymuria returned to baseline values 48 hours following the procedure. It is concluded that an increase in the urinary excretion of the brush-border enzymes within 24 hours of contrast media administration may suggest an early nephrotoxicity.

Disseminated mucormycosis in healthy adults.

Three patients of disseminated mucormycosis are described. None had predisposing factors. Two of them presented with nonspecific symptoms along with acute renal failure and peritonitis. Third patient had fulminating primary cutaneous mucormycosis which disseminated later. Development of acute renal failure with smooth enlargement of both kidneys in an apparently healthy individual or appearance of mould in a wound should raise the suspicion of mucormycosis. The hallmark of the infection was vascular invasion and thrombosis. Antemortem diagnosis could be made in one patient only. All patients had progressive downhill course despite supportive treatment, antibiotic and amphotericin in-B in one patient.

The effect of aspirin, paracetamol and analgin on pharmacokinetics of chloroquine.

The effect of Aspirin, paracetamol and analgin on the kinetic profile of a single oral dose of chloroquine was studied in 8 healthy subjects. Aspirin did not alter the kinetic parameters of chloroquine whereas paracetamol and analgin significantly enhanced the Cmax and AUC0-alpha of chloroquine (P < 0.01, < 0.05 respectively).

Invasive pulmonary aspergillosis and nocardiosis in an immunocompromised host.

A case of invasive pulmonary aspergillosis and nocardiosis following high dose prolonged steroid therapy given for suspected rapidly progressive glomerulonephritis is reported. A favourable response was achieved with a combination of amphotericin B and cotrimoxazole. A high index of suspicion and aggressive investigations are necessary for confirmation of diagnosis and early institution of appropriate therapy.

Renal amyloidosis in juvenile rheumatoid arthritis.

We report a child who developed juvenile rheumatoid arthritis at the age of 7 years and nephrotic syndrome due to renal amyloidosis within 2 years of the onset of arthropathy. Literature on the management and prognosis has also been reviewed.

Crescentic glomerulonephritis associated with puerperal sepsis.

Acute renal failure developed in a young female having puerperal sepsis due to beta-haemolytic streptococci. The patient succumbed to her illness and an autopsy revealed extensive crescentic glomerulonephritis. The association between chronic visceral sepsis and glomerulonephritis is discussed.

Spontaneous rupture of the oesophagus (Boerhaave's syndrome) presenting as pyopneumothorax.

Spontaneous rupture of the oesophagus presenting as a pyopneumothorax in an elderly male is described. Delayed presentation of the patient led to serious complications to which he succumbed.

Pharmacokinetics of sustained release and conventional tablets of theophylline plus hydroxyethyltheophylline and its comparison with tablet aminophylline.

Pharmacokinetics of a sustained release (SR) and conventional formulations of theophylline plus hydroxyethyltheophylline was compared with tablet aminophylline. Time concentration curve of serum theophylline with the three formulations after single and multiple dosage schedules revealed significantly retarded absorption with the SR preparation. SR tablet was also seen to produce uniform steady state levels with fluctuation of serum concentrations within the therapeutic range for a duration of over 12 hours. In comparison, aminophylline and conventional theophylline hydroxyethyltheophylline tablets produced sharp swings in steady state levels with trough levels dipping to subtherapeutic concentrations within 4-6 hours. SR formulation, therefore, is likely provide consistent serum levels and better therapeutic control in comparison to the other two conventional tablets.

Renal papillary necrosis in diabetes mellitus.

Renal papillary necrosis in 4 diabetic patients is described. Two of them had underlying diabetic nephropathy. Urinary tract infection was present in all of them. Three patients had passed fleshy material in the urine while in one the diagnosis was established by excretory urography. Two patients required haemodialysis for acute renal failure caused by sloughed papillae. The condition should be suspected in diabetic subjects who develop recurrent episodes of urinary tract infection, renal colic, haematuria or obstructive uropathy.

Pharmacokinetics of valproic acid after administration of three oral formulations in healthy adults.

The pharmacokinetics and bioavailability of valproic acid was compared in six healthy volunteers after single dose oral administration of 400 mg of the drug in tablet, capsule and syrup form in a crossover manner. Blood samples were collected for 48 hours and valproic acid concentration analysed by enzymatic immunoassay. Following the administration of the three dosage forms, the absorption varied (Ka = Syrup K 2.64 +/- 0.5; tablet 1.57 +/- 0.22; and capsule 0.55 +/- 0.55 h-1). Valproic acid concentration reached a peak level of 102.3 micrograms.ml at 1.9 h after syrup administration, 73 micrograms/ml at 3.3 h after tablet and 44.8 micrograms/ml at 5.4 h after capsule. The bioavailability of tablet and syrup formulation was not significantly different from each other but it differed from capsule form in that the bioavailability was only 52%.