Colon targeted tablets of Albendazole with enhanced solubility by Complexation and Micellar Solubilization

Albendazole (AZ) is a drug used for the treatment of gastrointestinal nematode infections. Phase solubility study was performed to investigate the optimized ratio of AZ: β-cyclodextrin (β-CD) solid dispersion (SD). Increase in the solubility of optimized AZ: β-CD SD was further enhanced by addition sodium lauryl sulfate (SLS) in different ratios was studied. Matrix tablets of the optimized ratio of AZ: β-CD SD with SLS and various proportions (10%, 15%, and 20%) of guar gum (GG). xanthan gum (XG) and pectin (PT) were prepared by non-aqueous wet granulation with PVP K30. Standard calibration curve for AZ was performed in three buffers like 0.1 N HCl, pH 6.8 phosphate buffer solution (PBS) and pH 7.4 PBS and absorbance were measured at 295 nm. Tablets were evaluated for various physical characteristics such as thickness, hardness, and drug content uniformity. The matrix tablets were subjected to in vitro drug release studies in 0.1 N HCl (2 h), pH 6.8 PBS (3 h) and pH 7.4 PBS (19 h) with and without rat caecal content medium. Formulation F9 shows 70.65% and 95.62% of AZ in with and without rat caecal content media respectively is selected as optimized one. Optimized formulation F9 passed the test for stability up to 3 months as per ICH guidelines.

Hereditary Hypotrichosis Simplex Of The Scalp: A Case Report With 10 Affected Members In A Family

Hereditary hypotrichosis simplex of the scalp is an autosomal dominant disorder, characterized by sparse or absent scalp hairs without structural defects, in the absence of other ectodermal or systemic abnormalities. Hairs are usually normal at birth but thin progressively during childhood to become very sparse or may be absent by the third decade. Hair loss is confined only to the scalp with normal growth of facial and body hairs.

Study of lipid profile in hypertensive subjects

Aim : The present study was designed to investigate lipid profile in hypertensive subjects. Material and Method : The present study was carried out on 25 healthy controls and 25 hypertensive subjects of either sex and of varying age groups attending the Out Patient Department of Medicine, Dr. S.N. Medical College and Associated group of hospitals, Jodhpur. Results: The results obtained in this study showed that the results of TG ,Total cholesterol ,HDL-c ,VLDL-c ,LDL-c were highly significant in patients compared with control subjects .Conclusion: The present study indicates an increased TG ,Total cholesterol ,VLDL-c ,LDL-c & decreased HDL-c values in hypertensive subjects, which is due to many factors like obesity ,age etc.

Association of Chlamydia pneumoniae IgG and IgA antibody in coronary artery disease.

Background: Cardiovascular disease, resulting from atherosclerosis, is a leading cause of global morbidity and mortality. Classical risk factors explain much of the attributable risk for cardiovascular events, but other risk factors for the development and progression of atherosclerosis, which can be identified, may be important therapeutic targets. Infectious agents, such as Chlamydia pneumoniae, have been proposed as contributory factors in the pathogenesis of atherosclerosis. The present study was conducted to determine the seroprevalence of C. pneumoniae antibodies and to study the association of chronic C. pneumoniae infection with Coronary Artery Disease (CAD). Methods: The study group included 90 angiographically proven CAD patients and age and sex matched 90 normal coronaries as control group. With total aseptic precaution 3 ml blood was collected. Enzyme linked immunosorbant assay was performed for all subjects to detect the presence of IgG and IgA antibodies to Chlamydia pneumoniae (Cp). Results: IgG and IgA Cp antibodies were detected in 67.8% and 58.9% CAD patients compared to 45.6% and 11.1% controls. IgG + IgA Cp antibodies were detected in 88.9% CAD patients when compared to 50.0% controls. Seroprevalence of IgG and IgA Cp antibodies were high among CAD patients compared to controls and was found statistically significant. A significant presence of Chlamydia pneumoniae antibodies was detected in smokers, diabetes mellitus, hypertension, and dyslipidemia. Conclusion: In the present study, the seroprevalence of IgG and IgA Cp antibodies was found to be higher in CAD patients compared to controls. The present study supports the association between Chlamydia pneumoniae infection and Coronary artery disease.

CD4 count evaluation in HIV-TB co infection before and after anti-tubercular treatment.

Background: The global impact of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) co-infection is one of the major public health challenge. India has a very high burden of TB according to the WHO. A decrease in CD4 counts in HIV-TB co-infection leads to an increase in morbidity and mortality. Methods: Information regarding the duration of HIV, type of TB, CD4 counts before and after ATT and any associated Opportunistic Infections (OIs) were collected from the records of 100 patients with HIV-TB co-infection who attended ART centre for a period of one year. The collected data was statistically analyzed. Results: In the study group, 35 had Pulmonary Tuberculosis (PTB) and 65 had Extra Pulmonary Tuberculosis (EPTB), 40 had OIs. Mean CD4 count prior to ATT in PTB was 197 (7-940), EPTB 192 (13-683) and with OIs 129 (7-288). After completion in PTB was 300, EPTB 302 and 252 in OIs. Least CD4 count of 121 was observed in patients above 50yrs and after completion it was 133. Incidence of both EPTB and PTB was higher in males 66.2% and 62.9%, and in the age group of 31-50 yrs 50.8% and 60% (Cell counts expressed in cells/μl.). Conclusion: In our study, we found that there was significant recovery of CD4 cells following ATT. Difference in CD4 counts among patients with PTB and EPTB was not significant. There was remarkable reduction of CD4 counts in patients who had other OIs and the recovery after ATT was also marginal.

Estrogen mediated protection of cytoskeleton against oxidative stress.

Background & objectives: Cytoskeletal proteins are deregulated during oxidative stress and cataract formation. However, estrogen which protects against cataract formation and harmful effects of oxidative stress has not been tested on the cytoskeleton of lens epithelial cells (LECs). The current study was undertaken to assess if the protection rendered to LECs by estrogen was mediated by preserving the cytoskeletal proteins. Methods: Oxidative stress was induced by 50 μM of H2O2 in cultured goat LECs (gLECs) and effect of 1 μM 17β-estradiol (E2) was tested. After treatment, morphological analysis of cells was carried out using haematoxylin-eosin staining and cell density was also quantified. Cell viability was determined using Hoechst (Ho), YO-Pro (YP) and propidium iodide (PI). F-actin and vimentin were localized using phalloidin and anti-vimentin antibody, respectively, and viewed under fluorescence microscopy. Vimentin was further analysed at protein level by Western blotting. Results: H2O2 led to increased condensation of nucleus, cell death and apoptosis but these were prevented with pre- and co-treatment of E2 with increase in cell viability (P<0.001). E2 also prevented H2O2 mediated depolymerization of cytoskeleton but was not able to reverse the changes when given after induction of oxidative stress. Interpretation & conclusions: Our findings showed that E2 helped in preventing deteriorating effect of H2O2, inhibited cell death, apoptosis and depolymerisation of cytoskeletal proteins in LECs. However, the exact mechanism by which estrogen renders this protection to cytoskeleton of lens epithelial cells remains to be determined.

Cx43, ZO-1, alpha-catenin and beta-catenin in cataractous lens epithelial cells.

Specimens of the anterior lens capsule with an attached monolayer of lens epithelial cells (LECs) were obtained from patients (n052) undergoing cataract surgery. Specimens were divided into three groups based on the type of cataract: nuclear cataract, cortical cataract and posterior subcapsular cataract (PSC). Clear lenses (n011) obtained from donor eyes were used as controls. Expression was studied by immunofluorescence, real-time PCR and Western blot. Statistical analysis was done using the student’s t-test. Immunofluorescence results showed punctate localization of Cx43 at the cell boundaries in controls, nuclear cataract and PSC groups. In the cortical cataract group, cytoplasmic pools of Cx43 without any localization at the cell boundaries were observed. Real-time PCR results showed significant up-regulation of Cx43 in nuclear and cortical cataract groups. Western blot results revealed significant increase in protein levels of Cx43 and significant decrease of ZO-1 in all three cataract groups. Protein levels of alpha-catenin were decreased significantly in nuclear and cortical cataract group. There was no significant change in expression of beta-catenin in the cataractous groups. Our findings suggest that ZO-1 and alpha-catenin are important for gap junctions containing Cx43 in the LECs. Alterations in cell junction proteins may play a role during formation of different types of cataract.

Psychosocial well-being in children with epilepsy.

Objective: To examine the aptitude, school performance and parent satisfaction (psychosocial wellbeing) of epileptic children in comparison to a control group Method: A prospective study was conducted from 30th May to 8th August 2005 at the Lady Ridgeway Hospital for Children, Colombo. Data was collected by a trained investigator. All children between the ages of 6 and 10 years, diagnosed with epilepsy for a period extending 2 years, and attending the hospital during the study period, were included as cases. Only children who were attending school (mainstream or special needs) were included. 102 questionnaires were administered and none were discarded. The controls were identified from 3 primary schools in the same district. Each epileptic child was matched by age and sex with a non-epileptic child. The social class profiles of the 2 groups did not differ significantly. Each participating parent completed a pre-tested questionnaire to assess the psychosocial well-being of the epileptic children and their parents. This was followed by a standardized aptitude test which was completed by both cases and controls. The data was entered into the Statistical Package for Social Sciences (SPSS) Version 12 for Windows to examine the differences between the groups via frequency distributions. Results: When compared with the non-epilepsy sample, the epilepsy sample was characterised by low academic achievement, extra-curricular participation, self and life skills, dependency, lethargy, restricted independence and less equal opportunity towards success. On the other hand, on items relating to aggressive behaviour and family relationships no significant differences were found between the two groups. On the Aptitude test the average score by an epileptic child was 4.12/10 whereas it was 8.42/10 in the control group. Conclusion: The psychosocial wellbeing of epileptic children is poor in comparison to the control group.

A case report of herpetic and candidal esophagitis in an immunocompetent adult

Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic. A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia, odynophagia and fever. Esophagogastroduodenoscopy (EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm. Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm, multinucleated and faceted nuclei with glassy chromatin, and an occasional Cowdry type A intranuclear inclusion bodies. Few candidal spores were seen in the underlying stroma. Intravenous acyclovir, fluconazole and pantoprazole were initiated. Oral analgesics were given for pain relief. She was treated for a total of 14 days. She showed significant improvement and was tolerating oral intake after discharge. The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.

Herpes simplex virus 2 infection: a risk factor for HIV infection in heterosexuals.

BACKGROUND: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. METHODS: The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value 'P' was calculated using the Chi-squared test. RESULTS: Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females) of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with 'P' value CONCLUSION: The high prevalence of HSV-2 seropositivity in the HIV-infected group (49%) as compared to normal controls (22%) was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients.

Sporotrichosis in Mysore: a case report to emphasize the role of histopathology.

Lymphocutaneous sporotrichosis is unusual in southern India. The diagnosis was made by histopathological examination which is purported to have poor sensitivity. The culture of the specimen confirmed the diagnosis. The pre-eminent role of a careful study of serial sections is emphasized.

Sensitivity pattern of gram negative bacilli to three beta-lactam/beta-lactamase inhibitor combinations using the automated API system.

PURPOSE: To evaluate the spectrum of activity of three beta-lactamase inhibitors such as amoxicillin/ clavulanic acid, ticarcillin/ clavulanic acid and piperacillin/ tazobactam in comparison to cephalosporins against gram negative bacilli. METHODS: Gram-negative bacilli isolated from the clinical specimens received in the laboratory were included in the study. Using the API system (bioMiotarieux) during a one-year period, a total of 1,252 Enterobacteriaceae and 385 non-fermenters were evaluated. RESULTS: The percentage resistance of the Enterobacteriaceae isolates was 82.92% to amoxicillin/ clavulanic acid, 58.22% to ticarcillin/clavulanic acid and 22.44% to piperacillin/tazobactam respectively. Pseudomonas aeruginosa showed resistance of 96% to ticarcillin/ clavulanic acid and 61% to piperacillin/ tazobactam and Acinetobacter baumannii showed 49% resistance to ticarcillin/ clavulanic acid and 77% resistance to piperacillin/ tazobactam respectively. The isolates exhibited high resistance to all the generations of cephalosporins and the other groups of antibiotics except carbapenems. CONCLUSIONS: Piperacillin/tazobactam was found to be the most active combination of the three against Enterobacteriaceae and Pseudomonas spp. and ticarcillin/clavulanic acid against Acinetobacter spp. and Stenotrophomonas maltophilia.

Pulmonary zygomycosis in a diabetic patient.

We report a case of pulmonary zygomycosis in an adult male diabetic patient who presented with fever and altered sensorium initially and later developed streaky haemoptysis. Bronchoscopy showed picture of necrotizing pneumonia. Sputum was negative for fungal elements on admission but later bronchial wash and repeat sputum samples were positive by microscopy and culture showed growth of Rhizopus species. Immediately the patient was put on amphotericin B but had a bout of massive haemoptysis and succumbed. A high index of suspicion is needed for an early diagnosis and aggressive treatment of this infection in view of the high mortality rate.

The role of quantitative cultures of non-bronchoscopic samples in ventilator associated pneumonia.

PURPOSE: The objective of this study is to determine the role of quantitative cultures of non-bronchoscopic samples such as blinded bronchial sampling (BBS) and endotracheal aspirates (ETA) in the management of ventilator associated pneumonia (VAP). The study also evaluates the clinical diagnosis of VAP based on the inclusion of Gram stain results of BBS/ETA samples into modified clinical pulmonary infection score (CPIS). METHODS: Fifteen out of the 120 patients admitted to respiratory intensive care unit under mechanical ventilation for more than 48 hours with a clinical suspicion of VAP, were included in this study. Quantitative cultures of BBS and ETA were performed from all the 15 patients. RESULTS: VAP was confirmed in 11 out of 15 cases by quantitative cultures of either the BBS or ETA samples. The condition of 8/11 VAP confirmed patients improved significantly with the change in antibiotic therapy. The overall mortality rate was found to be 18%. The agreement between BBS and ETA results was found to be 83.3%. Modified-clinical pulmonary infection score (CPIS) increased significantly when Gram stain results of BBS/ETA samples were included, thereby strengthening the clinical diagnosis of VAP. CONCLUSIONS: Quantitative culture of lower respiratory tract samples obtained by non-bronchoscopic methods may be a useful alternative to bronchoscopy, in the diagnosis of VAP. Inclusion of Gram stain results of BBS/ETA into modified-CPIS may augment the diagnostic evaluation of VAP.

Experimental Teaching and Interactive Computer Assisted Learning : The Student’s Viewpoint

A student view point regarding utility and present role of experimental teaching and interactive computer assisted learing was cited from three Medical Colleges of North India using a set of questionnaires. The majority of the student cited that animal experiments are important part of medical curriculum. However, computer assisted learning techniques will be useful aid in future but currently cannot replace animal experiments as the tool of choice for medical education and research.

Aplastic anemia in an HIV infected child.

Hematologic manifestations of HIV in children are common and include anemia, neutropenia, lymphocytopenia, thrombocytopenia that may occur due to many reasons. However, aplastic anemia due to HIV infection is rare and even more so in children. Though anemia is seen with advanced disease and associated with poor prognosis it is treated with various therapeutic modalities. Our patient with aplastic anemia due to HIV infection responded to antiretroviral therapy.

A case report of placental teratoma: an unusual primary non-trophoblastic tumor of placenta.

Placental teratoma, with less than 20 cases reported in the world literature is a rare primary nontrophoblastic tumour. The exact histogenesis is still controversial, with some regarding it as a true neoplasm, while others consider it as an extreme form of fetus amorphous. Whatever its histogenesis, it is invariably benign and causes no adverse effects on the fetus or the outcome of the gestation. This case is being presented for its rarity, with a review of literature.

Parotid gland tuberculosis--a case report.

Isolated parotid gland tuberculosis in the clinical absence of tuberculosis elsewhere in the body, is a rare clinical entity. It is often misdiagnosed as parotid gland tumour in the absence of symptoms suggestive of tuberculosis. We are presenting this case to highlight the unusual solitary nature of the lesion, the absence of any other tuberculous focus in the body, the inconclusive findings of the pre-operative investigations like fine needle aspiration cytology (FNAC), and computed tomography (CT), and the need for histopathology for definitive diagnosis.

Investigation of central mechanism of insulin induced hypoglycemic convulsions in mice.

Insulin produces seizures in healthy and diabetic animals. Amongst suggested mechanisms, the role of neuromodulators and neurotransmitters is not clear. The present study explores the mechanisms involved in insulin-induced convulsions. Convulsions were induced in Swiss male albino mice with graded doses of insulin. Blood sugar levels were measured prior to and after the first convulsion. Drugs like 5-HTP (5-HT precursor), pCPA (5-HT depletor), ondansetron (5-HT3 antagonist), ketanserin (5-HT, antagonist), ketamine (NMDA antagonist), 1-dopa (dopamine precursor) and reserpine (amine depletor) were studied for interaction with convulsive behaviour induced by insulin. Insulin in 2 IU/kg dose did not produce convulsions while 4 and 8 IU/kg doses produced convulsions in 50% and 100% of animals respectively. 5-HTP, ondansetron, ketanserin, ketamine and l-dopa significantly protected/inhibited animals from convulsions at all studied doses of insulin. On the contrary, pCPA and reserpine potentiated insulin induced convulsions. Insulin caused mortality in 40 and 100% animals with 4 and 8 IU/kg doses respectively. pCPA and reserpine treatments caused mortality at all doses of insulin, while other drugs did not influence insulin induced mortality. Blood sugar levels were reduced in all groups irrespective of the presence or absence of convulsions. A definitive link of serotonergic, dopaminergic and excitatory amino acid pathways in mediating insulin-induced hypoglycemic convulsions is suggested.