Pharmacological Potential Of Nymphaea Alba Flower Extract Against Streptozotocin Induced Experimental Diabetes Mellitus Model

Diabetes mellitus is a rapidly increasing incidence in the developing and developed countries throughout the world. The present investigation was performed to assess the anti–diabetic activity of Nymphaea alba flower extract against streptozotocin (STZ) induced diabetic condition in rat model. N.alba flower extract was orally given to experimentally induced diabetic animals (at the concentration of 200, 400 and 800 mg/kg body weight). Treatment of N.alba flower extract significantly (p < 0.05) lowered the level of blood glucose, serum insulin and HbA1C levels in experimentally induced diabetic animals in a concentration dependent fashion. A significant (p < 0.05) reduction in the levels of antioxidant enzymes such as glutathione peroxiodase, glutathione S transferase, catalase and superoxide dismutase were observed in experimental diabetic animal model. Upon treatment with N.alba flower extract the above said antioxidant enzyme levels were reverted back to normalcy in a dose dependent fashion. The present investigation revealed that N.alba flower extract exerted strongly antidiabetic action by restoring the antioxidant system and anti–hyperglycemic activity. Consequently, it might be used as a safer harmonizing substance in the diabetic conditions.

Clinical Study To Analyse The Causes & Functional Outcome Of Various Procedures To Treat Tendo-Achilles Injuries

The achilles tendon plays a crucial role in the bipedal human beings. Injury to achilles tendon causes great difficulty in walking and running. This study aims to present the various causes , various treatment modalities and the functional outcome of tendo Achilles injuries. This is a retrospective study of 25 patients of with Tendo Achilles injury who presented at our department between July 2015 to December 2018.Patient age , cause of Tendo Achilles injury associated skin and soft tissue defect, tendon defect, various modalities of treatment and functional outcome were reviewed. A total of 23 men and two women with a mean follow up period of 6months to 15months were included. The most common cause of tendo Achilles injury was due to slipping of foot in an Indian closet .

Clinical and angiographic profiles and six months outcomes of smokers with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary angioplasty

Background Outcomes of primary percutaneous coronary intervention (PCI) for acute STEMI (ST-segment elevation myocardial infarction) in smokers are expected to be better than non-smokers as for patients of acute STEMI with or without fibrinolytic therapy. Objectives This comparative study was designed to evaluate the outcomes of primary PCI in patients with acute STEMI in smokers and non-smokers. Clinical and angiographic profile of the two groups was also compared. Methods Over duration of two year, a total of 150 consecutive patients of acute STEMI eligible for primary PCI were enrolled and constituted the two groups [Smokers (n = 90), Non-smokers (n = 60)] of the study population. There was no difference in procedure in two groups. Results In the present study of acute STEMI, current smokers were about a decade younger than non-smokers (p value = 0.0002), majority were male (98.9% vs 56.6%) were male with a higher prevalence of hypertension and diabetes mellitus (61.67% vs 32.28% and 46.67% vs 14.44%, p = 0.001) respectively. Smokers tended to have higher thrombus burden (p = 0.06) but less multi vessel disease (p = 0.028). Thirty day and six month mortality was non-significantly higher in smokers 4.66% vs 1.33% (p = 0.261) and 5.33% vs 2.66% (p = NS) respectively. Rate of quitting smoking among smokers was 80.90% at 6 months. Conclusion The study documents that smokers with acute STEMI have similar outcomes as compared to non smokers with higher thrombus burden and lesser non culprit artery involvement. Smokers present at much younger age emphasizing the role of smoking cessation for prevention of myocardial infarction.

Relapse and Drug Resistance in Leprosy: Present Scenario and Critical Issues

The symposium was organized by The Leprosy Mission Trust India (TLMTI) on the 29 November, 2017 at India Habitat Centre, Lodi Road, New Delhi, India. The meeting was organized for the stakeholders who are engaged in the leprosy elimination programme for an exposure to the recently emerging scenario on relapse and drug resistance in leprosy. A total of sixty three participants including representatives from Government of India, WHO, ILEP, GLRA, LEPRA India, NLR, DFIT, BLP, FMR, NIMHANS, ICMR-NJIL & OMD and ICMR gathered in the symposium. Most of the famous advisors of the country, leprologists and dermatologists of TLM, Safdarjung, Guru Tegh Bahadur hospitals, PGIMER (Chandigarh, India), DLO and SLO of Delhi participated in the symposium. Leprosy researchers and scientists from different organizations across the country also gathered for the deliberations and discussions. The symposium began with a welcome address from the Executive Director, TLM which was followed by inaugural keynote addresses by the experts of the country. Scientific deliberations by the leprologists, dermatologists and laboratory researchers were divided in four main sessions. This symposium had presentations on most current areas of importance such as goals and achievements of NLEP; diagnostics with focus on different forms of disease including neuritic leprosy; newer methods such as imaging for studying CNS involvement; response to therapy; drug resistance in the context of relapses, poor responders, reactions and multibacillary leprosy, transmission, methods and strategies for detection of drug resistance and its surveillance; national and global perspective etc. The Symposium concluded with a plenary session for the road map of a future strategy with recommendations which include molecular detection of drug resistance with focus on relapses, reactions and MB leprosy; confirmation of relevance of novel mutations in animals; networks for drug resistance surveillance and epidemiology of drug resistance in leprosy.

Comparison of analgesic properties of perineural and systemic dexamethasone in patients undergoing upper limb surgeries under supraclavicular block

Introduction: Pain in the postoperative period is the distressing period after any surgeries particularly in the first 24 hours. Postoperative pain is associated with an increase in sympathetic activity leading to increases in heart rate, blood pressure, respiratory rate and even delirium and myocardial insults. Opioids and NSAIDS are very commonly used in the postoperative period in spite of their known adverse effects. So there is a need for a study to find a drug which prolongs the duration of analgesia in the postoperative period without many side effects so that usage of opioids and NSAIDS drugs in the first 24 hours can be decreased. The aim of the study: To compare during supraclavicular brachial plexus block, the single perioperative dose of intravenous Dexamethasone and perineural Dexamethasone effects on onset and duration of sensory and motor blockade ; quality of analgesia and reduction in the dose of opioids in first 24 hour. Materials and methods: A Randomized, Triple-Arm, Double-Blind, Placebo-Controlled Trial. Totally 90 patients were recruited in the study patients undergoing upper limb surgeries under supraclavicular block at govt. Kilpauk medical college hospital and govt. Royapettah Hospital from Sathyan Natarajan, Karthikeyan G, Murugan T. Comparison of analgesic properties of perineural and systemic dexamethasone in patients undergoing upper limb surgeries under supraclavicular block. IAIM, 2017; 4(11): 220-228. Page 221 December 2015 to May 2016 were included in the study. After obtaining written informed consent patients were divided into three groups of 30 in each group. Group A local anesthetics and perineural dexamethasone Group B local anesthetics & intravenous dexamethasone, Group C local anesthetics only. Results: The Sensory and Motor block onset time between the intervention groups group A VS group B and group A VS group C were found to be statistically significant (p < 0.05) and the association between group B VS group c was found to be not statistically significant (p>0.05) as per unpaired t-test. The sensory & motor block duration time showed statistical significance in group A VS group C, group B VS group C (p < 0.05) but group A VS group B had no statistical significance( p > 0.05) as per unpaired t-test. The association of Visual Analog Scale between the intervention groups (group A Vs group C and group B VS group C) and VAS scores at 6, 12 and 24 hours postoperatively were found to be statistically significant since p < 0.05 as per unpaired t-test. The number of doses of opioid required in 24 hours was considered to be statistically significant since p < 0.05 as per unpaired t-test between the intervention groups (group A VS group C and group B VS group C). Conclusion: Systemic Dexamethasone is equally effective as perineural Dexamethasone in providing the significant duration of sensory, motor blockade and quality of analgesia. We come to a conclusion that Dexamethasone consistently decreases the postoperative pain scores and decrease the early & number of doses of opioid consumption (48 hours).

Rhinosporidioma: Primary Cutaneous Rhinosporidiosis - A Rare Case Report.

Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. Rhinosporidium seeberi causes granulomatous inflammation of mucocutaneous sites, presenting most frequently as polypoidal lesions in the nose. Sites like the conjunctiva, trachea, nasopharnyx, skin, and genitourinary tract are less frequently involved. Primary cutaneous lesion is extremely rare and it is often mistaken for soft-tissue tumour. We present a case of 55 years male patient from Thanjavur, Tamilnadu, with primary cutaneous rhinosporidiosis without mucosal involvement.

Citrullinemia Type 1: Genetic Diagnosis and Prenatal Diagnosis in Subsequent Pregnancy.

Citrullinemia type 1 was diagnosed by tandem mass spectrometry in a full term male neonate who presented with an acute catastrophic collapse on the 3rd day of life. Both parents were identified to be carriers for the exon 15 p Gly390Arg mutation in the argininosuccinate synthetase gene located at chromosome 9q34.1. Chorionic villus sampling and prenatal genetic testing in the subsequent pregnancy revealed an affected fetus resulting in termination of pregnancy.

The Well Baby Certificate for Puerperal Sterilization – A Critical Appraisal.

From August 2004 to July 2005 at Coimbatore Medical College Hospital, Tamilnadu, the process of issuing well baby certificate to 1668 babies of 1658 mothers electing to undergo puerperal sterilization within a week of delivery was analyzed. 1553 babies (93.1%) were issued well baby certificates. Certificates were deferred in 88 babies (5.3%) and it was refused in 27 (1.6%). Reasons are analyzed and discussed.

Evaluation of wound healing activity of Acacia leucophloea bark in rats

Wound healing activity of the bark extracts of Acacia leucophloea Willd., Fabaceae, was investigated by excision and incision wound healing models in Wistar male rats. Ethanolic extract based ointment of A. leucophloea bark (2 and 5% (w/w)) was formulated and evaluated for its wound healing in Wistar male rats. In comparision with a standard wound healing ointment betadine. A. leucophloea ethanolic extract ointment exhibited marked wound healing activity and significantly enhanced the wound contraction and the period of epithelialization as assessed by wound contraction rate, tensile strength, increasing of DNA, collagen and protein synthesis and histopathological examination. The formulated ointment might well find use as skin repair agent without hazard to human health based on these results.

Acute hemodynamic effects of sildenafil in patients with idiopathic dilated cardiomyopathy.

Sildenafil, a phosphodiestrase-5 inhibitor, decreases pulmonary artery pressures (PAP) in patients with idiopathic pulmonary hypertension. There is little data pertaining to its use in unselected patients with idiopathic dilated cardiomyopathy (IDCM). A single oral dose of sildenafil (50 mg) was administered to 11 patients (mean age 44.9 +/- 7 years, 7 males) with IDCM with left ventricular ejection fraction < or = 40% in New York Heart Association class II/III at the time of right heart catheterization. There was a significant decrease in pulmonary artery systolic pressure (from 31.5 +/- 9.7 to 19.0 +/- 5.2 mmHg, p < 0.001) and pulmonary vascular resistance (PVR) (from 3.0 +/- 2.1 to 1.6 +/- 0.8 dyne/s/m(2)/cm(5), p = 0.01) following sildenafil administration. The systemic vascular resistance (SVR) and pulmonary wedge capillary pressure also significantly decreased. No significant differences in heart rate, cardiac index and PVR/SVR ratio were observed. There were no side effects documented. Sildenafil produces favorable vasodilation in both pulmonary and systemic vascular beds with decrease in left ventricular filling pressures, in stable patients with IDCM.

Scarabiasis.

Scarabiasis is a condition where beetles temporarily infest the digestive tract and the scarabes are identified in the fly away from the anus at the time of the defecation. This article highlights this rare problem of scarabiasis in a 4 year old girl that responded to bowel cleansing and personal hygienic measures.

Clinical Evaluation of an Indigenous Paclitaxel-Eluting Stent in De NovoCoronary Artery Stenosis.

BACKGROUND, Drug-eluting stents have enabled considerable reduction in restenosis in patients subjected to angioplasty. However, in view of high cost of drug-eluting stents, efforts to develop medicated stents at reduced cost using alternative polymers in Indian setting are imperative. Hence a multi-center study was undertaken to evaluate the safety and efficacy of the indigenously developed paclitaxel-eluting RELEASE-T stent. METHODS, The study included 100 patients (male:86, Female:14) who were undergoing angioplasty for various indications at four centres viz. Delhi, Hyderabad, Pune and Warangal. The age range was 29 - 76 years; 37 patients were diabetic. All patients were pre-treated with aspirin 150-325 mg plus clopidogrel 75 mg daily four days before procedure or clopidogrel alone. Aspirin was continued indefinitely. RESULTS, Direct stenting ws done in majority of patients. One patient, in whom stent could not be delivered, received only baloon angioplasty. Sixty-four patients had stenting of left anterior descending artery. The stent diameter ranged from 2.5 to 3.5 mm, and the length, 15 to 20 mm. All patients were followed up at 1,3 and 6 months. There was two deaths: one had subacute thrombosis on both stents, and the other (who was HIV positive) had sudden cardiac death. The 6-month rate of major adverse cardiac events was 4% and target lesion revascularization rate ws 2%. CONCLUSION, This ulti-locational study brings out that the use of indigenously developed paclitaxel-eluting stent is safe and clinically efficacious.

Conventional ventilation in neonates: experience from Saudi Arabia.

OBJECTIVE: To study the clinical profile and immediate outcome of inborn neonates receiving intermittent positive pressure ventilation (IPPV) at the neonatal intensive care unit of Civil Hospital, Khamis Mushayt, Saudi Arabia, a level II nursery. METHODS: 78 liveborn neonates who had received IPPV over a 20 months period from January 1999 to August 2000 were reviewed from their charts and nursery registers. The indications for IPPV and the immediate outcome including complications were studied with respect to various weight groups (1 kg or less, > 1-1.25 kg, > 1.25-1.5, > 1.5-2 kg and > 2 kg) and gestation groups (28 weeks or less, 29-32 weeks, 33-36 weeks and full term). RESULT: Hyaline Membrane disease (n = 31, 39.7%) and perinatal asphyxia (n = 29, 37.2%) were the major indications for IPPV. 67.9% (53 of the 78) ventilated neonates survived. The chances for survival showed a statistically significant increase with increasing birthweight (P = 0.0006) and with increasing gestational age (P = 0.002). (80%) (44 of 55) of neonates weighing more than 1.25 kg survived vs 39.1% (9 of 23) of those 1.25 kg or less, P = 0.0011. Similarly, 79.3% (46 of 58) of neonates of 29 or more weeks of gestation survived vs 35% (7 of 20) of those 28 weeks or less, P = 0.0007. The complications seen in the study group included blood culture positive sepsis (n = 7), pulmonary hemorrhage (n = 6), air leak syndromes (n = 4), endotracheal tube related problems (n = 5), chronic lung disease (n = 3) and retinopathy of prematurity (n = 2). CONCLUSION: Gestational age of less than 28 weeks and birth weight less than 1.25 kg can be recommended as the cut off weight and gestation criteria for in utero transfer in this centre and upgradation of existing facilities are urgently called for to improve the survival rates further.