A REVIEW ARTICLE ON THERAPEUTIC POTENTIAL OF GARLIC

Garlic or Lashun is the member Liliaceae family, is use as spice in food cooking as well as medicine to treat various ailments. Garlic is also acting as a flavoring agent for the cooking, and however it has also been used as a drug from very ancient and modern times in all over the world, it is used to inhibit and cure the vast range of ailments and disorders. Allicin found in the garlic is the chemically active substance of fresh garlic extract, possess the capacity of readily permeable through phospholipid membranes which contributes to its possible pharmacological activity and also contain sulfur compounds, which are believed to bring some of the health benefits. Currently, garlic is broadly used for different diseases related with the systemic circulation and heart, which includes atherosclerosis, HDL, LDL & heart attack, coronary heart disease, and hypertension. Garlic is also reported to treat the lung cancer, and various other cancers such as colon cancer& skin diseases too, it also has hypolipidemic, immunomodulator, aphrodisiac, & Antifungal actions. This article reviews the importance of garlic (Allium sativum), and, their active constituents to show whether or not can be further used as potential natural sources for the development of any novel drug formulations.

Cytology and Biochemical Analysis of Pleural Effusion in Dogs

Pleural effusion is the accumulation of fluid in the pleural space due to disruption of the hydrostatic and starling forces which maintain the pressure of pleural cavity. A total of 42 dogs presented to Madras Veterinary College Teaching Hospital Small Animal Medicine Outpatient Unit with a history of cough and dyspnea were selected. Pleural effusion was diagnosed and classified into cardiac, hepatic and tumour and others group based on physical examination, radiography, electrocardiography, ultrasonography, echocardiography, cytological and biochemical evaluation of pleural fluid. The incidence of pleural effusion was 13.5% of the respiratory cases. Cytology of pleural fluid revealed the presence of lymphocytes, neutrophils, macrophages, RBCs, fibrin and mesothelial cells. Cytology of tumour group revealed mesothelioma (3), adenocarcinoma (1) and lymphoma (1). Cytology of other group revealed the presence of numerous RBCs and a few mesothelial cells in hemothorax and mature and degenerated neutrophils along with the presence of numerous clumps of bacteria and macrophages in pyothorax. Estimation of LDH of pleural effusion and ratio of pleural fluid to serum LDH was effective to classify pleural fluid into transudate, exudate and modified transudate

Tumor-like Presentation of Tubercular Brain Abscess: Case Report

A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.

Needs assessment to identify the areas for the development of self learning modules in subject ashtang hridaya of first BAMS course.

Background and Objectives: M The new syllabus for the Ashtang hridaya by CCIM has addition of few more concepts. On the other hand number of lectures for the subject are reduced. It is practically difficult to teach complete syllabus in the given time. In the changed course structure and reduced lecture hours. The classroom teaching hours can be managed by development of self learning modules for the subject. Objectives: To identify the need of self learning modules. To enlist the must know, nice to know and desired to know areas of Ashtang Hridaya. To enlist the areas for Self learning and Classroom teaching. To evaluate efficacy of Self learning e Modules. Materials and Methods : Online Survey Faculties working in the Department of Basic Principles. with Questionnaire (www.qualtrics.com) was conducted. (63 completed Responses) and data was analysed. Development of Self learning eModule:- on the Chapter “Gandushadividhi” in Ashtang Hridaya. Testing of Module. Results: Study indicates that faculty came out with a clear mandate of Need of Self Learning Module.( Chi squared P<0.01) Ashtang hriday syllabus was classified is 18 Chapters in for Must Know(18), Nice to know (4) and desirable to know(7). Chapters were identified for Classroom teaching(20) and self learning(10). Insignificant distribution was observed for 7 chapters. Self learning module created on Gandishadividhi Chapter was tested on I BAMS students by Pre test and Post Tests (with Questionnaire containing 15 Questions) shows statistically significant (p<0.001) results for paired t test. Conclusions: There is certainly need of self learning modules for the I BAMS course. Study distributes in must know, nice to know and desired to know and chapters in Ashtang hridaya and classifies chapters for Classroom teaching and self learning. The self learning e Module shown statistically significant results when evaluated on I BAMS students.

Prevalence of work-related musculoskeletal complaints among dentists in India: A national cross-sectional survey.

Context: Work-related musculoskeletal disorders (WRMSD) had been previously reported to have a high prevalence among dentists in different parts of the world. Aims: The study aimed to assess the prevalence of self-reported WRMSD among dental professionals in India. Material and Methods: A cross-sectional survey of 646 dentists (response rate of 82.97%) was done using self-administered questionnaire which consisted of 27 items based on Nordic questionnaire for screening WRMSDs. Additional items of the questionnaire were added after preliminary content validation from six experienced dentists. Participant socio-demographic characteristics, work-related physical load characteristics, musculoskeletal symptom characteristics were evaluated. Statistical analysis used: All data were analyzed descriptively using percentiles and association between work-related physical load and WRMSD prevalence was done using Chi-square test. Results: All 536 dentists had at least one work-related musculoskeletal symptom in the previous year with an overall period prevalence rate of 100%. The type of symptoms present were pain (99.06%), stiffness (3.35%), fatigue (8.39%), discomfort (12.87%), clicks/sounds (4.1%), and other neurogenic (20.14%). The regions of symptoms were neck (75.74%), wrist/hand (73.13%), lower back (72.01%), shoulder (69.4%), hip (29.85%), upper back (18.65%), ankle (12.31%), and elbow (7.46%). Number of regions affected were two (82.83%), three (51.86%), four, or more (15.11%). Recurrent symptoms were present in 76.11%. Strong association was noted between sustained work postures and symptom regions for pain in WRMSD. Conclusion: The study found an overall one-year period prevalence rate of 100% for WRMSDs among Indian dentists. Measures for improving education and ergonomic evaluations are indicated on a large scale to prevent decline in work performance and incidence of WRMSDs among Indian dentists.

Standardisation of a two-site PTH immunoradiometric assay using various solid phase formats.

Background & objectives: Estimation of parathyroid hormone (PTH) levels is important in the management of metabolic bone disorders. Here we describe a simple, sensitive and specific second generation immunoradiometric assay (IRMA) to detect intact PTH levels using different solid phase matrices. Different methods for immobilization of antibodies have also been evaluated. Methods: Experiments were carried out with physical adsorption of antibodies, covalent coupling using 2 per cent glutaraldehyde and N,N`carbonyldiimidazole. In all cases, antibodies raised against C-terminal were used as solid phase agent. Detector antibodies were N terminal antibodies that were radio-iodinated with 125I followed by gel purification. Several of the antibodies coupled to various solid phase matrices were incubated with PTH standards and the detector antibody as well as the commercially available tracer from DiaSorin kit to identify a suitable match pair. Results: The best pair was polyclonal C-terminal PTH antibody along with the kit tracer from DiaSorin with regards to antibody coated to magnetic cellulose particles. Among the various antibodies and the solid phases evaluated, the best assay was obtained with the matched pair of antibodies (70×G67 and 70×G68) from Fitzgerald immobilized on polystyrene tubes. The polyclonal antibody against C-terminal PTH was chosen as the capture antibody and 125I labelled polyclonal antibody against N-terminal PTH as the tracer. The sample values obtained in the antibody coated tubes were comparable to those obtained using a commercial kit. Interpretation & conclusions: The results indicated the feasibility of adopting this system for further development into a PTH IRMA for regular production as there is no indigenous kit available for intact PTH.

Enhanced detection of herpes simplex virus from ocular specimens of herpetic keratitis patients.

Corneal scrapings collected from 70 patients were used to assess the diagnostic value of indirect immunofluorescence (indirect IF) procedure in comparison with routine virus culture (RVC) for the diagnosis of Herpes simplex virus induced keratitis (HSK). Virus specific antigen was detected by indirect IF in 22 (31.42%) cases. In contrast, only 20% (14) of the cases had positive viral isolation which sometimes took as long as a week to show a cytopathogenic effect (CPE). It is concluded that antigen detection by indirect IF is a rapid, specific and sensitive technique for demonstrating HSV-1 antigen in corneal scrapings from HSK patients and a useful laboratory tool not only for diagnosing HSK but also for monitoring efficiency of anti HSV treatment for HSK.

Acanthamoeba keratitis--a report of two cases.

Two cases of unilateral corneal ulcers caused by Acanthamoeba are reported. Neither of the patients had contact lenses at any time. The diagnosis was confirmed by Giemsa stain and cultures of the corneal scrapings.

Interpretation of treadmill stress test in patients with coronary artery disease receiving beta blocker therapy.

Graded maximal treadmill exercise responses were studied before and after beta blockade (atenolol 100 mg once daily for 2 weeks) in 20 male patients with chronic stable angina. Beta-blocking effect consisted of significant reduction of resting heart rate (HR) by 21%, systolic blood pressure (SBP) by 12% and rate pressure product (RPP) by 30%. While the maximum exercise capacity was marginally increased by mean 1.7 min +/- 1.6 SD (P less than 0.001) under the influence of therapy, peak HR, SBP and maximum RPP were significantly lower (P less than 0.001) than in preatenolol exercise tests. Similarly, while the configuration and magnitude of ST segment depression did not differ materially between the pre and post atenolol tests, onset time of ST change was delayed and offset time shortened significantly. These parameters cannot be relied upon to assess the extent and severity of coronary artery disease (CAD) if stress test is carried out while the patient is on a beta-blocking drug. The overall sensitivity of the stress test to detect coronary disease is, however, not likely to be compromised because of negligible influence of beta-blockers upon ST segment depression provided maximally tolerated (not submaximal) exercise is performed. ST/HR slope, an exercise test variable known to correlate well with the extent of CAD, was shown to be uninfluenced by beta-blockade. Its measurement is therefore recommended in interpreting stress tests performed in patients receiving beta-blocker therapy. This, however, requires a meticulously prepared protocol of recording computer averaged QRST complexes and multilead ECG tracings at very frequent intervals throughout the exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Nasopharyngeal carriage of Neisseria meningitidis in general population and meningococcal disease.

Nasopharyngeal carriage of Neisseria meningitidis was determined in the normal healthy population in Delhi at monthly intervals for a period of 2 years from January, 1986 to December, 1987. Of a total of 6513 individuals screened only 107 (1.64 per cent) were found to carry Neisseria meningitidis serogroup A. There was no age and sex difference in carriage. During the same period, data of laboratory confirmed cases of meningitis due to N. meningitidis serogroup A was obtained from 6 hospitals of Delhi which acted as sentinel centres. Of the total 11,870 pyogenic C.S.F. samples processed, only 557 (4.69 per cent) were due to N. meningitidis serogroup A. There was no correlation observed between the nasopharyngeal meningococcal carriage in the healthy population with the disease prevalence. There was no seasonal variation in nasopharyngeal carriage though upsurge in the number of meningococcal meningitis cases was noticed from January to April.

Comparative study of monocomponent insulins and conventional insulins on the course of diabetic nephropathy. A follow-up study.

Two matched groups of insulin requiring non-insulin dependent diabetic (NIDDM) patients with mild proteinuria (200 to 999 mg/day), one on mono component (MC) insulin therapy and the other on conventional insulins were studied for a 3 year period to evaluate the course of nephropathy in these two groups. Twenty-seven and 35 patients were followed-up in the MC insulin and conventional insulin groups respectively. In the MC insulin treated group, the percentage of patients showing deterioration in proteinuria was lower (11% vs 34%, P less than 0.05) and the percentage showing improvement was higher (48% vs 29%) compared to the conventional insulin treated group. Insulin antibody titres decreased significantly in the MC insulin group and serum C-peptide values decreased in both groups on follow-up.

Autonomic function tests in cases of chronic severe anaemia.

Autonomic functions were studied in 30 adult cases of chronic severe anaemia (CSA) and equal number of age and sex matched healthy controls. Blood pressure and heart rate responses to standing, to respiration (expiratory-inspiratory ratio), to Valsalva manoeuvre (Valsalva ratio) and to hand immersion in ice cold water and given 1.8 mg of atropine intravenously were studied. Patients with CSA had significantly high basal pulse rate and low blood pressure as compared to control subjects (p less than 0.001). The expiratory inspiratory ratio was abnormal in 30% of the cases of CSA (p greater than 0.10) valsalva ratio was abnormal in 50% of cases (p less than 0.01) and postural tachycardia was observed in 60% of cases (p less than 0.001). Normal response to hand immersion in ice cold water was observed in 56.6% of cases (p less than 0.001). Atropine resulted in tachycardia in 73.4% of cases of CSA as compared to 86.7% of controls (p less than 0.10). All the cases of CSA showed one or more abnormal response and in 16.6% of cases all responses were abnormal.

Comparative efficacy of atenolol and labetalol in essential hypertension--a double blind cross over trial.

In a double blind cross-over drug trial, antihypertensive effects (resting and after dynamic exercise) of atenolol and of labetalol were studied in 20 patients of mild to moderate essential hypertension. Both drugs exhibited almost equal antihypertensive response, and were well tolerated. Haemodynamic variables (HR, SBP, DBP and RPP), both at rest and after maximal tread mill exercise, were significantly altered (P less than 0.001) by both drugs. Exercise capacity was observed to be marginally improved by atenolol. Although the antihypertensive effect, when compared between the two drugs, was not statistically significant, individual suitability or comparison revealed a preference for atenolol in 17 patients and for labetalol in 3 patients.

Retinopathy in insulin dependent diabetes mellitus (IDDM) in south India.

The prevalence of diabetic retinopathy was assessed by direct and indirect ophthalmoscopy in a group of patients with insulin dependent diabetes mellitus (IDDM). Fourteen percent of patients had retinopathy. Proliferative retinopathy and severe background retinopathy including maculopathy were both seen in four percent of patients. It is possible that the lower prevalence rates for these complications is due to the shorter duration of diabetes in our patients.

Steroid induced glaucoma and cataract.

Long term use of topical & systemic steroids produce secondary open angle glaucoma similar to chronic simple glaucoma. The increased IOP caused by prolonged steroid therapy is reversible but the damage produced by it is irreversible. In this study, we analysed 25 patients (44 eyes) with steroid induced glaucoma, who reported to us with dimness of vision, haloes and elevated I.O.P. and were using steroids for long duration due to various causes. The behaviour of the I.O.P. due to different steroid preparations, the type of lenticular change, and the management of those cases are discussed in this paper. From our study we conclude that dexamethasone and betamethasone both topical as well as systemic are more potent in producing glaucoma and cataract than medrysone and prednisolone. The condition is reversible without permanent damage when the duration of steroid therapy is short and vice versa.