Anti-inflammatory effect of dikaempferol rhamnopyranoside, a diflavonoid from Eugenia jambolana Lam. Leaves.

Traditionally, the Indian Blackberry or locally called Jamun, Eugenia jambolana Lam. (Syn.: Syzygium cumini), is well known for its pharmacological potential, particularly anti-inflammatory. Here, we studied kaempferol-7-O-α-L-rhamnopyranoside]-4'-O-4'- [kaempferol-7-O-α-L-rhamnopyranoside (EJ-01) isolated from the E. jambolana leaves for possible anti-inflammatory activity. EJ-01 (3, 10 and 30 mg/kg, p.o.) was assessed for anti-inflammatory activity using carrageenan-induced paw edema model in mice by determining edema volume, myeloperoxidase (MPO), nitrite plus nitrate (NOx) and cytokine levels in paw edema tissue. EJ-01 significantly attenuated the edema, MPO levels, tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1ß) levels in the edema of paw at the 5th hour after carrageenan injection at all doses. EJ-01 (30 mg/kg) decreased the nitric oxide (NO) levels of the edema of paw at the 5th hour after carrageenan injection. The anti-inflammatory mechanisms of EJ-01 might be related to the decrease in the level of edema paw by reduced activities of NO and MPO. It probably exerts anti-inflammatory effects through the suppression of TNF-α and IL-1ß. Therefore, we conclude that EJ-01 could be positively exploited for itspotential benefits against inflammatory diseases and support the pharmacological basis of E. jambolana as traditional herbal medicine for the treatment of inflammatory diseases.

The use of cinacalcet in pregnancy to treat a complex case of parathyroid carcinoma.

UNLABELLED: We present the case of a patient with metastatic parathyroid carcinoma whose hypercalcaemia was medically managed through two pregnancies. The diagnosis was made when the patient presented with chronic knee pain and radiological findings consistent with a brown tumour, at the age of 30. Her corrected calcium and parathyroid hormone (PTH) levels were significantly elevated. Following localisation studies, a right parathyroidectomy was performed with histology revealing parathyroid carcinoma, adherent to thyroid tissue. Aged 33, following biochemical recurrence of disease, the patient underwent a second operation. A subsequent CT and FDG-PET revealed bibasal pulmonary metastases. Aged 35, the patient was referred to our unit for treatment of persistent hypercalcaemia. The focus of treatment at this time was debulking metastatic disease using radiofrequency ablation. Despite advice to the contrary, the patient conceived twice while taking cinacalcet. Even though there are limited available data regarding the use of cinacalcet in pregnancy, both pregnancies continued to term with the delivery of healthy infants, using intensive medical management for persistent hypercalcaemia. LEARNING POINTS: Parathyroid carcinoma is a rare cause of primary hyperparathyroidism.Hypercalcaemia during pregnancy can result in significant complications for both the mother and the foetus.The use of high-dose cinacalcet in pregnancy has been shown, in this case, to aid in the management of resistant hypercalcaemia without teratogenicity.

A synbiotic containing Lactobacillus gasseri [corrected] CHO-220 and inulin improves irregularity of red blood cells.

This randomized, double-blind, placebo-controlled, and parallel-design study was conducted to investigate the effect of a synbiotic product containing Lactobacillus gasseri [corrected] CHO-220 and inulin on the irregularity in shape of red blood cells (RBC) in hypercholesterolemic subjects. The subjects (n=32) were randomly allocated to 2 groups, a treatment group (synbiotic product) and a control group (placebo), and received 4 capsules of either synbiotic or placebo daily for 12 wk. Morphological representation via scanning electron microscopy showed that the occurrence of spur RBC was improved upon supplementation of the synbiotic. In addition, the supplementation of synbiotic reduced the cholesterol:phospholipids ratio of the RBC membrane by 47.02% over 12 wk, whereas the control showed insignificant changes. Our present study also showed that supplementation of the synbiotic reduced the concentration of saturated fatty acids (SFA), increased unsaturated fatty acids (UFA), and increased the ratio of UFA:SFA over 12 wk, whereas the control showed inconspicuous changes. The alteration of RBC membrane was assessed using fluorescence anisotropy (FAn) and fluorescence probes with different affinities for varying sections of the membrane phospholipid bilayer. A noticeable decrease in FAn of three fluorescent probes was observed in the synbiotic group compared with the control over 12 wk, indicative of increased membrane fluidity and reduced cholesterol enrichment in the RBC membrane.

Immune responses to hepatitis C virus structural and nonstructural proteins induced by plasmid DNA immunizations.

DNA-based immunizations have been used to elicit cellular immunity to hepatitis C virus (HCV) proteins in mice. Mice were immunized by intramuscular or intradermal injections of plasmid DNA derived from a near-full-length HCV genotype 1b genomic clone (pRC/B2) or individual genomic clones. These immunizations induced cytotoxic T lymphocytes (CTLs), as revealed in standard chromium-release assays that used syngeneic peptide-pulsed or transfected target cells. These assays identified four CTL epitopes within the capsid, E1, and E2 regions of the polyprotein sequence of HCV genotype 1a that were cross-reactive with HCV genotype 1b. Additionally, CTLs derived from mice immunized with either NS3 or NS5 specifically lysed target cells sensitized to either the genotype 1a or 1b gene products. Nucleic acid immunizations also generated humoral immunity to HCV proteins, as detected by anti-HCV reactivity to NS3 and capsid in ELISAs and immunoblot assays.

A novel human estrogen receptor beta: identification and functional analysis of additional N-terminal amino acids.

A novel human estrogen receptor beta (hERbeta) was cloned from human testis mRNA, ovary and thymus cDNA utilizing PCR and 5' RACE methods. The 5' end of hERbeta contained an additional open reading frame, in-frame and upstream of the published clones. hERbeta encodes a protein of 530 amino acids with an approximate molecular weight of 63 kDa and is larger than the previously reported rat, mouse and human protein. To determine the functional role of additional N-terminal amino acids, we compared the transcription functions of receptor lacking (hERbetaT) and receptor containing (hERbetaL) this N-terminal extension. hERbetaL is more active than hERbetaT in transactivating ERE-based reporter genes. hERbetaL, but not hERbetaT, attenuated cytokine mediated NFkappaB activation. Taken together, the additional N-terminal amino acids appear to play a role in modulating estrogen responsive gene expression in vitro.

Regulating the private health care sector: the case of the Indian Consumer Protection Act.

Private medical provision is an important constituent of health care delivery services in India. The quality of care provided by this sector is a critical issue. Professional organizations such as the Medical Council of India and local medical associations have remained ineffective in influencing the behaviour of private providers. The recent decision to bring private medical practice under the Consumer Protection Act (COPRA) 1986 is considered an important step towards regulating the private medical sector. This study surveyed the views of private providers on this legislation. They believe the COPRA will be effective in minimizing malpractice and negligent behaviour, but it does have adverse consequences such as an increase in fees charged by doctors, an increase in the prescription of medicines and diagnostics, an adverse impact on emergency care, etc. The medical associations have also argued that the introduction of COPRA is a step towards expensive, daunting and needless litigation. A number of other concerns have been raised by consumer forums which focus on the lack of standards for private practice, the uncertainty and risks of medicines, the effectiveness of the judiciary system, and the responsibility of proving negligence. How relevant are these concerns? Is the enactment of COPRA really appropriate to the medical sector? The paper argues that while this development is a welcome step, we need to comprehensively look into the various quality concerns. The effective implementation of COPRA presumes certain conditions, the most important being the availability of standards. Besides this, greater involvement of professional organizations is needed to ensure appropriate quality in private practice, since health and medical cases are very different from other goods and services. The paper discusses the results of a mailed survey and interview responses of 130 providers from the city of Ahmedabad, India. The questionnaire study was designed to assess the opinion of providers on various implications of the COPRA. We also analyze the data on cases filed with the Consumer Disputes and Redressal Commission in Gujarat since 1991. Four selected cases filed with the National Commission on Consumers Redressal are discussed in detail to illustrate various issues affecting the implementation of this Act.

PIP: The private sector provides an important proportion of overall health care delivery services in India. As such, efforts must be made to ensure that such services are of acceptable to high quality. With professional organizations such as the Medical Council of India and local medical associations unable to influence the behavior of private providers, the recent decision to bring private medical practice under the Consumer Protection Act (COPRA) 1986 is considered an important step toward regulating the private medical sector. The author surveyed the views of 130 private health care providers from the city of Ahmedabad on the legislation. Data were also analyzed on cases filed with the Consumer Disputes and Redressal Commission in Gujarat since 1991. While respondents believe that COPRA will reduce the levels of malpractice and negligent behavior among private practitioners, they envision an increase in physicians' fees, a greater number of prescriptions made and diagnostic tests conducted, and an adverse effect upon emergency medical care. Medical associations have argued that introducing COPRA will foster expensive and needless litigation. Other concerns have been raised by consumer forums.

A comparative clinico-pathological study of oral submucous fibrosis in habitual chewers of pan masala and betelquid.

BACKGROUND: Oral submucous fibrosis associated with chewing of betel nut products has an estimated prevalence of 0.2-1.2% in India. The increasing use of pan masala/gutkha, a mix of tobacco and a less moist form of betelquid lacking the betel leaf, seems associated with an earlier age of onset of oral submucous fibrosis. METHOD: A prospective study examined the in vivo effects of pan masala/gutkha and betelquid chewing on buccal mucosal cytology in 50 patients with oral submucous fibrosis and 40 controls. RESULTS: The percentage of nucleolated intermediate cells or proliferative fraction of buccal mucosa cells was significantly higher in all habitual chewers than controls. Pan masala/gutkha chewers presented with oral submucous fibrosis after 2.7 +/- 0.6 y of use whereas the betelquid users presented with oral submucous fibrosis reported 8.6 +/- 2.3 y of use (p < 0.05). CONCLUSIONS: Habitual chewing of pan masala/gutkha is associated with earlier presentation of oral submucous fibrosis than betelquid use. Factors which may be responsible for these differences are the tobacco content, the absence of the betel leaf and its carotenes and the much higher dry weight of pan masala/gutkha.

Traditional herbal medicine in Transkei.

The indigenous people of Transkei depend on natural plant resources from the forests for the medicinal, cultural, religious and other needs. This area, predominantly occupied by the Xhosa people, has remained ethnobotanically unexplored until recently. The present survey among the traditional doctors, herbalists, herb sellers, tribal priests and local people recorded medicinal uses of 26 plants. The firsthand information points out the significance of local plants to tribal groups and people of Transkei.