Moringa oleifera (Lam.): a natural remedy for ageing?

Effect of Moringa oleifera, an age-old ingredient of Indian ayurvedic and traditional medicine, was tested for its effect on age related antioxidant activity in Wistar albino rats of three age groups (6, 12 and 18 months old). Aqueous extract of M. oleifera leaves (MOAE) was administered orally at a dosage of 200 mg/kg body weight for a period of 30 days. MOAE treatment showed significant reduction in lipid peroxidation and lipofuscin pigmentation along with elevated serotonin and antioxidant enzymes in the brains of treated groups of aged rats. LC-MS-MS analysis revealed blood brain barrier permeable secondary metabolites viz., 9,9-bianthracene, 4-Methoxycinnamic acid, Cinnamic acid, (E)-p-coumaric acid pyrogallol and ostruthin from the extract. 9,9-bianthracene and ostruthin showed better binding affinity to Keap-1 and SERT in silico. The present result suggests the protective efficacy of M oleifera against age related oxidative stress in brain.

Cryopreservation of Encapsulated Axillary Buds of Clitoria ternatea (L.).

BACKGROUND: Clitoria ternatea is a brain revitalizing legume, with immense pharmacological value including antimicrobial, antioxidant and anticancer. The lack of a commercial cultivation has led to its' over collection from the wild to meet the demand of herbal pharmaceutical sector and the species is now rare in the wild. Hence, the plant needs to be conserved. Cryopreservation of the species would supplement the conventional conservation strategies in the field or seed bank. OBJECTIVE: The objective of the study was to evolve an efficient and simple protocol for the cryopreservation of Clitoria ternatea using an encapsulation-dehydration technique. MATERIALS AND METHODS: An in vitro culture system via axillary shoot proliferation was developed using nodal segments in MS medium and optimization of the levels of cytokinins and auxins. Calcium alginate encapsulated axillary buds were subjected to 0-5 h of dehydration, to determine the optimum drying time and moisture content for effective cryopreservation. RESULTS: The beads dehydrated for 4 h to 20.1 % moisture content had 60 % survival after freezing in LN, of which 65 % regrew. Based on RAPD analysis, the plants regrowing after cryostorage were genetically stable. CONCLUSION: A simple and efficient cryopreservation protocol has been established for C. ternatea using an encapsulation-dehydration technique, and this could be effectively utilized for germplasm conservation of this species.

Pulmonary Mycobacterium kansasii disease in immunocompetent host: Treatment outcomes with short-course chemotherapy.

Mycobacterium kansasii, most virulent of all atypical mycobacteria, causes pulmonary disease identical to the disease caused by Mycobacterium tuberculosis. Early identification of the species and prompt initiation of treatment for M. kansasii is necessary to prevent morbidity and mortality due to this disease. This case series highlights the similarity in the clinical presentation of both M. tuberculosis and M. kansasii and response to direct observation of short-course chemotherapy with rifampicin, in the management of pulmonary M. kansasii disease. Larger studies are required to evaluate the long-term effect of short-course chemotherapy, especially use of moxifloxacin, in the management of pulmonary M. kansasii disease.

Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma.

OBJECTIVE: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients. MATERIALS AND METHODS: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 weekly regimen with cisplatin and docetaxel as 75 mg/m 2 each, 5-FU as 1000 mg/m 2 . NACT was either given with the intent of achieving: (1) surgical resection (extensive soft tissue disease, oropharyngeal involvement, extensive disease with cartilage erosion) or (2) organ preservation (Bulky disease with inner cartilage erosion, exolaryngeal disease without cartilage erosion, large N3 nodes). RESULTS: The mean age of this population was 55 years. Most (83%) of the patients had pyriform sinus (PFS) involvement. 69% patients had Stage IVa disease, 21% Stage IVb and 10% Stage III. The overall response rate was 66%, including 06% complete responses and 60% partial responses. Following NACT, resectability was achieved in 30% (10/33) and organ preservation protocol was planned after NACT in 73% (19/26) patients. The main toxicities were neutropenia (grade 3, 4, 04%; febrile neutropenia, 4%), mucositis 5%, diarrhea 5%. The median progression free survival was 20 months. CONCLUSIONS: NACT can be useful in patients with oropharyngeal involvement to achieve surgical resection and larynx preservation in patients with bulky T3 disease.

Extensively drug-resistant tuberculosis: experience at the Tuberculosis Research Centre, Chennai, India.

Ten extensively drug-resistant tuberculosis (XDR-TB) patients were identified among 104 human immunodeficiency virus negative multidrug-resistant tuberculosis (MDR-TB) patients treated at the Tuberculosis Research Centre, Chennai, India, in two different cohorts between 1999-2003 and 2006-2007. They were managed with individualised treatment regimens. At the time of diagnosis of MDR-TB, one patient had XDR-TB and three had initial ofloxacin resistance. One patient who had had a lobectomy in addition to chemotherapy became bacteriologically negative, three died, three defaulted and the remaining three, who are bacteriologically positive, are still continuing treatment. Although based on a small number of patients, our results have not been encouraging.

Assessing recovery in middle cerebral artery stroke using functional MRI.

PRIMARY OBJECTIVE: To understand the temporal evolution of brain reorganization during recovery from stroke. RESEARCH DESIGN: A patient who suffered left middle cerebral artery stroke 9 months earlier was studied on three occasions, approximately 1 month apart. METHODS AND PROCEDURES: Brain activation was studied using functional Magnetic Resonance Imaging (fMRI). During each session, the patient performed a finger-to-thumb opposition task, which involved one bimanual and two unimanual conditions. Each condition consisted of overt movement of fingers and imagery of the same task. RESULTS: With recovery, greater recruitment was observed of the affected primary motor cortex (M1) and a decrease in activation of the unaffected M1 and supplementary motor area. In addition, the widespread activation of brain areas seen during the initial session changed to a more focused pattern of activation as the patient recovered. Imagery tasks resulted in similar brain activity as overt execution pointing to imagery as a potential tool for rehabilitation.

[Electric brain stimulation for epilepsy therapy]. / Elektrische Hirnstimulation in der Epilepsietherapie.

Attempts to control epileptic seizures by electrical brain stimulation have been performed for 50 years. Many different stimulation targets and methods have been investigated. Vagal nerve stimulation (VNS) is now approved for the treatment of refractory epilepsies by several governmental authorities in Europe and North America. However, it is mainly used as a palliative method when patients do not respond to medical treatment and epilepsy surgery is not possible. Numerous studies of the effect of deep brain stimulation (DBS) on epileptic seizures have been performed and almost invariably report remarkable success. However, a limited number of controlled studies failed to show a significant effect. Repetitive transcranial magnetic stimulation (rTMS) also was effective in open studies, and controlled studies are now being carried out. In addition, several uncontrolled reports describe successful treatment of refractory status epilepticus with electroconvulsive therapy (ECT). In summary, with the targets and stimulation parameters investigated so far, the effects of electrical brain stimulation on seizure frequency have been moderate at best. In the animal laboratory, we are now testing high-intensity, low-frequency stimulation of white matter tracts directly connected to the epileptogenic zone (e.g., fornix, corpus callosum) as a new methodology to increase the efficacy of DBS ("overdrive method").

Tuberculosis in Bombay: new insights from poor urban patients.

This study explores the health seeking behaviour of poor male and female tuberculosis patients in Bombay, and examines their perceptions of the causes and effects of the disease on their personal lives. Sixteen patients who attended an NGO's tuberculosis clinic were interviewed in-depth. Almost equal numbers of respondents stated 'germs' and 'worry' as the cause of tuberculosis. Men worried about loss of wages, financial difficulties, reduced capacity for work, poor job performance, and the consequences of long absence from work. Women were concerned about rejection by husband, harassment by in-laws, and the reduced chances of marriage (for single women), in addition to their concerns about dismissal from work. During the first two months of symptoms most patients either did nothing or took home remedies. When symptoms continued, private practitioners were the first source of allopathic treatment; they were generally unable to correctly diagnose the disease. Respondents shifted to municipal and NGO health services when private treatment became unaffordable. Respondents shifted again to NGO-based services because of the poor quality of municipal tuberculosis control services. The wage-earning capacity of both men and women was affected, but women feared loss of employment whereas men, being self-employed, lost wages but not employment. Married men and single women perceived a greater level of family support to initiate and complete treatment. Married women tried, often unsuccessfully, to hide their disease condition for fear of desertion, rejection or blame for bringing the disease. Women dropped out from treatment because of the pressure of housework, and the strain of keeping their condition secret particularly when the reasons for their movements outside the home were routinely questioned. Health programmes will have to be sensitive to the different needs and concerns of urban men and women with tuberculosis; in the case of women, health care providers will have to make particular efforts to identify and treat married women with tuberculosis completely.

PIP: 16 low-income patients attending a nongovernmental organization's (NGO) tuberculosis (TB) clinic in Bombay were interviewed to gain insight into their health-seeking behavior and perceptions of the causes and effects of TB upon their personal lives. There were seven male respondents of mean age 22.0 years and nine females of mean age 21.2 years. Almost equal numbers of respondents cited germs and worry as the cause of TB. Most patients either did nothing or took home remedies during the first 2 months of symptoms. When symptoms continued, private practitioners were the first source of allopathic treatment, although they were generally unable to correctly diagnose the disease. Respondents later sought municipal and NGO health services when private treatment became unaffordable. Respondents shifted again to NGO-based services because of the poor quality of municipal TB control services. With their health compromised, women feared the loss of employment. Since the men were self-employed, they lost wages, but not their jobs. Married men and single women perceived a greater level of family support to initiate and complete treatment, while married women tried to hide their condition out of fear of desertion, rejection, or blame for introducing TB to the household. Women dropped out of treatment because of the pressure of housework and the effort required to keep their disease secret.

Effects of dietary fatty acids in an animal model of focal glomerulosclerosis.

The obese Zucker rat develops hyperlipidemia, proteinuria and focal glomerulosclerosis without prior changes in renal hemodynamics. To study the effects of oral fatty acid intake on the development of renal injury in this model, rats were fed standard chow or chow supplemented with either 14% fish oil or 14% beef tallow after unilateral nephrectomy at the age of 10 weeks. At 32 weeks post-nephrectomy animals were sacrificed and renal tissue saved to assess histology and glomerular eicosanoid production. Fish-oil treated rats had lower mean plasma cholesterol levels and developed less proteinuria than control or tallow-fed animals although there was no difference in plasma creatinine or blood pressure. Histological analysis showed significantly fewer sclerosed glomeruli in the fish oil group (4.0 +/- 0.8% vs. control 19.4 +/- 4.1%, P less than 0.0005 and vs. beef tallow 10.8 +/- 1.9%, P less than 0.005). Glomeruli derived from rats on fish oil supplements produced smaller amounts of prostaglandin (PG)E2 and of the stable metabolites of PGI2 (6-oxo-PGF1 alpha), PGF2 (PGF2 alpha) and thromboxane (TX)A2 (TXB2) than those from tallow-fed animals. This study demonstrates that oral fatty acid intake may influence the development of glomerulosclerosis. The apparent beneficial effects of fish oil have not been fully defined, but may relate to favorable changes in plasma lipid concentration and renal eicosanoid production.