Symphytum officinale augments osteogenesis in human bone marrow-derived mesenchymal stem cells in vitro as they differentiate into osteoblasts.

ETHNOPHARMACOLOGICAL RELEVANCE: Mesenchymal stem cells (MSCs) are multipotent stem cells possessing regenerative potential. Symphytum officinale (SO) is a medicinal plant and in homoeopathic literature, believed to accelerate bone healing. AIM OF THE STUDY: This study aimed to determine if homoeopathic doses of SO could augment osteogenesis in MSCs as they differentiate into osteoblasts in vitro. MATERIALS AND METHODS: Bone marrow samples were obtained from patients who underwent bone grafting procedures (n = 15). MSCs were isolated, expanded and characterized by flow cytometry (CD90, CD105). Cytotoxicity of SO was evaluated by MTT assay. Osteogenic differentiation was induced in MSCs with ß-glycerophosphate, ascorbic acid and dexamethasone over 2 weeks. Different homoeopathic doses of SO (MT, 3C, 6C, 12C and 30C) were added to the basic differentiation medium (BDM) and efficiency of MSCs differentiating into osteoblasts were measured by evaluating expression of Osteocalcin using flow cytometry, and alkaline phosphatase activity using ELISA. Gene expression analyses for osteoblast markers (Runx-2, Osteopontin and Osteocalcin) were evaluated in differentiated osteoblasts using qPCR. RESULTS: Flow cytometry (CD90, CD105) detected MSCs isolated from bone marrow (93-98%). MTT assay showed that the selected doses of SO did not induce any cytotoxicity in MSCs (24 hours). The efficiency of osteogenic differentiation (2 weeks) for different doses of Symphytum officinale was determined by flow cytometry (n = 10) for osteoblast marker, Osteocalcin, and most doses of Symphytum officinale enhanced osteogenesis. Interestingly, gene expression analysis for Runx-2 (n = 10), Osteopontin (n = 10), Osteocalcin (n = 10) and alkaline phosphatase activity (n = 8) also showed increased osteogenesis with the addition of Symphytum officinale to BDM, specially mother tincture. CONCLUSIONS: Our findings suggest that homoeopathic dose (specially mother tincture) of Symphytum officinale has the potential to enhance osteogenesis.

Reconstruction with fibular autograft and silicone implant arthroplasty after resection of giant-cell tumour of the proximal phalanx: a case report with 18-month follow-up.

Primary giant-cell tumour of phalanx is a rare entity. Only few cases are described in the literature. Giant-cell tumour of hand is reported to have high local recurrence rate. Curettage and bone grafting have been performed by few authors with limited success. Most of the cases have been treated with ray amputation. We report this case as the first reported case in the literature that has been treated with fibular autograft and silicone implant arthroplasty for giant-cell tumour of the proximal phalanx.

Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal.

INTRODUCTION: WHONET is a freely downloadable, Windows-based database software which is used for the management and analysis of microbiology data, with a special focus on the analysis of antimicrobial susceptibility test results. Urinary Tract Infections (UTI) are a common medical problem and they are responsible for notable morbidity among young and sexually active women. OBJECTIVES: The major objective of this study was the utilization and application of the WHONET program for the Antimicrobial Resistance (AMR) surveillance of uropathogens. METHODS: A total of 3209 urine samples were collected from patients who visited Manipal Teaching Hospital with a clinical suspicion of UTI, during December 2010 to July 2011. The isolation and characterization of the isolates were done by conventional methods. Antimicrobial Susceptibility Testing (AST) was performed by Kirby Bauer's disc diffusion method. The data entry and analysis were done by using the WHONET 5.6 software. RESULTS: Out of the 3209 specimens, 497 bacterial isolates were obtained and they were subjected to AST. Escherichia coli (66.2%) was the commonest bacterial isolate, followed by Enterococcus species (9.3%), Staphylococcus aureus (5.0%), and Klebsiella pneumoniae (4.2%). Among the gram-negative enteric bacilli, a high prevalence of resistance was observed against ampicillin and ciprofloxacin. The gram negative nonfermenters exhibited a high degree of resistance to ceftazidime. Staphylococcus species. showed a moderately high resistance to co-trimoxazole. One isolate was Vancomycin Resistant Enterococci (VRE). CONCLUSION: This study, a first of its kind which was done in Nepal, was carried out by using the WHONET software to monitor, analyze and share the antimicrobial susceptibility data at various levels. This study was also aimed at building a surveillance network in Nepal, with the National Public Health Laboratory, Nepal, acting as a nodal centre. This would help in the formulation of antibiotic policies and in identifying hospital and community outbreaks at the nodal centre, as well as in sharing information with the clinicians at the local level.

Hemophilic pseudotumor--is there a role of radiotherapy? Literature review and a case report.

We share the literature and management of an adult with moderate hemophilia a presented with a calcaneal pseudotumor and non healing ulcer by radiation therapy, factor VIII and cryoprecipitate supplement. Numerous literatures so far have quoted the satisfactory role of radiotherapy in hemophilic pseudotumor. We found it to be of great help as our case responded with radiotherapy, factor VIII and cryoprecipitate supplement and has a satisfactory 2 years follow up.

Effect of naproxen on the pharmacokinetic parameters of rifampicin.

The effect of naproxen (500 mg) on the pharmacokinetics of rifampicin (450 mg) was evaluated in healthy human subjects (n = 10). Subjects participated in a two way crossover trial, the first dosing condition was rifampicin alone (control), and the second dosing condition was naproxen with rifampicin. The concentrations of rifampicin from the serum samples were determined by HPLC. The pharmacokinetic parameters indicated a significant (P < 0.05) increase in elimination rate constant (Ke), clearance (Cl), volume of distribution (Vd), while significant decrease in the mean residence time (MRT), and area under the concentration-time curve (AUC). Insignificant increase and decrease in absorption rate constant (Ka), and elimination half-life (t1/2), time for maximum concentration (Tmax), maximum drug concentration (Cmax) respectively was observed.

Pharmacokinetic study about interaction of Naproxen and Isoniazid.

Effect of Naproxen (500 mg) was studied on the pharmacokinetic characteristics of Isoniazid (300 mg) in ten healthy human volunteers in a complete crossover design. A high performance liquid chromatography (HPLC) method was used to analyze serum drug concentrations. Naproxen caused a highly significant (P<0.001) increase in AUC, significant (P<0.05) increase in elimination half life (t(1/2)) and time for the maximum drug concentration (tmax) while significant (P<0.05) decrease in elimination rate constant (Kc). Insignificant decrease and increase was observed in absorption rate constant (Ka) and maximum drug concentration (Cmax) respectively.

Organochlorine pesticide residues in human blood in the population of Multan (Pakistan).

Organochlorine pesticide residues were monitored in samples of human blood (N=32), obtained from concerned volunteers suspecting oral, dermal, or inhalation exposure to Endosulfan and Heptachlor, either environmentally, or occupationally, either recently or in the recent past of Multan Division, (Pakistan) during 1995-96. The pesticide residues were extracted with n-hexane; detection and quantification was performed by gas chromatography (Shimadzu GC 14-A) with a 63Ni-Electron Capture Detector (ECD). Residues of Endosulfan were found higher as compared to Heptachlor in all samples. The highest concentration of Endosulfan residues in blood in the population of Multan and Mailsi regions was 90.29 g/kg and 82.14 g/kg, lowest as 58.13 g/kg and 60.13 g/kg while Heptachlor had highest level as 12.978 g/kg and 9.997 g/kg, minimum as 0.37 g/kg and 1.23 g/kg respectively.