Phytochemical composition, anti-microbial, anti-oxidant and anti-diabetic effects of Solanum elaeagnifolium Cav. leaves: in vitro and in silico assessments.

The aim of this study was to screen the chemical components of Solanum elaeagnifolium leaves and assess their therapeutic attributes with regard to their antioxidant, antibacterial, and antidiabetic activities. The antidiabetic effects were explored to determine the α-amylase and α-glucosidase inhibitory potential of the leaf extract. To identify the active antidiabetic drugs from the extracts, the GC-MS-screened molecules were docked with diabetes-related proteins using the glide module in the Schrodinger Tool. In addition, molecular dynamics (MD) simulations were performed for 100 ns to evaluate the binding stability of the docked complex using the Desmond module. The ethyl acetate had a significant total phenolic content (TPC), with a value of 79.04 ± 0.98 mg/g GAE. The ethanol extract was tested for its minimum inhibitory concentration (MIC) for its bacteriostatic properties. It suppressed the growth of B. subtilis, E. coli, P. vulgaris, R. equi and S. epidermis at a dosage of 118.75 µg/mL. Moreover, the IC50 values of the ethanol extract were determined to be 17.78 ± 2.38 in the α-amylase and and 27.90 ± 5.02 µg/mL in α-glucosidase. The in-silico investigation revealed that cyclolaudenol achieved docking scores of -7.94 kcal/mol for α-amylase. Likewise, the α-tocopherol achieved the docking scores of -7.41 kcal/mol for glycogen phosphorylase B and -7.21 kcal/mol for phosphorylase kinase. In the MD simulations, the cyclolaudenol and α-tocopherol complexes exhibited consistently stable affinities with diabetic proteins throughout the trajectory. Based on these findings, we conclude that this plant could be a good source for the development of novel antioxidant, antibacterial, and antidiabetic agents.Communicated by Ramaswamy H. Sarma.

Serum siderocalin levels in patients with tuberculosis and HIV infection.

OBJECTIVES: Mycobacterium tuberculosis produces high-affinity siderophores that play essential roles in iron acquisition and tuberculosis (TB) pathogenesis. In response, host cells secrete a siderophore-binding protein, siderocalin, to limit the bacteria's access to iron. The objective of the present study was to evaluate the levels of siderocalin in patients with TB with or without HIV infection compared to controls. METHODS: Siderocalin levels were tested using a neutrophil gelatinase-associated lipocalin (NGAL) ELISA kit in four populations: HIV-infected patients with TB (HIVpos, TBpos), non-HIV-infected patients with TB (HIVneg, TBpos), HIV-infected patients without TB (HIVpos, TBneg), and healthy controls (HIVneg, TBneg). RESULTS: Serum siderocalin levels were significantly elevated in patients with TB regardless of their HIV status (HIVneg, TBpos 920 (480-1050) pg/ml; HIVpos, TBpos 494 (166-1050) pg/ml), whereas lower levels of siderocalin were seen in HIV-positive patients (HIVpos, TBneg 268 (77-937) pg/ml; HIVneg, TBneg 453 (193-994) pg/ml). CONCLUSIONS: The results indicate that active TB leads to an up-regulation of serum siderocalin regardless of HIV status, whereas HIV infection leads to a down-regulation of serum siderocalin levels in both TB-negative and TB-positive individuals. Further studies are needed to evaluate siderocalin as a potential marker of active TB and to clarify its role in the pathogenesis of HIV-associated TB.

Instilling fear makes good business sense: unwarranted hysterectomies in Karnataka.

This paper uses data from two fact-finding exercises in two districts of Karnataka to trace how government and private doctors alike pushed women to undergo hysterectomies. The doctors provided grossly unscientific information to poor Dalit women to instil a fear of "cancer" in their minds to wilfully mislead them to undergo hysterectomies, following which many suffered complications and died. The paper examines a review, made by two separate panels of experts, of women's medical records from private hospitals to illustrate that a large proportion of the hysterectomies performed were medically unwarranted; that private doctors were using highly suspect diagnostic criteria, based on a single ultrasound scan, to perform the hysterectomies and had not sent even a single sample for histopathology; and that the medical records were incomplete, erroneous and, in several instances, manipulated. The paper describes how a combination of patriarchal bias, professional unscrupulousness and pro-private healthcare policies posed a serious threat to the survival and well-being of women in Karnataka.

Risk scoring system to predict contrast induced nephropathy following percutaneous coronary intervention.

BACKGROUND: Contrast induced nephropathy (CIN) is associated with significant morbidity and mortality after percutaneous coronary intervention (PCI). The aim of this study is to evaluate the collective probability of CIN in Indian population by developing a scoring system of several identified risk factors in patients undergoing PCI. METHODS: This is a prospective single center study of 1200 consecutive patients who underwent PCI from 2008 to 2011. Patients were randomized in 3:1 ratio into development (n = 900) and validation (n = 300) groups. CIN was defined as an increase of ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 hours after PCI when compared to baseline value. Seven independent predictors of CIN were identified using logistic regression analysis - amount of contrast, diabetes with microangiopathy, hypotension, peripheral vascular disease, albuminuria, glomerular filtration rate (GFR) and anemia. A formula was then developed to identify the probability of CIN using the logistic regression equation. RESULTS: The mean (±SD) age was 57.3 (±10.2) years. 83.6% were males. The total incidence of CIN was 9.7% in the development group. The total risk of renal replacement therapy in the study group is 1.1%. Mortality is 0.5%. The risk scoring model correlated well in the validation group (incidence of CIN was 8.7%, sensitivity 92.3%, specificity 82.1%, c statistic 0.95). CONCLUSION: A simple risk scoring equation can be employed to predict the probability of CIN following PCI, applying it to each individual. More vigilant preventive measures can be applied to the high risk candidates.

Door-to-balloon: where do we lose time? Single centre experience in India.

BACKGROUND/AIMS: To assess the factors causing delay in attaining DTB time of <90 min. METHODS: Eighty-five patients who underwent primary PCI from August 2008 to July 2009 were studied. From door-to-balloon, time was divided into 6 stages; any reason for delay was studied. RESULTS: The mean DTB time was 80.5 min (SD = 34.4, median time 75 min, range 30-195). DTB time was <90 min in 76.5%, and DTB time >90 min occurred in 23.5%. Mean door to ECG - 6.5 min (SD = 2.7), mean time for the decision of PCI - 7.5 min (SD = 10.5), mean time taken for the patient's consent - 19.6 min (SD = 17.6), for STEMI team activation - 6.7 min (SD = 7.6), average time for financial process - 39.2 min (SD = 22.9). Average time for sheath to balloon - 5.2 min (SD = 1.7). Hospital related delay occurred in 5%, patient related delay in 80%, both together in 15%. 89.5% of patient related delay was due to delay in giving consent and financial reasons. There was no statistically significant delay for patients presented at morning or night and during the weekdays or weekend. Total mortality was 4.7%. Mortality among <90 min was 3.1%, mortality among >90 min was 10% ('p' = 0.2). CONCLUSIONS: With effective hospital strategies, the DTB time of 90 min can be achieved in majority of patients. The chief delay in DTB time in this study was due to a delay in obtaining consent and financial reasons.