Anti-diabetic and anti-cataract effects of Chromolaena odorata Linn., in streptozotocin-induced diabetic rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Chromolaena odorata Linn., is used in traditional Indian medicine in the treatment of diabetes and eye problems. AIM OF THE STUDY: The present study was designed to investigate the effect of the ethanol extract Chromolaena odorata leaves (ACO) in streptozotocin (STZ; 45 mg/kg, i.v) induced diabetes and cataract in rats. MATERIALS AND METHODS: Different doses of ACO (200 and 400mg/kg) was administered once daily for eight weeks to STZ-induced diabetic rats. To know the mechanism of action of title plant, AUC(glucose), AUC(insulin), Homeostatic Model Assessment (HOMA), insulin tolerance test (ITT) and glucose uptake by rat hemi-diaphragms were carried out. Further, cataract score was taken once in a week upto eight weeks and opacity index was measured. HPLC fingerprinting profiling of ACO was also carried out. RESULTS: Administration of ACO exhibited significant reduction in glucose, HOMA, lipid profiles and significantly improved glucose and insulin tolerance, glycogen content, glucose uptake by skeletal muscle, serum insulin and HDL-c levels. In addition, ACO also decreased oxidative stress by improving endogenous antioxidants. Further, treatment of ACO showed significantly reduced onset and extent of cataract. CONCLUSION: The present data suggested that the treatment of ACO reversed the STZ-induced diabetes and cataract in rats. The observed beneficial effects may be mediated by interacting with multiple targets operating in diabetes mellitus and its complication. Taken together, this study provided the scientific evidence for the traditional use of Chromolaena odorata.

Removal of sub-mucosal foreign body (metal wire) from the pharynx using image intensifier.

It is well known how difficult it is to localize a foreign body in the sub-mucosal tissues. This is a report of a male who swallowed a metal wire which lodged in the pharyngeal sub-mucosal tissue. The foreign body was localized using an image intensifier and removed successfully.

Spherical foreign bodies in the oesophagus removed by balloon angiographic catheter.

Two children aged three and seven years presented to the department of Otolaryngology with total dysphagia following the accidental swallowing of a steel ball bearing and a plastic ball. These rare spherical foreign bodies were removed successfully by oesophagoscopy under general anaesthesia using an innovative method involving a balloon angiographic catheter.

Transcanal atticoaditotomy and transcortical mastoidectomy for cholesteatoma: the Farrior-Olaizola technique revisited.

Conservative mastoid surgery in the management of middle ear cholesteatoma has been a subject of controversy for decades. Proponents of the combined-approach tympanoplasty for cholesteatoma do not entirely support the conservative approach in children, especially in the hands of an inexperienced surgeon. We describe here our experience with a modified technique of conservative mastoid surgery involving an atticoaditotomy and a separate simple mastoidectomy with lateral attic wall reconstruction (modified Farrior technique) that can be relatively safely used in the majority of cases of chronic squamous otitis media, even in children. This was a prospective analysis of the therapeutic effects and benefits of the technique used in 103 cases of cholesteatoma at Staffordshire General Hospital from 1991 to 1997. The follow-up was between 3 and 9 years. The study group consisted of 55 male patients and 48 female patients, including 28 children less than 16 years of age. The age ranges were 9 to 61 years in male patients and 10 to 48 years in female patients. After an audiological assessment, all patients underwent the described mastoid procedure, and some of them required revision surgery, mostly for a second look or for ossiculoplasty. The chief outcome measures used were complete eradication of disease, incidence of disease recurrence, and restoration of hearing. The steps of the procedure, its pros and cons, and the results of the series are presented. Also discussed is an overview of the literature pertaining to intact-canal wall mastoid surgery. Of the 103 patients, only 3 had a recurrence of disease, and 9 patients showed no hearing improvement. We conclude that this modified technique has several advantages over the previously described mastoidectomy procedures. It is a relatively simple and effective technique that can be performed even in children.

Effect of arsenite on certain aspects of protein metabolism in fresh water teleost, Tilapia mossambica (Peters).

The sublethal toxicity of sodium arsenite on protein metabolism was investigated in teleost fish, Tilalpia mossambica at the end of 24, 48, 72 and 96 h of exposure. Total protein content, free amino acid content and activities of the enzymes aspartate amino transferase (AAT) and alanine amino transferase (ALAT) in liver, gill, brain and muscle exhibited significant (P<0.05) alterations throughout the investigation in relation to that of control. It is suggested that the fish is able to respond to the stressful situations by gearing up the metabolic activity as revealed by the elevated protein, amino acid content and the activities of AAT and ALAT.

Self-retaining aural speculum: a valuable aid to middle-ear surgery.

We report the use of a self-retaining aural speculum that provides an excellent view of the middle ear through a small endural incision. We have found this instrument of value in tympanoplasty and stapes surgery in particular.

A new tongue plate for use in oropharyngeal KTP laser surgery.

The KTP laser is used in both uvulopalatopharyngoplasty and tonsillectomy. However the need to use laser guarded endotracheal tubes represents a sizeable expense to the procedure. The authors describe a modified tongue plate to the oropharyngeal gag that covers all of the endo-tracheal tube, thus enabling the safe use of a non-laser guarded, PVC endotracheal tube. In over a hundred such procedures there has been no laser-related complications. The authors consider that the one off cost of this tongue plate and gag allows a more cost-effective method for performing laser-assisted uvulopalatopharyngoplasty and tonsillectomy.

Emergency management of bilateral choanal atresia in the newborn by the endoscopic endonasal approach: a clinical record and review of literature.

The advent of rigid paediatric nasal endoscopy has revolutionised management of congenital choanal atresia. We believe that the endoscopic endonasal approach is a simple, safe and reliable procedure that can be employed in the management of bilateral choanal atresia in the newborn. We present here a case of bilateral choanal atresia in a 36 h old female neonate, managed by this state-of-the-art technique. A literature review of all reports using this approach has been compiled and presented.

Modulatory effect of sepia shell extract on activity of glucose-6-phosphatase and alanine amino transferase in diabetic mice.

Alkali extract of sepia shell possesses hypoglycemic effect. The status of glycogen and pyruvate and the activity of glucose-6-phosphatase and alanine amino transferase in liver was studied under the influence of sepia shell extract in both normal and streptozotocin induced diabetic mice. The glycogen concentration was elevated steeply in both and the pyruvate concentration increased substantially in diabetic mice, while the activity of glucose-6-phosphatase and alanine amino transferase was inhibited in normal and diabetic mice. The sepia shell extract enhances glycogenesis and reduces the formation of glucose from metabolic intermediates like pyruvate and glucose-1-phosphate and by suppressing gluconeogenesis.

Glycogenic effect of an alkali soluble fraction from sepia shell.

The alkali soluble fraction of the sepia shell possesses both anticonvulsant and hypoglycemic effect. The investigation regarding the fate of the blood sugar during the hypoglycemia revealed that the sepia shell extract acts as a glycogenic agent by mobilising the blood sugar towards liver glycogen reserve through the modulation of the enzymes glycogen phosphorylase a and ab in normal and streptozotocin diabetic mice. The glucose tolerance test (GTT) showed a depression in the GTT curve in experimental mice. The available literature on the biochemistry of the shell reveals that it contains glucosamines and some amino acid residues. The presence of amine group may resemble the sulfonylureas like tolbutamide which also possesses both anticonvulsant and hypoglycemic effect.

Ocular abnormalities in children from a Malaysian school for the deaf.

The prevalence of ocular abnormalities was studied in 165 children from a Malaysian school for the deaf. Ninety-five children (57.6%) had one or more ocular abnormalities. Rubella retinopathy was the commonest form of ocular abnormality (35.2%). Refractive errors were found in 23 children (13.9%). Refractive errors in the rubella group were significantly more common than in the non-rubella group of deaf children (p < 0.001) (chi 2 test). Thirteen children had congenital anomalies causing significantly impaired vision. Ophthalmological examination of deaf children helps in the detection of cases with rubella eye signs and thus helps to identify the cause of deafness. Since deaf children are at greater risk of visual and ocular abnormalities, periodical ophthalmological examination should be carried out in these children.

Changing trends in the epidemiology and management of gonococcal ophthalmia neonatorum.

Between June 1985 and December 1988, 58 cases of gonococcal ophthalmia neonatorum were admitted to the neonatal unit at the University Hospital (USM). Of these, 15 (25.9%) cases were due to penicillin-resistant strains of Neisseria gonorrhoea. Of the 58 cases, 56 cases were treated effectively with a single dose of antibiotic given systemically. The mean period of recovery was shorter with spectinomycin in doses of 40 mg/kg than with cefotaxime (100 mg/kg). There was no permanent sequelae in the treated cases. An increasing incidence of infection with penicillin-resistant strains of N. gonorrhoea has been observed in the area of study.

Orbital complications of acute sinusitis.

Orbital complications of sinusitis may occur either by spread along the venous system or by direct extension of infection between contiguous structures. The association between sinusitis and inflammation of the orbits has been known for centuries. But in the post antibiotic era there is a marked decline in the number of case reports in the literature. This paper presents 10 cases of sinusitis who had orbital complications. The classification of this disease complex as given by Chandler helps in planning the treatment. Groups I and II respond very well to antibiotics but in groups III, IV, V surgical intervention is necessary. Early identification and aggressive therapy reduces the morbidity of this disease.

Vogt-Koyanagi-Harada syndrome--a case report.

A 30 year old Malay male developed bilateral choroiditis followed by vitiligo, poliosis and canities. CT scan showed nodular thickening of the optic nerves. Characteristic abnormalities were seen in visual and brainstem auditory evoked potentials and fluorescein angiography. These findings were in keeping with the diagnosis of Vogt-Koyanagi-Harada syndrome. Treatment with dexamethasone resulted in complete recovery of vision and partial improvement in skin and hair lesions.

Toxigenic strains of Staphylococcus epidermidis and their experimental corneal pathogenicity in rabbits.

Thirty strains of Staphylococcus epidermidis, ten each from normal conjunctival sacs, corneal ulcer cases and from those who developed postoperative endophthalmitis, were examined for their dermonecrotic and haemolytic activities. Dermonecrosis was studied on rabbit skin whereas haemolysis was determined against sheep, guinea pig, rabbit and human erythrocytes. None of the cell free filtrates from strains derived from normal sacs showed any evidence of toxin production. Four strains from corneal ulcer cases and five from postoperative infections produced + to + + + dermonecrosis whereas haemolytic activity was exhibited by one strain in the former and by two in the latter. Only those strains that were highly dermonecrotoxic were haemolytic. Experimental corneal lesions in the rabbit were mild by strains from normal sacs. Those showing highest dermonecrotoxic reaction, irrespective of their source, produced identical and most severe corneal pathology when compared to those producing minimal necrosis.