Forskolin: upcoming antiglaucoma molecule.

Forskolin is the first pharmaceutical drug and product derived from a plant to be approved in India by the DCGI in 2006. Forskolin (7beta-acetoxy-8, 13-epoxy-1a, 6ß, 9a-trihydroxy-labd-14-en-11-one) is a diterpenoid isolated from plant Coleus forskohlii (Lamiaceae). It is a lipid-soluble compound that can penetrate cell membranes and stimulates the enzyme adenylate cyclase which, in turn, stimulates ciliary epithelium to activate cyclic adenosine monophosphate, which decreases intraocular pressure (IOP) by reducing aqueous humor inflow. The topical application of forskolin is capable of reducing IOP in rabbits, monkeys, and humans. In its drug interactions, forskolin may act synergistically with epinephrine, ephedrine and pseudoephedrine. Whereas the effects of anti-clotting medications like warfarin, clopidogre, aspirin, anoxaparin, etc., may be enhanced by forskolin. Forskolin is contraindicated in the medications for people with ulcers as forskolin may increase acid level. Forskolin has a very good shelf-life of five years. Recently, its Ophthalmic inserts and in situ gels for sustained and delayed-release drug delivery systems were tested in New Zealand Albino Rabbits for its antiglaucoma efficacy. This drug review explains Forskolin as a drug, its antiglaucoma potential and recent findings of forskolin as an antiglaucoma agent. The literature search method used for this review was different databases and search engines like PubMed, International Pharmaceutical Abstracts, Google, Medicinal and Aromatic Plants (MAPA).

Drape estimation vs. visual assessment for estimating postpartum hemorrhage.

OBJECTIVE: To compare (1) visual estimation of postpartum blood loss with estimation using a specifically designed blood collection drape and (2) the drape estimate with a measurement of blood loss by photospectrometry. METHODS: A randomized controlled study was performed with 123 women delivered at the District Hospital, Belgaum, India. The women were randomized to visual or drape estimation of blood loss. A subsample of 10 drape estimates was compared with photospectrometry results. RESULTS: The visual estimate of blood loss was 33% less than the drape estimate. The interclass correlation of the drape estimate to photospectrometry measurement was 0.92. CONCLUSION: Drape estimation of blood loss is more accurate than visual estimation and may have particular utility in the developing world. Prompt detection of postpartum hemorrhage may reduce maternal morbidity and mortality in low-resource settings.

Spinal retroflexion in craniorhachischisis: its classification and limitations.

Spinal retroflexion has been studied in five stillborn human fetuses having craniorhachischisis. The findings show that retroflexion in this variant of anencephaly can be classified into severe, moderate and mild forms. The three grades can be differentiated from one another by the direction of the face, shape of the mentothoracic junction, extension of hairline on back, radiographic abnormalities of the spine, and the diaphragmatic defects. It is discussed that, though the anencephalies with severe or moderate degree of cervical retroflexion resemble iniencephaly in their features of spinal retroflexion, those having mild retroflexion are contrasted and should not be categorised with iniencephaly. It is suggested that for precision the term "spinal retroflexion" should be used after duly prefixing it by an appropriate word (severe, moderate or mild) indicating the degree of retroflexion observed.

Twinning in India.

The incidence of twinning in India, as estimated on the basis of data from the various types of maternity centers, so as to include both urban and rural population, appears to be 15.97 per thousand (12.6 DZ, 3.3 MZ). The incidence is significantly higher in rural than urban populations (18.1 vs. 11.8 per thousand). It is suggested that this may be accompanied with a higher production of DZ, possibly opposite-sexed twins.

Ectopic pregnancy: 125 cases.

PIP: 125 cases of suspected ectopic pregnancy and proven ectopic pregnancy admitted in S.M.R. and Lady Elgin Hospital, Jabalpur, India from 1963-1965 received complete clinical examination, with particular attention given to history, mode of presentation, symptoms and signs present per abdomen and on bimanual examination. Past history of patient was obtained, particularly history and treatment of sterility, pelvic inflammation or any abdominal operation performed. The following investigations were performed: 1) hemogram, total and differential count, erythrocyte sedimentation rate, and V.D.R.L. tests; 2) urine examination; 3) culdocentesis; 4) histopathological examination of the specimen obtained at operation; and 5) dilation and curettage in a few cases. Patients were followed with special reference to recurrence of ectopic pregnancy and future gestation. There was variation in the incidence of ectopic pregnancy during the 3 years -- 40 in 1963, 50 in 1964, and 35 in 1965. The variation occurred with the rise and fall of total number of deliveries in the hospital. Pain in abdomen, vaginal bleeding, and amenorrhea were the most frequent symptoms. Of the procedures used as an aid to diagnosing or confirming the diagnosis, culdocentesis was performed in 77 cases with promising results. On follow-up, conception occurred in 8 cases, intrauterine in 5, and repeat ectopic pregnancy in 3. The factors responsible for low mortality were specialist service, early diagnosis, quick treatment, the facilities of blood transfusion, and use of antibiotics. 31 of the patients were left sterilized after surgery.^ieng