GC-MS analysis and anti-oxidant activity of bioactive compounds of Simarouba glauca leaf extracts.

The aim of this study is to analyse the phytochemical composition, anti-oxidant activity, FT-IR and GC-MS analysis of Simarouba glauca leaf extracts. The chloroform extract exhibited highest T.P.C. (139.82 ± 0.06 mg/g GAE) and highest T.F.C. (41.95 ± 0.50 mg/g QE). The GC-MS analysis confirmed the presence of ten compounds in acetone extract and twenty-two compounds in methanol extract. The GC-MS analysis of acetone fraction showed the major peaks such as Glycerine (13.20%), 1,1,1-trichloro-2-methyl-2-propanol (8.92%), Cyclohexanol,2-methyl-5-(1-methylethenyl)- (6.09%), Tetradecane, 2,6,10-trimethyl (7.68%) and Phytol (7.53%). Some of these compounds exhibit anti-oxidant activities. GC-MS analysis of methanol fraction exhibited the presence of following compounds: Undecane (8.52%), 2,3-Trimethylene-4-pyrone (1.79%), cis-Sinapyl alcohol (2.33%) and Umckalin (1.19%). The acetone and methanol fractions exhibited higher percentage of inhibition in DPPH assay. The overall results of this study indicate that the acetone and methanol fractions have been demonstrated to be efficacious against various diseases.

Effect of Aloe vera (Barbadensis Mill) on Letrozole Induced Polycystic Ovarian Syndrome in Swiss Albino Mice.

Background: Polycystic ovarian syndrome (PCOS) is the predominant endocrine abnormality in premenopausal women characterised by hyperandrogenism, ovulatory dysfunction, metabolic disturbances such as, insulin resistance and obesity. Aim: The key objective of this study was to evaluate the efficacy of Aloe vera as a treatment drug to identify the factors among female Swiss albino mice (PCOS) models displaying ovarian and metabolic abnormalities and serum sex steroids that are associated with insulin sensitivity. Study Setting and Design: The laboratory breed 4 months adult virgin female Swiss albino mice showing regular estrous cycle and weighing about 20-30 g were employed in present study under CPCSEA guidelines with ethical clearance from the institutional ethical committee. These mice were categorized into two groups with 10 mice in each as control and test animals. Materials and Methods: The mice which were categorised into two groups with 10 mice in each. Carboxy methyl cellulose control and letrozole were induced for 21 days followed by 30 days treatment with distilled water for control, Diane as standard drug and Aloe vera gel formulation. Body weight, estrous cycle, biochemical estimations, hormone assay and histopathology were the parameters studied. Statistical Analysis: IBM SPSS version 20.0 was used for the mean and standard error calculations of biochemical and antioxidants estimation. Results: During the induction period, we observed a significant increase in the body weight, decrease in the number of estrous cycle, and the concomitant increase in diestrous. The biochemical estimations showed changes in the regular activity; hormonal imbalance was observed in hormone assay and cyst formation was also observed in the histopathological study. After the treatment of Aloe vera and Diane, all the parameters showed considerable good results. Conclusion: The findings of the current study provide a baseline data for designing further investigations on the therapeutic benefits of Aloe vera as an adjunct therapy in the management of PCOS.

Modified Inguinal Lymph Node Dissection in Groin-Negative Patients of Penile Cancer: Our Experience.

Cancer of the penis is an important health problem in India, causing significant morbidity. Involvement of locoregional lymph nodes is the most significant prognostic factor for patients with penile cancer. In this study, we reviewed clinical data of all patients who underwent modified inguinal lymph node dissection as a means to diagnose micro-metastasis in inguinal lymph nodes, and analysed the outcomes. We retrospectively reviewed the hospital clinical charts of patients treated for carcinoma of the penis. Inguinal and distant metastases were assessed by physical examination, ultrasound imaging of the inguinal region, computed tomography of the abdomen and pelvis and a chest radiograph. Patients with clinically negative inguinal lymph nodes underwent modified lymph node dissection (mILND) both to diagnose and stage the disease. Complications occurring during a 30-day period after surgery were defined as early and thereafter as late complications. A total of 40 patients with a mean age of 52.27±13.10 (range 25-73) years underwent mILND. Wedge biopsy from the primary lesion had revealed intermediate-risk disease in 22 (55%) patients and high-risk disease in 18 (45%) patients. Histopathological examination of the primary penile lesion revealed a pT1 lesion in 32 patients and a pT2 lesion in the remaining 8 patients. Fourteen (35%) of the 40 patients showed micro-metastases in the inguinal lymph nodes on frozen sections. The mean follow-up in these patients was 56.6±18.09 months. There were no instances of local or systemic recurrences seen in 38 (95%) patients within 5 years. Superficial lymph node dissection and where facilities are available DSLNB remain the standard of care in the management of patients with clinically groin-negative (cN0) intermediate- and high-risk groups. Modified inguinal lymph node dissection would be a safe and appropriate alternative to this in all centres that do not have access to newer modalities like DSLNB, video-endoscopic (VEIL) or robotic-assisted techniques.

Postpercutaneous Nephrolithotomy Ureteropelvic Junction Obstruction.

Percutaneous endoscopic renal surgery such as percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for patients with large and/or complex renal calculi. However, a unique set of complications can occur with this surgical approach that may involve the targeted kidney and surrounding structures. Renal collecting system obstruction after PCNL is rare, but may result from ureteral avulsion, stricture formation, transient mucosal edema, blood clot, or infundibular stenosis. Impaction of stone and trauma during PCNL could induce stricture formation and obstruction. Use of proper percutaneous and endoscopic techniques and instruments will help to reduce the chances of developing such strictures and obstruction.

Adrenal leiomyosarcoma in a young adult male.

Leiomyosarcomas are known to typically originate from smooth muscle cell. Primary adrenal leiomyosarcoma is an extremely rare mesenchymal tumor associated with delayed diagnosis and poor prognosis. We report a rare case of leiomyosarcoma arising from the left adrenal gland in a 27-year-old male who presented with left side back ache. It was a solid mass of 9 × 6.5 × 7  cms situated superior to the left kidney. Left adrenalectomy was done and microscopic examination revealed a primary adrenal leiomyosarcoma.

Bleeding angiomyolipoma mimiking a ruptured adrenal tumour.

Angiomyolipoma is a benign neoplasm of the kidney, and is the most common renal tumour associated with haemorrhage. Risk of bleeding increases with the size of the angiomyolipoma. We report a case of spontaneous bleeding from an upper polar renal angiomyolipoma mimicking a spontaneous adrenal bleed from a pheochromocytoma.

Evaluation of Seminal Fructose and Citric Acid Levels in Men with Fertility Problem.

CONTEXT: Male infertility is a medical problem, attributed to 50% of infertility. Seminal plasma can be an anticipating factor as it comprises secretions of accessory sex gland, thus offering novel and precise ways to understand potential roles of these biochemical markers in male infertility. AIM: The objective of this study was to assess the correlation between biochemical markers and sperm parameters in envisaging male infertility. SUBJECTS AND DESIGN: We enlisted 105 men with fertility issue as patients and 25 fertile men as controls to evaluate the sperm parameters and biochemical markers, namely fructose and citric acid in ascertaining male infertility. MATERIALS AND METHODS: The semen samples from patients were collected properly and analyzed according to the World Health Organization-2010 manual. Later samples were centrifuged, seminal plasma was collected, and biochemical markers assessment was carried out by standard protocols. STATISTICS: Descriptive statistics, independent t-test, one-way ANOVA, and Pearson correlation were used for statistical analysis of different variables using SPSS 20.0. The mean sperm count and motility by all infertile conditions displayed a significant difference when compared with the controls (P < 0.05). RESULTS: The mean fructose levels of oligozoospermia showed a nonsignificance difference when compared with controls (P < 0.05). Asthenozoospermia, asthenoteratozoospermia, and azoospermia had a significance difference (P < 0.05) for citric acid levels. Pearson correlation coefficient showed significant negative correlation of sperm count (r = -0.564) and sperm motility (r = -0.574) with fructose levels. Whereas seminal citric acid concentration had a positive correlation with sperm count (r = 0.458) and sperm motility (r = 0.446). CONCLUSION: Therefore, evaluation of certain biochemical markers of seminal fluid may benefit in understanding the functionality of accessory glands which subsidizes significantly to the seminal volume.

Co-delivery of paclitaxel and curcumin to foliate positive cancer cells using Pluronic-coated iron oxide nanoparticles.

Active targeting of folic acid and passive targeting of magnetic nanoparticles to bring about co-delivery of hydrophobic chemotherapeutic agents were the focus of this work. Co-precipitation in alkaline environment was employed for synthesizing Fe3O4 nanoparticles and stabilized by oleic acid. Aqueous dispersibility of oleic acid coated nanoparticles was brought about by folic acid modified Pluronic F127 and Pluronic F127 mixture. Folic acid is used as a targeting agent which was joined to Pluronic F127 via diethylene glycol bis(3-aminopropyl) ether spacer. The nanocomposite was used to delivery hydrophobic anticancer drugs, paclitaxel, and curcumin. Successful modification at each step was confirmed by FTIR and NMR. Quantitative analysis of attached folic acid indicated a total of 84.34% amount of conjugation. Nanoparticles characterization revealed the hydrodynamic size of and nanocomposite to be 94.2 nm nanometres. Furthermore, transmission electron micrograph reveals the size of the nanoparticle to be 12.5 nm hence also shows the superparamagnetic activity. Drug encapsulation efficiency of 34.7% and 59.5% was noted for paclitaxel and curcumin, respectively. Cytotoxic property of drug-loaded nanocomposites was increased in case of folic acid functionalized nanoparticles and further increased in the presence of an external magnetic field. Cellular uptake increased in the folic acid conjugated sample. Further many folds in the presence of an external magnetic field.

Percutaneous Nephrolithotomy in an Elderly Female with Severe Kyphoscoliosis: Modified Prone Position.

Percutaneous nephrolithotomy (PCNL) is one of the important options in the management of large (>2 cms) and complex renal calculi. Traditionally the prone position has been used to access the pelvicaliceal system as well as to remove renal calculi. Several modifications to this position have been suggested and reported by several urologists. We performed PCNL in an elderly female with a severe kyphoscoliosis by modifying the classical prone position.

Synergistic delivery of 5-fluorouracil and curcumin using human serum albumin-coated iron oxide nanoparticles by folic acid targeting.

Human serum albumin is the most abundant protein in plasma with the ability to bind to a variety of drug molecules. Magnetic nanoparticles are being extensively used in drug delivery due to its intrinsic magnetic properties. In this work, we have synthesized human serum albumin-coated citrate-functionalized iron oxide nanoparticles by CDI coupling. Furthermore, folic acid was decorated on human serum albumin by EDC and NHS coupling to confer targetability. Two cytotoxic drugs 5-fluorouracil (5FU) and curcumin were co-delivered. Wherein, the former is an anticancer agent and latter is a drug resistance depressor of former. The nanoparticles showed good aqueous dispersibility with a zeta potential of - 49.1 mV and magnetic core size in the range of 10-15 nm, thus exhibiting good magnetic property with magnetic saturation of 33.59 emu/g. Controlled drug release behavior was noticed in both drugs with faster release profile of 5FU. Nanoparticles also showed good cytotoxicity with lower IC50 values in the presence of magnetic field. The contrasting difference was noticed in folic acid-decorated and non-decorated composites, similarly in the presence of magnetic field where cell uptake was enhanced.

Bladder Invasion in Patients with Advanced Colorectal Carcinoma.

Involvement of the bladder by colorectal cancer is sufficiently rare to be encountered by an individual surgeon on an infrequent basis. Extirpative procedures for advanced colorectal cancers can involve partial/total bladder resections. In patients without evidence of distant metastatic disease, a reasonable therapeutic effect can be expected when negative surgical margins are obtained. The decision to perform a bladder-sparing procedure or a total pelvic exenteration (TPE) will be based on the extent of the primary lesion as well as patient characteristics. In this study, we report our experience in the management of operable locally advanced colorectal carcinomas involving the urinary bladder. We retrospectively reviewed the hospital records of all patients with advanced colorectal cancer invading the urinary bladder. The age, gender, clinical presentation, physical examination findings, and imaging records were noted. Colonoscopy reports and images were noted and biopsy findings recorded. Similarly, cystoscopy findings and biopsy reports were noted and analyzed. Eight (88%) patients had a primary sigmoid tumor and one (11%) had primary rectal tumor. The clinical staging of the primary tumor was T3 in three (33%) and T4 in six (66%). A biopsy taken during cystoscopy confirmed the malignant lesion in all the nine patients. Four (44%) patients received neoadjuvant chemotherapy with 5-fluorouracil. Eight (88%) patients underwent bladder-sparing resection and the remaining one underwent total pelvic exenteration with ileal conduit for urinary drainage. The mean overall survival was 44 months. The wide spectrum of possible bladder involvement by colorectal cancer requires individual patient-specific and disease-specific approaches. En bloc bladder resection for adherent or invading colorectal cancers achieves good local control and prognosis. The potential for cure in completely excised, node-negative tumors is good. Bladder reconstruction is achievable in most patients.

Low-Grade, Multiple, Ta Non-muscle-Invasive Bladder Tumors: Tumor Recurrence and Worsening Progression.

Nearly half of newly diagnosed cases of bladder cancer are low grade, noninvasive, and papillary tumors. The standard treatment for non-muscle-invasive bladder cancer (NMIBC) has been transurethral resection of the bladder tumor (TUR-BT) with or without adjuvant intravesical instillation (IVI) of chemotherapy or Bacillus Calmette-Guerin (BCG) therapy. NMIBC is known to be associated with high rates of recurrence and risk of progression. In this study, we have retrospectively analyzed the clinical outcome of initially diagnosed multiple low-grade Ta tumors, with a special focus on tumor recurrence and worsening progression (WP) pattern. We retrospectively reviewed 42 patients with primary, multiple, low-grade Ta bladder cancer. We defined WP as confirmed high-grade Ta, all T1 or Tis/concomitant CIS of bladder recurrence, upper urinary tract recurrence (UTR), or progression to equal to or more than T2. The associations between clinico-pathological factors and tumor recurrence as well as WP pattern were analyzed. Tumor recurrence and WP occurred in 23 (54.76%) and 8 (19.04%) patients during follow-up (median follow-up: 57.38 months), respectively. WP to high grade/stage was seen in 8 patients. Multivariate analysis demonstrated that use of tobacco (p < 0.0001) and absence of IVI (p < 0.0001) were significant risk factors for tumor recurrence. The 5-year recurrence-free survival rate for non-tobacco users (74.0%) was significantly higher than that for tobacco users (42.5%, p = 0.0001), and also higher for patients receiving intravesical instillation (84.2 vs. 30.0% without IVI, p = 0.0001). Recurrence is common in patients with low-grade, Ta bladder cancer, especially in the setting of multiplicity. Recurrences occurred in 54.76% of patients and WP occurred in 19.04% of patients. Use of tobacco and non-use of IVI were strongly associated with high recurrence rate.

Frontiers of monoclonal antibodies: Applications in medical practices.

With the flourishing of innovation in drug discovery into a new era of personalized therapy, the use of monoclonal antibodies (mAbs) in the treatment of various ailments lies at the forefront. Major improvements in genetic sequencing and biomedical techniques as well as research into mAbs emphasize on determining new targets for advanced therapy while maximizing efficacy for clinical application. However, a balance has to be achieved concerning developing a target with low toxicity combined with high specificity and versatility, to allow a specific antibody to facilitate several biotic effects, ranging from neutralization of virus mechanisms to modulation of immune response and maintaining low global economic cost. Presently, there are approximately 30 mAbs' permitted for therapeutic use with many more being tested in clinical trials. Nevertheless, the heavy cost of mAbs' production, stowage and management as well as the subsequent hindrances to their development are outweighed by mAbs' clinical advantages. Compared to conventional drugs, since mAbs use as pharmacologic iotas have specific physical features and modes of action, they should be considered as a discrete therapeutic category. In this review, the history of mAb generation and the innovative technological applications of mAbs that has advanced in clinical practices is reviewed.

Retained Double J Stent with Huge Renal and Bladder Calculi Extracted by Percutaneous Nephrolithotomy and Percutaneous Cystolitholapaxy in a Single Encounter.

We report a case of retained Double J ureteral stent with huge, multiple calculi at both ends in a 10-year-old female child. The renal and bladder calculi were managed by percutaneous nephrolithotomy and percutaneous cystolitholapaxy in a single sitting.