A comparative in vitro study on antifungal and antioxidant activities of Nervilia aragoana and Atlantia monophylla.

Ethyl acetate extract of the whole plant of Nervilia aragoana Gaud. (Orchidaceae) and ethanol extract of the leaves of Atlantia monophylla Linn. (Rutaceae) were evaluated for antifungal and antioxidant activities. At 5 mg/mL concentration of the extracts, the former exhibited more inhibitory activity than the latter against fungi. The order of MIC values for Nervilia aragoana were Saccharomyces cerevisiae (1.4 mg/mL) > Aspergillus niger (1.2 mg/mL) > Aspergillus fumigatus (0.95 mg/mL) > Cryptococcus neoformans (0.75 mg/mL). In the case of Atlantia monophylla values were Cryptococcus neoformans (1 mg/mL) > Candida albicans (0.95 mg/mL) > Aspergillus niger (0.65 mg/mL). TLC-DPPH method assay was carried out to evaluate the antioxidant potential. Further DPPH radical, superoxide, nitric oxide, H(2)O(2) scavenging, and reducing power activities were carried out. N. aragoana (85%) extract exhibited more scavenging activity than that of A. monophylla (66%) by DPPH free radical scavenging method. A. monophylla extract exhibited more superoxide, nitric oxide, H(2)O(2) scavenging activities than that of N. aragoana. The acute toxicity studies of both extracts have shown no mortality rate even up to 3 g/kg body weight in albino rats. Screening for secondary metabolites showed the presence of carbohydrates in both extracts. Flavonoids were found only in the ethyl acetate extract of N. aragoana. Tannins, alkaloids, triterpenoids and steroids were present in A. monophylla. Total phenols present in N. aragoana and A. monophylla were 340 and 560 mg/g extract of gallic acid equivalents, respectively.

Meticulously restored lumina of injured veins remain patent.

We report our experience with 38 major venous injury repairs in 37 patients between January 1981 and December 1989. The injuries were caused by gunshot (n = 27), shotgun (n = 3), knife (n = 5), blunt trauma (n = 1), and dog bite (n = 1). These involved 27 femoral, 10 popliteal, and one brachial veins. Thirty patients had associated major arterial injuries and seven had major long bone fractures. Retrospective analysis yielded two groups. Group I consisted of 17 patients who underwent meticulous restoration of venous lumina ensured by intraoperative postreconstruction venography (IPV) in all patients. Two of these required revision on the basis of IPV findings. Late patency of venous repair was confirmed by postoperative venography (n = 10) or duplex scans (n = 7). All 17 venous repairs were patent (100%). In group II none of the 20 patients (21 veins) underwent IPV. Fifteen of the 20 patients underwent venography and five patients (six veins) underwent duplex scanning after surgery. Eight veins were occluded and 13 (62%) were patent. The difference in patency rates of venous repair between groups I and II was significant (p = 0.02). Three (37.5%) of eight patients with occluded venous repair required delayed fasciotomy, but only 1 (3.4%) of 29 limbs (30 veins) with patent lumina required fasciotomy (p = 0.03). We conclude that meticulous restoration to normal-caliber venous lumina, confirmed by IPV, can achieve high patency and low morbidity rates.

Monitor-guided responses. Operability with safety is increased in patients with peripheral vascular diseases.

Poor cardiopulmonary reserve was demonstrated in a group of 75 elderly patients undergoing elective vascular reconstruction when cardiovascular hemodynamics were analyzed with the automated physiologic profile (APP) preoperatively. Only 25 patients (33.3%) had normal left ventricular function (LVF) and did not need any corrective therapy before surgery. Increment in preload was necessary in 20 patients (26.7%) to improve myocardial function; 30 patients (40%) revealed abnormal LVF and hence required pharmacologic modulation and preload adjustment, inotropic support, and afterload reduction to enhance the ventricular performance. Conventional methods of clinical evaluation did not reveal the degree of compromised ventricular function and potential high risk of surgical morbidity and mortality in many of these patients. The APP disclosed subtle and important physiologic aberrations indicating modification of anesthetic and operative procedures and precise modulation of physiologic factors. Optimization was achieved in all except two patients, and only one was denied the benefits of vascular reconstruction.

Chemical constituents of gentianaceae XXIII: tetraoxygenated and pentaoxygenated xanthones and xanthone O-glucosides of Swertia angustifolia Buch.-Ham.

The whole plant extract of Swertia angustifolia Buch.-Ham., collected at different stages of growth, contained 14 tetraoxygenated and five pentaoxygenated xanthones and xanthone 1-O-glucosides. Of the eight xanthone 1-O-glucosides isolated, five were previously unreported in nature. The xanthones are broadly based on 1,3,5,8- and 1,3,7,8-oxygenated systems, with an added oxygen function at C-4 in some compounds, and represent a number of methoxylated patterns. The content and relative abundance of the free xanthones and their 1-O-glucosides changed with plant growth. These results are the first demonstration of the variation in chemical characters in the different parts of a Swertia species during its ontogeny. The biolgocial significance of these results is appraised.

Chemical constituents of gentianaceae XIV: tetraoxygenated and pentaoxygenated xanthones of Swertia purpurascens Wall.

The whole plant of Swertia purpurascens Wall. (Gentianaceae) has been shown to contain five tetraoxygenated and three pentaoxygenated zanthones. These are identified as 1,5,8-trihydroxy-3-methoxyxanthone, 1,3,8-trihydroxy-5-methoxyzanthone, 1-hydroxy-3,7,8-trimethoxyxanthone, 1,3,7,8-tetrahydroxyxanthone, 1,3,5,8-tetrahydroxyxanthone, and 1-hydroxy-3,4,7,8-tetramethoxyxanthone by chemical and spectral evidence. Additionally, the crude mixture of natural xanthones has been shown to include two partially emthylated pentaoxygenated xanthones as minor entities, which yield 1-hydroxy-3,4,7,8-tetramethoxyxanthone and 1-hydroxy-3,4,5,8-tetramethoxyxanthone on methylation. This is the first time that pentaoxygenated xanthones have been found in a member of the genus Swertia. 1-Hydroxy-3,4,7,8-tetramethoxyxanthone was previously known only as a synthetic compound. The total xanthones of S. purpurascens produce significant CNS stimulant actions, consistent with some therapeutic uses of the plant extract in the Indian system of medicine. The chemotaxonomic significance of the cooccurrence of various biogenetically related chemical characters in a single plant species is appraised.

Chemical constituents of Gentianaceae XIX: CNS-depressant effects of swertiamarin.

CNS activity of swertiamarin, a secoiridoid glucoside from Swertia chirata, was evaluated. An apparent anomaly, associated with the unanticipated finding that the alcoholic extracts (excluding mangiferin) of S. chirata significantly reversed the mangiferin-induced CNS-stimulating effects in albino mice and rats, was resolved. The results indicate that swertiamarin and mangiferin antagonize each other in vivo and thereby reverse their CNS effects.

Bullet embolism.

Bullet embolism is a rare complication of vascular trauma. During the last ten years we have treated six patients with bullet embolism. Three patients had inferior vena caval injuries with embolizations of the bullets to the heart or pulmonary arteries. Two had infrarenal aortic injuries with embolization to vessels of the lower extremities. One patient with a shotgun injury to the superficial femoral artery and vein had both arterial and venous embolizations. The site of vascular penetration was repaired in all six patients. All peripheral arterial bullet emboli were removed except for an asymptomatic shotgun pellet in the peroneal artery. One bullet was removed from a right atrium and another from a proximal pulmonary artery. Emboli in the distal pulmonary artery branches were left undisturbed in two patients. All six patients survived without any complications. A 14-year review of the literature is presented in order to emphasize some important features of this rare pathology.

Changing patterns in civilian arterial injuries.

A critical review of 185 patients with 211 arterial injuries over an eleven year period was performed to recognize the changing patterns in clinical findings, management and results. A ten fold increase in multiple arterial injuries as well as higher incidence of associated venous and visceral injuries occurred during the last five years. Despite this, the incidence of hypotension on arrival at hospital was reduced by half due to rapid transportation and resuscitation during transit. Shock in patients with only extremity injuries heralded dual injuries (arterial and venous). Lateral repair of both arterial and venous injuries has given way to end to end anastomoses, vein grafts and patch grafts. A greater tendency to repair all major arteries, most minor arteries, more liberal use of heparin, fasciotomy, intraluminal shunts, repair of venous injuries and extra-anatomic bypass has been noted. Rapid patient retrieval, early resuscitation, improved recognition and management of arterial injuries has not lead to better limb salvage or survival. The apparent lack of benefit in limb salvage is probably due to the higher incidence of multiple arterial injuries and associated venous injuries as well as the willingness to attempt repair all major arterial injuries and reluctance to advise primary amputation. Early patient retrieval, rapid transportation and resuscitation during transit has increased the number of potentially unsalvageable patients (who would otherwise be declared dead on arrival) resulting in an unchanging mortality.

Arterial thrombosis and embolism in malignancy.

In most reviews of arterial embolism or thrombosis the source of emboli or the cause of thrombosis can reasonably be established in over 90% of patients. Still about 10% remain without demonstrable cardiac or intraarterial sources. Although hypercoagulability induced by malignancy has been alluded to as a cause of unexplained intravascular thrombosis reports of arterial thromboembolism with such association are rare. Seven patients with unequivocal thromboembolism are presented. Two distinct clinical patterns are observed, one with in situ thrombosis of small arteries and the other with occlusion of large arteries causing limb ischemia or fatal organ infarction. The various pathogenetic mechanisms of arterial thrombosis or embolism in malignancy include sustained spasm of arteries, precipitation of cryoglobulins or other abnormal proteins in small arteries, direct tumor invasion of arteries, fragmentation and embolization of intracardiac or intraarterial metastases and spontaneous arterial thrombosis due to hypercoagulability. The hypercoagulable state can be recognized by the observation of shortened bleeding and clotting times, partial thromboplastin and prothrombin times, elevation of coagulation factors, platelets and yield stress index and resistance to anticoagulation. Patients presenting with arterial thromboembolic events with out demonstrable source should be investigated for malignancy. Conversely patients with malignancy should be searched for evidence of hypercoagulability in an attempt to prevent arterial thromboembolic complications.

Genital lesions following bestiality.

A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

Angiotensin converting enzyme gene polymorphism in type II diabetics with nephropathy.

Nephropathy is an important and a frequent complication of long-term type II diabetic nephropathy. Strong evidence exists that genetic predisposition plays a major role in the development of diabetic nephropathy. Recent studies have implicated association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and nephropathy. The deletion gene polymorphism of ACE gene has been shown to be associated with increased activity of this enzyme. This study examines the association of ACE I/D polymorphism with type II diabetes without nephropathy in 30 patients and type II diabetes with nephropathy in 30 patients. The results of the study suggest the association between the DD polymorphism and type II diabetes with nephropathy.

The caraka-tattvapradipika of sivadasa sena.

In this article the author describes the salient features of Carakatattvapradipika, a commentary on the Caraka Samhita by Sivadasa sena and highlights his theory and practice of medicine.

Haramekhala - tantra (the first chapter on medicine).

This translation of Haramekhala - tantra of the author is based on Banaras Hindu University manuscript which seems to be a novel one. The manuscript runs into 133 stanzas in all in the form of dialogue between lord Siva and goddess Parvati. This is only the first chapter (of the great work) dealing with medicine. From stanza 109 onwards some magic spells are described and as such those have not been included in this translation.

Some new facts about candranandana.

In this paper the author probes the identity of Candranandana a well known author and commentator of various works in Ayurvedic literature by interpreting the classical texts.

Historical biography of medicinal plants.

Medicinal plants, have been the chief source of drugs used in treatment of various ailments. It is observed that the position of medicinal plants is not the same as in Samhitas. There is a lot of addition of new synonyms and also recording of new observations in terms of actions and uses. Thus, it would be interesting to study such developments in case of each drug historically and scientifically under the heading of 'The Historical Biography', covering the entire life of a medicinal plant along with various changes taking place from time to time.

Sarkara.

The word 'Sarkara' is used to denote several meanings. That it also denotes a plant is a little known fact. This hitherto hidden fact has been brought to light with support of relevant references. The description of the plant themeda arundinacea (Roxb.) Ridley is also given.