Revascularization in Anterior Teeth with Immature Apices

Treatment of immature teeth with necrotic pulp is a difficult procedure because of difficulty in obtaining fluid tight seal with normal root canal treatment. Revascularization may be considered as a treatment option in such teeth because of the stem cells present inside may help in closure of open apex by differentiating into cells required for root formation. Methods: 35 patients with history of trauma to upper front teeth were included in the study. For pulp regeneration procedure, bleeding was induced in canal and was allowed to clot over 15 min period to a level 3mm below CEJ coronally and was sealed off with MTA. Patients were followed up for period of 09 months to observe changes in pulp sensibility, increase in root length and increase in dentinal wall thickness. The obtained data was statistically analyzed. Results: There was significant increase in root length and dentinal wall thickness after the procedure. Conclusion: The results conclude that pulp regeneration procedure may be considered as a treatment option for patients with immature apices following trauma.

A Descriptive Study of Various Causes and Treatment Modalities of Mastalgia in Females of all Age Groups in Guru Nanak Dev Hospital, Amritsar

Mastalgia or Breast pain, is a common symptom which women may experience at different time in their lives. Many women worry that pain in their breasts is caused by breast cancer. Breast cancer rarely causes breast pain, however a thorough history and clinical examination by clinician appreciates it. Methods: A descriptive study was carried out in department of general surgery, Govt. Medical College in Guru Nanak Dev Hospital, Amritsar. there is 500 cases of mastalgia collected in Guru Nanak Dev Hospital and diagnosis was made on basis of clinical history and local examination of both breasts. All the quadrants of the breast were examined. Treatment of each patient was done as per the diagnosis. Results: Among 500 Patients 449 patients had cyclical mastalgia were as 51 patients has non cyclical mastalgia. Conclusion: In our study 89.8% of the patients experienced cyclical mastalgia and 10.2% non cyclical mastalgia.

Assessment of Clinical Response to Multimodality Approach in Advanced Carcinoma Breast

Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of multimodal treatment approach in cases of stage 3 technically inoperable breast cancer. Its effect on clinical response was studied. Methods: This prospective study was carried out in department of general surgery, government Medical College, Amritsar, Punjab. Main part of multimodal approach is neoadjuvant chemotherapy, so in collaboration with department of radiotherapy, relevant data was collected. 25 cases of locally advanced breast carcinoma were studied. These patients were studied on treatment with FAC regimen (as neoadjuvant chemotherapy), then underwent surgical excision (MRM) followed by chemotherapy, radiotherapy and hormonal therapy wherever indicated, and response was assessed. Results: Initially assessment of lump was done after 3 cycle of chemotherapy. 2 patients (8%) have reduction <50%, 22 patients (88%) have reduction in size which ranges between 51- 75% of the initial, remaining 1 patient (4%) has reduction >75% of the initial. Thus making them operable therefore after this they all had undergone modified radical mastectomy. During follow up period no lump was detected clinically, ultrasonographically or radiologically. There was no any loco-regional recurrence in any case. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in down staging the tumor enabling definitive surgery with less morbidity.

Ultra-performance liquid chromatography electrospray ionization-tandem mass spectrometry method for the simultaneous determination of itraconazole and hydroxy itraconazole in human plasma / 药物分析学报

A highly sensitive, selective, and precise ultra-performance liquid chromatography tandem mass spectrometry method was developed and validated for simultaneous quantification of itraconazole and hydroxy itraconazole in human plasma by a single liquid-liquid extraction step. The precursor to product ion transitions of m/z 705.3/392.3, m/z 721.2/408.3 and m/z 708.2/435.4 were used to detect and quantify itraconazole, hydroxy itraconazole and itraconazole-d3 respectively. The lower limit of quantitation was found to be 0.500 ng/mL for itraconazole and 1.00 ng/mL for hydroxy itraconazole. The mean recoveries for itraconazole and hydroxy itraconazole were found to be 100.045% and 100.021%, respectively. This developed method with a chromatographic run time of 2.0 min was successfully applied to a bioequivalence study of 100 mg itraconazole capsule.

Evaluation of anti-inflammatory activity, effect on blood pressure & gastric tolerability of antidepressants.

Background & objectives: Antidepressants are being used as analgesics for various pain related disorders like neuropathic and non neuropathic pain. Although their analgesic activity is well recognized but anti-inflammatory potential of antidepressants is still inconclusive. Since the antidepressants are used for longer duration, it becomes important to elucidate effect of anti-depressants on blood pressure and gastric mucosa. This study was undertaken to evaluate the anti-inflammatory potential of various antidepressant drugs as well as their effect on blood pressure and gastric tolerability on chronic administration in rats. Methods: Rat paw oedema model was used for studying anti-inflammatory activity, single dose of test drug (venlafaxine 20 and 40 mg/kg, amitryptline 25 mg/kg, fluoxetine 20 mg/kg) was administered intraperitoneally 45 min prior to administration of 0.1 ml of 1 per cent carrageenan in sub-planter region. Oedema induced in test group was compared with normal saline treated control group. For studying effect on blood pressure and gastric tolerability, test drugs were administered for 14 days. Blood pressure was recorded on days 0, 7 and 14 using tail cuff method. On day 14, 4 h after drug administration, rats were sacrificed and stomach mucosa was examined for ulcerations. Results: Pretreatment of rats with venlafaxine (40 mg/kg) resulted in a significant decrease in paw oedema as compared to control (2.4 ± 0.15 to 1.1 ± 0.16 ml, P<0.01). Similarly, in the group pretreated with fluoxetine, significant decrease in paw oedema was observed in comparison to control (P<0.05). Significant change in mean blood pressure was seen in rats pretreated with venlafaxine 40 mg/kg (126.7 ± 4.2 to 155.2 ± 9.7, P<0.05) and fluoxetine (143.5 ± 2.6 to 158.3 ± 1.2, P<0.05) on day 7. No significant difference with regard to gastric tolerability was observed among groups. Interpretation & conclusions: Our findings showed significant anti-inflammatory activity of venlafaxine (40 mg/kg) and fluoxetine but these drugs were also associated with an increase in blood pressure. No significant change in mean ulcer index was observed among groups.

Aliskiren: a novel renin inhibitor for hypertension.

Hypertension is one of the major causes of cardiovascular morbidity. Most patients who are on treatment for hypertension fail to achieve adequate control with the existing therapy and rates of cardiovascular morbidity remain high. As the renin-angiotensin-aldosterone system is strongly implicated in the development of hypertension-related target organ damage, intensive efforts have been devoted towards the development of drugs targeting this system. In addition to angiotensin converting enzyme inhibitors and angiotensin receptor blockers, inhibition of renin has also become a clinical reality. Aliskiren, a novel renin inhibitor, has overcome a number of shortcomings of existing drugs and is now available to address angiotensin production directly at its rate-limiting step.

Hepatoprotective effect of tocopherol against isoniazid and rifampicin induced hepatotoxicity in albino rabbits.

Antitubercular drug induced hepatotoxicity is a major hurdle for an effective treatment of tuberculosis. The present study was undertaken to assess the hepatoprotective potential of tocopherol (50 mg/kg and 100 mg/kg, ip) and to compare it with cimetidine (120 mg/kg, ip). Hepatotoxicity was produced by giving isoniazid (INH, 50 mg/kg, po) and rifampicin (RMP, 100 mg/kg, po) combination to albino rabbits for 7 days. Assessment of liver injury was done by estimating levels of alanine transaminase (ALT) and argininosuccinic acid lyase (ASAL) in serum and by histopathological examination of liver. Results revealed that pretreatment with high dose of tocopherol (100 mg/kg) prevented both biochemical as well as histopathological evidence of hepatic damage induced by INH and RMP combination. Moreover, tocopherol (100 mg/kg) was found to be a more effective hepatoprotective agent as compared to cimetidine.

Cytochrome P450 enzyme isoforms and their therapeutic implications: an update.

Clinicians should be cognizant of potential drug drug interactions and become familiar with the substrates, inhibitors and inducers of the common enzymatic pathways responsible for drug metabolism. Our knowledge of and ability to predict drug interactions have improved with growing understanding of substrates, inhibitors and inducers of cytochrome P450 (CYP-450) isoenzymes. These isoenzymes are a major determinant of the pharmacokinetic behavior of numerous drugs. In addition to inhibition and induction, microsomal drug metabolism is affected by genetic polymorphisms, age, nutrition, hepatic disease and endogenous chemicals. Prescribing physicians by understanding the unique characteristics of these isoenzymes may better anticipate and manage drug drug interactions.

Effect of cimetidine on hepatotoxicity induced by isoniazid-rifampicin combination in rabbits.

OBJECTIVE: To evaluate the hepatoprotective potential of cimetidine in hepatotoxicity induced by isoniazid-rifampicin combination in albino rabbits. METHODS: Six groups of six rabbits each were studied. Three groups received saline (control), isoniazid (50 mg/Kg/d) alone or isoniazid with rifampicin (100 mg/Kg/d) daily orally for 7 days. Other groups received intraperitoneal cimetidine (50 mg/Kg/d) alone or cimetidine (50 or 120 mg/Kg/d) along with isoniazid-rifampicin combination. Serum levels of liver enzymes were measured at baseline and on day 8 and liver histology was studied on day 8. RESULTS: Rabbits receiving isoniazid alone for 7 days showed no increase in serum ALT and AST levels, whereas those receiving isoniazid-rifampicin combination had a 3-4-fold increase in these levels (p=0.02). Animals receiving cimetidine pre-treatment did not show a significant increase in ALT and AST levels. Histological changes in the liver were more common with isoniazid-rifampicin combination than with isoniazid only. These changes were reduced in animals receiving low-dose cimetidine and prevented in those receiving high-dose cimetidine. CONCLUSION: Cimetidine in high dose can prevent hepatotoxicity induced by isoniazid-rifampicin combination.

Immobilization of alpha-amylase produced by Bacillus circulans GRS 313

A maltooligosaccharide-forming amylase from B circulans GRS 313 was immobilized by entrapment in calcium alginate beads. The immobilized activity was affected by the size of the bead and bead size of 2mm was found to be most effective for hydrolysis. Kinetics constants, Km and Vmax were estimated and were found to be affected by the bead size. The catalytic activity of the enzyme was studied in presence of various starchy residues and metal ions. HgCl2, CuSO4 and FeCl3 caused inhibition of the enzyme. The reaction conditions, pH and temperature, was optimized using response surface methodology. At the optimum pH and temperature of 4.9 and 57ºC, the apparent activity was 25.6U/g of beads, resulting in almost 2-fold increase in activity. The immobilized enzyme showed a high operational stability by retaining almost 85 percent of the initial activity after seventh use