ABSTRACT
Aims: To assess the therapeutic effect of curcumin supplementation in modulating the expression of NF-κB in the joints of collagen-induced arthritis (CIA) rats. Place and Duration of Study: Department of Postgraduate Studies and Research, International Medical University, between July 2011 and May 2012. Methodology: Arthritis was induced in each group of Dark Agouti (DA) rats, by intradermal injection with collagen emulsified in complete Freund’s adjuvant. Treatment groups which were induced with CIA were treated with: 500 mg/kg curcumin; 1000 mg/kg curcumin; 2000 mg/kg curcumin; 25 mg/kg aspirin. Combination treatment groups which were induced with CIA were treated with: 500 mg/kg curcumin and 25 mg/kg aspirin; 1000 mg/kg curcumin and 25 mg/kg aspirin; 2000 mg/kg curcumin and 25 mg/kg aspirin from day 25 to 38. Efficacy was assessed based on ability to reduce paw oedema, histopathological changes, NF-κB expression, serum tumour necrosis factor alpha (TNF- α), interleukin 1-beta (IL-1β) and gluthathione peroxidase (GPx) levels. Results: Based on histopathological study, immunohistochemical scoring of NF-κB and ELISA analysis of TNF-α, IL-1β and GPx levels, our study found that curcumin given after arthritis in high doses, shows effects of healing and this results were comparable to positive control group, which is the arthritic group treated with 25 mg/kg aspirin. Curcumin given in combination with aspirin, showed better reduction in pathology in arthritic group compared to positive control group, especially with higher doses of curcumin. Conclusion: Curcumin was effective in reducing inflammatory changes seen in CIA joints which were proved through histopathological, immunohistochemical and biochemical analysis, however only at high doses.
ABSTRACT
The dramatic advances that have taken place in recent years in the care of sick and premature infants also have been matched by a similar increase in the use of blood transfusion therapy. Haematological features indicate that a newborn has a blood volume of 85-125 ml/kg the foetal haemoglobin is 60-85% and average Hb in full term infant is 18 gm/dl. By 2-3 months it falls to 11-12 g/dl the main cause of anemia are iron poor diet, weaning diets recurrent or chronic infections and hemolytic episodes in malarious areas. The red cells transfusions are usually top up transfusions, exchange transfusions, partial exchange transfusions. Top up- are for investigational losses and correction of mild degrees of anemias, upto to 5-15 ml/kg. They comprise 90% of all neonatal transfusions and are used in low birth babies in special care units for a maximum of 9-10 episodes. The walk in donor programs once popular are not much in vogue. The threshold for transfusion is 8-10 g/dl Hb for upto 5 weeks. Exchange transfusions are done for correction of anemia, removal of bilirubin, removal of antibodies and replacement of red cells. Ideally plasma reduced red cells that are not older than 5 days are used. It is prepared by removal of 120 ml of standard whole blood donation. The advantage of fresh cells is that hyperkalemia is avoided and good post transfusion survival acceptable red cell oxygen affinity. However it has to be screened for sickle cell disease and G6PD deficiency. Indications for exchange transfusion are kernicterus, neonatal hemolysis, G6PD deficiency, ARDS, neonatal sepsis, DIC and neonatal isoimmune thrombocytopaenia. Complications include over transfusion, perforation of major vessels, hypocalcaemia, citrate toxicity, hypothermia, hypoglycaemia, thrombocytopenia, necrotizing enterocolitis, GVHD, bacterial, viral infections. Partial exchange transfusions are done for symptomatic anemia, where Hb<10 g/dl, it is indicated in polycythemia and hyperviscosity syndromes. Exchange volume = Blood volume x (observed Hct-Desired HCt) divided observed Hct. Points to consider-there is weak expression of ABO antigens so particular care while grouping. Transfusing volumes should be 2-5 ml/kg/hour in paediatric bags of 50-100 ml with infusion devices. Platelet transfusion are indicated in neonatal throbocytopaenia, thrombocytopaenia due to sepsis, DIC, bacterial pathogens, CMV, TORCHS, Obstetric conditions such as pre eclampsia, intrauterine death abruption placenta birth injury hypoxia schock neonatal iso immune thrombocytopaenia and maternal ITP. Administration 1 RDE/pack per 2.5 kg single dose of fresh platelets less than 24hrs which contains 55 x 10(9) cells. This also contributes fresh plasma so is useful for coagulation defects also, though there is a risk of CMV and GVHD due to leucocyte contamination. Granulocyte concentrate; Gravity leucopheresis-1:8 ratio of 60 ml of 6% HES made to stand for 1hr.