A Comparative study of insight in patients of depressive spectrum disorders attending outpatient department of tertiary care centre.

Introduction: Poor insight is a common feature of bipolar depression and unipolar depression with and without psychotic symptoms (PS) which may lead to poor clinical outcome. Studies on insight in these populations are relatively limited and the majority of studies were published over the previous decade. Methods: This was a cross-sectional, observation study conducted in Psychiatry O.P.D. of tertiary care hospital. The sample consisted cohort of 20 outpatients each with unipolar depression, unipolar depression with psychotic symptoms and bipolar disorder current episode depression with psychotic symptoms. The depression was assessed by HAM-D and insight by Item G12 of the General Psychopathology section of PANSS. Results: Significant difference in insight is seen in all three groups. Bipolar patients with PS had the poorest insight, patients with unipolar depression had best. Statistically significant correlation is present with older age and lack of insight among patients of unipolar depression with PS (rho =.599, P =.005) and bipolar depression with PS (rho =.686 P=.001). Conclusion: Insight in depressive illness is affected by multiple factors; this study shows that age, bipolarity and presence of psychotic symptoms are associated with poor insight. Management of the patients of depressive spectrum should incorporate strategies to improve insight

Exploring Biodiversity for Prevention and Control of Cancer and other Non-Communicable Diseases using Indigenous Environmental Resources: An Interdisciplinary Research

Background: An interdisciplinary research of public health, biomedical and pharmaceutical sciences is neededfor integrating qualitative and quantitative researches undertaken. It hence requires focus on public beneficencefor non-communicable diseases. Purpose: To study anticancer activities of soil samples of Central India andits stability for applied public health use. Material and Methods: Screening on Actinomycetes isolates obtainedfrom rural and urban farm soils illustrating arginase production was conducted from equated soil samples ofgeo-representative localities and adjoining areas of Bhopal, India. Enrichment Technique (CDSEA) was usedfor detection of extracellular production of L-arginase and their anticancer activities using MTT 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay along with characterization and probioticproperties of selected isolate. Results: L-Arginase activity quantified by ornithine (21.06-117.92 U/mg) wasfound in isolates BRD-21, KAR-73, BHA-162, BAR-199, ARH-210, HAB-228. Urea release (15.88 – 59.79 U/mg protein) depicted L- arginase activity in crude enzyme samples. It shows noticeable anticancer activity.Morphological and biochemical characterization of these isolates revealed metabolic diversity. Isolate KAR 73produced collagenase (specific activity 57.8 U/mg), L-asparaginase (specific activity 116 U/mg) and L-arginasewith tolerance to higher temperature (45°C) and salt concentration (2-8% w/v). Equal concentrations ofcrude L- arginase from these isolates inhibited growth and proliferation of colorectal adenocarcinoma celllines (19.99%-38.65%) under in-vitro conditions. Conclusion: Arginine depletion through arginase activity isevidenced for potential effectiveness in cancer treatment especially adenocarcinomas and squamous cellcarcinoma. It is useful for wider public health purposes

Multisystemic Pediatric Langerhans cell histiocytosis: a comprehensive clinico-pathological and BRAF V600E mutation study at autopsy

Langerhans cell histiocytosis (LCH), a disorder of antigen-presenting cells, is the commonest disorder of the mononuclear phagocytic system. Diagnosis is always challenging due to heterogeneous clinical presentation. However, with the evolution and better understanding of its biology, many of these children are being diagnosed early and offered appropriate therapy. Despite these advances, in developing countries, an early diagnosis is still challenging due to resource constraints for specialized tests. As a result, many patients succumb to their disease. Autopsy data on LCH is notably lacking in the literature. We sought to analyze the clinical (including mutational) and morphologic features at autopsy in six proven cases of LCH. This study includes a detailed clinico-pathological and mutational analysis of 6 proven cases of LCH. Presence of BRAF V600E mutation was assessed by both Real Time PCR and Sanger sequencing. A varied spectrum of organ involvement was noted with some rare and novel morphological findings, like nodular bronchiolocentric infiltration of LCH cells, lymphovascular emboli of LCH cells, and paucity of eosinophils within the infiltrate; these features have not been described earlier. Surprisingly, all cases were negative for BRAF V600E mutation on both RQ-PCR and Sanger sequencing. The present study is perhaps the first autopsy series on LCH. This extensive autopsy analysis represents a correlation of pathological features with clinical symptoms which provides clues for a timely diagnosis and appropriate therapeutic intervention. Also, our findings hint at the low frequency of BRAF V600E mutation in our LCH patients.

Foreign Body Rectum: A Case Report

Rectal foreign bodies are confronted frequently in a surgical emergency. These are often related to sexual behaviour. Due to the fear of social embarrassment, patients tend to hide the facts associated with the incident and present late. Because of the serious complications, foreign body rectum should be considered as an emergency and managed in a well-organised manner. Diagnosis can be made by clinical and radiological examination. In the majority of cases, the transanal approach is successful. Laparotomy is reserved for cases with perforation or peritonitis. Here, we report the case of a 24-year-old male who inserted an electrical beard trimmer in his rectum under alcohol intoxication. Since transanal removal failed, emergency laparotomy with successful removal of foreign body was done

Incidence of malignancy in intestinal polyp of Peutz-Jeghers Syndrome: Case Series

Introduction: Peutz-Jeghers syndrome is also known as “Hereditary Intestinal Polyposis Syndrome”. It is an autosomal dominant disease, characterized by the development of benign hamartomatous and adenomatous polyps in the gastrointestinal tract, and hyperpigmented macules on the lips, nostrils, buccal mucosa, palmer surfaces of the hands, genitalia and perianal region. Its incidence is 1 in 200000 births. 25 cases of Peutz-Jeghers Syndrome were studied in tertiary health centre. Diagnosis of Peutz-Jeghers Syndrome was made on the basis of clinical details, radiology reports and the histopathological study. The patients were from both urban and rural areas of Ujjain. The entire study was retrospective study. Aims and Objectives: To study the incidence of malignancy in intestinal polyp of Peutz-Jeghers Syndrome. Materials and Methods: Polyps from patients with Peutz-Jeghers Syndrome were studied in the histopathology department. The corresponding medical records were reviewed to confirm that the diagnosis of Peutz-Jeghers Syndrome. Hematoxylin and Eosin (H&E) stain was used for the histopathological diagnosis. Particular attention was paid to the presence and pattern of distribution of network of connective tissue, smooth muscle, lamina propria and glands lined by intestinal epithelium. Results and Conclusion: We evaluated colonic polyps from 25 patients of Peutz-Jeghers Syndrome. Out of all patients, none of the intestinal polyps turned out to be malignant. The incidence of malignancy in intestinal polyps in Peutz-Jeghers Syndrome as per this study is insignificant.

Antimicrobial Efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum and Porphyromonas gingivalis

The herbal extracts have been effectively tried in the treatment and prevention of many oral diseases. Aim: The aim is to assess the antimicrobial efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum (Fn) and Porphyromonas gingivalis (Pg). Materials and Methods: The extraction process was carried out by Soxhlet apparatus using ethanol as solvent. The combinations of the four plant extracts were prepared by combining an equal quantity of 10% solution of each of the four plant extracts. The antimicrobial efficacy testing of the plant extracts and their combinations on Fn and Pg was performed using agar well diffusion method. Columbia 5% of sheep blood agar plates were used for antimicrobial efficacy testing under anaerobic conditions. The qualitative assay was carried out to identify the various phytochemical constituents. Dimethyl sulfoxide and 0.2% chlorhexidine acted as negative and positive controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. Results: All the individual plant extracts and their double, triple, and quadruple combinations were effective in inhibiting the growth of these bacteria. However, 0.2% chlorhexidine produced the highest mean diameter of inhibition zone. Conclusion: The plant extracts in combinations offer enhanced antimicrobial efficacy due to their synergistic action besides slowing the development of bacterial resistance. Hence, these extracts in combinations could be used tried as effective alternates to chlorhexidine.

Hepatic and Cardiac Iron-load in Children on Long-term Chelation with Deferiprone for Thalassemia Major

Objective: To evaluate the efficacy of prolonged deferiprone monotherapy in patients with ?-thalassemia major. Methods: This cross-sectional study included 40 patients (age range 9 to38 years) with thalassemia major receiving deferiprone for ?5 years. Serum ferritin, andmyocardial iron concentration (MIC) and liver iron concentration (LIC) assessed by T2*MRIwere recorded. Results: The patients were receiving deferiprone for a mean (SD) duration of12.1 (4.7) years. The median (IQR) dose of deferiprone was 85 (74.3, 95) mg/kg/day. TheMIC was normal or had a mild, moderate or severe elevation in 29 (72.5%), 3 (7.5%), 3(7.5%), and 5 (12.5%) patients. The LIC was normal or had a mild, moderate or severeelevation in 2 (5%), 4 (10%), 11 (27.5%) and 23 (57.5%) patients. Conclusions: The majorityof patients receiving deferiprone had a moderate/severe hepatic but normal cardiac iron load.Prolonged deferiprone monotherapy was suboptimal for hepatic iron load in the majority.

On the novel inhibitory action of mushroom extract of coriolus versicolor and it’s bioactivity against drug resistant bacteria salmonella typhimurium (MTCC 3241).

The aim of this study was to investigate the effects of the mushroom extract of Coriolus versicolor on drug resistant strain of S. typhimurium experimental results revealed that hot water ethanol extract and Tris- HCl ethanol extract of C. versicolor were not only effective against drug resistant strain of S.typhimurium (MTCC 3214) but also against other pathogenic microorganisms such as K. pneumoniae, S. typhi, E. coli, S. pyogenes and Aspergillus niger. The extracts exerted their effects on the microorganisms by inhibiting their growth.The optimum temperature and pH conditions for mycelial growth of C. versicolor were found to be 28±1ºC and 5.98 pH respectively. Maximum mycelial growth was observed by employing starch and ammonium sulphate as carbon and nitrogen source and on supplementing the cultivation medium with 20% (v/v) culture filtrate of C. versicolor. The present investigation highlights optimization of culture conditions and determination of antimicrobial spectrum C. versicolor .This indicate that the extracts of C. versicolor is a novel inhibitory source against drug resistant bacteria salmonella typhimurium.

L-asparaginase: A promising enzyme for treatment of acute lymphoblastic leukiemia.

Asparaginases are known to be the cornerstone for treatment of acute lymphoblastic leukemia (ALL) and are used for treatment in all pediatric regimens as well as in the majority of adult treatment protocols. Clinical hypersensitivity reactions against commercially available asparaginase have resulted in failure of asparaginase in treatment of ALL in more than 60% of cases. Thus, it is required to search for serologically different asparaginase from new organisms for the patients exhibiting sensitivity to one formulation of asparaginase, so that they can be switched to another to ensure that they receive the most efficacious treatment regimen possible. The present study report E. coli VRY-15, E. coli VRY-8 and E. coli VRY-14 as potent producer of L-asparaginase. The L-asparaginase obtained from E. coli VRY-15 showed highest specific activity i.e., 19.56 µmol/mg. Attempt was made to purify the enzyme. Molecular weight of purified L-asparaginase obtained from E. coli VRY-15 was found to be 56 K Da as determined using Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS- PAGE).

Clinical Profile and Outcome of Swine Flu in Indian Children.

Objective: To describe the clinical characteristics and outcome of Indian children infected with 2009 H1N1 influenza virus. Study design: Retrospective chart review. Setting: Outpatient department and hospitalized patients in a tertiary care hospital. Methods: Clinical details of 85 children (positive for the 2009 H1N1 virus infection tested by real-time reversetranscriptase– polymerase-chain-reaction assay) were analyzed from medical charts. Results: Of the 85 (55 boys) children positive for 2009 H1N1 virus infection, 64.7% were between 5 years to 16 years, and 35.3% were below 5 years age. The mean age of these children was 7.5±3.5 yr. Contact history was positive only in 22 (26%) cases. High grade fever was the most common symptom, followed by cough and rhinorrhea. Twenty-nine (34%) patients had an underlying co-morbid condition. Of the 34 patients who underwent chest radiography during evaluation, 18 children (52.9%) had findings consistent with lower respiratory tract infection. Antiviral therapy was initiated in 76 patients. Hospitalization was required in 30 (35.3%) children. Risk factors for hospitalization included underlying co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph. Mean length of hospitalization was 131+76 hours, irrespective of underlying disease. Three children developed Acute Respiratory Distress Syndrome and died. Conclusions: Clinical features and routine laboratory investigations in children with swine origin influenza were non-specific. Children with co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph were at higher risk of hospitalization.

Production and partial characterization of collagenase of Streptomyces exfoliatus CFS 1068 using poultry feather.

Streptomyces exfoliatus CFS 1068, an isolate of cultivated field soil, produced maximum collagenase activity (58.19 ± 0.83 U ml-1min-1) in 5 days when soybean meal and starch were used as nitrogen and carbon sources, respectively at pH 7 and 30°C in shake cultures (150 rpm). Production of collagenase was higher (40.43± 0.63 U ml-1min-1) when poultry feathers were used as nitrogen source. Thus, the strain was found to be of biotechnological importance. The purified enzyme showed 30.34 fold increase in collagenase activity and was stable at 70°C for 1h. The enzyme was found to be of serine type.

Blood and blood component therapy in neonates.

Blood component therapy is a very common intervention practiced in newborns; nearly 85% of extremely low birth weight (ELBW) babies get transfusions during their hospital stay. However, there are no set guidelines for transfusion of blood component therapy in newborns. This protocol includes available types of blood components, their methods of preparation, indications and side effects of transfusion, in relation to newborns.

Production of industrially important enzymes by some actinomycetes producing antifungal compounds.

Seventeen strains of actinomycetes antagonistic to yeast and moulds have been tested for their ability to produce amylase, lipase, gelatinase and caseinase using solid media containing starch, Tween-20, gelatin and skimmed milk, respectively, Enzyme producing potential of test strains is expressed in ternis of relative enzyme activity (REA). Actinomycetes strain Streptomyces somaliensis GS 1242 and Streptomyces sampsonii GS 1322 showed higher amylase production (REA 6.5) while maximum lipase activity was noted in Streptomyces strain SAP 1089 (REA 7.0). Gelatinase activity was noted higher is S. sampsonii GS 1322 (REA 9.6) and S. somaliensis GS 1242 (REA 8.8). Enzyme producing potential of these strains has been discussed in terms of their industrial significance.