Anti-Tumour Activity Of Bromopyrrole Alkaloids Against Human Breast Tumour (MCF-7) Through Apoptosis Induction

Objective: The present study was conducted to screen the cytotoxicity and initiation of apoptosis in MCF-7 human breast tumour cells using the Indian sponge Acanthostylotela cornuta of the Gulf of Mannar. Methods: The crude methanol extract of A. cornuta was fractionated using a reversed phase silica gel column chromatography. The purity of the active fraction of bromopyrrole alkaloids was confirmed with Gas Chromatography-Mass Spectrometry (GCMS). The bromopyrrole alkaloids induce apoptotic changes in MCF-7 cells were studied with electrophoresis, caspase assay, and different staining analysis. The MCF-7 cells were analyzed by Flow cytometry to determine their DNA content. Results: Bromopyrrole alkaloids of A. cornuta showed cytotoxicity against MCF-7 human breast tumour cells with the IC50 value of 8.0μg/ml. The bromopyrrole compounds induced cells exhibited scatted red fluorescence, showing the presence of several residual bodies and condensation of chromatin. Caspase-3, pro-caspase-9, caspase-9 and Poly-ADP-Ribose-Polymerase (PARP) activity were occurred in bromopyrrole alkaloids treated tumour cell. The cell cycle arrest is conceivable that the compound prevented the progression of cell cycle through the G phase resulting from inhibition of survival, leading them to undergo apoptosis. Conclusion: Bromopyrrole alkaloids of A. cornuta possess antitumor activity which was arrested the G phase in cell cycle that clearly indicated its nature as that of antitumour drugs.

Correlation between Mitral Annular Systolic Velocity and Left Atrial Appendage Function in Mitral Stenosis

The left atrial appendage is a long, tubular and trabecular structure and has a narrow junction with the left atrium. The left atrial appendage has been the focus of clinicians’ interests, because it is a potential site for the development of thrombus in several diseases. Aim: To study the correlation between mitral annular systolic velocity and left atrial appendage function in mitral stenosis. Methods: 60 patient with moderate to severe Mitral Stenosis with MVO <1.5 cm2 were included in the study. All eligible patients underwent a detailed history and clinical examination. A 12 lead electrocardiogram was taken. Echocardiographic evaluation was done for all patients Atrial fibrillation diagnosis was based on the electrocardiogram. Result: There was a positive correlation between these two variables which are statistically significant. (r=0.944, p-value<0.001). There was a positive correlation between left atrial appendage emptying velocity and mitral annular late diastolic velocity in patients in sinus rhythm. (r=0.695(p<0.001) The cut off value of peak annulus systolic velocity which is derived from the analysis of the receiver operator characteristic curve is 13.5cm/sec. The area under the curve is 0.840 with confidence interval 0.689 to 0.936 and the p-value<0.001. This value predicts inactive LAA (Laaev<25cm/sec) with a sensitivity of 92% and specificity of 96.5%. Conclusion: The systolic and diastolic annular velocities obtained by Doppler tissue imaging are reduced in patients with mitral stenosis. There is a positive correlation between annular systolic and left atrial appendage emptying velocities in mitral stenosis. The annular systolic velocity is an independent predictor for the presence of inactive left atrial appendage in mitral stenosis patients with sinus rhythm.

Prognostic Significance of Left Atrial Volume Index in Acute Myocardial Infarction and its Angiographic Correlation

Evaluating left atrium volume is a good way to estimate prognosis in acute myocardial infarction patients because it indicates to time and severity of diastolic dysfunction and longer-term results of acute myocardial infarction. Left atrial (LA) volume is a prognostic predictor across a wide spectrum of cardiac and non-cardiac diseases. Aim: To assess the left atrial volume index in Myocardial Infarction & Angiographic correlation and to assess any correlation between with left atrial volume index and outcomes of MI such as heart failure, short term mortality, arrhythmias, and ejection fraction. Methods: 100 patients with ST elevation in ECG, with history, examination, ECG changes and elevated CK-MB, Anterior, Inferior, Right ventricle & Posterior wall Myocardial infarction were included. The patients were studied considering demographic factors, risk factors, echocardiography indexes such as systolic and diastolic functions and left atrium volume and angiography. Results: Among LAVI >34, 22 had (70-90%) of RCA, 7 had (70-90%) of LCX, 29 had (70-90%) of LAD. Among LAVI>34, 14 patients had TVD, 5 had DVD, 29 had SVD, 9 normal coronaries, which are not statistically significant. Among LAVI >34, 22 patients undergone PCI, 7 patients underwent CABG, 1 patient had CHB, 3 patient had VT and 9 patients had AF, which is statistically significant. Among LAVI>34, 24 patients had HF at 30 days follow-up. Among LAVI>34, in 30 days follow up 1 patient expired. When compared with LAVI <34 it was not statistically significant. Conclusion: LA Volume index provides prognostic information incremental to clinical data and standard Echocardiographic predictors of outcome, including LV systolic function and Doppler assessment of Diastolic Function.

A prospective, randomized controlled study to compare the intubating conditions achieved with suxamethonium and rocuronium bromide

Background: Endotracheal intubation is required for giving general anesthesia for which adequate muscle relaxation is necessary Suxamethonium is still used as a relaxant for endotracheal intubation Rocuronium, a nondepolarizing muscle relaxant was compared here for tracheal intubating conditions Aim of the study: To compare the intubating conditions achieved in patients undergoing elective surgeries under General Anaesthesia with Suxamethonium or Rocuronium in 60 secs and complications in both groups Materials and methods: This study was conducted in Institute of Anaesthesiology and Critical care at Madras medical college, Chennai during the period 2014 – 15100 patients of ASA I and II were divided randomly into 2 groups undergoing elective surgeries: Group I - Suxamethonium Group II - Rocuronium assessed for intubating conditions after administration of the corresponding drug Results: The intubating conditions were excellent in group I Suxamethonium as against Group II Rocuronium in 60 secs According to the cooper scoring system the scores of vocal cord movement in group I (Suxamethonium) was 268 (mean) ± 0471 and in group II (Rocuronium) was 234±0557, the scores of response to intubation in group I (Suxamethonium) was 298±0141 and in group II (Rocuronium) was 270±0463 with better intubating conditions in group I receiving Suxamethonium than Rocuronium The results were significant with a p-value of<005 whereas the scores of jaw Stalin R, Raja Manikandan S A prospective, randomized controlled study to compare the intubating conditions achieved with suxamethonium and rocuronium bromide IAIM, 2018; 5(12): 72-76 Page 73 relaxation in group I patients (Suxamethonium) was 270 (mean)±0463 and group II patients (Rocuronium) was 252±0544 with better jaw relaxation Conclusion: Rocuronium can be used as an alternative when suxamethonium is contraindicated for rapid intubation but not if the anticipated difficult airway is present Rocuronium can be chosen as an alternative to it even in rapid sequence intubation in emergency cases, provided the airway is properly assessed and no anticipated difficult intubation is present

In-vitro antibacterial activity of aqueous and ethanolic extracts of acorus calamus.

The aqueous and ethanolic extracts of Acorus calamus was evaluated for antibacterial activity against clinically important bacteria viz.. Bacillus subtilis (MTCC 441), Staphylococcus aureus (MTCC 96), Escherichia coli (MTCC 443), Proteus mirabilis (MTCC 1429), Pseudomonas aeruginosa (MTCC 424). The in-vitro antibacterial activity was performed by agar well diffusion method. The ethanolic extracts of A. calamus was active against all the investigated bacterial strains while aqueous extract was totally inactive against the studied gram negative bacterial strains (E. coli, P. mirabilis and P. aeruginosa) and showed moderate antibacterial activity against gram positive bacteria B. subtilis and Stap. aureus only at high concentration (200ml). However, further works are needed to identify the chemical nature of the active substances as well as their modes of actions on the bacterial cells and their roles in disease curing.

Infrarenal abdominal aortic aneurysm repair in presence of coronary artery disease: Optimization of myocardial stress by controlled phlebotomy.

The repair of abdominal aortic aneurysm (AAA) in the presence of significant coronary artery disease (CAD) carries a high-risk of adverse peri-operative cardiac event. The options to reduce cardiac risk include perioperative β-blockade, preoperative optimization by myocardial revascularization and simultaneous (combined) coronary artery bypass grafting and aneurysm repair. We describe intra-operative controlled phlebotomy to optimize myocardial stress during repair of infrarenal AAA in a patient with significant stable CAD.

Aprepitant: a substance P antagonist for chemotherapy induced nausea and vomiting.

The episodes of nausea and vomiting which follow each cycle of chemotherapy are the most troublesome side effect experienced by cancer patients. Introduction of ondansetron was a definite therapeutic advance in treating chemotherapy induced nausea and vomiting (CINV) with more effectiveness with corticosteroids. However, the protection remained largely limited to acute phase of CINV with little or no effect over delayed phase. Aprepitant, a drug that antagonizes the effect of substance P on neurokinin type 1 receptor showed promising results in controlling both phases of CINV. This drug is well absorbed orally with a t max of about four hours. The addition of aprepitant to ondansetron and dexamethasone was found to be superior to ondansetron and dexamethasone alone in clinical trials with patients taking high and moderate emetogenic chemotherapy. This drug also showed a good safety profile, but its inhibitory effect on CYP3A4 may result in clinically significant drug interactions needing dose modifications of co-administered drugs. The National Comprehensive Cancer Network guidelines for CINV recommends the use of aprepitant with high and moderately emetogenic anticancer drugs. Results of ongoing clinical trials with aprepitant and other agents of this new class of antiemetics are awaited and may alleviate the sufferings of cancer patients.

Newer insulin analogues and inhaled insulin.

Diabetes is a metabolic disease with high prevalence worldwide. Exogenous insulin is used in the management of this condition. The development of human insulin has provided tighter control of glycaemia in diabetic patients. Insulin analogues like insulin lispro and aspart were developed to closely match its profile with physiological secretion. The newer additions to this armamentarium are insulin glulisine, insulin detemir and albulin.Insulin glulisine is a short acting analogue with a rapid onset of action. The antiapoptotic property, mediated through insulin substrate receptor-2 has a favourable protective action on beta cells. Insulin detemir is a long acting analogue, soluble at neutral pH, which reversibly binds to albumin in plasma, prolonging its action. Its lower affinity for insulin receptors necessitates higher doses compared to human insulin. The reduction in body weight is an additional advantage of detemir. A major concern about all newer insulin analogues is their altered mitogenic properties and resultant risk of carcinogenicity on long term use. Albulin is a latest addition of insulin analogue which is under various in vitro and in vivo studies. Inhaled insulin in powder form (Exubera) is recently approved by FDA and appears promising.